Made a huge mistake now worried for career.

[newRNhereMI]

I'm a new RN and have only worked in LTC for a few months. A situation happened where a resident requested a PRN drug and it was unavailable. We have been instructed not to be afraid to use our edk's and get what we need. I have never had to pulled anything from the Narc box before and was told by different ppl we had a new policy. So in short the policy was misunderstood and I didn't get prior authorization from pharmacy to pull the drug. The resident did however have an order and the pharmacy had a copy of a hard script and got the pills out later that night. I pulled the med and gave them when they were requested. My problem is I didn't get authorization for pharm and now I am concern for my job and license. The adon when I notified him stated this wasn't a med error but a very big problem and would take care of today. I didn't get a response back today everyone was unavailable or in meetings. I dont know all the rules and regulations but really am in constant worry over well my career now. I cant seem to get an answer or call back to know how this is going to be handled.

Has anyone had any similar situations or offer any input.

[CrunchRN, ADN, RN]

So, the patient will have to be trasnported to the emergency room to get adequate pain relief after hours? I mean you cannot ethically just leave them in their bed suffering............

Great use of health care dollars.

Stupid, stupid, stupid..... may the creators of these rules lie in a nursing home and suffer unrelieved pain themselves.....:down:

[Forever Sunshine, ASN, RN]

But it's also not a candy machine that dispenses whenever the user chooses. The law stinks..BIG TIME...but unfortunately it is a law.

But if a resident is out of a med.. or has a stat order for one in the ebox, why should we have to jump through hoops to get it.

[prinsessa]

I was told that we can take Narcs from the E-box as long as we have an order from the MD saying we can. According to the law we can't? It can take days for the Pharmacy to get in contact with the MD. When I am admitting a resident who I know will be in a lot of pain (just had surgery) I will ask the MD if it is ok to take from the E-box until the medication gets here. I guess I shouldn't be doing that. So what about the poor patient? Do I have to tell the MDs to call the pharmacy immediately so the resident can get pain meds? Can we take from the E-box if pharmacy has that verification but hasn't delivered the meds yet?

[CoffeeRTC, BSN, RN]

I was told that we can take Narcs from the E-box as long as we have an order from the MD saying we can. According to the law we can't? It can take days for the Pharmacy to get in contact with the MD. When I am admitting a resident who I know will be in a lot of pain (just had surgery) I will ask the MD if it is ok to take from the E-box until the medication gets here. I guess I shouldn't be doing that. So what about the poor patient? Do I have to tell the MDs to call the pharmacy immediately so the resident can get pain meds? Can we take from the E-box if pharmacy has that verification but hasn't delivered the meds yet?

Nope...can't do that any more. Even if you have an order from the doc that says "May use xyz med from the E box until regular supply comes from pharmacy" you still need permission from the pharmacy to use it.

I wouldn't mind this last step, but try getting a hold of the pharmacy on an off shift or weekend holiday. (See the other thread about Omnicare)

Its this last little step that I cannot wrap my head around.

[CapeCodMermaid, RN]

Call your pharmacy consultant. There is new legislation that allows the doc to appoint nurses to act as his/her agent. There is a form to be filled out, of course and then you get what you need.

[Nascar nurse, ASN, RN]

Call your pharmacy consultant. There is new legislation that allows the doc to appoint nurses to act as his/her agent. There is a form to be filled out, of course and then you get what you need.

Unfortunately my very large corporation has decided that we will not be allowed to do this. Not sure of the rationale of this decision but it is really frustrating.

[Forever Sunshine, ASN, RN]

Lets have these big rulemaking to dos do a med pass. On an off shift. With short staffing. Lets see what they do when they need a med from the ebox and their patient is in 10/10 pain and has none left.

[suri_wild]

NewRNMI

I was just wondering if you have received any word from your supervisor? I'm rooting for you! Also have you thought anymore about switching to a hospital position?

[systoly]

Lets have these big rulemaking to dos do a med pass. On an off shift. With short staffing. Lets see what they do when they need a med from the ebox and their patient is in 10/10 pain and has none left.

They'd send the patient out.