Pharmacists giving injections!?!

[chevyv]

I went into a a local store the other day to get a presription filled. I saw a sign that said basically get your flu, tetorifice, meningitis, and other vaccinations right there. My first thought was "Great, I missed the flu shots given at work and they take my insurance." I went onto read that the vaccinations are given by specially trained pharmacists that took a course. I was a bit upset reading this. I don't want to fill my pts meds and I don't want a pharmacist who took an hour course to be thinking that is enough training to safely do part of my job!

Am I overreacting? Just seems like nursing should remain nursing. Once they start this, who knows what's next!

[VICEDRN, BSN, RN]

Well, that makes sense. However, I don't think we should worry about Pharmacists taking our job. I guess it just depends on your facility, but at my facility during a code a RN is pushing meds and hanging their own drips when needed in other cases.

If I was a pharmacist, I wouldn't want that extra responsibility when a properly trained RN can do it.

I can see why you would worry though if you facility runs things like that.

The question I have for you and others who aren't worried is what if your facility is next? What if your patient load is increased and they take skills that you enjoy doing?

This stuff happens in a heartbeat unless we remain proactive.

[GilaRRT]

The situation that started this thread did not involve a hospital, it involved somebody going into the pharmacy at a store. Again, I see no problem with a pharmacist in his/her pharmacy administering vaccinations. In fact, this is proactive and progressive, unless we are suggesting pharmacies hire nurses just to administer vaccinations? However, we've clearly established that nurses do not have any special education or essence that makes them better at vaccine administration.

[VICEDRN, BSN, RN]

The situation that started this thread did not involve a hospital, it involved somebody going into the pharmacy at a store. Again, I see no problem with a pharmacist in his/her pharmacy administering vaccinations. In fact, this is proactive and progressive, unless we are suggesting pharmacies hire nurses just to administer vaccinations? However, we've clearly established that nurses do not have any special education or essence that makes them better at vaccine administration.

I don't know if you noticed but several people have already mentioned that pharmacies used to hire nurses to administer flu vaccinations which provided extra holiday income and opportunities to new grads struggling to find work. Special laws have ended all of those!

[chevyv, BSN, RN]

Yep, the thread was about pharmacists giving injections and where would it end? It's not the fact that a pharmacist shouldn't be able to take a class and give im's, but rather what else will we lose?

It was kind of a rant/worry thread. It's not about the IM's alone. I get the monkey thing was a funny, really I do.

What I worry about, again, is what else will become someone else's job? The injection was an example of something that could become bigger and by the sounds of another poster, has become bigger. That is my concern. Many people will not worry until it's placed on them.

[evolvingrn, BSN, RN]

I think these are two different issues, i would certainly not chart on something a pharmacist gave and I would write and incident report. that way the hospital would be required to write policy and address the situation at the very least.

[VICEDRN, BSN, RN]

I think these are two different issues, i would certainly not chart on something a pharmacist gave and I would write and incident report. that way the hospital would be required to write policy and address the situation at the very least.

Oh! the hospital has a policy: in an emergency, anyone can and should adminster code drugs to the patient and of course, we are short staffed...

of course, a code narrative rarely has everyone signing off on their own meds, a team player doesn't just sign for another RN, right? you would sign for other people who push code drugs in an emergency, right? ;-)

[Okami_CCRN, BSN, RN]

I have never heard of a pharmacist in the hospital setting administering medication. If that is truly happening then the issue needs to be taken to the Board of Health and Human Services as well as the Board of Nursing. If your facility would opt to take on the added liability of having a pharmacist practice outside their scope of practice they should answer to the state. I would also like to see what policies and procedures are in place for when they do administer the medication.

I work at two different facilities in northern NJ (ICU and ER) and I have never seen a pharmacist outside of the pharm dept except when we had a crashing patient and asked them to personally deliver some levophed.

[GilaRRT]

Nursing is more than able to evolve. We are afraid of pharmacists encroaching on our turf, but become upset when physicians feel the same about the nurse practitioner proliferation that is occurring? The dichotomy in how nurses look at this situation is interesting. However, a pharmacist is more than capable of administering vaccinations and it is not the role of pharmacists to ensure new grad nurses have jobs. In addition, there are more than 30 states that allow pharmacists to administer vaccinations. That is to say administering vaccinations is well within the pharmacist scope of practice in these states, therefore scope of practice arguments are inane.

American Pharmaceutical Association. States where pharmacists can immunize. http://www.aphanet.org/pharmcare/immunofact.html

http://www.medscape.com/viewarticle/458894_2

[VICEDRN, BSN, RN]

I have never heard of a pharmacist in the hospital setting administering medication. If that is truly happening then the issue needs to be taken to the Board of Health and Human Services as well as the Board of Nursing. If your facility would opt to take on the added liability of having a pharmacist practice outside their scope of practice they should answer to the state. I would also like to see what policies and procedures are in place for when they do administer the medication.

I work at two different facilities in northern NJ (ICU and ER) and I have never seen a pharmacist outside of the pharm dept except when we had a crashing patient and asked them to personally deliver some levophed.

Operative words: "in NJ." I have seen nurses on here posting that you have to be a nurse to push meds in NY. I have seen other nurses say a nursing student can't push meds in your state. Well, this is Georgia honey and these fruitcakes (am a NYer) do whatever they want. Nothing here protects your right to give medications as a nurse.

[VICEDRN, BSN, RN]

Nursing is more than able to evolve. We are afraid of pharmacists encroaching on our turf, but become upset when physicians feel the same about the nurse practitioner proliferation that is occurring? The dichotomy in how nurses look at this situation is interesting. However, a pharmacist is more than capable of administering vaccinations and it is not the role of pharmacists to ensure new grad nurses have jobs. In addition, there are more than 30 states that allow pharmacists to administer vaccinations. That is to say administering vaccinations is well within the pharmacist scope of practice in these states, therefore scope of practice arguments are inane.

American Pharmaceutical Association. States where pharmacists can immunize. www.aphanet.org/pharmcare/immunofact.html

http://www.medscape.com/viewarticle/458894_2

bob and weave there a little more!

I never said I would be upset if MDs are trying to protect their right to prescribe though you seem to want to link one argument with the other.

Laws that allow pharmacists to administer vaccinations are relatively new. Saying that it is well within their scope of practice is frankly ridiculous. I have personally queried the pharmacists on staff here. Aside from administering the medications and assessing for associated potential allergies, they are not trained in assessing for the PRESENCE of a variety of side effects including localized site reactions as well as identifying anaphylaxis (though they seem to understand the theory well enough). They are also not trained in patient education. Were you saying something about inane?

As we prepared to intubate an asthma patient last month, the pharmacist wondered aloud how we knew she needed to be intubated. The paradoxical breathing just wasn't obvious to her. Inane, right?

In terms of administering vaccines, I rather think vaccines should be administered by a nurse, LPN or RN only or perhaps the MD/NP/PA. If an assessment is required, the assessment of the patient's health status should be done by a qualified person and pharmacists are not trained in assessment. But assessment? that's inane!

[GilaRRT]

Anecdotal experience is probably not the best method for making a valid argument however.

[VICEDRN, BSN, RN]

Anecdotal experience is probably not the best method for making a valid argument however.

It isn't the best method but I thought it would nicely illustrate the point. Posters here are mistaking a PhD in pharm with training in area specific skills like assessment. The training is fairly standardized. Again, bob and weave away.