Calling In Scripts

Nurses General Nursing

Published

My hospital has been trying to nudge the physicians into writing more prescriptions for patients to take to their pharmacies to get filled instead of calling them in.

In the past, the dr's just wrote out discharge meds and left it up to nursing to decide what is an old med and what is new and needs to be called in. There were rarely instructions for # and refill, it was just left up to nursing to figure it out.

This still largely occurs, but dr's ARE writing more scripts, which I think the gold standard is for the patient to present it personally to the pharmacy so they have it right in front of them when filling. Second best is faxing it. But then you have a variety of things that people do with the originals, everything from handing them back to the patients (amazingly, this happens frequently on my unit!) to writing "faxed" on it and placing it on the cahrt, to destroying the original.

My problem is with patients who won't take the paper prescription and insist it be called in. There are a few pharmacies around here that either don't have faxes or have been known to "lose" the fax and the patients end up with NO meds (of coorifice it is the nurses's fault).

I always insist if the dr writes a paper script that the patient take it, even if they give me a hard time (and mostly, they do).

I explain that it is a safety initiative, that by physically taking the script to the pharmacy they are significantly reducing the chance of a med error, and point out how med errors have been cited in the news as so dangerous.

Does anyone see this reluctance to take their own scripts to the pharmacy or is this a regional thing? Our patients ARE pretty used to being spoiled by the hospitals areound here and pretty much getting anything they want. (I don't feel like going home yet. Maybe tomorrow. The food is so good!)

Specializes in Psychiatry, Case Management, also OR/OB.

The way I do it, and I am a Mid-Level Practitioner at our hospital... dr gives a written order for dismissal -- dc pt to home.... continue the following medications, doses written duration etc. Don't get me wrong, I'm not pulling rx's out of thin air, its what the doc wants at dismissal. Some of the physicians who have NP's or PA's will do that, but some hospitals are not staffed with this level of care or docs don't employ them. NO NURSE can call in scheduled drugs without her own DEA#, even though I am an ARNP, in my state you have to be "prescribing under physician protocols ", that is a doc u work for. If nurses are calling in scheduled drugs, and giving the doc's DEA #, and he's OK with that, both are in for a big surprise one day. Nurse Manager too. And why in God's name are these #s on the computer system... I mean that is really crazy. Computer systems get hacked, no matter where u are, and that is asking for trouble, IMO. Oh well, this is turning into a rant.... sorry . :angryfire

Just watch what u do, because the state and pharmacies will.

we do call in scripts from the ER occasionally, if there is a good reason to do so (Pt had conscious sedation procedure, etc.). The DEA and license #s are right on the script pad for the ER docs, and they are also on file at the local pharmacies. We do not destroy the original script, we void it and write "called in" and keep it in the medical records. The inpts are expected to take their own hard copies to get them filled, they are not called in.

Thanks for all the replies.

I am pretty much the only one not willing to phone is a script on patient demand around here when a written one is available. Management also is more concerned with patient satisfaction in giving them what they want (not having to wait at the pharmacy....the hell with safety!)

Also, physician satisfaction is high on their list, so making them do something they're not accostomed to (writing rx instructions) is not easy in this good-old-boy atmosphere.

You know, I think I'll go back to hounding the docs for specific instructions on d/c meds, while the patient waits IMpatiently to go home and the ER is circling like vultures for the room to become available!

I wouldn't do it myself.

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