The overuse and misuse of PRN medications

[xsummer12x]

I need some advice I've been suspended from work for the overuse and misuse of PRN medications. I work on a dementia unit with very unpredictable patients, with varying mental health and physical health conditions. I have documented why I used these medications and I know and looked after these patients for long time. I am very familiar how they present, there triggers and interventions and will only use PRN as a last resort. I am very worried at this time, I've consulted with my manager previously with my concerns about the unit, and I am finding it stressful and overwhelming on the unit, due to its unpredictability due to the range of residents we have.  I think the only thing is when I have given the medications, we have cameras in work and have a online medication system to sign for medications which is often slow and glitchy. Staff see me give  the medications out on the unit. I'm under a union and they can't understand why I've been suspended. I have completely cooperated with the process also out -lining my concerns. Could anyone give advice?

[Davey Do]

Yeah, wow, xsummer, that sounds rather hinky, because if PRN meds are given as ordered, there should be no problem. 

I, too, have been suspended and/or terminated without good reason, and it usually came down to putting personalities before principles. In other words, they didn't like me, or something that I was involved in, and found a reason to get rid of me.

In my cases, it all came out in the wash.

[Been there,done that, ASN, RN]

Was the PRN within prescribed parameters?

 

[xsummer12x]

4-6 hours. I made sure the dosages where not exceeded what was recommended. I even wrote the PRN protocols. 

[Emergent, RN]

Are these controlled substances? If so, it is a sign of diversion when one nurse is giving way more controlled substances than others.

[hppygr8ful, ASN, RN, EMT-I]

xsummer12x said:

4-6 hours. I made sure the dosages where not exceeded what was recommended. I even wrote the PRN protocols. 

I don't know about Pyxis but the Omnicel produces a report each month that shows each employee's use of the system. It highlights anomalies that diviate from other users activity.  Unless they suspect diversion it might be the setting you work in. Long term care(At least in the US where I am) is very consumed with the avoidance of chemical restraints. IT Haldol, Xanax, Ativan and even comon antipsychotics. If they use too much they ge dinged by their licensing agency. 

Still as Davey stated it may all come out in the wash.

Hppy

[xsummer12x]

The only PRN medications I have given are lorazpam or paracetamol, co-codamol. The other nurse I work with also use these drugs depending on the assessment and needs of the residents.These are last resort in some cases. 

[Been there,done that, ASN, RN]

xsummer12x said:

The only PRN medications I have given are lorazpam or paracetamol, co-codamol. The other nurse I work with also use these drugs depending on the assessment and needs of the residents.These are last resort in some cases. 

Somebody in administration is out to get you. Can you figure out who  or why? Your union should be doing more for you. Start looking for another position. 

[xsummer12x]

I work in a very toxic work environment. I've never had complaints before. I've been burnout from my job for a while. 

[xsummer12x]

My union doesn't understand it either when I spoke to them. They're confused about the whole thing. 

[kp2016]

Random question, is your unit over staffed or are you paid significantly more than your co-workers? 

[xsummer12x]

Yeah we have sufficient nurses. I'm paid the same as the other nurses.