No, He CAN'T Wait Another 6 Hours for the Med

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  1. This is a discussion on No, He CAN'T Wait Another 6 Hours for the Med in Hospice Nursing, part of Nursing Specialties ... Was at a call yesterday morning for an actively dying Pt. Family around the bedside, tearful, Pt...

    by Jul 3, '09
    Was at a call yesterday morning for an actively dying Pt. Family around the bedside, tearful, Pt gurgling more than my old coffee maker.

    Yep, there's a day old order for Atropine prn on our chart. So, off I go the the facility nursing station to ask when it was last given. Ooops, none on site, and the NH pharmacy usually doesn't make it's morning deliveries until 1100--it's now a little past 0500. :angryfire

    Atropine isn't the only med that this happens with, either.
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    by rngolfer53 Jul 3, '09 5:01 am
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  3. 8 Comments so far...

  4. Jul 3, '09 by
    Our company has a pharmacy we use that provides 24/7 coverage for meds. Since we are paying for these meds, our point is that we use the pharmacy we want...not the facility pharmacy. The list of meds we pay for are clear and when we receive an order from the doc we call OUR pharmacy directly and have them delivered in a timely manner. It is also cost effective as we have a contract that spells out the markup. Hope this suggestion helps.
  5. Jul 3, '09 by
    that seriously stinks.
    any form of scopolamine available?
    levsin gtts?
    e-kit??

    for whatever reason a pt may be wet, i always remind the family that it's much harder on them than it is the pt.
    it seems to somewhat help.

    anyways, that's pretty shabby and inexcusable.
    it shouldn't have happened.

    leslie
  6. Jul 6, '09 by
    Lucky for you who has a 24/7 pharmacy available!!!!
    we sink or swim on off shifts
    there shooudl be legislation that we are allowed to carry emergency meds for the late admissions, for the ones we run out of meds in the middle of the night.....
    there should be a lot of things.....in a perfect world.... but this sort of mess should not happen in a facility, yet is does more so then not
  7. Jul 7, '09 by
    Quote from leslie :-D
    that seriously stinks.
    any form of scopolamine available?
    levsin gtts?
    e-kit??

    for whatever reason a pt may be wet, i always remind the family that it's much harder on them than it is the pt.
    it seems to somewhat help.

    anyways, that's pretty shabby and inexcusable.
    it shouldn't have happened.

    leslie
    I make it a point to educate families on it, and it usually does help, but you still feel bad when they have to listen to it longer than absolutely unavoidable.

    The staff at the NH was actually pretty attentive to the Pt and family, and did what they could. I don't know what kind of hassle they get from their pharmacy--or more to the point, what after-hours delivery charge they incur--but it really isn't the Pt's problem.

    Most of our home Pts use our pharmacy, and I don't hesitate to get them out if it's needed. Usually, a little planning goes a long way to prevent it, and our day teams do a reliably good job in that.
    leslie :-D likes this.
  8. Jul 7, '09 by
    Quote from Ginapixi
    Lucky for you who has a 24/7 pharmacy available!!!!
    we sink or swim on off shifts
    there shooudl be legislation that we are allowed to carry emergency meds for the late admissions, for the ones we run out of meds in the middle of the night.....
    there should be a lot of things.....in a perfect world.... but this sort of mess should not happen in a facility, yet is does more so then not
    Actually, I would not want to carry meds, especially in some of the areas I visit, and I work nights, too.

    Once people know nurses have drugs, it would be like the old Far Side cartoon of the deer with the target on his chest, and his friend saying "Bummer of a birth mark, Hal."

    Most of the NH's I go to are willing to borrow from another Pt, or get their pharmacy to deliver what's needed stat, but a few are just plain lousy. Or perhaps it's just the individual nurse that doesn't want to explain an extra charge, listen to the pharmacist complain about being rousted at 0400, etc.
  9. Jul 7, '09 by
    Quote from rngolfer53
    Actually, I would not want to carry meds, especially in some of the areas I visit, and I work nights, too.

    Once people know nurses have drugs, it would be like the old Far Side cartoon of the deer with the target on his chest, and his friend saying "Bummer of a birth mark, Hal."

    Most of the NH's I go to are willing to borrow from another Pt, or get their pharmacy to deliver what's needed stat, but a few are just plain lousy. Or perhaps it's just the individual nurse that doesn't want to explain an extra charge, listen to the pharmacist complain about being rousted at 0400, etc.
    Yes some of the inner city areas are not the best, then again way out in bumble county, far away from the next pharmacy, over 2 hrs from civilisation and things go from worse to bad, yes I would like to have some emergency stuff if needed.... but we were talking facility to start with: facilities are a whole other ball game and thankfully i do not have to deal with a lot; their rules and regs drive me crazy (what goes in one does not work in the next.....); and you are right, one nurse is willing to go the extra mile and the next one could care less
    alot of them you have your target birthmark on walking into the NH (no meds needed!) {can you tell i dislike NHs?:icon_roll}
  10. Jul 11, '09 by
    Quote from rngolfer53
    Was at a call yesterday morning for an actively dying Pt. Family around the bedside, tearful, Pt gurgling more than my old coffee maker.

    Yep, there's a day old order for Atropine prn on our chart. So, off I go the the facility nursing station to ask when it was last given. Ooops, none on site, and the NH pharmacy usually doesn't make it's morning deliveries until 1100--it's now a little past 0500. :angryfire

    Atropine isn't the only med that this happens with, either.
    That needs to be addressed! Not cool. I don't blame you for being frustrated! Do you guys have an emergency kit? I would be complaining and bringing that up to the people in charge....
  11. Jul 11, '09 by
    Quote from HappyJaxRN
    That needs to be addressed! Not cool. I don't blame you for being frustrated! Do you guys have an emergency kit? I would be complaining and bringing that up to the people in charge....
    Our home Pts almost always have E-kits in the home, but nursing homes are a hodgepodge. Lots do, but some don't. As I say, most are good at doing what's needed to keep the Pt and family comfortable.

    Then there are the others...........................................