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Denise Gardiner's avatar

Midazolam is rarely used outside of a surgical setting here in the USA. Speaking from years of experience as an independent prof nurse auditor, I have never seen this prescribed in any care-home setting in the US, I know it is sometimes used for people with poor clearance but it is rare. Lorazepam (Ativan) is the DOC anxiolytic prescribed here for the geriatric population so commonly prescribed for agitation/anxiety it is often referred to as Vit A among nursing staff. Oral tabs (po) are small, can be cut or crushed, and it is prescribed the majority of the time, rarely IM or IV unless the patient can not swallow. Haloperidol is not prescribed often outside of the geri-psych population d/t SE, opioids are rarely prescribed for anything other than pain greater than 6/10 d/t high risk for constipation/impaction/blockage, delirium, CNS depression, drowsiness, and when they are prescribed it is a PRN and a bowel regimen must be in place, this is or was protocol. If I see opioids in the chart I'm looking for ALOT of documentation on pain assessment and a diagnosis of Cancer or other pathologies warranting their use.

All of the drugs listed in your article increase Fall Risk which is serious, so if these drugs were prescribed, one or God forbid all four, then I'd be very concerned, enough so that patients records better have documentation, documentation, documentation. Lots of it and I'd be having a discussion with the DNS, and if that wasn't satisfactory I'd be talking to the Admin.

If I was auditing an organization readying them for a state or federal Audit and saw these drugs, one or combination of them written in a chart I would think it a very big error or 'ding'. I'd think what the heck is going on here, and that I may have witnessed evidence of doctor assisted suicide.

The people given those drugs were murdered.

The staff who allowed this to happen are guilty. They could have spoken up, refused, fought back, or walked out instead they gave them drugs which they knew would lead to their deaths. God forgive them, I don't have too

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Dennis K McGee's avatar

I have been brutalized beyond the point where I "refuse to accept". Realization of the horrid truth about 9/11 got me here. It wasn't a fun journey. I can have some sympathy for those just now having to make the transition. I lost family to this genocide too.

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