d/c with meds....are you a RN or Phamacist?

[shinerchia]

I work in a busy ER with a pharmacy that closes at the drop of a hat. Consequently, we don't send folks to pharmacy upon d/c much of the time; we fill, mix, and dispense their meds so they can go home with the drugs they need.

I have brought up the practice to my command and they pulled out the "well, that's the way we've always done it" answer. Having done a lot of legal research on my own, I find reference after reference in my state of licensure and the one in which I practice that say docs, PA's, and ARNPs can dispense manufacturers sample packs for home....but not a RN mixing meds and sending folks home....and certainly not filling scripts (which we are expected to do when the pharmacy closes for the 4-day holiday/training day/family day/you name it day).

Anyone else find that she/he is in the same predicament? If so, have you ever been provided with a reference from the military or DoD that said you were exempt from laws and could fill in as the PharmD when it was convenient?

"Integrity last, self before service, and mediocrity in everything we do" are our core values here ...just curious how the rest of the AF is doing.

As always, my opinions are mine only and not that of the Air Force

[shinerchia]

I've been polling military RNs everywhere I can and the common thread is that they have never worked in the real world. All they know is military nursing so all they know is what command tells them. Unfortunately, they've never worked in a civilian corporate run hospital that shoves law down your throat every day to make sure they don't get sued.

I have the luxury of knowing the law since I worked as a civilian. If you are a military nurse and fill scripts, dispense, etc, please let me know. Our OI where I work addresses the subject and says it has to be an MD to send a pt home with meds. Local laws say they can do it if it is a manufacturer's sample pack.

Let's not let ignorance rule while we break the law every few minutes. As officers we have to have integrity, which means we can't follow practice laws when they suit our command.

My opinion is not meant to harm, discourage, nor inflame. Nothing I post is related to the official views of the U.S. Air Force. My views are my own!

[RNPATL, DNP, RN]

I can not comment on the military portion of your post, but at the VA, RN's do not do this. Of course, at night, the supervisor may pull medication here or there, but there is no mixing or dispensing of perscriptions. Yes, you are right, working for the DoD does give us some freedoms .... but there is a clear standard of what an RN can and can not do.

Good luck standing your ground. Sounds like you are in the right.

[Hellllllo Nurse, BSN, RN]

[quote=shinerchiaI've been polling military RNs everywhere I can and the common thread is that they have never worked in the real world. All they know is military nursing so all they know is what command tells them. Unfortunately, they've never worked in a civilian corporate run hospital that shoves law down your throat every day to make sure they don't get sued

I work in a civilian, corporate, for-profit facility. RNs are pressured into dispensing meds there, too.

[jmoli4]

I work in a South African military hospital and although we are subject to military law, we are still governed by the nursing act in our country. This act contains certain regulations, of which one is the scope of practice of the Registered Nurse. Any "illegal" order must therefore be ignored and military orders does not take precedence over this.

Registered Nurses may, however, dispense medicines in special circumstances, but a 6-month short course must be completed, or a 1-year primary health care course. This is especially relevant to the military as military RN's currently deploy to Burundi and the Democratic Republic of the Congo (on UN peacekeeping missions) and Dr's are not always available.

You (the RN) may however not dispense medicines in a hospital setting, or when a Dr is available. We had similiar demands a few years back (having to dispense meds at he after hours casualty dept), but through negotiation and communication (and application of or scope of practice) managed to resolve it.

I work in a busy ER with a pharmacy that closes at the drop of a hat. Consequently, we don't send folks to pharmacy upon d/c much of the time; we fill, mix, and dispense their meds so they can go home with the drugs they need.

I have brought up the practice to my command and they pulled out the "well, that's the way we've always done it" answer. Having done a lot of legal research on my own, I find reference after reference in my state of licensure and the one in which I practice that say docs, PA's, and ARNPs can dispense manufacturers sample packs for home....but not a RN mixing meds and sending folks home....and certainly not filling scripts (which we are expected to do when the pharmacy closes for the 4-day holiday/training day/family day/you name it day).

Anyone else find that she/he is in the same predicament? If so, have you ever been provided with a reference from the military or DoD that said you were exempt from laws and could fill in as the PharmD when it was convenient?

"Integrity last, self before service, and mediocrity in everything we do" are our core values here ...just curious how the rest of the AF is doing.

As always, my opinions are mine only and not that of the Air Force