What exactly does a IV pharmacist do?

[manjungs]

Well I have a general idea but if there is anybody who specifically works in IV field/as an IV pharmacist, could you please share the roles you're responsible for? Thank you in advance

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[Sparda29]

Well today I worked as the IV pharmacist. I pretty much stayed in the IV room all day long making IVs, TPNs, etc. Went around the hospital checking electrolyte levels on the patients who were given potassium + IV fluid orders, finding out if anything is being DC/ed, finding out if the patient needs to be on IV vs PO.

 

[joetrisman]

Well today I worked as the IV pharmacist. I pretty much stayed in the IV room all day long making IVs, TPNs, etc. Went around the hospital checking electrolyte levels on the patients who were given potassium + IV fluid orders, finding out if anything is being DC/ed, finding out if the patient needs to be on IV vs PO.

Harrowing

 

[cycloketocaine]

Harrowing

Truly harrowing.

 

[Sparda29]

I actually like doing IVs. It's calm, no phones going off every 5 seconds, there's an iPod dock in there so you can work with music in the background, and time flies since you have like 100-150 things to compound, so by the time you are done it is around 2PM. Music thing is funny because every day the music coming out of the IV room changes. Some of the older pharmacists, it's country and pop, super old pharmacists usually listen to classical, some of them like rap, I like heavy metal, house, and trance.

 

[Ackj]

I actually like doing IVs. It's calm, no phones going off every 5 seconds, there's an iPod dock in there so you can work with music in the background, and time flies since you have like 100-150 things to compound, so by the time you are done it is around 2PM. Music thing is funny because every day the music coming out of the IV room changes. Some of the older pharmacists, it's country and pop, super old pharmacists usually listen to classical, some of them like rap, I like heavy metal, house, and trance.

I've never seen the actual rph doing all the IVs. It's usually been techs and interns, with the IV pharmacist verifying the IV orders and checking them. I loved being an IV tech though, for all the reasons you mentioned. Peace and quiet, day flies by, and it's a nice climate controlled environment. Only downside is the chlorhexidine hand scrub annihilates your hands and your skin gets ridiculously dry.

You never struck me as a heavy metal guy.

 

[Sparda29]

I've never seen the actual rph doing all the IVs. It's usually been techs and interns, with the IV pharmacist verifying the IV orders and checking them. I loved being an IV tech though, for all the reasons you mentioned. Peace and quiet, day flies by, and it's a nice climate controlled environment. Only downside is the chlorhexidine hand scrub annihilates your hands and your skin gets ridiculously dry.

You never struck me as a heavy metal guy.

I'm into the older heavy metal bands like Iron Maiden, Judas Priest, Blind Guardian. I went to an Iron Maiden concert a couple of years ago, which happened to be at 7PM on a Monday. Most of the concertgoers were 35-50 year old men looking like they just got off work from the banks and stock exchange, untucked shirts, messed up ties and all.

Here, they have the techs making all the IV-advantage, minibags. IV orders that need to be compounded are made by an intern or the pharmacist. Being that we have no interns, other than an IPPE student that comes in once a week, we have the pharmacists make them.

 

[iFarm]

Here, they have the techs making all the IV-advantage, minibags. IV orders that need to be compounded are made by an intern or the pharmacist.

That seems like a huge waste of labor $$ to me...

 

[Sparda29]

That seems like a huge waste of labor $$ to me...

There might be something in NYS law that only allows pharmacists and pharmacy interns to compound. Not sure though. From what I know about the health-system, most of the hospitals that are part of it don't hire pharmacy interns.

 

[rxlea]

There might be something in NYS law that only allows pharmacists and pharmacy interns to compound. Not sure though. From what I know about the health-system, most of the hospitals that are part of it don't hire pharmacy interns.

figures you wouldn't know about the law in your state

 

[Ackj]

There might be something in NYS law that only allows pharmacists and pharmacy interns to compound. Not sure though. From what I know about the health-system, most of the hospitals that are part of it don't hire pharmacy interns.

