Tips on how to improve communication between pharmacy and nursing staff

Nurses Medications

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I work on an oncology/med surgical unit and one of the persistent problems we have been having on the floor (esp. on night shift) is the communication between pharmacy. Most of our medications are in the pixus, but the most "important" ones like the antibiotics, scheduled IV ibuprofen, and insulin always seem to never be tubed up to our tube station in time. Now I know usually there are limited RNs mixing these medications, and I know the workload can be rough, but I find myself calling multiples times asking why my antibiotic that was due an hour ago still isn't here and their response is "oh we do not have tubes to send medications up. If you tube us one we can send it." Like, really? THAT is why my patient isn't getting their antibiotic for their neutropenic fever?? Other times I request missing medications and when I call to ask for it they tell me there was never a "request" in the first place (which I hardly believe).

We have a government council on our floor with several staff members and we will be meeting with some of the pharmacy staff to discuss this. So my question is basically, how is the communication between your unit and the pharmacy? What are ways that improve the communication between your unit's staff and the pharmacy staff? If you want to see improvements, what are ways you would recommend?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Before I comment on anything else...you have nurses in pharmacy mixing meds?

Now I know usually there are limited RNs mixing these medications, and I know the workload can be rough,
I have only known pharmacy techs and the pharmacists that handle the meds in pharmacy.
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Tubes not being sent back to pharmacy is a legitimate "bump in the road" and something you may have control over- at least some of the time. Other than that, it sounds like a staffing issue. I worked in a hospital with a pharmacy like that, and know how frustrating it is to spend so much time chasing medication that should be there. I also have sympathy for pharmacy, though. Not only are they expected to be fast with a skeleton crew, but they also have to pay attention to what they're doing and be accurate so that someone doesn't get killed.

The place I work at now is wonderful, in that regard. Very rarely do I have to call for anything. Medication is always there waiting for me like magic. And the difference is ....there are lots of people working in the pharmacy!

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Yes, there are pharmacy techs and pharmacists, but there are also RNs who mix the medications.

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Tubes not being sent back to pharmacy is a legitimate "bump in the road" and something you may have control over- at least some of the time. Other than that, it sounds like a staffing issue.

Since I am night shift, we might be having more issues with this only because there tends to be less staff at night (at least that is what I have noticed). But we can bring it up to our unit to make sure we tube our tubes down whenever we receive something. It is simple and takes only seconds of our time.

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I try not to judge pharmacy, I know they're busy. But sometimes I can't can't help but think...man! If I was this inefficient at my job, I'd get fired! It's a constant battle, meetings happen, people try to come up with solutions...the only thing that has even moderately worked is when the hospital bought more tubes. It was great for like 3 weeks, then they started to disappear.

People say they break, but as many times as I've handled one I have never seen one break! I think people are hiding them places and forgetting about it. Maybe if there was some way to count them every so often...when they got low enough, new ones could be purchased.

Anyway. I sound like I'm completely fixated on tubes now.

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Specializes in Emergency, Telemetry, Transplant.
I try not to judge pharmacy, I know they're busy. But sometimes I can't can't help but think...man! If I was this inefficient at my job, I'd get fired!

I'm with you on both counts on this one! At my current job, we are usually fine a pharmacy gets up stat meds in a timely manner to the ED.

At my previous job, on a PCU, not so much. Had a patient due for a cardiac cath the next day. Cardiologist wanted a 6 pm dose of Lovenox. Pt had come up from the ED to the floor in the afternoon. At 6pm, no meds yet (even though pharmacy had the orders for a couple hours). 7 pm, no meds. Call down explaining why the Lovenox had to be given. From the pharmacy: "we are a couple hours behind on orders right now." After some pleading they sent up the Lovenox--about 4 hours after it was due, but they were not thrilled about being thrown off routine so they could get this med up.

I wish I had some magic answer. Until there is demonstrable patient harm as a result of pharmacy delays, it is unlikely to get better. :down:

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Yes, there are pharmacy techs and pharmacists, but there are also RNs who mix the medications.

What area of the country do you work where they have RN's working in the pharmacy?

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