Wine Debate

Specialties Geriatric

Published

I was wondering if I could get a few opinions on this subject. I work in an ALF and we have a resident who has a doctor's order for the individual 6oz bottles of wine to be given during lunch and dinner times. According to the resident, the doctor made this order to prevent her from being put on any anti-anxiety medication. At any rate her complaint is that the bottles are too hard to find and that she runs out sooner than what she thinks she should. Here is the debate we are having now. Since it is a doctors order that she is allowed wine twice day, is it the facility's responsiblilty to ensure that she has the wine (at her cost) or is it her responsibilty? I can already tell you there has been alot of drama involved with this and this situation has been going on for quite some time. At any rate any opinions would be welcome! Thank you!

Specializes in ICU-Stepdown.

No one seems to have really answered the OPs question. Allow me to try :)

IF the facility is responsible for getting and maintaining her medications, then they are ALSO responsible for getting and maintaining the stock of wine (if it was prescribed, it is part of her medication routine) -if the patient is responsible for maintaining her OWN medication stock, then she is also responsible for maintaining her own wine stock (and I'd be darned if I'd settle for 6oz bottles- hehe. )

The 'hard to find' comment does not (I assume) refer to the patient having a tough time finding it in her room (or wherever) but to it being difficult to find in a store -and someone already addressed that (I didn't know you could order things like that in a grocery store -thanks for the info). So I guess the answer would be dependant on how your facility treats patients' meds.

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Specializes in Gerontology, Med surg, Home Health.

I'm not sure about the regs in assisted living, but I think the resident is responsible for her medications and libations....good for her. I've already decided that if I have to live in an ALF or SNF, I will have all the wine I want....it's in my care plan which I keep on the fridge next to my health care proxy.

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Specializes in ICU-Stepdown.

Hehehe. I'm planning on having a pony keg in my kegerator. I have one now, why shouldn't I enjoy the wonders of draft beer in my later years?

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Specializes in ALF, Medical, ER.

Wow! Thank you all for the responses! Ok let me clarify a few things. The resident's wine is kept locked in the med room along with all of her other meds. She is not self med. Yes she has accused the med techs and SIC's of stealing her wine. It started out with her being able to have 8oz of wine at lunch and dinner. Well since no one makes little individual 8oz bottles, she was getting the big wine bottles delivered to her. From the beginning she was supposed to be getting these delivered to the med room where she would sign for each bottle and date it. Instead we found out that she was getting them delivered to her room and hiding them. Strike one. Now since she was getting 16oz of wine per day, she would know how many days a bottle of wine would last her right? NO! Instead she would act surprised and be extremely upset (read argumentative) that she should not have run out so quickly and that the med techs and SIC's must be drinking some of it. Strike two. Needless to say the PCD was not fond of this and asked the doctor if he could write orders that she was only to be allowed the individual 6oz bottles at lunch and dinner. Each individual bottle would then have the date and time given written on the cap. The doctor agreeded. So now she is even more upset *sigh* I could go on and on haha I'm sure you know what I'm getting at! But yes I guess my main question was if it is on the MARs and has doctors orders for it, I guess we have to assume responsibility for providing it. Thank you all for listening!

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Specializes in ICU-Stepdown.

Well, its pretty obvious that she is playing 'fox in the hen house' with the wine. A patient that is not a 'self-med' should not be allowed to keep their medications -and this includes the wine. I'd even go a step further and insist on returning the dead soldiers (empties) after her meal is done -its the only way to know that she is taking her uhm, meds, and not hoarding them. Her getting upset is irrelevant -she knows she can't get away with it anymore (y'all are "onto her").

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Specializes in nursing home care.

I saw a man in hospital getting a can of guinness everyday to help iron levels and to biuld him up, hospital supplied it. I also had saw a lady who was prescribed cranberry juice (100ml) daily and hospita supplied that too. Interesting question though, if I had given her 150ml cranberry juice, would I have given her an overdose???

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Specializes in med/surg, telemetry, IV therapy, mgmt.
Since it is a doctors order that she is allowed wine twice day, is it the facility's responsiblilty to ensure that she has the wine (at her cost) or is it her responsibilty? I can already tell you there has been alot of drama involved with this and this situation has been going on for quite some time. At any rate any opinions would be welcome! Thank you!

I'm surprised that your facility hasn't informed you nurses how this is to work. The patient is ultimately responsible for anything the doctor orders. If they don't want to pay, then, the doctor needs to be informed and the orders changed. This issue of the wine should have been worked out between the administration and whoever is responsible for paying the patient's bill. Then, it should have been communicated to all you nurses. In all the facilities where I worked, it was usually the patient, or the patient's family, who supplied the wine. It was kept locked in the medicine room, given by the nursing staff and signed off on the MAR. Individual bottles? We used graduated cups to pour out the proper amount. If we were running out, we called the family and let them know that more was needed. If the patient is getting upset about the wine disappearing too fast, start signing it out just like you do narcotics. This will give you a documented record of how the wine is being distributed if she wants proof. You can also mark the side of the wine bottles with a Sharpie to indicate the time and fluid levels. Get the names of the liquor stores who are delivering to her room, call the owner and manager and tell them in no uncertain terms that they are to deliver all liquor to the nurses station as it is considered a medication and that they could be liable for contributing to a medical complication by continuing to ignore the nursing staff. You might get some clout as well by threatening to report these liquor stores to the department of health or aging of your state since they are unwittingly interfering in the care of the patient.

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When I completed nursing school and started in a ltc facility i was only 19. I had a resident that got 6oz. of wine every night. I had to have another nurse give the wine to him because I was not old enough to serve alcohol. Kinda funny I could give morphine but not a glass of wine.

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Specializes in ICU-Stepdown.

I've had drs orders to give coffee (black, cold) down dobhoff tubes before, but never booze.

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