Can pharmacists order labs at your institution?

[Sparda29]

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We can't here. It's ******ed. Instead of saving everyone time and ordering that vanco trough myself, I gotta call the doc to have it ordered.

 

[PharmDstudent]

Are you being consulted?

 

[joetrisman]

Make friends with the docs and get the ok to do telephone orders prn on such things

 

[joetrisman]

Most of the places I've been rphs can order labs

 

[PumpkinSmasher]

Our hospital has us responsible for ordering a number of labs

 

[BidingMyTime]

When I worked hospitals, we would order labs if consulted (ie if dr ordered Vanco per pharmacy, we would dose the Vanco & order appropriate labs to follow) That seems very odd that you would be asked to dose & then not given the tools to actually be able to do it. But maybe not so odd, considering the other stories you've told about your workplace.

 

[awval999]

I can order any lab.

 

[Sparda29]

When I worked hospitals, we would order labs if consulted (ie if dr ordered Vanco per pharmacy, we would dose the Vanco & order appropriate labs to follow) That seems very odd that you would be asked to dose & then not given the tools to actually be able to do it. But maybe not so odd, considering the other stories you've told about your workplace.

We're not asked to dose it. I've seen people put on Vanco 1 gram q12 and its like a whole week has gone by with no trough.

 

[metrarx]

Yes, any lab

 

[mustang sally]

Yes, certain ones.

 

[benjee]

Yes, any lab

then who draws it? rph or phlebotomist?

 

[awval999]

then who draws it? rph or phlebotomist?

I've never heard of an RPh drawing labs.
I don't know of any RPh that is certified in venipuncture.

When I order labs--- the lab technician gets it. Whomever that is.

 

[WVUPharm2007]

I used to order labs all the time.

 

[metrarx]

then who draws it? rph or phlebotomist?

I've also never heard of pharmacy collecting blood. Phlebotomy or RN if central line.

 

[rph3664]

I've never heard of an RPh drawing labs.
I don't know of any RPh that is certified in venipuncture.

When I order labs--- the lab technician gets it. Whomever that is.

I've known a few pharmacists who were nurses before (and one who became one later) and my BFF was a med tech (and still has his license) and knows how to do it. Otherwise, the phlebotomy team usually does it.

As for ordering labs, I generally did that for vanco, aminoglycosides, INRs, and related labs.

 

[rxlea]

Your hospital is a mess.

We ordered labs on vanco, AGs, INR, whatever.

 

[confettiflyer]

When formally consulted we can order labs on protocol.

If your messed up hospital doesn't have that system, make friends with physicians and get an empiric OK to order things or even adjust doses.

Our hospital has limited protocols but with some intensivists and a few hospitalists, I'm able to "just take care of it" for them.

your clinical coord really should be pushing for per pharmacy dosing on a few select meds, but i don't know how the rest of your hospital culture is and it sounds like poop.

 

[Sparda29]

The main hospitals in my health system have a lot of these nice dosing protocols in effect but my hospital was bought by the health system like 10 years ago when it was on the verge of being shut down. It still loses like $20 million a year.

Most if the physicians here are established private practice jerks, and most of the employees are union employees who have been here for years.

 

[awval999]

The main hospitals in my health system have a lot of these nice dosing protocols in effect but my hospital was bought by the health system like 10 years ago when it was on the verge of being shut down. It still loses like $20 million a year.

Most if the physicians here are established private practice jerks, and most of the employees are union employees who have been here for years.

No offense Sparda but your hospital seems to really suck.

 

[Sparda29]

No offense Sparda but your hospital seems to really suck.

The union structure in the hospital doesn't allow for much change. It's good that it provides great job security, but it's bad that it allows for people used to the old ways to stay on.

 

[storyhill]

We can order any basic labs that we need. What's nice now is that when we order medications we can just enter them via CPOE and don't have to write an order.

 

[ethyl]

Sounds like you have a weak clinical coordinator and manager. Does your hospital even have a P&T committee?

 

[xiphoid2010]

Here, pharmacists can order labs when consulted for dosing. After all, can't dose if you don't have relevant labs.

 

[Sparda29]

Sounds like you have a weak clinical coordinator and manager. Does your hospital even have a P&T committee?

Yeah it does, but its a stupidly long process to make changes here. Has to go through P&T and some other bull**** committee.

Honestly, maybe it's good that we don't have these protocols so that I can develop some myself, add that to the CV/resume and leave it up to the clinical coordinator and DOP to argue for it at P&T. Most of the docs here are old fashioned private practice asshats.

 

[confettiflyer]

Most of the docs here are old fashioned private practice asshats.

You just gotta know how to talk to them, there are old fashioned need-to-retire asshats at many hospitals.

Just sell yourself as a service to make _____'s life easier.

"Oh Dr. head of medical staff, I know your docs have more important things to do than dose vanco or coumadin, want us to take care of that for you? we'll log progress notes frequently and make sure everyone on our staff that touches your patients are trained and complete annual competencies. lots of other hospitals are doing it with good results - and it would be optional too, so if any of your physicians aren't comfortable it's okay."

something like that

sell the service, sell the service, sell the service!

what people don't get is there's all this focus/vitriol on closing/preventing new pharmacy schools from opening that the real solution is in selling services. If every backward hospital like yours can sell services to the physicians/nurses and add just one FTE to your ranks, we would have done more to blunt the overflow of new pharmd's than attempting to close new schools (which would fail miserably anyway)

/rant

 

[Sparda29]

You just gotta know how to talk to them, there are old fashioned need-to-retire asshats at many hospitals.

Just sell yourself as a service to make _____'s life easier.

"Oh Dr. head of medical staff, I know your docs have more important things to do than dose vanco or coumadin, want us to take care of that for you? we'll log progress notes frequently and make sure everyone on our staff that touches your patients are trained and complete annual competencies. lots of other hospitals are doing it with good results - and it would be optional too, so if any of your physicians aren't comfortable it's okay."

something like that

sell the service, sell the service, sell the service!

what people don't get is there's all this focus/vitriol on closing/preventing new pharmacy schools from opening that the real solution is in selling services. If every backward hospital like yours can sell services to the physicians/nurses and add just one FTE to your ranks, we would have done more to blunt the overflow of new pharmd's than attempting to close new schools (which would fail miserably anyway)

/rant

That could work. The upper level department heads and chiefs are very friendly with pharmacy, but even after them since we're part of a health-system, it has to go through with them also.