War against the nursing staff.

[Requiem]

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You know how I know you work for a piss poor managed hospital?

Nurses are running around trying to get meds.

Pharmacy will never win the war against nursing.

Better yet, it's not a war. Pharmacy is an ancillary service, not the center of the universe.

Nursing is the core business in patient care.

Take care of nursing and your life will get easier.

Sparda, as someone who worked in a very similar environment to you and felt the frustration of every one of the complaints you've aired, what I can say to you is that Z is completely right. It's actually funny looking back how right he is.

Pharmacy is an ancillary service. Nursing is at the core of taking care of patients.

Getting your head around that, having graduated at a pharmacy institution where they probably painted this ivory tower idea of pharmacists doing life saving interventions on CYP interactions, is difficult. Pharmacy may not be what you signed up for, or it may be. But it is probably quite distinctly different than the idea which is portrayed to most pharmacy graduates. The knowledge and training isn't necessarily in congruence with what the health care system/retail sector expect/demand.

Anyway, best of luck with your situation, I would recommend a good discussion with your management about ways to tackle problems in a healthy manner. And certainly, as Z pointed out, if you want any leg to stand on and get things done when you do need it done, treat the nurses well.

 

[BidingMyTime]

You will never win a nursing war. Never. Really, I'm not joking, never. Accept that fact, and then you can start thinking about of ways to get nursing on your side. Legal issues, JCHO mandates, medicare mandates, safe medication recommendations....these must be your priority. As others have mentioned, the timing of medications is because of JCHO mandates/recommendations, and discrepencies have to be noted. These mandates also concern timing of STAT/ASAP medicaitons orders such as antibiotics for certain diagnoses.If nursing practices are hindering conforming to law/mandates/recommendations, then write up a proprosal of the problem and solutions and to through the appropriate committee. If lost medications are a continual problem (the most likely cause is education, is a nurse taking them out of the delivery box and putting them in a wrong place, and then the next shift can't find them?), start tracking what shifts the medications are disappearing on, what medications are disappearing, & on what wards they are disappearing on--this will help narrow down the problem (and if nurses know they are being tracked, they are more likely to comply with hospital protocol.) Obviously, you must also do what ever is necessary to follow mandates/recommendations/laws....even if you feel its an inconvience.

 

[Sparda29]

You will never win a nursing war. Never. Really, I'm not joking, never. Accept that fact, and then you can start thinking about of ways to get nursing on your side. Legal issues, JCHO mandates, medicare mandates, safe medication recommendations....these must be your priority. As others have mentioned, the timing of medications is because of JCHO mandates/recommendations, and discrepencies have to be noted. These mandates also concern timing of STAT/ASAP medicaitons orders such as antibiotics for certain diagnoses.If nursing practices are hindering conforming to law/mandates/recommendations, then write up a proprosal of the problem and solutions and to through the appropriate committee. If lost medications are a continual problem (the most likely cause is education, is a nurse taking them out of the delivery box and putting them in a wrong place, and then the next shift can't find them?), start tracking what shifts the medications are disappearing on, what medications are disappearing, & on what wards they are disappearing on--this will help narrow down the problem (and if nurses know they are being tracked, they are more likely to comply with hospital protocol.) Obviously, you must also do what ever is necessary to follow mandates/recommendations/laws....even if you feel its an inconvience.

We have a window tracking form (nobody uses it unless they are getting pissed off) and when nurses see me writing down their names and unit, they look like they're about to **** their pants.

 

[Indypharm]

Candy. If you have a dish of candy for the nurses in the pharmacy your life will improve dramatically. At least then when they come to the pharmacy they won't have an attitude. Everyone loves candy.

 

[confettiflyer]

Candy. If you have a dish of candy for the nurses in the pharmacy your life will improve dramatically. At least then when they come to the pharmacy they won't have an attitude. Everyone loves candy.

