Discharge medications not ready for pickup

[tcy12345, ASN]

I was discharging a patient who had insulin lispro and insulin lantus ordered. I was also having 2 other discharges at the same time. Pharmacy confirmed lispro is ready but lantus won't be for another 2 days. I was told need to find another pharmacy that carries lantus today. My other discharge was halted because I had to call around while house sup and charge nurse asking me what's the hold up for my other discharge.  So my question is: if patient has lispro already, is it  going to kill the patient if he doesn't have lantus for 2 days? 

[JKL33]

The more appropriate question is whether there is a better process than having an RN stop what they are doing in order to make random phone calls. I would have either turfed it to care management or perhaps the supervisor who is concerned with the hold up would like to help solve it. Seriously.

[kbrn2002, ADN, RN]

I don't understand how this became your problem in the first place. If the pharmacy doesn't have a med in stock why aren't they the one's looking for an alternate supplier?

Since they dumped it on you, it would be entirely appropriate to dump it yourself to somebody who is not working the floor. There's more issues here than just finding a needed med. First you have to cold call pharmacies to find the med. Does the pharmacy that has it in stock accept the patient's insurance? Insulin is darn expensive out of pocket. Does the pharmacy that does have it in stock either deliver free or are they easily accessible to the patient?  Just getting the med filled doesn't guarantee the patient will even pick it up if cost of location makes getting there a hardship. All this is time consuming and shouldn't be attempted when you are responsible for patient care. The supervisor or discharge planner should have taken on this task.

[canoehead, BSN, RN]

I agree. Ask your charge or supervisor to make the calls while you get the tasks done they are requesting. You aren't a damned octopus.

[HiddenAngels]

Yes this is usually done by the Physician and CM.  Physician because they may need to switch the brand or order a different med once CM tells them whether or not it will be covered by the patient's insurance.  Also either the Physician or CM can call around to see which meds are carried or in stock at the patient's chosen pharmacies. 

To answer your initial question, yes, it can hurt if they don't receive their long-acting insulin, absolutely.  Always err on the side of caution.