[needsmore$]

I agree with checking with your state board of nursing- are you allowed to dispense or does this fall under pharmaceutical practice? (something to consider) Our hospital stopped this practice as they discovered that insurance companies would not cover this cost- lost $$$ to them. In our ED, (we have a pyxis), the ED physicians can get out what they want if they want to dispense. The exception to this are ear/eye drops and/or ointments- once used by a patient- they cannot be "re-used" for others so we dispense if needed. ( I'm talking about antibiotic drops-). They must be carefully labeled in layman terms including directions, storage concerns, names of pt/ prescribing physician, content amt., date, phone # of prescribing unit, etc. (This is where the pharmaceutical standards of practice come in to play-)

We also used to dispense the reconstituted PO antibiotics for children- but now our pyxis is stocked with more unit doses than it used to be-

Have a safe holiday weekend everyone!

Anne

[srknurse]

I am a current Public Health Nurse (soon to be an ER nurse...in 1 month!), and I wish we could give medicines to go for our patients in the STD clinic....what I mean is, dispense additional medicines for the partners of the patients that have STD's.

I feel that if you are only treating one person, then you are not fully rectifying the situation...and there is no way to know if their partner will be tested and/or treated....as partner notification is not mandatory.

I am all for medicines to go...not only in this context, but others as well.

Interesting thread!

SRKnurse

[mommatrauma]

Originally Posted by srknurse

I am a current Public Health Nurse (soon to be an ER nurse...in 1 month!), and I wish we could give medicines to go for our patients in the STD clinic....what I mean is, dispense additional medicines for the partners of the patients that have STD's.

I feel that if you are only treating one person, then you are not fully rectifying the situation...and there is no way to know if their partner will be tested and/or treated....as partner notification is not mandatory.

I am all for medicines to go...not only in this context, but others as well.

Interesting thread!

SRKnurse

It sounds good but gving out the extra to go meds doesn't guarantee treatment either...then you are assuming that they are even going to tell their partners they have or been treated for an STD, or that they even know what their partners name is let alone what they might be allergic to...I think that leaves a little too much open for error...

[srknurse]

You definitely have a point....it would be a legal liability nightmare if you dispensed to someone without knowing their allergic history. Furthermore, yes, you are right again...we have no definitive way of knowing if their partners did take the medicine or not. It's really an ethical dilemma all around, with no clear way of ensuring that everyone receives proper treatment.

However, some larger health departments in parts of this country are doing just this. My health department isn't that progressive, I guess

We are now asking clients to list their email address, as well as their physical address, so we have another means of attempting contact in case their test results are positive.

SRKnurse

[sgent]

I'm in Mississippi, which is definately underserved. Probably only a dozen 24 hour pharmacies in the entire state if you exclude Jackson, and they are definately NOT in the rural areas.

Here, Physicians and PA's (not NP's, don't ask) are completely exempted from the pharmacy law. They can dispense a month's worth or three month's worth.

However, the act of counting medicine, applying labels, and doing internaction checking (which is required by state law), is considered a pharmacy service. People (including nurses) who run afoul of this can be cited by the pharmacy board for practicing outside their scope of practice.

End result, the doctor can dispense the meds, or a PA. Which means that in your case, if you were in my state, I would have absolutely nothing to do with dispensing period -- other than preping a label and letting the MD apply it, as well as printing out patient education info. One the doctor counts the pill and affixes the labels, anyone can give it to the patient.

[moetrn1]

I work in a large popular university and this is an ongoing conflict with our doctors and lawyers vs nurses and our union. The state says we are not allowed to give pt meds to go home w/ that it is considered dispensing. The hospital lawyers and docs say we can because it is hospital policy. Policy does not mean it is the law. They don't seem to see it that way.

Originally Posted by mtnmom

I recently began work in a 10-bed ER in a rural area. The closest 24-hour pharmacy is close to an hour away, so it is common practice for our ER MD's to order a couple doses of meds (usually pain meds) sent "to go" with patients discharged after the local pharmacies close up shop (8 is the latest any of them stay open).

While I realize that this is done as a great convenience and is in the best interest of the patients, I and some of my co-workers are not entirely comfortable with the idea. For one thing, it could be construed as dispensing meds if a nurse gives the meds out...couldnt a nurse be cited for practice violation???

I guess my question to you all is, surely there are some of you out there who practice in a similar area where there is no 24-hr. pharmacy available. How does your institution handle it?

[mdslabod]

I get a big kick out of the folks that ask we have have "samples" lying around.

Originally Posted by moetrn1

I work in a large popular university and this is an ongoing conflict with our doctors and lawyers vs nurses and our union. The state says we are not allowed to give pt meds to go home w/ that it is considered dispensing. The hospital lawyers and docs say we can because it is hospital policy. Policy does not mean it is the law. They don't seem to see it that way.