DEA States that LTC Nurses Are No Longer Agents Of The Prescribers

Oh brother....this seems like it is going to be awful! Those poor, poor patients! I can understand the pharmancy would like a hard copy. This would be great in the real world. I can honestly say, I don't think it would go over well in my facility, since we have been known to wait and wait for a MD to call back. I know more than one nurse that would send these residents to the hospital for uncontrolled pain if the MD didn't call back/call the pharmancy. Is this a state to state thing?

It is not a state to state thing but it is federal. I am guessing at the rationale is that the DEA wants either the MD to personally evaluate the patient before prescribing a controlled substance or it is some bureaucrat that has been able to get this regulation past who has no idea how the real world works. Actually I wonder whether it has to be an MD providing the hard copy but rather anyone who has a DEA number and is able to write a script?
I know there has been a push to get rid of all verbal orders especially when EMR's get implemented.

I haven't heard of this regulation. We need to fax scripts for certain meds but not for Ativan or Vicodin. If we take anything out of the med kit, we need a script. For sure I'll be calling the pharmacy tomorrow.

This would be a great line for you to tell the greasy trial lawyer in you deposition. "The pharmD (yes another person who can actually obtain a doctorate besides an MD or DO) told me this would stop the patient's heart but dammit...."My BOSS told me to push the marcaine intravenously and I always do EXACTLY what my BOSS says".

Dude, is this REALLY the way you run your nursing practice?

Is this only LPNs or RNs also? It isn't clear from your title. I did take verbal orders for controlled substances as an LPN.

It's any nurse-LPN or RN. I spoke to my pharmacy and was told that this has been a regulation for years but now the DEA has started to try to enforce it. Just simply ridiculous.

This is federal. I have had this in place since March. It is an old law but, no one ever paid any attention to it. Because Omnicare is the largest in the nation, they were the ones who got the initial ding from the authorities. You can get an order over the phone BUT, you still need the script to get it filled. You can get the narc out of the e-kit BUT, before it is repaced in the e-kit it needs a script. We are now running quite smoothly iwth all of this in place. It takes a bit getting used to. Don't forget that the scripts need to have a quantity listed on it.

As long as I can get it from my e-kit I'm good.

Thanks.

I work in a Skilled LTC unit and we were informed of this 2 weeks ago w/c took effect. We are not allowed to get any starter from the C Box of any Schedule 11 Narcs order unless we have the form signed by the MD and Pharmacy has to have it in their hands before you can obtain the Narcotic.

A hard lesson learned when 2 days later after hearing of this I had a new admit who was in a LOT of pain d/t Severe Osteoarthritis, etc... She came in having only PRN Tylenol order. It made for a hellish two days at work having to deal with a very angry ' don't want to be bothered' MD on the Phone and having to have DON take over the situation
d/t angry family very upset why it's so hard to get a response from this MD.

FYI:

Keep in mind when receiving phone orders from MD- Know your list of schedule 2 Narcs and bring it to their attention to try something else so u can obtain it from the C Box. The first chance you get with the MD on the phone may be your last.

Yes my facility also started this about 6 months ago. It took awhile to get things started and get paperwork for it, but it does get easier. The only complaint I have is that Hospice people are suffering when they get a new order for Roxanol or Ativan or is a brand new resident, I have to track down the Doctor on the weekend for him to call in the scripts to the pharmacy. And yes that is what we did, but he got upset and told us to have the pharmacy call him. We waited 5 hours before we got the ok to pull it from our C-box.