Last minute refills.... grrr...

[bsn2b2013]

I am on week 3 at my new job at a clinic and also a new grad lpn. I have had 2 weeks of training with a supervisor and have a tremendous MA working with me. I have got my nursing stuff down and am starting to get a hold of the paperwork but there are still things that bother me. For one, people calling me at the last minute, 20 min. before we close, for b/p refills and they have nothing left. That, or they give me practically no information and I am left playing the fax game with the pharmacies and rushing to get verbals from the pharmacy. When I can't get that done in time (and we are talking the same day... on a Friday...) I feel incredibly guilty. But at the same time, they are waiting until they have nothing left so am I just being too harsh on myself? I want to get them things as quickly as possible but these last minute emergencies are going to drive me absolutely nuts. Would love some been-there-done-that feedback on how to handle this.

[tewdles, RN]

You are being too hard on yourself

No matter what area of health care we work in we will be confronted with people who make choices which are inconvenient and even problematic for us.

When I worked in community health I had a couple of elderly patients and a couple of parents who created chaos with their lack of ability to manage meds and refills. I found that I could flag their charts so that I could send them a note to remind them of the upcoming needs (sometimes they need to have a BP check, etc in advance of the med refill) and this helped with the "panic calls".

Sometimes you have to get another family member involved in order to make sure the patient is safe with meds.

That being said, some things we cannot fix...we cannot always save people from their own decisions and actions (or lack of action).

It sounds like you are very much engaged in going the distance for your patients, KUDOS to you for that ethic!

[thehipcrip]

Feeling guilty that you can't get all of these last minute requests completed speaks volumes of your strong work ethic and how much you care for your patients' well-being.

Now stop it.

Feeling guilty about things that are out of your control will put you on a fast track to burn out.

For many years, I had a sign posted in my office that read, "A lack of planning on your part does not constitute an emergency on my part." The next time you're starting to beat yourself up about this, take a deep breath and repeat this mantra to yourself until the bad feelings abate.

Congrats on the new job, btw. Sounds as though the clinic you're working for found themselves a keeper.

[mustlovepoodles, RN]

Feeling guilty about things that are out of your control will put you on a fast track to burn out.

Most doctors offices and clinics publicize their 48hr turnaround time. You are not responsible for the patient's lack of forethought, they are. If they run out of meds it's there problem. Usually if patients go to the pharmacy they'll be given a couple days worth of doses, at there own expense of course.Perhaps next time they'll remember.

Stop taking this on as your problem.

[JoJo626]

i have experienced that at every office where i have worked. one office a "ya-hoo" receptionist who couldn't find her butt with a hand full of fish hooks, took the messages. she would just write refill "b/p med" or misspell meds or totally screw up the messages. (she was related to the ya-hoo office manager, so she never got called on it). i'd have to call the patient to verify which b/p med or whatever.

i finally got so fed up that the lpn and i made office policy to accept routine med refill requests if they were faxed directly from the pharmacy. that way we had the correct med, strength, and directions. we also instituted a 24-48 hr turnaround for rx requests. we stuck to our guns, and we retrained 99% of our patients.

i'm a firm believer in the old adage, "poor planning on your part does not constitute an emergency on mine."