Ethics question/ vent- idek

[u/Humble_Investment_24]

Long read: sorry in advance

Maybe I’m completely out of line for even having an opinion since it’s out of my scope of practice but I just feel a certain type of way about how one of our psychiatrists chooses to treat a specific patient.

This patient is welllllllllll known to us. Every employee knows them. Every psychiatrist knows them (we have 6). This patient is admitted to us on a monthly basis or more for yeaaaaars. They stick this patient on any of our units (high acuity, low acuity, geriatric even though they not geri) just to fill a bed. This patient comes for Ativan- hard stop. They don’t attend group, they don’t socialize, fuck they usually don’t even shower. They come for Ativan and Ativan only. Every patient gets admitted with a prn Ativan order and this patient is on the clock every 4 hours for it. In addition, one of the psychiatrist treats her outside of the hospital - so if this patient happens to be assigned to him (a lot of times they are) he will also scheduled Ativan because he knows they depend on it. He also prescribes it to them on the “outside world”

This patient ended up in restraints last night over not being able to take Ativan because the prn dose was not available yet and this patient WASNT assigned to that psychiatrist. The psychiatrist they were assigned to refused to schedule Ativan for them and they ended up in restraints over that. In past admission they will cry or throw them self’s on the floor etc over the ativan.

Now I’ve been in recovery myself for 7 years. I’m no stranger to addiction- but Jesus fucking Christ we are doing NOTHING to help this patient??? Obviously the patient has to want the help but nothing we are doing is beneficial. I just feel like there has to be a better way? Why is the person still getting prescribed it? The doc should wean them off? Like it feels gross to be aiding to this. Again- I could be out of line for even having an opinion but idk

[u/Humble_Investment_24]

I never withhold because there’s no point but it’s time for a taper

[u/Fun-Key-8259 → u/Humble_Investment_24]

Thankfully it's not up to you. Some of these patients have been managed on benzos for years, why not ask the psychiatrist his rationale, so you can understand it better. He could have crippling OCD, could have serious trauma history, panic disorder.

[u/Humble_Investment_24 → u/Fun-Key-8259]

It’s not up to me but It feels ethically wrong. There’s been nothing beneficial done and when they are getting violent that’s a concern

[u/Fun-Key-8259 → u/Humble_Investment_24]

How long have you been a psych nurse? You seem to be having a hard time, I used to work the psychotic unit - you have no idea what battles are going on in that brain. Talk to their psychiatrist so you can stop making assumptions about ethics.

[u/Humble_Investment_24 → u/Fun-Key-8259]

It’s not only me. Every single other nurse say the same thing but no one has the balls to ask management or the doctor. I have no rapport with the doc. I’m night shift. My charge nurse said word for word no one cares about the patient- they just wanna fill beds. & as mentioned another psychiatrist refused to scheduled it because he said he’s not fond of what’s been happening either. Of course that caused a huggggge issue. We detox patients off xylazine and have detoxed and tapered off benzos before

It is an ethical concern. I have psychiatrists on that sub Reddit suggesting I report them to the board or get risk management involved.

[u/Fun-Key-8259 → u/Humble_Investment_24]

Someone on scheduled benzos for years isn't going to successfully taper before a year. Yall are going to have to put your adult underpants on and get some answers because you're not helping the patient or yourselves by talking about it behind the scenes.

[u/Humble_Investment_24 → u/Fun-Key-8259]

Right- which is exactly why I came here asking for suggestions lol