Pharmacists getting hosed on Capitol Hill

[RNtoPharmD]

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Thank you for posting!! Do you have the direct link to the Capital Hill Feedback so I can forward it to my classmates?

 

[Handy388]

It actually is possible, especially when the school is ranked above such schools as Brown and Emory, along with grades, qualifications, connections, and USMLE scores.

Sorry, but connections, grades, international standing have an impact.

Sorry, big guy.

No foreign med school ranked above Emory (22th by USNEWS) will take you as a non-citizen, big guy.

also, stop trolling the pharm board.

 

[solzont]

This hospital sounds weak at best...

There are several hospitals that currently use that system, it's called "Quantify;" I don't think it's going away anytime soon either. Now I'm not sure where they fall in someone's subjective ranking of hospitals, but at least two are major national hospitals. It's management that's weak, because their poor implementation of this system both negatively impacts the productivity of their clinical pharmacists while encouraging and by default, rewarding, dodgy pharmacists who fill the logs with meaningless if not outright libelous data in lieu of *real* interventions.

From a business perspective, I understand the necessity of such a system to justify costs to the bean counters. But, without a regular validation of intervention data there's no way to fairly evaluate clinical contributions made by the staff. Then again, any institution that implements a flat raise regardless of performance should be bound, gagged, and dragged to a class on the fundamentals of effective management.

 

[solzont]

oh yea docs are hard to work with, they are all in it together

i remember the one hospital i rotated with, the orthapod was giving every1 vanco (which is wrong unless pt has pcn allergy or if u have high mrsa rates in ur area [this wasnt true in our case])...over and over again, we told him why ancef was better choice, and he never changed...he even got the ID specialist to say it was ok, and ever since that day, he consults that ID person on like every wound infection case now...so the ID is happy cuz seeing more cases = more $$, and the orthapod is happy cuz he can do watever he wants knowing ID has his back

crap like this goes on everywhere, especially in the depressed area hospitals of the rust belt

Yup, the doctors continue to have the hospital management and heathcare system as a whole, by the balls.

 

[Handy388]

Yup, the doctors continue to have the hospital management and heathcare system as a whole, by the balls.

I don't know, maybe that MD isn't stupid?

After all, if he get sued from an infection, it's his license and livehood, his malpractice insurance.

he doesn't get sued for creating super bug.

Think about it, any orthopeadic infections are diffcult to clear out from.

 

[prevacid]

I don't know, maybe that MD isn't stupid?

After all, if he get sued from an infection, it's his license and livehood, his malpractice insurance.

he doesn't get sued for creating super bug.

Think about it, any orthopeadic infections are diffcult to clear out from.

no

for surgical prophylaxis, ancef is the better choice to cover non mrsa staph...it covers it better since its cidal and vanco is more static...hence, unless pt has pcn allergy or if u have high mrsa rates in ur area (this hospital i was at had mrsa rates lower than natl avg), there is no reason to use vanco over ancef

i work retail and i still remember that 🙂

 

[StaviZFingerZ]

Our ID docs are flat out incompetent. They sent a woman home on a 3-week vanc home infusion regimen with cellulitis and a trough of about 4. They were just giving her a gram daily...renal function wasn't too bad. WTF? That is so unbelievable.


The word "consult" makes me want to vomit. Where I work, the consulting docs just go around making mass changes to orders without even talking to the attending. Over the weekend I had a hell of a time with a stupid Solu-medrol order. Saturday its 125mg q8...the attending comes in at 6AM (he's weird) and changes it to 40mg q12h...then at 8AM, the consulted pulmonary doc comes in and writes an order that reads "decrease solumedrol to 80mg q8h" because he didn't read the f'ing order the attending wrote...and THEN at like 11AM, a renal doc comes in and, based off of the pulmonary guy's order, writes and order to decrease the dose to 40mg q8h starting Monday. So what the hell do I do? The attending won't respond to my pages...out playing golf *cough*typical*cough*...I just used my judgment and went with the attending's order and left it at that.

But this is what makes their world go round. They consult each other when it isn't really needed...the system is charged a bazillion dollars...and my time gets wasted because the ******s never communicate with each other and something as run-of-the-mill as an iv steroid takes up 30 minutes of my day.

Be patient. I've got hospitals where ID docs are pain in the ass then again I have another hospital where the hospital canned the ID doc based on my recommendation. It all depends. When you have an offender who drive up the cost, some admin will act on it and some won't.

 

[StaviZFingerZ]

This exactly right...thats why we do not consult people unless absolutely necessary...they just order a bunch of needless BS...and we wonder why we need healthcare reform

I just happened to look at a patients mar next to another patient that we were seeing today....the patient was on the vent with MRSA pneumonia....the MAR has zyvox 600 mg IV q24 and has been there for 7 days...and I say to myself WTF?

What was the MRSA MIC?

 

[prevacid]

This exactly right...thats why we do not consult people unless absolutely necessary...they just order a bunch of needless BS...and we wonder why we need healthcare reform

I just happened to look at a patients mar next to another patient that we were seeing today....the patient was on the vent with MRSA pneumonia....the MAR has zyvox 600 mg IV q24 and has been there for 7 days...and I say to myself WTF?

just from a personal opinion i disagree...i believe there is a medium as to when specialist needs to be consulted...some times the fam md tries to take care of patient and consults very late in the case (which ticks of specialists), and then there are some fam md who ive seen that consult gi surgery for a non specific stomach pain without any tests or scans performed (which ticks of the gi guys as they are plenty busy themselves)....i see both sides and believe there is a happy medium when to consult specialist