Hospital pharmacy is nuts.

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Oh, no...he might go off of it and we'd have to waste $1.65 worth of ingredients. And I do make 4 at a time when I'm there...alone, anyway...

I would surely reimburse the $1.65 worth of ingredients to make my life easier. Just dock it from my salary! It may even be tax-deductible. Who knows. If I were running a department, I'd rather spend a few extra bucks here and there to have workers who are not overburdened.

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Psssh? 8 hours? Nah man, we work 10s. I only have to go to work 4 days a week. I was there 1-11....just as I was there 1-11 the three nights prior. I love evening shift. No management, it's quiet, I have more ability to freestyle...it's nice.

same here.
have had alot of similar evenings/overnights.
I liked being in the IV room making things, but it makes it a little hard to answer the
two ringing lines for "missing" crap that we already sent 3 doses in the tube.
I kinda miss those nights - as busy as it got, I always kind of liked being the "man" (for lack of a better term). My tech and I knew exactly what each other was doing and we always got stuff done, made you feel good at the end of a shift when you know you did a good job.
 
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What's balls is that our department policy is to send them down in 100mL bags.

Probably that policy came into effect because years before a nurse had hung a big bag of versed thinking it was plain normal saline. So a policy is made to ensure that never happens again, and then it must be adhered to inspite of all common sense.
 
Oh - and the depressing prologue - all three patients have since passed. The lady who was crashing up in PACU went today. I seriously just kinda sat there and stared at the little "expiration notice" that prints out on her for a minute. Kinda pissed off at fate, to be honest...all that work...for nothing. Hopefully their grandkids got to see them one last time or...something...
 
So, how's work going Mikey?

Still got one of you guys working on the shift alone? ...you haven't shared any of your crazy night stories lately.

Everything's been smooth, actually. The worst thing I've done so was send a med down that a physician checked "do not order" on a certain home med due to reading the med reconciliation form incorrectly. Yay for me not harming anyone yet.
 
just wondering why your docs call you to prepare levo, fentanyl etc drips. i am also a critical care nurse and work night shifts and we get levo, neo, even fentanyl from our pyxis or accudose and prepare the drips ourselves without calling the rph when pt is crashing. it is only prepared by the rph when the drip is continuous and is about to be started for those non-critical patients.
cardiac meds such as levo, neo, dopamine should be available in the pyxis/accudose or if the crash cart is already open, these meds are readily available in their drawers.
 
just wondering why your docs call you to prepare levo, fentanyl etc drips. i am also a critical care nurse and work night shifts and we get levo, neo, even fentanyl from our pyxis or accudose and prepare the drips ourselves without calling the rph when pt is crashing. it is only prepared by the rph when the drip is continuous and is about to be started for those non-critical patients.
cardiac meds such as levo, neo, dopamine should be available in the pyxis/accudose or if the crash cart is already open, these meds are readily available in their drawers.

I don't know for sure. That's how we do it as well - they will make the first bag on the floor and we send subsequent bags. Sometimes they do come late from the pharmacy, or we don't know that they had to increase the rate, and it becomes stat, but rarely does a 1st bag come from us unless it's something not available on the floor. (I don't think we keep nitroprusside in accudoses, but we now have Cardene RTUs...)
 
Why do you suppose?

I had a patient crashed on the CT table as well, and that was within 3 months of being put in the ED sat, and I only work 2 weekends per month. So yeah, it's pretty common.

The main reason is the PT who are sent to CT usually have some kind of serious condition. In my case, he had a GSU to the chest w/o exit wound, and an INR of 9 (botched suicide attempt). The ER doctor can tell he's bleeding internally but can't tell what/where's been nicked. The patient was fully responsive and stable on Neo + transfusion. With an INR of 9, groaping around inside blindly would be dicey, so he tried to get a quick CT.

But the patient went down hill really fast on the CT table. (blood reached a level in his pleural cavity to stop the heart). We had to abort the CT in the middle. No amount of epi could get his heart beating. and the physician was faced with let him die on the CT table, or crack his chest open to relieve the pressure (but knowing for sure that with his INR, he'll bleed out like a butchered pig). Well, he cracked his chest open on the CT table, heart came back on, but he was spilling blood everywhere. We where literally running him from CT to OR just like the movies. Never saw so much blood in my life and was dripping on my shoes as I help push the cart.

When we got to the OR, he had the faitest femoral pulse, but I have never seen a person so white before, white as a sheet of paper. The OR physician just mumbled "he's dead". And sure enough, he didn't make it out of there. His suicide attempt was successful I guess, just not he way he would have liked.
 
I love working the evening shift at my hospital until pyxis drawers break or nurses call pharamcy and say, "I can't find the medication" and it turns out they never even looked in the tube system. Other than that, it's cool. It's just on certain nights you need more than one pharmacist and tech working.

Thats hilarious and so true. I can't count the number of times I've gone to the floors and found the "missing" IV bag they were "looking" for sitting on the counter one foot away from where they're sitting. I guess nurses are the same everywhere.
 
this is awesome insight.....you need a day like that every now and then though to enjoy your slow days :p
 
Psssh? 8 hours? Nah man, we work 10s. I only have to go to work 4 days a week. I was there 1-11....just as I was there 1-11 the three nights prior. I love evening shift. No management, it's quiet, I have more ability to freestyle...it's nice.



I know this post is old, but you are a pharmacist AND you can RAP?? Amazing!
 
Can anyone give me a detailed overview of a hospital pharmacists job, their wage and opportunities to move up?
 
sounds like you guys need to hire more pharmacists. I have never had it get that bad. I did have an ortho surgeon call and ask me what anaesthetic when administered intraarticularly lasts the longest-in regards to your strange MD question.
 
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