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"Nurses do not get paid extra for being pharmacists" - KevinMD

KidPharmD

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    Can we put KevinMD up there with Dr. Oz now as someone who has no real medical credibility? I realize that the book author wrote this, but since Kevin put it on his site he certainly shares the blame for distributing this drool.
     
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    radio frequency

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      Can we put KevinMD up there with Dr. Oz now as someone who has no real medical credibility? I realize that the book author wrote this, but since Kevin put it on his site he certainly shares the blame for distributing this drool.
      I can tell by reading this that neither KevinMD nor the author have an editor. This was a painful read, on multiple levels.

      I never call the nurse unless I absolutely have to, or if I keep paging the MD and they don't respond and I figure the nurse may be able to flag them down in person to call me back. I think this author doesn't understand either the pharmacy or the nurse role.
       
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      owlegrad

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        I can tell by reading this that neither KevinMD nor the author have an editor. This was a painful read, on multiple levels.

        I never call the nurse unless I absolutely have to, or if I keep paging the MD and they don't respond and I figure the nurse may be able to flag them down in person to call me back. I think this author doesn't understand either the pharmacy or the nurse role.

        I bet you know what a Pyxis machine is after reading it though! A Pyxis machine is a machine that is automatic and holds drugs.
         
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        KidPharmD

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          I can tell by reading this that neither KevinMD nor the author have an editor. This was a painful read, on multiple levels.

          I never call the nurse unless I absolutely have to, or if I keep paging the MD and they don't respond and I figure the nurse may be able to flag them down in person to call me back. I think this author doesn't understand either the pharmacy or the nurse role.
          It definitely doesn't sound like this had an editor, but someone published into a book! I can only assume this is one of those predatory publishers that will put anyone's book through for an exorbitant fee.
           
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          owlegrad

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            Obviously don't work in a hospital but I assume no one is actually asking the nurse what they think an order says.

            Right?

            When you need a script clarified do you talk directly with the prescriber or with their office?

            Asking a nurse to clarify an order is SOP in LTC. Can’t speak for inpatient but I assume it’s the same.
             
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            wagrxm2000

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              When you need a script clarified do you talk directly with the prescriber or with their office?

              Asking a nurse to clarify an order is SOP in LTC. Can’t speak for inpatient but I assume it’s the same.
              When asking a nurse, I'm asking them to find out what it says. Not what they think it says

              Yes I understand they are probably just guessing and not confirming

              My question was though that no one is actually asking for the nurses opinion

              Right?
               
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              owlegrad

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                When asking a nurse, I'm asking them to find out what it says. Not what they think it says

                Yes I understand they are probably just guessing and not confirming

                My question was though that no one is actually asking for the nurses opinion

                Right?

                Asking a nurse what something says is the same as asking her what she thinks it says. That’s what the article is referring to.
                 

                wagrxm2000

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                  Asking a nurse what something says is the same as asking her what she thinks it says. That’s what the article is referring to.

                  I guess I'm not being clear, is that what you guys actually do?

                  I don't want the nurses opinion.

                  Obviously I just document though to protect myself.
                   
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                  owlegrad

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                    I guess I'm not being clear, is that what you guys actually do?

                    I don't want the nurses opinion.

                    Obviously I just document though to protect myself.

                    Yea, it is SOP to call the nurse to have her clarify the script, at least in LTC. Perhaps in the nurse’s mind I am asking for her opinion but in my mind I am asking her to clarify an unclear order.
                     
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                    gwarm01

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                      "No it's not in the fridge or the patient specific".

                      It definitely is in there.
                      You make an new bag STAT. Five minute later your tech returns the bag.

                      "They didn't need it. They already had one running."

                      You NEVER get a phone call when they find the med, usually in the location you said it was. You only get a call letting you know it's missing and it's late and you need to make a new one NOW.

                      Along with many other issues, the article seems to suggest at times that floor nurses should be the ones restocking a Pyxis. Good luck suggesting that to any nursing department at any hospital I have ever been at.

