NEW DR.'S ORDERS.....How do the medication orders get to the pharmacy ? - page 4

I work on the most inefficient unit in the country. !!! Or it's me !! Here is my question. I would like to hear how other hospitals are handling this. Forget standing orders. The doctor... Read More

  1. by   nitenurse78
    Oh yeah and at night pharmacy is closed. If it's not in the pixis then we'll have to page the house supervisor.
  2. by   nitenurse78
    Oh yeah we fax too. but now with hippa we don't do it as often because of the risks of wrong fax numbers being dialed and Personal health information being sent to the wrong place. ect... Yes, it is a hassle.
  3. by   nitenurse78
    WOW! I always said our hospital needs a tube for lab specimens. We have to take the elevator down and it would be so easy to make a little tube, the lab is directly below us!!!!
  4. by   HappyNurse2005
    We also just take the order sheet that the doc wrote the med order on and scan it down to pharmacy (special fax type machine), then stamp it with a stamp that says "scanned" so we know its been done.
    someone on the other end will enter this med into the computer so we can get it out of pyxis and it shows up on hte mak. If, by chance, its one of the few uncommon meds that we dont keep in our pyxis, they'll use the pneumatic tube. (or bring it to us, if its a narc). If its a stat order, we scan it down with a big stat sticker on it.

    Of course, sometimes I doubt that stat means anything to hte pharmacy. THey can be slow as snot. I've scanned it stat, called the pharmacy to put the rush on it, scanned it stat again.......

    Thats when you use the override feature on the pyxis machine to get out certain meds before pharmacy puts them in.
  5. by   HappyNurse2005
    WOW! I always said our hospital needs a tube for lab specimens. We have to take the elevator down and it would be so easy to make a little tube, the lab is directly below us!!!!
    Yeah, we use the tube for lab specimens, too. Double bag them, and the tube has foam padding, too.
    Love it.
  6. by   nitenurse78
    WOW!!! We'd have to find our unit secretary a new job. But that is awsome!!! I've always wondered Why Doctors don't just type all orders instead of writing them.
  7. by   gypsyangelrn
    On days and evening shifts there is a pharmacist with his own computer who enters the orders into pyxis....and I will call him if I have a STAT med. On night shift we tube the order to pharmacy, again, with a call to the pharmacist for STATS.
  8. by   Marie_LPN, RN
    Fax machine, or the tube system. The fax is faster. Plus we've had STAT orders get stuck in the tube.
  9. by   RN12345656
    On the unit that I work on we have floor pharmacists. LOVE IT!!!
  10. by   CathRN
    I also work in a very inefficient hospital. we have the tube system, they pyxis and supposedly a pharmacist on the floor. Even with stat orders we have to fax, re-fax, and re-fax the orders all the time. When you call the pharmacy you get the standard "we didn't get it, re-fax it" at least 3 or 4 times before we get the medication. I can't tell you how many times I've written incident reports up on the pharmacy. The charge nurse tells me when I've got new orders and then says "how long before she calls the pharmacy and starts fussing at them"? ARGH!
  11. by   Indy
    Tube them down, put a note on it if I need it now, call if I need it yesterday. I had one patient crashing that I needed dopamine on, and no time to even write telephone orders on this patient. So I just called and said "look, no time to write order, so and so is trying to die on me, I need a bag of dopamine NOW please!!" And whattayaknow, they sent it up within a minute. Of course, within that minute another nurse had sprinted to ICU and grabbed one off floor stock and was halfway through programming the dose when I walked in the room with my bag. She was fast! It was another hour or so before I got the chance to write all the telephone orders down and send to pharmacy. So yes, we do have a lot of floor stock IV meds. Sometimes tho, it's a good idea to wait and let pharmacy call ya back...

    I had a lady with orders for a heparin drip. Tubed orders down, ER doc specified rate and bolus so I didn't have to figure it out, coworker primed my heparin bag and showed me the floor stock for the bolus. No problem. Draw my bolus, go give it and start the drip. I'm so proud of myself! Until I get back to the desk and the pharmacist wants to tell me that the reason he didn't send the bolus yet was that he thought they gave it in the ER.
    Oh me, oh my, the phone started to look a little wavy to me and I got this hot feeling... turns out we found no evidence that the bolus was given twice, but I could have done without that heart attack.

    If I do not need the meds till say, 8 am, 'cause they ordered nothing for the middle of the night on a new admit, I might put it in the box for the courier to take to pharmacy. But that hardly ever happens.
  12. by   christvs
    Quote from passing thru
    I work on the most inefficient unit in the country. !!!
    Or it's me !!

    Here is my question.
    I would like to hear how other hospitals are handling this.

    Forget standing orders.
    The doctor comes in and writes out new orders, a chest x-ray,
    a diet change, and 5-6 new medication orders.

    Now, forget the cxr and diet change.... I just wanna know,

    On your unit, How does the pharmacy get these new
    medication orders?

    When the doc writes new med orders or when we take telephone orders from them, we then simply fax the orders down to the pharmacy and then they appear in our pyxis machine shortly after (unless pharmacy has a question on something, in which case they'll call).
    -Christine

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