👍👍👍👍👍

omg i believe in candy diplomacy, i've seen it EVERYWHERE

 

[RN2013]

I have a lot of respect for the pharmacists. I know they are prob. busy and short staffed. It is part of my job to check medication orders are entered correctly and I do find several mistakes. Like forgetting to enter a med or putting a med order in for a patient that NO doctor has ordered..but I am nice about it and pharm. corrects it when I contact them.

The nurse needs to administer the med at the time the Doctor ordered it(give or take 30min. or per hospital policy) nurses do not have the authority to change the time without contacting the Doc. and if med isn't given at ordered time, makes the nurse looks bad. But still, why wouldn't they pull it out of pyxis if available? The time it takes to recover a drawer should be ALOT quicker than running to pharmacy.

I have also seen our pharmacy enter med order in when I check the Doc's written order there is no frequency or part of order missing. Shouldn't this be clarified first?

 

[Sparda29]

I have also seen our pharmacy enter med order in when I check the Doc's written order there is no frequency or part of order missing. Shouldn't this be clarified first?

I've seen that a lot. Usually what happens is that I contact the doc, take a telephone order and send up the meds and the telephone order. However, more often than not, the med finds its way into the patients drawer, and the telephone order gets lost instead of being filed into the chart.

 

[xiphoid2010]

The nurse needs to administer the med at the time the Doctor ordered it(give or take 30min. or per hospital policy) nurses do not have the authority to change the time without contacting the Doc. and if med isn't given at ordered time, makes the nurse looks bad. But still, why wouldn't they pull it out of pyxis if available? The time it takes to recover a drawer should be ALOT quicker than running to pharmacy.

The thirty minute policy is now out of date, due to the risk people cutting corner to meet that window resulting in more risk to patients. ISMP released new guidelines in 2011 to allow more time for most meds.

 

[Alby]

I have a lot of respect for the pharmacists. I know they are prob. busy and short staffed. It is part of my job to check medication orders are entered correctly and I do find several mistakes. Like forgetting to enter a med or putting a med order in for a patient that NO doctor has ordered..but I am nice about it and pharm. corrects it when I contact them.

This irritates me to no end... I've seen tons of nursing errors, pharmacy errors and physician errors. Instead of calling each other out we need to look out for and help each other. The reason we have these systems of double checking each others work is to protect the patient, not to point fingers at each other. I believe what comes around goes around, so I try to be nice to everyone, that way others are more likely to help me out when I need it. 🙂

 

[Angela1234]

It makes it look like working at that pharmacy is no walk in the rose gardens either. I still would rather work there than retail. Chances are there are fewer nurses yelling at you and cursing you out than customers every day. Would you like to work through bullet proof glass everyday or worry about being robbed? How about have customers threaten you with physical violence in the parking lot if their prior authorization through the insurance isn't fast enough for them? How about not eating lunch or going to the restroom?

 

[Sparda29]

It makes it look like working at that pharmacy is no walk in the rose gardens either. I still would rather work there than retail. Chances are there are fewer nurses yelling at you and cursing you out than customers every day. Would you like to work through bullet proof glass everyday or worry about being robbed? How about have customers threaten you with physical violence in the parking lot if their prior authorization through the insurance isn't fast enough for them? How about not eating lunch or going to the restroom?

We still have a bullet proof glass + RFID access card separating the pharmacy from the floor. Pharmacists have had their cars keyed/tires slashed by nurses who didn't like how they were treated by pharmacy (when you come in at the same time every day, people start to learn which car you drive, and quite a few nurses are jealous of the flashy cars the pharmacists here drive).

Lunch/restroom, you got me there. I get a one hour lunch break every day where I go home and have dinner or nap. It's so amazing to be able to go home and nap in your own bed during your break. This doesn't include bathroom/lemme go grab a coffee breaks.

 

[Angela1234]

Not a good situation knowing you have to deal wtih cars being keyed/ tires slashed. Is that all anyone wants to do anymore is to solve things with acts of violence? All you have to do is look at the news each night to see how violent society has become. It might not even be safe to work at McDonald's anymore or any job dealing with the public.