                      Sounds like a good way to completely deplete your supply of saline flushes.
                       
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                      BidingMyTime

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                        So, the nurse who wrote this book sounds like an idiot, and so is Kevin MD for apparently agreeing with the nurse.

                        Here is the big thing, I don't expect a nurse to drop everything and call a doctor (we'll assume it's not a stat order, and a good portion of the time, the question is about a home medication dosing that doesn't make sense, so it's not a stat.) Nurses are most likely going to be calling or talking with the doctor at some point during that day, so instead calling her/him, and then having the nurse call her/him--it makes more sense to let the nurse know, so when he/she talks to the doctor he/she can ask him/her all the questions at once, instead of the doctor being harassed by many phones calls one after the other.

                        The other complaints sound very petty, and made up. How often does a technician refuse to get out of the way for a nurse to get an actual stat med out of the Pyxis? Or is the nurse complaining because she is an hour late given the pt's morning meds, so suddenly they are all "stat"?

                        And the reason outpatient pharmacists usually end up talking to the nurse is because 1) the pharmacy isn't 24 hrs and is closed 2) medical records is also not 24hrs and is closed 3) the on-call doctor never took care of the patient and has no idea about the history.....so the pharmacist calls the floor, hoping to talk to a nurse who took care of the patient and can clarify the order.

                        And I agree, the book definitely needed an editor!
                         
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                        Mad Jack

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                          Can we put KevinMD up there with Dr. Oz now as someone who has no real medical credibility? I realize that the book author wrote this, but since Kevin put it on his site he certainly shares the blame for distributing this drool.
                          KevinMD was sold many years ago. It is a brand he hasn't owned for some time.
                           
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                          Mad Jack

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                            It's weird how the site still claims he is the owner. About Kevin Pho, MD | KevinMD | KevinMD.com

                            It's similar to how Bob's Furniture was sold to another company but kept Bob as a figurehead spokesman and CEO in the Northeast. Yeah, he is still involved, but he no longer controls KevinMD.com and is only there to lend the brand an image.
                             
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                            njac

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                              It sounds like the author works at an unfortunately not progressive hospital.

                              I am fortunate enough to work in the ED - it’s exceptionally rare that I can’t just walk 20 feet and speak directly with a prescriber.

                              But I’ve staffed in central pharmacies too. In community hospitals it’s sometimes nearly impossible to get a physician to call back. So I would call the nursing unit to a) see if the doc was still physically there and b) talk with the RN - maybe they discussed the plan with the physician, or they need to call about something else and we can take care of multiple issues in one call. At an academic medical center I often do the opposite - talk with the RN and if there’s something they have a concern about I’ll bundle it into my conversation with the prescriber.

                              The editorial sounds like a worst case scenario - between handwritten orders and pharmacists not readily available on the floor. And that’s too bad.


                              Sent from my iPhone using SDN
                               
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                              xMikeyDay

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                                Wow, just wow. That article was EXTREMELY painful to read. Holy hell.

                                As a RN working in a level 4 NICU, I have to say this guy is way off the mark. Not sure what beef he has with Pharmacy, but dang.

                                90% of what he said doesn't make sense, and the stuff the author said that was KINDA true, was exaggerated.

                                I dont understand this author, why is he trying to make pharm techs sound so dumb. Like they are unable to count meds before putting them in the Pyxis/Accudose
                                 
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                                lane one

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                                  When you need a script clarified do you talk directly with the prescriber or with their office?

                                  Asking a nurse to clarify an order is SOP in LTC. Can’t speak for inpatient but I assume it’s the same.

                                  I think that is going to depend largely on how the order is being received. At my hospital, SOP is definitely to page the MD to clarify since they enter their own orders. Before CPOE, I would routinely call nurses to clarify a written order if I couldn't interpret it. If I could interpret it and simply disagree with it, then that's gonna be the MD.

                                  The article is hot garbage though. My dog is a better novelist.
                                   
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