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

yes another example of tying the nurses hands behind her back!!! You better give that pain medicine!! but how you get it is beyond me lol. I have never looked as myself as an "agent fo the prescriber" I just thought that you were suppose help the resident when they hurt and I teach ours to do that quickly so I guess I better get all the docs in my facility on speed dial as well. After enough 2am calls they might get the laws changed lol.

It was just in McKnights Long Term Care News last week that enough of us nurses have contact our congressmen and senators that they are putting the pressure on the DEA to lighten up.

sounds like an issue that needs to be brought to the medical director of your facility's attention. This will call for a change in your policy. Then an inservice to the MD's that admit residents to your facility. From what you say it sounds like after you get a verbal order from an MD the MD needs to call the pharmacy. This would mean that a pharmacy would need to be available to take the calls 24/7. If a resident has a change of condition or pain then the nurses must notify an MD doesnt matter what time of the day or night. This all comes down to assessment. If a resident experienced sudden, severe, unusual pain I would want to send them to the hospital unless they had an advance directive requesting no hospitalization. I dont understand how an MD could perscribe a pain med without knowing what the cause is.

I don't think you live in MY world...speak to the medical director?? He doesn't answer his phone half the time. Tell the docs what you want. I've been in the business for more than 25 years and the docs still don't get it. My pharmacy told me the DEA has to have something to do and going after nurses in LTC is far safer than going after the drug lords who bring in tons of cocaine.

See the OBRA ACT of 1987 says we have to give pain meds and reassess the effectiveness in a timely manner ?? hm and we have to make a doc call the pharmacy ours is 4 hours away. WE dont have an e-kit and if our people hurt after 10pm they go to the hospital period because we dont keep anything stronger than vicodin. We asked the pharmacy to give us and e-kit with narcs but they avoid this so we just send them out. Poos resident that has horrible compression fractures for example get out in the cold on a stretcher to get pain meds. What is wrong with this picture??? Yes I live close to the mexico border the DEA could surely go watch out for some loads of dope crossing but yes that is dangerous and slapping a cuff on a nurse seems much easier

Yep we just got a letter put up in our nursing home sayng we are no longer allowed to remove narcs from the e-kit without phamacy approval. We must fax over a sheet that they will confirm or deny that we have the right to open the ekit. There have been a couple instances that pharmacy has denied our request even though it was a refill order to begin with. We've been told we'll be written up if we dont follow protocol. So until we get things straightened out hopefully tylenol holds out the pain. Its sad because it takes away the whole purpose of an E-kit and leaves residents in pain.

In what universe are nurses "agents of the prescribers"? I don't work for the facility docs. I work for the facility. I am an agent of the facility and have to do what the facility AND the scope of the nurse practice act determine to be correct. If it insists that I follow the DEA directive, I will. At the same time, I will speak my mind and make my concerns known as I cannot believe that patients in pain are well served by this directive.

Well, the facility is responsible for setting up a procedure that will meet the DEA requirement and meet the needs of the patient at the same time. Now I don't work LTC but I would imagine that one thing that would be required is a good assessment on nights and early on days to determine the pts pain needs so that you can get in touch with the physician during regular hours so you can hopefully get the pain meds ordered before you will need them for after hours.

That being said, what ever system the managers come up with they have to suffer with. And I guarantee you that if they come up with some stupid policy that says that a certain person has to be called at all times when this issue comes up, after you call them at 3 am for about two weeks in a row, they will figure out another way to go about it. You won't get what you need until they have the problem dumped in their lap. And it gets dumped in their lap when they are called at 3 am.

I imagine that the DEA has a very good reason for making this change in rules and I am sure that all of us are going to suffer some changes in the way we administer and prescribe pain medications. Abuse of "legal" pain medications has gotten so out of hand.

This is crazy. Maybe when everybody is admitted we Nurses will have to get a PRN order for pain med, however our narc drawers will be full and we will have the duty of counting all the stuff that most won't ever use, but what do you do? Call the doctor and get a script? Good luck. Call the pharmacy and get them to call the doctor for an ok?- haha that is even funnier....

has anyone heard any new info?

The office of aging (congress) sent the DEA a very strongly worded letter on oct. 16. they have obviously been listening to nurses and docs about this. the letter lays out specifically the problems pts are facing now. they even went so far as to tell the DEA that while we are trying to follow their guidelines/laws that we are being tagged by CMS for not treating pts for pain. we are damned either way. the letter requested that the DEA respond within 20 days but i havent found any response from them yet.

keep writing congress guys! drown the office of aging with letters! we have got to get this changed.