If you’re in a private psych ward in Australia, there are two types of medication on your chart: your regular medications, which are taken at the times dictated by your psychiatrist, and “PRNs” (pro re nata, from the Latin; or as I inaccurately prefer, patient request needed) which you can request when needed. (Actually, there are two others, though less frequently used: nurse initiated doses, which are of course wrapped in piles of legislation, and phone orders, which must be signed by the issuing doctor within a certain timeframe and only last 24 hours. But I digress.)
I’m pretty good with my PRNs. I know some people are addicted to alprazolam (xanax) but I’ve been on it since 2006 and can go for weeks without taking a tablet. However, I do use it when I feel extreme anxiety building.
This started to happen one Sunday afternoon while I was in hospital. However, the nurses could not give me an alprazolam because – more administrivia! – all the boxes in that PRN row had been filled. They asked me if I’d like them to call my psychiatrist, but I thought to myself: “Hey, just because I have no quality of life right now is no reason why he should have his Sunday afternoon ruined.” Let’s just say that next time this happens, I’d be saying: “Yep, get him on the buzzer RIGHT NOW, please.”
I had been expecting to see my psychiatrist the following Monday morning before work, but he didn’t make it. I was due to leave the hospital for some day leave later that day and my anxiety was really growing. I went to the medications room and pointed out that there was a gap between the last box and the edge of the page. “Couldn’t you write it in there?” “No, that’s illegal.” Damn.
The frustration was that my psychiatrist was in the same building, just a couple of floors away, but wasn’t returning the calls of the ward nurses. That poor man must have been very busy that day. I did consider camping out near his office, but on balance decided our long-term relationship was more important. That was before I ended up lying face-down on my bed breathing into my pillow.
I wish I could say that some world-weary nurse eventually slipped me a tablet with strict instructions to tell no-one. Of course that didn’t happen, because that would be illegal.
The story has a happy ending: I survived my day leave, my anxiety didn’t get the better of me, no-one died, and that precious second row of PRN medications was filled in by my psychiatrist, bless his cotton socks.
And I doubt my ‘breathing’ could even be heard in the next room 🙂