Situation about PRN lorazepam

Nurses General Nursing

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While orienting on nights, a traveller shouted to me as I was entering the med room, "Get me 2 mg Ativan quick!" I was startled, but asked, "Who's the patient?" She told me, and I went in and got it for her. I had expected to see a pt climbing the walls, but strangely, when I found her in the pt room the lights were down and it was very quiet. I handed her the vial and she said, "Thanks, hon." That was it. Later I found out she did the same thing with 2 other nurses, demanding PRN Ativan and behaving as if she wasn't able to leave the pt room (there was a sitter in there, but I am assuming on break at the time). Questions popped into my head, like, Why all these PRNs were needed when she was relieving the sitter and couldn't get them herself, and Maybe as a newbie I was taken advantage of??? I didn't see anything else out of the ordinary to lead me to assume diversion was taking place, but the sitter seemed very stressed and overwhelmed. Was I right to "step and fetch" Ativan for this traveller? Should I have administerd the dose myself?

Any thoughts on this?

Specializes in Med-Surg, LTC, Rehab, HH.

The traveler sounds fishy to me....like someone else said, sounds like shes a diverter. At one of my previous jobs, we noticed a pattern every time certain agency nurses worked. Any PRN narc that could be given was signed out. It was noticeable because many patients had a prn order that hadnt been used in months. Several of the patients were questioned, and sure enough, no narc was given. It was reported and they were banned from the facility.

Specializes in Med-Surg, LTC, Rehab, HH.

Your responsible for anything you sign out. So you give it:) What would happen if an hour later this patient really did need it? and the traveler was gone? But it said you gave it? You would get into alot of trouble.

Thanks to all for the feedback!

Looking back, there were several things I could have done rather than just "follow orders" and pull the med and just drop it in the traveler's lap. I didn't do any of those things, but I will next time!

BTW - I found out later that the other nurses that pulled meds for her only gave 1 mg ativan because early in the shift that was all that had been ordered. When I pulled the med the order was for 2 mg - so I guess the nurse got the doctor to up the dosage for her pt., supposedly because of increasing agitation. Which made me feel a little better, because the MD was aware that the nurse was giving frequent PRNs.

Specializes in Med-Surg, LTC, Rehab, HH.
Thanks to all for the feedback!

Looking back, there were several things I could have done rather than just "follow orders" and pull the med and just drop it in the traveler's lap. I didn't do any of those things, but I will next time!

BTW - I found out later that the other nurses that pulled meds for her only gave 1 mg ativan because early in the shift that was all that had been ordered. When I pulled the med the order was for 2 mg - so I guess the nurse got the doctor to up the dosage for her pt., supposedly because of increasing agitation. Which made me feel a little better, because the MD was aware that the nurse was giving frequent PRNs.

This is how we learn:), and next time your antenna will go up.lol I know...been there..done that!!

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