Sleeping IM

[chillywil]

Please settle an argument. I work at a psychiatric hospital. My coworker believes that it is okay to give a patient having a nightmare that causes her to cry out loud in her sleep an IM injection while she is asleep. I disagree. What do you think? This is in Michigan.

[Sour Lemon]

I wouldn't give a sleeping patient an IM injection ...and I wouldn't medicate a patient for being noisy while having a bed dream, either.

[Davey Do]

I have never ever heard of such a thing. This act is illegal, immoral, and unethical!

Except in emergent and/or life-threatening situations where the patient is unconscious and consent is implied, the Patient is ALWAYS informed of any medication they are receiving and instructed in its administration process.

What your coworker is doing is a heinous crime which needs to be reported.

[Wuzzie]

Your co-worker is guilty of assault among other things. What an evil person.

[Ruas61, BSN, RN]

Your coworker sounds like they need some remedial education and some critical thinking skills. What if they were having problems with OSA?

[smf0903]

Totally ridiculous. As PP said, patient needs to be informed before they're given medication.

Aside from that, that's a good way to get socked by a patient. I don't even touch someone who's asleep, you never know if they'll take a swing. Can you imagine sleeping and having someone jab a needle into you?!

[Crystal-Wings, LVN]

No, that's assault and your coworker is an a-hole (and has watched One Flew Over the Cuckoo's Nest one too many times). If this person is actually doing it, you need to tell your supervisor ASAP.

[Sassy-RN]

Not "okay" at all! I'm interested in what the official order is. I'm guessing it's a PRN For something? Not only is this ethically wrong, she/he is not following proper orders.

[offlabel]

What shot would a patient get for a bad dream? They're already asleep.

[chillywil]

Pt has PTSD and nightmares, nurse gave the shot because Pt was crying out in their sleep. The nurse in question reported me for neglect because I refused to give a sleeping patient an IM. True story, I was terminated yesterday.

[chillywil]

Thanks to all who commented, the nurse in question reported me for neglect because I refused to give the patient an IM while they were sleeping. I was terminated yesterday. This is a true story. Mental health in Michigan.

[FolksBtrippin, BSN, RN]

Hmmm.

Was the patient having night terrors which are different from nightmares and have a small potential to be dangerous?

Was the patient aware that this happens to her and consenting to IM meds if it happens?

Was there an order for the medication IM PRN for nightmares or night terrors?

If they are nightmares and not night terrors, did the patient fail oral meds for nightmares like clonidine? What is the plan for management of the problem at home?

It's a bad hospital system if you got fired for this no matter the answers to the above questions.

This was a situation where you assessed that the med was not needed and the other nurse assessed the med was needed. That should not have led to.one of you getting fired.