 

[Sparda29]

The nurses who did that in view of the security cameras got fired though lol.

 

[type b pharmD]

The nurses who did that in view of the security cameras got fired though lol.

Lol.

 

[Angela1234]

AT least they had security cameras in the parking lot. At my place, they don't have one pointed at the license plates or people in the drive through when they drop off fake prescriptions. They also seem to have most of the cameras pointed at us, they mistrust employees more than other people. They open all my pockets and check my bags whenever I go.

 

[mustang sally]

I've seen that a lot. Usually what happens is that I contact the doc, take a telephone order and send up the meds and the telephone order. However, more often than not, the med finds its way into the patients drawer, and the telephone order gets lost instead of being filed into the chart.

Agree with this. If something is on the patient's profile that is not written, it should be a phone order or verbal order on that the pharmacist received from the physician. In our system (I would assume in every electronic system), we enter the order in so that it shows up to nursing as phone, verbal etc. It always irritates me when the nurse calls up and says "Why did you enter this in when there's no written order for it?" Um, it says phone order right on there...

 

[confettiflyer]

AT least they had security cameras in the parking lot. At my place, they don't have one pointed at the license plates or people in the drive through when they drop off fake prescriptions. They also seem to have most of the cameras pointed at us, they mistrust employees more than other people. They open all my pockets and check my bags whenever I go.

Well... #1 source of shrink = employees, so it makes sense.

 

[Bostonredsox]

Is this war winnable as a pharmacist? So many things at this hospital that have got to change. ****ing nurses coming running over from the ER for meds that don't even need to be administered immediately. Then the nurses from the CCU and ICU who think that their stuff takes priority over the rest of the hospital.

What the **** is it with nurses and specific dose times? I'm here for the 3PM-11PM shift. From 5PM-7PM, it is an absolutely nut house, and then it calms down, and then boom at 930PM it is a nuthouse again until I leave at 11PM. Is it that big a deal that a patient doesn't get a med at 6PM or 10PM and gets it at 8PM or 12AM instead?

That is because it does. This is why their patients are denoted as 'critically ill". When I write for levophed and vasopressin I damn well expect them to come up before the cipro on the asymptomatic UTI 80 year old on the floor. If they are calling you because their pts plavix is missing then you have a valid point. But in general, my nurses are calling down because the drips are not coming fast enough or they come back from the pixus saying 'they havent restocked the ketamine and the Roc, keep bagging for now".

 

[confettiflyer]

That is because it does. This is why their patients are denoted as 'critically ill". When I write for levophed and vasopressin I damn well expect them to come up before the cipro on the asymptomatic UTI 80 year old on the floor. If they are calling you because their pts plavix is missing then you have a valid point. But in general, my nurses are calling down because the drips are not coming fast enough or they come back from the pixus saying 'they havent restocked the ketamine and the Roc, keep bagging for now".

you're preaching to the choir, my friend.

 

[Bostonredsox]

Candy. If you have a dish of candy for the nurses in the pharmacy your life will improve dramatically. At least then when they come to the pharmacy they won't have an attitude. Everyone loves candy.

hell, i will come and get the drips myself if there are watermelon jolly ranchers in that bowl.

 

[rxlea]

That is because it does. This is why their patients are denoted as 'critically ill". When I write for levophed and vasopressin I damn well expect them to come up before the cipro on the asymptomatic UTI 80 year old on the floor. If they are calling you because their pts plavix is missing then you have a valid point. But in general, my nurses are calling down because the drips are not coming fast enough or they come back from the pixus saying 'they havent restocked the ketamine and the Roc, keep bagging for now".

Agreed.

 

[Sparda29]

I get it with the Levophed and Vasopressin and critical care drugs.

But something happened the other day that just blew my mind. ER nurse and an ER tech come running over demanding a vial of haloperidol. No order, no chart #, no allergy information, nothing. All they tell me is that there is a psych patient flipping out in the emergency room and tossing stuff all over the place. To me, that sounds more like a security issue than a pharmacy issue. How the **** do they even plan on safely administering the haloperidol when the guy is swinging chairs around like a baseball bat?

