During the morning round she appeared very sleepy and difficult to stay awake to answer questions about her condition. She was suffering from anxiety, acid reflux, and chronic pain issues besides other comorbidities.
As I asked about her last night with regards to her anxiety and pain; she broke into tears as she mentioned that she suffered all night from anxiety and pain and she has to ask for help. She said help arrived but after she keeps asking for medications.
As I reviewed her chart she was on multiple scheduled as well as as-needed (PRN) medications for anxiety and pain. She received scheduled medication on time but as-needed (PRN) medications were discretionary and not received.
As we know, and some may not that p.r.n.: abbreviation meaning "when necessary" (from the Latin "pro re nata", for an occasion that has arisen, as circumstances require, as needed)
She wanted me to make a difference in nursing practice by implementing a COWS rule for every nursing shift. Nurse must review PRN medications with their patients as not to miss an opportunity to intervene when help is already on stand by. The red flag then turns into a smiley face on COWS (Computers on Wheels) as a goal to achieve structured compassion.
To some with their old school of care, nursing involves care of giving beyond one's asking for help. They feel with their heart and eyes. They know what is there for their patient's needs. Others forget available necessary medications even as circumstances require to be administered. Certainly, the abbreviation PRN does not mean "please remember not".
