Does anyone else have this problem with their hospital pharmacy?

[nursenancy57]

Does anyone have any ideas about an ongoing dispute we have with our hospital pharmacy? Our hospital has "approved dosing schedule" which our pharmacy thinks should be followed without fail. Example: Last night I received an order for Zantac 2mg/kg q8hr on a 19 day old and I started it asap at 2200. Today I was "pleasantly reminded" that the approved dosing schedule would have the first dose given at midnight. My good nursing sense tells me new orders should be carried out asap and the "approved dosing schedule" can be adjusted.

[Mimi2RN, ASN, RN]

Our pharmacy puts times on the computer printed MAR, and we tell them when we really are giving the meds for the next nights MARs. We give the med as soon as we can, including overriding the pyxis when possible. There is a complication with qid and q6 meds, as we always give baby meds around the clock, and the pharmacy does not understand that.

It amazes me how long it can take to get the meds from pharmacy, NicuGal, I do agree. Not only mixing the meds, but getting them to our unit! Luckily it's not far to run for things, but sometimes not possible.

[rnmaven]

What is PharmD? As a traveler I have run into many problems when the schedule is set by pharmacy, some people like to take their meds at night, some in the morning, the DR. sometimes write for specific times, sometimes I want to start an antibiotic right away, the scedule says wait,( for what, the bacteria to kill the pt?) I believe this is part of my scope of practice, there are too many variables for any one branch to have complete control.

I haven't looked at pharmacy schools lately, but from what I was told by a dean of Long Island College of Pharmacy a few years ago was that the Pharm D was going to be the required education of all pharmacists. It used to be that pharmacy school was 5 years......now it's 6 and you finish with a doctorate in Pharmacy. They may work as clinical pharmacists or they may work in the pharmacy. No matter what their education, I agree that they should not be telling nurses when to administer medication since they are not with the patient. Also......if they have a doctorate degree why IS it that we always have to READ the prescription to them!

In most of the smaller hospitals that I work at (with agency) we don't even have a pharmacist on at night......so all of this is a non-issue for me. It's just at the larger med ctrs that I run into this problem.

[Jolie, BSN]

We had to write a policy in our NICU to over-ride the hospital's set schedule for meds. I agree that it is idiotic to wait to administer the first dose of ANY med. After all, they are ordered for a reason. It also makes sense with babies (and adults, for that matter) to schedule meds with feeding and treatment times.

[heart queen]

While we have a policy on accepted times, the meds sheets print out with the standard times and I change them according to how I initiated orders. Now herein lies the difference, my pharmacy does not argue this point with me, if a med is scheduled Q8, they will need to supply it Q8.

Seems like a power struggle to me, if the meds do not interact.

From an ICU.