Medication refills

[countrygirl2013]

Office nurses I need your input-- Working as a float nurse where I spend most days in this one clinic. The Md has not liked me since the day I walked in the door 6 months ago. He always finds something wrong with what I do not matter what it is. Everyday there is something I do that he does not like. I dont trust him I think he's looking to get me fired. I have been a nurse for 20yrs and worked as an office nurse for 5 years. My latest issue is my manger wants me to call in refills for this Md's patient's without a signature if they meet certain criteria. ( ie in for an office visit in the last three months.) The manager is not a nurse. I have been writing the orders for the refills in the chart and having the Md sign off on them before I call them to the pharmacy. My manage insists I must just call the refills in without a signature. All the other clinics have the Mds sign the order before its called to the pharmacy. I told the manager I do not trust this doctor. She told me since I am not doing what I was told she is going to write me up as I am disobeying policy. We cant find a written policy on medication refills. I have never in my whole career been written up for any reason. It makes me sick to go to work for I never know what I am going to be yelled at for next. I am a good nurse with a great record. The last MD I worked with never once questioned anything I did for him. I worked for him 3 yrs. Please share your thoughts. TY

[Ella26, BSN, RN]

At my clinic, we have a written protocol that says if the patient has been in for office visit/check up in this amount of time (like 6 months or a year) we can refill the order with out dr signature. If they are asking for refill an they have not been in and its like a month over since the time they were due back we can ok a 30 days supply with an appt reminder. If it is like a year and half or more we deny it per our facility protocol. But if its an inhaler we are to check with the MD before denying it or an epi pen refill ( Im in allergy and asthma). Or if we have a question about anything then we need to get signature/script from MD. Does that help?

[notmanydaysoff]

I am also a float nurse and quite frankly, some drs want to sign each and every refill request, others don't even want to know about them...unless, the situation is how ella26 described, or if the request is for some (but not all) controlled substances.

at first, I was wary of approving refills for meds w/o a signature, but got over that reluctance when I understood the reasoning behind doing so. does your dr, when writing the original Rx, indicate how many refills are available?

it's unfortunate that you do not have any written protocols to follow. sheeze...at one place I work, the MA approves refills!

sounds like your situation stinks countrygirl. who needs that kind of stress on a daily basis? I wouldn't stand for it for a nanosecond - no job is worth my sanity. hopefully you are in the position to be looking elsewhere for work.