ER Pharmacist?!

Altra, BSN, RN · Aug 7, 2012

In larger hospitals, particularly academic ones, there may be pharmacists assigned full-time to certain units - most typically the various ICUs and the emergency department. They monitor meds prescribed for adherence to protocols developed by the in-house physician groups and offer assistance when needed, including during codes. They also work with physicians on developing new protocols/preferences for meds. And they certainly have a role in monitoring for nursing compliance with the hospital's policies regarding med administration, and investigation into suspicions of diversion and other problems.

Asystole RN · Aug 7, 2012

My hospital is a moderately sized community hospital, we assign a pharmacist to every patient care unit. The pharmacists allow the staff and physicians to ask the pharmacists questions and visa verse. The program was started to improve patient medication safety and improve interdisciplinary communication and has been extremely successful.

That Guy, BSN, RN, EMT-B · Aug 8, 2012

Have you been around during physician run codes in the ER? The pharmacist is a godsend! Not saying the docs dont know what they are talking about but the pharmacists really really know their stuff and having them present to mix everything on the spot is great. We also have a lot of times where when a lot of drips are going, like after an RSI, having one to consult with is invaluable.

Creamsoda, ASN, RN · Aug 8, 2012

Hey nurse folk! I have serious question that even Google isn't providing clear enough answers to. Recently, in the hospital I work for, we've had a pharmacist in the ER on each shift sitting in a nook behind the nurses desks. I am not sure what there purpose is, as far as physically being in the department, when we already have pharmacists in staff in the hospital pharmacy that we consult with, seems kind of redundant. Ive been meaning to ask one if them but just got busy and forgot.
The ER pharmacist, or another that's available if the ER one is not, has also been responding to codes. What do you guts make of this, as far as their purpose in being there. One website I found said that they were there to monitor and ensure the proper use of medications during a code. To me that seems like the physicians job, but maybe the pharmacist presence is from a different perspective. Idk, that's why I'm asking. What is their job?

Dont disregard their use! Start using them as a resource. Theyre great for codes. i work inpatient/RRT, but a critical care pharmacist comes to all our codes. When we need drugs that arent in the code cart, they are there getting it! They will mix up drips, hand the IV nurse syringes of drugs that are ordered, they also bring along a drug box of their own so we have more stuff on hand if needed. I love our pharmacists!

PatMac10,RN, RN · Aug 8, 2012

Thanks guys. I wasn't trying to "brush them off" I've worked at this hospital for 2 years now and we ran codes, as far as I knew, fine without their physical presence. I knew there had to be a legitimate reason why there was one put in the dept, I just couldn't find a clear answer why.

Im sure know hospital would "throw" an extra pharmacist in a area for no reason, not as expensive as they are. Lolz!

PatMac10,RN, RN · Aug 8, 2012

Dont disregard their use! Start using them as a resource. Theyre great for codes. i work inpatient/RRT, but a critical care pharmacist comes to all our codes. When we need drugs that arent in the code cart, they are there getting it! They will mix up drips, hand the IV nurse syringes of drugs that are ordered, they also bring along a drug box of their own so we have more stuff on hand if needed. I love our pharmacists!

When you explain it line that they seem awesome!! I haven't seen them in full action yet I guess. We are a smaller rural hospital.

BluegrassRN · Aug 8, 2012

We're a small, community hospital. Our pharmacist attends all codes, and if possible all rapid responses. He/she is in charge of the med drawer in the crash cart, distributing meds for the code. If they see we're running low during the code, they send someone to the main pyxis or pharmacy to resupply. If the code/rapid response is medication related, they're there to give input.

Additionally, our pharmacists see all admitted pts, and they try to see them again before discharge, particularly if we're adding a new med or if there is a big change up in their home medications. During the day, each unit has an assigned pharmacist. We only have one house-wide at night. The night pharmacist often hangs out in the ED, to attend codes and see all admits, to go over their home meds.

medicnowrn · Aug 8, 2012

We have a pharmacist that responds to all of our codes and they will come for those difficultly breathers that need intubation. I love having them there to draw up meds while the nurses are doing other things ( assessments, IVs, etc).

sauconyrunner · Aug 8, 2012

We LOVE our ER pharmacist. In addition to doing all the code drugs and being generally helpful in those emergent situations...they are also excellent resources for when we start a drug that we don't have a lot of experience with...or when someone comes in as an overdose with a medication that is atypical, or new or unusual.

They also do all of our Medication Reconciliation, something the Nurses used to try to do in between everything else.

PatMac10,RN, RN · Aug 8, 2012

Wow it seems like they have an amazingly important role. Even 3 weeks ago we had a code and a pharmacist didn't attend this one, but the charge nurse was the one putting together the vials of medicine and etc..... And then they would pas it to whatever nurse was pushing meds. I think because we are just getting them that they are just observing at our codes for a little while so they can set up a protocol/ process for their role in the coding process. I haven't seem them do much if anything regarding codes, yet.

Editorial Team / Admin · Aug 8, 2012

We have satellite pharmacies and pharmacists in several of our units- Trauma ICU, Surgical ICU, Medical ICU, ER, and OR (possibly intermediate care as well, not sure). They are there for questions, getting us meds faster than if we had to wait for them from main pharmacy, mix drugs, and get us things that aren't stocked in pyxis or that we run out of. If I need a med that isn't in our pyxis, I can get it from the OR satellite pharmacy in less than 5 minutes. If I had to wait for it from main pharmacy after the satellite pharmacy closes (at 3pm, when most scheduled cases are at least well underway), it can take more than half an hour. And some of these meds are critical.