Does anyone else have this problem with their hospital pharmacy?

  1. Does anyone have any ideas about an ongoing dispute we have with our hospital pharmacy? Our hospital has "approved dosing schedule" which our pharmacy thinks should be followed without fail. Example: Last night I received an order for Zantac 2mg/kg q8hr on a 19 day old and I started it asap at 2200. Today I was "pleasantly reminded" that the approved dosing schedule would have the first dose given at midnight. My good nursing sense tells me new orders should be carried out asap and the "approved dosing schedule" can be adjusted.
    •  
  2. 15 Comments

  3. by   TinyNurse
    I am not aware of the usual ped zantac dosing, but, yes my pharmacy would SURE to let us ER nurses know when we could give it.........
  4. by   Tweety
    We have schedules that are recommended by the pharmacy, but it is the nurses discretion when it is given. We try to keep close to their schedule. For example in your case, I would have given it at 22:00 and maybe the next dose closer to the time the pharmacy wants, then eventually get to the pharmacies schedule.

    It's not their place to tell you when to give the meds. They just dispense them. In my not so humble opinion.
  5. by   Darchild77
    I so know what you are talking about, at our hospital, the nurses complain if the meds aren't "on schedule" and that you should get them on the pharmacy scheduled times!! this is rediculous to me, I'm not going to give a med an hour or two early just because it's more convenient!!:angryfire
  6. by   TaraER-RN
    In the ER the pharmacy has no say in when we give the meds...we give them when they are ordered and if we start the floor orders we give stat or "give first dose now" meds at the time we recieve them, and then I think they later get adjusted by the pharmacy for the floor
  7. by   rnmaven
    Quote from nursenancy57
    Does anyone have any ideas about an ongoing dispute we have with our hospital pharmacy? Our hospital has "approved dosing schedule" which our pharmacy thinks should be followed without fail. Example: Last night I received an order for Zantac 2mg/kg q8hr on a 19 day old and I started it asap at 2200. Today I was "pleasantly reminded" that the approved dosing schedule would have the first dose given at midnight. My good nursing sense tells me new orders should be carried out asap and the "approved dosing schedule" can be adjusted.
    I have worked at hospitals with very active (and quick) satellite pharmacies that set the schedule for a med based on when they dispense the medication. A nurse can override the schedule once it's in the system if necessary for a more accurate schedule of when the meds were administered by the nurse. But you can only make that change initially. After that you need to go to the pharmacist and state your case and they will change the times in the system.

    In my not so humble opinion, this is all about justifying all the Pharm.D's or clinical pharmacists who are employed by the hospital. After all, PharmD is the new minimal education for a pharmacist.....we need to justify the job!
  8. by   lever5
    What is PharmD? As a traveler I have run into many problems when the schedule is set by pharmacy, some people like to take their meds at night, some in the morning, the DR. sometimes write for specific times, sometimes I want to start an antibiotic right away, the scedule says wait,( for what, the bacteria to kill the pt?) I believe this is part of my scope of practice, there are too many variables for any one branch to have complete control.
  9. by   suzanne4
    A PharmD is essentially a clinical pharmacist. It is one year longer than the basic pharmacy program......................
  10. by   sharann
    Now, now...lets not be too hard on the pharmacists(even when they call 40 times in 2 hours to ask you what the order SAYS). We couldn't run the hospital without them just as they couldn't without us and others. Now, when they start telling me I have to call the M.D to clarify, grrrrrrrr
  11. by   fergus51
    We make our own schedules since po meds need to be given when the baby eats. If he doesn't eat at midnight, he won't be getting his med at midnight.
  12. by   Dplear
    A PharmD is more than just a clinical pharmacist. They have a doctorate in Pharmacy. Most PharmD's do work in the clinical setting but some work in the retail section.

    Big difference in the level's.

    Dave
  13. by   NicuGal
    We don't have that problem either. Unless it is a stat med, we get in on the next run, usually within the hour. You need to talk to your unit manager about this issue. I probably would have said, well Junior is eating in an hour, so I need it by then. Our antibiotics are stats and so are drips and one time dose Lasix and Dig.

    Now, IVF are a whole nother matter...what takes them so long to put some Calcium into a bag?
  14. by   Mimi2RN
    Our pharmacy puts times on the computer printed MAR, and we tell them when we really are giving the meds for the next nights MARs. We give the med as soon as we can, including overriding the pyxis when possible. There is a complication with qid and q6 meds, as we always give baby meds around the clock, and the pharmacy does not understand that.

    It amazes me how long it can take to get the meds from pharmacy, NicuGal, I do agree. Not only mixing the meds, but getting them to our unit! Luckily it's not far to run for things, but sometimes not possible.

close