What do you think? (warning: vent ahead)

[Nursey103]

Young patient. Allergies: Compazine, Reglan, Zofran, NSAIDs, Haldol

Patient "fired" me because I wouldn't push his Dilaudid 1.5mg & Benadryl 50mg (both IVP) together. I told him I would give his Benadryl 30 min. apart. He literally yelled, "they always give it to me together". When asked what he took the Benadryl for he told me for "reactions" to Dilaudid & he was gonna bleed from itching if I didn't get it to him at. the. same. time. First of all, he get's Dilaudid Q2h & Benadryl Q4. Weird how he doesn't bleed the times he gets Dilaudid without the Benadryl. He also gets Phenergan IM Q4h.

I tried explaining my reasoning but he wanted to talk to my CN. She went in....w/ Benadryl. She totally understood my reasoning but in the end he got what he wanted. He got a new nurse & was happy because she gave him everything he wanted. These patients are so frustrating. They act like the hospital gives them an excuse to act like a child throwing a tantrum when they don't get what they want. I'm not there to give him everything he asks for....if it's not safe! Sure, he may have a high tolerance but it's my license on the line & I don't want to be the exception if something bad actually happened to him!

And because these nurses are giving in to "shut him up"...it makes it worse on the next nurse!!! Ugh...

[RNperdiem, RN]

Some patients think in black and white. You are either the best nurse in the world or you are evil incarnate.

[Stalirris]

You people are extremely judgemental and uncompassionate being a sickle cell patient as well as health professional I can attest to the itching associated with dilaudid and morphine and have scratched in my sleep to the point of drawing blood and it usually doesn't take much to browse through a patient's recent admission people aren't boss that's where judgement congress in and I highly doubt a patient who had never had both would make it up because they wouldn't even know the effect so when it comes to things like this you listen to the patient not give them anything they want but realize they probably know themselves way better than you do

This is so true. I agree. Too many judgey people here with bad information.

The other problem is that Dilaudid is effective for 3-4 hours and Benadryl for 5-6 hours. So you're just not going to ever give them both meds because you feels it's unsafe? Don't you think the MD knows this person is a frequent flyer and is aware of what they ordered? I think any MD would laugh if someone asked them if it was "safe" to give them both at the same time. It is seriously not a problem giving these drugs together, at the same time. You do not need to wait anytime in between giving them.

I'm sorry the OP got fired from that patient, but maybe she should have asked around. The patient was a jerk for reacting the way he did, no doubt, so it's just as well she didn't have to take care of him anymore.

There is no possibility of her losing her license because she gave these 2 drugs together, either. I wouldn't mix them in the same syringe... obviously.

Zofran is not in anyway a sedative, either. It's not going to add to their "high."

[calivianya, BSN, RN]

I wouldn't mix them in the same syringe... obviously.

Why not? My frequent flyer a few months back informed me that Dilaudid, Benadryl, and something else... Phenergan, I think, were compatible. I checked Micromedex, and sure enough, she was right. I gave her PRNs in the same syringe after that. I was glad to change jobs and get away from that one!