That is true, but most facilities get around it by "batching" the IV orders. Apparently techs can do that, since it's not for any specific patient. However, sometimes the "batch" contains just one dose... oh well. That's how it's been done at all of the facilities I've been through, which includes 4 different regional health systems.

 

[Sparda29]

That is true, but most facilities get around it by "batching" the IV orders. Apparently techs can do that, since it's not for any specific patient. However, sometimes the "batch" contains just one dose... oh well. That's how it's been done at all of the facilities I've been through, which includes 4 different regional health systems.

That is true. For anything that can be batched by simply attaching a vial to a bag with a connector or twist-on connector, the techs make those and pharmacists check them.

For example, yesterday for one of the patients I entered 3 IV orders. One of them was for Vanco 1 gm, another for Primaxin 250 mg, and another for Levophed 16 mg/250 ml. The first 2 could be pre-made with the vials so I just grabbed those off of a shelf and labeled them, the Levophed I had to compound myself.

 

[Ackj]

That is true. For anything that can be batched by simply attaching a vial to a bag with a connector or twist-on connector, the techs make those and pharmacists check them.

For example, yesterday for one of the patients I entered 3 IV orders. One of them was for Vanco 1 gm, another for Primaxin 250 mg, and another for Levophed 16 mg/250 ml. The first 2 could be pre-made with the vials so I just grabbed those off of a shelf and labeled them, the Levophed I had to compound myself.

In your example, the tech would make a Levophed "batch" and then "coincidentally" there would be a patient order for it to be used. They're allowed to do all of the manipulations as long as they've been properly trained, and the pharmacist can verify what they did, ie leave the syringe pulled back to 16mL.

 

[Sparda29]

In your example, the tech would make a Levophed "batch" and then "coincidentally" there would be a patient order for it to be used. They're allowed to do all of the manipulations as long as they've been properly trained, and the pharmacist can verify what they did, ie leave the syringe pulled back to 16mL.

Once my facility shifts to CPOE, I believe that is what we are going to be headed to. Right now all the pharmacists and techs stay in the pharmacy but according to my DOP and the other bigwigs in the hospital, once the hospital shifts to CPOE, most pharmacists will be on the floors with a couple staying in the pharmacy to check tech work, dispense narcotics and anesthesia kits.

 

[smercer]

Sparda has a good setup if you are a tech.

Around here techs do the manual labor and pharmacists check/calculate everything + enter orders. Techs make all IV meds, standard drugs, chemo, and narcotics. As a previous poster stated the techs show what was done by pulling back syringes and showing drugs/fluids used.

Chemo and NICU orders are calculated by the pharmacist with a double check on the calc. by another pharmacist. Then the tech draws up the meds and the pharmacist checks them before they are compounded into the bag/syringe.

Pretty much they just do order entry and checking.

 

[Sparda29]

Sparda has a good setup if you are a tech.

Around here techs do the manual labor and pharmacists check/calculate everything + enter orders. Techs make all IV meds, standard drugs, chemo, and narcotics. As a previous poster stated the techs show what was done by pulling back syringes and showing drugs/fluids used.

Chemo and NICU orders are calculated by the pharmacist with a double check on the calc. by another pharmacist. Then the tech draws up the meds and the pharmacist checks them before they are compounded into the bag/syringe.

Pretty much they just do order entry and checking.

Techs spend a lot of time outside the pharmacy refilling Pyxis and delivering meds and unit dosing meds.

 

[Praziquantel86]

That is true, but most facilities get around it by "batching" the IV orders. Apparently techs can do that, since it's not for any specific patient. However, sometimes the "batch" contains just one dose... oh well. That's how it's been done at all of the facilities I've been through, which includes 4 different regional health systems.

This is the way we did it as well. In New York.

 

[Ackj]

This is the way we did it as well. In New York.

Since you're a UB alum, you are likely mentioning one of the facilities I'm talking about.