 

[rxlea]

I get it with the Levophed and Vasopressin and critical care drugs.

But something happened the other day that just blew my mind. ER nurse and an ER tech come running over demanding a vial of haloperidol. No order, no chart #, no allergy information, nothing. All they tell me is that there is a psych patient flipping out in the emergency room and tossing stuff all over the place. To me, that sounds more like a security issue than a pharmacy issue. How the **** do they even plan on safely administering the haloperidol when the guy is swinging chairs around like a baseball bat?

5mg shot in the ass?

Did you ever have a psych rotation?

 

[Carboxide]

5mg shot in the ass?

Did you ever have a psych rotation?

Quiz question...why don't we use IM diazepam for patients who are seizing, and instead use rectal?



....think about it...




Because if you try to give an IM injection in a patient who is thrashing, they can actually break the needle off. It is not safe. Any patient who is in the state Sparda described is not going to get an IM injection either.

 

[All4MyDaughter]

Quiz question...why don't we use IM diazepam for patients who are seizing, and instead use rectal?



....think about it...




Because if you try to give an IM injection in a patient who is thrashing, they can actually break the needle off. It is not safe. Any patient who is in the state Sparda described is not going to get an IM injection either.

No, that is not why Diastat is preferred over IM diazepam for acute treatment of seizures. And yes, IM injections (haldol and other agents) are commonly used acutely to manage out of control psychiatric patients. How else are you going to deliver the drug in that situation?

 

[Bostonredsox]

1. Er nurses <<< icu nurses.
2. Neither rectal diazepam nor IM is indicated for seizures/status the onset is too slow. Lorazepam is the first line followed by phenytoin/fosphenytoin.
3. Haldol is a standard ed drug for psych pts they shouldn't have to bother you for it, it should be in their pyxus.

 

[rxlea]

No, that is not why Diastat is preferred over IM diazepam for acute treatment of seizures. And yes, IM injections (haldol and other agents) are commonly used acutely to manage out of control psychiatric patients. How else are you going to deliver the drug in that situation?

This

 

[rxlea]

1. Er nurses <<< icu nurses.
2. Neither rectal diazepam nor IM is indicated for seizures/status the onset is too slow. Lorazepam is the first line followed by phenytoin/fosphenytoin.
3. Haldol is a standard ed drug for psych pts they shouldn't have to bother you for it, it should be in their pyxus.

Yep. And haldol is in our Pyxis.

 

[Carboxide]

No, that is not why Diastat is preferred over IM diazepam for acute treatment of seizures. And yes, IM injections (haldol and other agents) are commonly used acutely to manage out of control psychiatric patients. How else are you going to deliver the drug in that situation?

K. I'll let you argue that one with our psychiatric pharmacist, who feels very strongly about IM drugs being used in agitated or seizing patients.

 

[Sparda29]

1. Er nurses <<< icu nurses.
2. Neither rectal diazepam nor IM is indicated for seizures/status the onset is too slow. Lorazepam is the first line followed by phenytoin/fosphenytoin.
3. Haldol is a standard ed drug for psych pts they shouldn't have to bother you for it, it should be in their pyxus.

It is in their Pyxis, however they can't get it out of the Pyxis without an active medical record. This guy was still not admitted so they wouldn't be able to take it out of there.

We ended up going over there with a paper to take a order on and a vial of haldol. All of a sudden when me and the clinical pharmacist arrive there, he just looks at the clinical pharmacist and is all like "heyyy baby". We ask him if he has any allergies, he says no so we give the vial to the nurse and then watched the debacle ensue as he whacked like 5 nurses with a chair before someone managed to inject it. I was hoping to see him take out more nurses, lol.

Personally, I hate this current medical mindset about agitation/violent outbursts having to be treated chemically.

 

[praetorianz]

I get it with the Levophe🙂 d and Vasopressin and critical care drugs.

