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

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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>

I would report it because it is cruel. It is not necessary to order every pain med and antiemetic on a schedule. Pain is difficult to catch up on..nausea is the same way.

If I consistently found my patient suffering because the previous nurse wanted to be on a power trip, I would absolutely report it. I would also tell the physician so he could file a similar complaint.

Nurses that cannot critically think through PRN meds have no business working in nursing.

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well PRN q6hrs is after 6 hours the patient can request this med and get it for only nausea and/or vomitting. Not for any other purpose. If the patient does not have nausea or is not vomiting then the medication desire is like me getting my alcohol from the fridge every 4 hours because i like the way it makes me feel. The doctor has to write a progress note as to what is causing this behavior. if my patient wanted benadryl every 6hrs prn then ill have to find out whats causing the itch, i wont just give it because he/she likes the feeling.

Have you ever taken Zofran? Nobody takes Zofran for the "feeling".

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Specializes in Cath/EP lab, CCU, Cardiac stepdown.

Doesn't zofran cause/exacerbate qt prolongation? Does the patient have any heart issues?

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Does your facility utilize essential oils for nausea? Ginger oil works like a charm for nausea. I've been told spearmint does too, but I haven't used it.

Either way, this nurse sounds like a real piece of work. Page the provider and get the Zofran scheduled q6, and then take the issue up the chain. If this nurse has such an aversion to giving Zofran, I can't help but imagine she's very stingy with the pain meds, among other things.

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Doesn't zofran cause/exacerbate qt prolongation? Does the patient have any heart issues?

I think the OP is referring to nurses refuse no to give PRNs out of arrogance...not medical judgement.

Even still, if you think a PRN med would have an adverse effect on a patient..you call the MD for an alternative. You don't refuse treatment, let the patient suffer and do nothing.

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Specializes in SICU, trauma, neuro.
well PRN q6hrs is after 6 hours the patient can request this med and get it for only nausea and/or vomitting. Not for any other purpose. If the patient does not have nausea or is not vomiting then the medication desire is like me getting my alcohol from the fridge every 4 hours because i like the way it makes me feel

Nobody ever said the pt was requesting it for the side effects (come to think of it, the couple of times I've been given it, I had no side effects.)

The OP said the pt does have nausea, but still not getting his ordered prn to relieve said nausea. That's the precise problem.

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Specializes in Cath/EP lab, CCU, Cardiac stepdown.
I think the OP is referring to nurses refuse no to give PRNs out of arrogance...not medical judgement.

Even still, if you think a PRN med would have an adverse effect on a patient..you call the MD for an alternative. You don't refuse treatment, let the patient suffer and do nothing.

I'm aware, the reason why I ask is because there are posters who say zofran has virtually no adverse effects, which is not true.

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I agree that the refusing nurse is jacked up, but it is not normal or appropriate to give anti-emetics q6H scheduled indefinitely based on subjective complaints. This patient needs a GI workup.

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if this is long term care, the threads been going a while, the patient may end up on meds for sx relief. and if there is a problem, it may be neuro, not GI, at all.

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Specializes in Critical Care.
I agree that the refusing nurse is jacked up, but it is not normal or appropriate to give anti-emetics q6H scheduled indefinitely based on subjective complaints. This patient needs a GI workup.

It's more likely that long term intractable nausea is from a neuro, not GI source.

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It's more likely that long term intractable nausea is from a neuro, not GI source.

Perhaps, but we really don't have enough information to judge that; either way, this patient needs a workup instead of having Zofran slapped on them q6h forevermore.

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Specializes in Critical Care.
Perhaps, but we really don't have enough information to judge that; either way, this patient needs a workup instead of having Zofran slapped on them q6h forevermore.

he has all testing done by gastro everything is neg so far

He's been worked up for GI and everything was negative. Why keep looking for something that isn't there?

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