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

Nurses General Nursing

Published

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?

Specializes in everywhere.

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!

Specializes in ICU, telemetry, LTAC.

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!:eek: 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.

Specializes in ACNP-BC.
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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