But something happened the other day that just blew my mind. ER nurse and an ER tech come running over demanding a vial of haloperidol. No order, no chart #, no allergy information, nothing. All they tell me is that there is a psych patient flipping out in the emergency room and tossing stuff all over the place. To me, that sounds more like a security issue than a pharmacy issue. How the **** do they even plan on safely administering the haloperidol when the guy is swinging chairs around like a baseball bat?

 

[All4MyDaughter]

1. Er nurses <<< icu nurses.
2. Neither rectal diazepam nor IM is indicated for seizures/status the onset is too slow. Lorazepam is the first line followed by phenytoin/fosphenytoin.
3. Haldol is a standard ed drug for psych pts they shouldn't have to bother you for it, it should be in their pyxus.

I've seen intra-nasal midazolam used for status in pediatrics. But the issue wasn't "what's the drug of choice?" I was responding to the statement comparing rectal diazepam to IM diazepam. When comparing dosage forms of diazepam, rectal is still preferable to IM because of faster onset and more complete absorption. Rectal diazepam is still used outpatient - I have patients who have it in their home for their caregivers to use. I have also compounded a clonazepam preparation for this purpose.

K. I'll let you argue that one with our psychiatric pharmacist, who feels very strongly about IM drugs being used in agitated or seizing patients.

Not at all interested in arguing with your pharmacist. But you should know that this is his opinion, and doesn't reflect clinical practice everywhere. At the facility where I worked, certain patients had standing orders for for IM olanazpine, haldol and sometimes Geodon in cases of extreme agitation or med refusal.

You never answered my question about how to get an extremely agitated patient to calm down if you aren't going to give them an IM med. Redirection only works some of the time and, at least in my area, the use of restraints and seclusion is extremely limited.

 

[SpecterGT260]

I've seen intra-nasal midazolam used for status in pediatrics. But the issue wasn't "what's the drug of choice?" I was responding to the statement comparing rectal diazepam to IM diazepam. When comparing dosage forms of diazepam, rectal is still preferable to IM because of faster onset and more complete absorption. Rectal diazepam is still used outpatient - I have patients who have it in their home for their caregivers to use. I have also compounded a clonazepam preparation for this purpose.



Not at all interested in arguing with your pharmacist. But you should know that this is his opinion, and doesn't reflect clinical practice everywhere. At the facility where I worked, certain patients had standing orders for for IM olanazpine, haldol and sometimes Geodon in cases of extreme agitation or med refusal.

You never answered my question about how to get an extremely agitated patient to calm down if you aren't going to give them an IM med. Redirection only works some of the time and, at least in my area, the use of restraints and seclusion is extremely limited.

What gauge needle are we talking about? Many out there are flexible enough that broken needles is the least of my worries. Honestly if rather go for the big meaty ass cheek with a small needle than try to administer anything rectally to an agitated and combative pt.

Sent from my DROID RAZR using SDN Mobile

 

[All4MyDaughter]

What gauge needle are we talking about? Many out there are flexible enough that broken needles is the least of my worries. Honestly if rather go for the big meaty ass cheek with a small needle than try to administer anything rectally to an agitated and combative pt.

Sent from my DROID RAZR using SDN Mobile

Right?!? At my facility, if someone needed IM meds because they were agitated or refused meds, the mental health techs (the big males usually) just held them down on the bed so the nurse could administer the injection. The nurses were fast and efficient and it did not appear extremely difficult (although I did not participate). I would rate the risk of "needle breakage" as pretty low.

 

[SpecterGT260]

Right?!? At my facility, if someone needed IM meds because they were agitated or refused meds, the mental health techs (the big males usually) just held them down on the bed so the nurse could administer the injection. The nurses were fast and efficient and it did not appear extremely difficult (although I did not participate). I would rate the risk of "needle breakage" as pretty low.

