dual responsibilty and a fine line..

[mandi2]

Greetings!

I have a complex situation going on here, and i'm a member of 1199 union. I've been an LPN since 1993 and have worked in hospitals, and in medical clinics. I am now employed in a mental health facility and i really can't complain - what LPN gets her own office with a bathroom! - also, i'm 12 minutes from the job via train - with all the negativity of nursing, that is a positive for me anyway.

The 'Old' pharmacy that was within the facility (but it's own entity), has left and the new pharmacy that will be renting from the facility can not practice within the building for 90 days since the old pharmacy left.

Okay, so, my supervisors are not nurses !, they are all social workers, and there is another LPN on a different unit within the facility but she is an agency nurse - and excellent one too.

We have been encountering many errors from this 'new' pharmacy as he is farming out patients RX's and they are coming back incorrect by the barrel! - Please keep in mind we have individual dosing NOT unit dosing. Because of these constant errors, (wrong meds in PROPER labeling bottles!!!!), the 'big' bosses want me and this nurse to count these meds and compare them to the PDR.

Now, my main thing is the safety of all our patients, her unit (which is a day program and the patients are gone by 230pm), and my unit which is an outpatient unit, where patients come in for groups, psychiatrist appts and social work therapy appts. -and blood work drawn by me, and any injections they are to rec. I administer.

I have a gut feeling in the years i'm doing nursing, that although there is a dual responsibility and checking our meds is THE UTMOST, as i could have given my patient a haldol dec injection, when the Box was clearly labeled prolixin (as the Doc ordered!) - SCARY!

I'm uncomfortable checking pills and tabs against a PDR d/t some pharmacist out there making SERIOUS errors.....in my gut, i don't think this is even legal for us to be responsible. I think they need a pharmacist to be 'in house' or somewhere, that is checking 'his' people's work....

I asked a pharmacist about this that i know well, and he shared with me that the legal end lies within the pharmacist - naturally if the pills or vials do not look right we hold the meds, which we seem to be doing alot lately.

I have contacted my union - not to complain but to speak with someone there that is medically legally knowlegable, as my Docs really don't know what a nurse can or can not do, but this doesn't seem correct to them either.

It is our practice naturally do check our meds again and again and again - but since this new pharmacists has taken over and has been sending our patients RX's to his other pharmacies (wherever that is), the hits keep on coming, I'm also worried about what are the patients receiving at their home???????!!!!!!!!!!!!! IMAGINE? - the other unit - the nurse administer's daily from individual bottling - labeled, and then hands to them on friday to take to their residence for the weekend.

She never needed my help before and doesn't need it now, but we have been checking meds again and again. together. With the way generics are - and so many pharmaceutical companies out there, the PDR is not always helpful, and we have no pharmacist to ask in house for sure!

Anyone actually doing this???

It just seems almost un-ethical to be checking a pharmacist's work every single day - we're talking about 4-5 different meds per 60 patients!!, that's about 200 bottles !, as familiar as we are with the meds i'm having nightmares that LIC03 300mg, may be actually LIC03 100mg!

This almost seems un-ethical in a sense, as it is not an isolated incident. I'm nervous for my patients, and for my license, which, i LOVE!

Please advise!

Thanks,

mandi

'nurses call the shots'

[caliotter3]

If I read your post right you have brought this problem to the attention of others. You should seriously consider a job change if no action is taken to rectify the situation. And don't forget to document, document, document. I might consider a letter to the Pharmacy board, describing what is happening, if I were you. But if you are afraid of stirring the pot, then you should make certain you find a new job first. This is too dangerous a situation and you should not be developing ulcers because of the consistent mistakes of others. Good luck. Hope you are able to resolve this to your satisfaction and the satisfaction of keeping your license intact.

[Jolie, BSN]

It sounds like you need an independent pharmacist to examine the meds you receive BEFORE they are placed in the med cart. The nurses don't have the time, and perhaps not the expertise to do this, given the many generics available.