My doctor ordered my mom Lorazepam 0.5mg. I told the nurse to only give her half and they make that change for me. Can they get in trouble?
Now a new nurse says we have to get a new Dr. order for any changes. She won't even give Tylenol or supplements without a doctor order. We are in a assisted living, not a nsg home.
I just reread and this says "new nurse". As most of us said in your last post, the other nurse was wrong in not following doctor's orders and could get fired. This new nurse is absolutely correct. No RN* can override a drs. order.
*I say RN because Nurse Practioners can prescribe but not sure they can override a doctor.
When it comes to pills, one needs to check not only the main ingredient in a pill but also the fillers.... the binder.... and the coating. The main ingredient may be ok, but it could be one of the fillers that one could have a side effect. Filler are used to make the pill large enough to handle.
Or the binder that is used to keep the pill together. Typical binders are tapioca flour, lactose, sucrose, microcrystalline cellulose, polyvinylpyrrolidone and various starches.
Or the coating that makes the pill easier to swallow. Shellac is very common. Please note that shellac is also used to polish apples to make them last longer.
I remember a few years back, I could only take a certain pill if it was made by a certain manufacturer. If made by someone else, big time side effects. I was amazed to find out that my Mom could only use the same manufacturer as I was using. Neither one of us knew the other had the same problem.
0.5mg of lorazepam? I don't think it comes in a smaller dose than that. The nurse is right. It's not for you to determine the dose. The nurse has to follow the orders the doctor gives.
Yes, the Nurse is correct. ALs are also overseen by the State. They must keep records of medications given and the dose needs to correspond to the Doctor's orders or the AL gets into trouble. This goes for OTC too. My Mom suffered from arthritis in her lower back and Tylenol helped with her occasional discomfort. The doctor wrote it up "2 pills a day" which would not help at all. Nurse called and asked that the order be changed to " 2 pills when needed" .
I agree 5mg is a low dose. The Nurse is now in charge of Moms medications. We were told this going in with my Mom. You have every right to question. Especially if you think Mom is having an adverse reaction to a med. You have a right to go over the Nurses head and call the doctor. We were allowed to use Moms PCP and the Nurse called him with any changes she felt was needed. I was the one who caught the Tylenol thing and the Nurse agreed and called the doctor. I am lucky I have a Nurse in the family that is qualified to question doses but she cannot change a doctors order. Not under any circumstance, she can only request.
gardenview1, any time I get a prescription for a med that I have never taken before, I always cut the pill in half as I am pill sensitive. And my primary doctor knows I do this. Is that why you wish for your Mom to take half a pill?
But when one is living in senior living and using the med-tech staff to get one's meds, there needs to be a doctor's script on-file. So, yes, the doctor needs to write out a new script if there is a change in dosage.
A .5 mg dose of Lorazepam is a 'baby dose'---it probably wouldn't do a thing to your mom.
Also, to cut it in half would be a challenge as they are so tiny. Many pills cannot be cut, as they lose their efficacy if cut. (Time release meds come to mind).
BUT--the bottom line is, the Dr makes the orders for whatever reason and the nurse's job is to administer them. Period. She could lose her job for fussing around with dosages.
The only way 'around' this is if mom is in control of her meds, which is some AL's is the case, but mom would have to be able to completely understand what she's doing.
Are you a doctor and able to over ride the other doctors orders? If not, why are you even putting a nurse in this position as it is not her job to follow a families requests, it is her job to follow the doctors orders.
The doctor is in charge of the medications. Not the nurse and not the family. The nurse may lose her license if she makes the changes you ask for. talk with your mother's physician if you want changes.
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*I say RN because Nurse Practioners can prescribe but not sure they can override a doctor.
Or the binder that is used to keep the pill together. Typical binders are tapioca flour, lactose, sucrose, microcrystalline cellulose, polyvinylpyrrolidone and various starches.
Or the coating that makes the pill easier to swallow. Shellac is very common. Please note that shellac is also used to polish apples to make them last longer.
I remember a few years back, I could only take a certain pill if it was made by a certain manufacturer. If made by someone else, big time side effects. I was amazed to find out that my Mom could only use the same manufacturer as I was using. Neither one of us knew the other had the same problem.
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I think the nurses and doctors taking care of your mom sound like they’re doing fine.
Give it a few days and ask them if the see any positive changes.
https://www.agingcare.com/questions/will-a-nurse-be-liable-if-she-tweaks-or-changes-a-dr-order-for-a-resident-to-please-the-family-or-do-476412.htm
Yes, the Nurse is correct. ALs are also overseen by the State. They must keep records of medications given and the dose needs to correspond to the Doctor's orders or the AL gets into trouble. This goes for OTC too. My Mom suffered from arthritis in her lower back and Tylenol helped with her occasional discomfort. The doctor wrote it up "2 pills a day" which would not help at all. Nurse called and asked that the order be changed to " 2 pills when needed" .
I agree 5mg is a low dose. The Nurse is now in charge of Moms medications. We were told this going in with my Mom. You have every right to question. Especially if you think Mom is having an adverse reaction to a med. You have a right to go over the Nurses head and call the doctor. We were allowed to use Moms PCP and the Nurse called him with any changes she felt was needed. I was the one who caught the Tylenol thing and the Nurse agreed and called the doctor. I am lucky I have a Nurse in the family that is qualified to question doses but she cannot change a doctors order. Not under any circumstance, she can only request.
But when one is living in senior living and using the med-tech staff to get one's meds, there needs to be a doctor's script on-file. So, yes, the doctor needs to write out a new script if there is a change in dosage.
Also, to cut it in half would be a challenge as they are so tiny. Many pills cannot be cut, as they lose their efficacy if cut. (Time release meds come to mind).
BUT--the bottom line is, the Dr makes the orders for whatever reason and the nurse's job is to administer them. Period. She could lose her job for fussing around with dosages.
The only way 'around' this is if mom is in control of her meds, which is some AL's is the case, but mom would have to be able to completely understand what she's doing.
And yes, a nurse can get in trouble/fired for not following what the doctor prescribed.
Assisted living is still responsible for administering the medications.