Gender-specific differences in nursing staff’s administration patterns of ‘pro re nata’ medication: A prospective observational study

Abstract

Background: Pro re nata‘(PRN) medications are important parts of the management of critically ill patients. PRN medications are predominantly administered by nurses, and indications, frequencies and doses of PRN might be influenced by experience, attitude, and empathy. Since it is advocated that empathy has a gender-specific pattern, we compared the PRN prescription model in female and male nurses. Methods: On the Operative ICU of a University Hospital, 1000 shifts (each 500 male and female nurses) were prospectively analyzed regarding PRN medications via a Patient Data Monitoring System. The data collection included characteristics of nurses and patients, and the severity of illness. PRN medication was analysed qualitatively and quantitatively. Results: Female nurses tended to perform less night shifts and more morning shifts compared to male, and female nurses cared significantly more frequent for female patients. In a major area of patient comfort, sedative and analgesic PRN medication, we found no statistically different gender-specific patterns. For constipation, the average amount of polyethylene glycol was significantly higher (p = 0.018) when prescribed by female nurses (189.3 ± 62.7 ml) compared to male nurses (170.9 ± 60.5 ml). For cardiovascular instability, male nurses applied significantly higher (p = 0.011) cumulative doses of norepinephrine (5.4 ± 5.8 mg vs. 4.1 ± 4.3 mg). Conclusions: In this first assessment of potential gender differences in the administration of PRN medications, we found only minor differences in two categories of medication (gastrointestinal and cardiovascular support), with no difference in the major element of suffering (pain and anxiety).