And again, there are some soft needles out there. I have no idea what the dose is or what volume is being pushed, but if this can be done with a fine needle, you can basically wrap those around a straw without breaking or losing the lumen. These may be inappropriate here, I'm just saying anything approaching that won't be an issue. In and out in under a second and if the pt jerks it bends but doesn't break.

Sent from my DROID RAZR using SDN Mobile

 

[Ackj]

That is because it does. This is why their patients are denoted as 'critically ill". When I write for levophed and vasopressin I damn well expect them to come up before the cipro on the asymptomatic UTI 80 year old on the floor. If they are calling you because their pts plavix is missing then you have a valid point. But in general, my nurses are calling down because the drips are not coming fast enough or they come back from the pixus saying 'they havent restocked the ketamine and the Roc, keep bagging for now".

Why you treating? And why cipro?

 

[SpecterGT260]

Why you treating? And why cipro?

It is excreted unmetabolized by the kidney = gets to bladder and urethra in active form.

UTIs can have some bad sequelae if left untreated even if asymptomatic. Gram negative shock in an 80 year old is enough to justify just going after it.

There may be drugs with better profiles out there now making cipro more of an old school treatment, but I'm not sure. Its ability to cover pseudomonas in the bladder PO is kinda neat though.

Sent from my DROID RAZR using SDN Mobile

 

[njac]

1. Er nurses <<< icu nurses.
2. Neither rectal diazepam nor IM is indicated for seizures/status the onset is too slow. Lorazepam is the first line followed by phenytoin/fosphenytoin.
3. Haldol is a standard ed drug for psych pts they shouldn't have to bother you for it, it should be in their pyxus.

I don't like giving anything IM in status, but if that's all we have access wise, IM.or intranasal versed is the way to go - more hydrophilic so better absorption.

At my hospital the Ed nurses >>> icu nurses, but I know that's not the case everywhere.

 

[Bostonredsox]

For the peds rectal diazepam, idk I don't see kids but I trust your correct. Clearly rectal is favored over IM in terms of absorption time. But the standard of care for true status is IV lorazepam. If no IV then give IM. Given the lorazepam shortages our machines are stocked with midazolam for IV/IM use in status.

As for the arguement about what your psych pharmacist feels about giving IM meds to out of control combative pts, I could care less. Unless he is going to come up and pin down the 6'5 250 pound college kid wacked out on PCP his opinion is irrelevant to me. I use IM haloperidol/geodon/zyprexa like its going out of style In Addition to benzos in anyway I can get them in.

And as for the student questioning my uti analagy, there are three scenarios in which all UTIs are treated regardless of symptoms. You should learn them prior to commenting. I use Levaquin at my shop as you guys interchange cipro I assume because of cost, most commonly based on our areas antibiogram statistics and cephalosporin resistance. Pts who are sick enough from their uti to be in the hospital are too sick for PO bactrim or macrobid, and they invariably have impaired GFRs anyway. If their cultures come back sensitive to those agents or even pcn I will discharge them in high dose Amox, but I do not use them as initial anti microbial agents for hospitalized pts with utis who are more often than not septic.

 

[njac]

I don't have it in front of me, but there are studies showing intranasal midaz to be superior to pr diazepam, and equivalent to Iv diazepam.

But I've got scotch on board, so no links.

I'm the Ed pharmacist. I give psycho patients IM meds every single day. Never seen a bent needle.

 

[njac]

The guidelines do prefer iv lorazepam - but if you have to give im, give midaz, and if suspected febrile sz give midaz because its shorter acting so you can discharge the kid faster.

 

[rph3664]

We still have a bullet proof glass + RFID access card separating the pharmacy from the floor. Pharmacists have had their cars keyed/tires slashed by nurses who didn't like how they were treated by pharmacy (when you come in at the same time every day, people start to learn which car you drive, and quite a few nurses are jealous of the flashy cars the pharmacists here drive).

Lunch/restroom, you got me there. I get a one hour lunch break every day where I go home and have dinner or nap. It's so amazing to be able to go home and nap in your own bed during your break. This doesn't include bathroom/lemme go grab a coffee breaks.

