It's not uncommon for folks to be prescribed medication to take when it's needed, rather than regularly at the same time each day.
Such medicine is prescribed with the accepted abbreviation PRN (pro re nata), i.e. when required.
Doesn't this get you thinking?
If I prescribe a drug PRN for one of my in-patients, it's not there to be used regularly (or I'd write it up regularly, at specified times). It's then wholly up to the nurse to decide if or when it's given.
Usually if I want a nurse to decide if the patient has a particular problem, then formulate presentations to conclude that pharmacological treatment is indicated, then determine that a drug I've suggested is the right drug for that patient with that problem at that time, then ensure my patient gets that drug, the nurse is a Supplementary Prescriber. She's done courses on therapeutics, pharacokinetics and dynamics and (critically) has ongoing teaching and ongoing individual supervision with me and mandatory attendance at our ongoing training programme and attendance at our non-medical prescribing forum.
Thus, for an experienced band 7 community to think, yes, this psychotic patient who is believing that "they are out to get me" and is 'phoning police a dozen times a day and daren't leave the house really could use some additional medication (that a Consultant has written in a Clinical Management Plan with the nurse) to de-escalate their distress and help them cope, they have a rigorous training and ongoing development programme.
For a less experienced band 5 ward nurse to think, yes, this psychotic patient is agitated and I'll settle them down with some additional medication (that a Consultant has written on a drug card with a nurse at the MDT), they have no scrutiny or guidance or support or supervision or review of their practice.
This seems odd.
Is it just in my corner that life's like this?