WHAT TO DO...Nurse is refusing to give PRN medication

[purplenurse1]

I work in long term care. I have a patient that is chronically nausea. The patient asks for his prn nausea medications Q6H on the dot. The day nurse is refusing to give the medications because she feels it in the patient head and he is not really nausea. Myself and the other nurse give the medication if he asks for it because who are we to say he doesn't feel nausea. I have reported this to management multiple time and nothing is being do. I did confront the nurse and ask why she not giving it. She said its a matter of her option he does not need it. What right doe she have to with hold his PRN medication? IS there someone else I should be contacting>

[SHGR, MSN, RN, CNS]

Yes, nausea can be considered a subjective symptom. I agree with scheduling the medication.

[purplenurse1]

I agree. I doesn't matter if the nausea is caused by anxiety. We still nned to treat it. I will speak to his md again about a standing order.

[ghillbert, MSN, NP]

Jeez, I hope she's never in charge of my pain meds

[purplenurse1]

Seriously, mine either

[Penelope_Pitstop, BSN, RN]

She wouldn't last long on a surgical floor, what with all of the Dilaudid and Zofran (not to mention Ativan and Benadryl) pushes every two or three hours.

Gosh, it's an ODT every six hours, so it's only probably given once during day shift. I doubt it's even kept with the narcs. Takes a second to give.

I don't think I like this lady.

[purplenurse1]

Corret its not with the narcs. And it only takes a moment to give

[iluvivt, BSN, RN]

She is actually negligent, which is failing to do what a prudent nurse would do in a similar situation and I WOULD HAVE No issue telling the nurse just that. If she does not listen I would report her the BRN.There is no excuse for denying a patient relief if no harm will come by giving the medication.

[lindseylpn]

I've actually worked with several nurses that refuse to give prns, I've never understood it. One would flat out say "I don't do prns", she would occasionally give them after being talked to about it several times. Another nurse wouldn't give anything, even Tylenol before okaying it, she would seriously call the on call nurse to okay that she was giving Tylenol, a breathing treatment, cough syrup etc and she refused to give narcs at all. Weird.

[RobotNurse]

I've actually worked with several nurses that refuse to give prns, I've never understood it. One would flat out say "I don't do prns", she would occasionally give them after being talked to about it several times.

i don't get that either! unless there's a VS problem, give the malingerers their pills so they'll shut up!

[rager2001]

I absolutely agree, call MD have it ordered this avoids all the above problems.

[bellabellabijou]

Well, the bottom line is: it's PRN and she is refusing to give it based on her own personal assumptions and the powers that be refuse to do anything about it. Tell the doctor. Take him/her aside and just put it in their ear. If the attending MD doesn't care there is nothing you can do. This stuff happens in nursing. Unfortunately, you can only hope the patient gets a more understanding RN to care for them. Otherwise, learn now that not everything goes as we would hope.

[RegisteredNuisance, RN]

Another agreement for the scheduled vs PRN option here. Pain, nausea and other symptoms are NEVER the nurse's prerogative to judge. If the patient says they're in pain/nauseous, we have to assume they are. The "but" here is that we do it regardless if it's true and most nurses know sometimes, it's not. It's not our place to judge. Sucks, but it's a standard of care in place so that the people who are telling the truth have their needs met.

I would keep on the management if you can't get the med rescheduled to q6.