😱

I wouldn't want a nurse like that working there, or anywhere for that matter! That is absolutely horrifying.

You must work at a very small hospital, because with very few exceptions, nobody knew what car someone drove, and people would park in different places every day depending on when they got to work or if other events were going on in the area. And for the most part, the pharmacists I've worked with over the years didn't drive flashy cars, except for the one I worked with at the grocery store who owned two Corvettes but he didn't drive those to work. He had his own store for some years, and selling it had made him a very wealthy man.

p.s. My old hospital had an employees-only retail division, and there was a nurse one time who was angry because her RX wasn't ready, so she started throwing things through the slot in the window. They included her soda bottle AND HER NAME BADGE which was why she almost lost her job for that.

 

[Sparda29]

😱

I wouldn't want a nurse like that working there, or anywhere for that matter! That is absolutely horrifying.

You must work at a very small hospital, because with very few exceptions, nobody knew what car someone drove, and people would park in different places every day depending on when they got to work or if other events were going on in the area. And for the most part, the pharmacists I've worked with over the years didn't drive flashy cars, except for the one I worked with at the grocery store who owned two Corvettes but he didn't drive those to work. He had his own store for some years, and selling it had made him a very wealthy man.

p.s. My old hospital had an employees-only retail division, and there was a nurse one time who was angry because her RX wasn't ready, so she started throwing things through the slot in the window. They included her soda bottle AND HER NAME BADGE which was why she almost lost her job for that.

It is pretty small (a little over 300 beds). Parking is so limited though, so that's probably how people figure out who you are. What I meant by flashy is the Corvettes, BMWs, etc, nothing crazy like Ferraris. However, there are quite a few docs at my hospital who have some nice exotic cars and they always seem to park next to each other right by the front of the parking lot.

I would only come to this hospital for orthopedic surgery since that's like the one thing they are awesome at here.

 

[Taraleigh]

They like to have everything signed off not just "not available". There are warden nurses that patrol and will get mad at other nurses that they did not phone pharmacy to track down the medication and get an ETA(even just for Cipro.) Hospitals should have 24hr pharmacy!

 

[Taraleigh]

Throwing things at people is assault. I hope you made a complaint to the police. There should be a zero tolerance for violence in healthcare. Violent patients should be restrained and violent employees fired! That is completely unacceptable.

 

[Sparda29]

My new issue with them is narcotics. Instead of ordering a large stock of narcotics while the narcotic pharmacist is here, they end up ordering it only when they need it, which usually ends up being while the other pharmacist is on break or I'm making an IV or something.

I don't get this, why not order your 50 Percocets at 9AM and keep them up there instead of coming down at 730PM for it. Then the remote times that someone does order a large stock of narcotics in the morning, the nurse who comes around to pick up her one narcotic order that she ordered 10 minute ago refuses to take the rest of them up.

 

[njac]

My new issue with them is narcotics. Instead of ordering a large stock of narcotics while the narcotic pharmacist is here, they end up ordering it only when they need it, which usually ends up being while the other pharmacist is on break or I'm making an IV or something.

I don't get this, why not order your 50 Percocets at 9AM and keep them up there instead of coming down at 730PM for it. Then the remote times that someone does order a large stock of narcotics in the morning, the nurse who comes around to pick up her one narcotic order that she ordered 10 minute ago refuses to take the rest of them up.

Why aren't the Percocet in your automated dispensing cabinet???

 

[owlegrad]

Why aren't the Percocet in your automated dispensing cabinet???

You took the words right out of my mouth.

 

[Sparda29]

Why aren't the Percocet in your automated dispensing cabinet???

Only the ER has a Pyxis for now. Everywhere else the narcotics are dispensed as floor stock and locked in a safe on the unit.

 

[njac]

Only the ER has a Pyxis for now. Everywhere else the narcotics are dispensed as floor stock and locked in a safe on the unit.

That makes sense for patient specific doses, but not something as common as a Percocet.