CRBRNCPHT

I am a pharmacy technician and just graduated from nursing school. I dont know about your state specifically but in Texas everything you are describing is completely and utterly ILLEGAL. Its not just unsafe its downright against pharmacy law. The Pharmacist must be present in the pharmacy when a technician is there and the pharmacist must check every medication that leaves the pharmacy whether it is directly dispensed for the patient or loaded into an automated dispensing device. The tech is allowed to load the automated dispensing device without the pharmacist being physically present but the pharmacist must check those medications against a list of inventory being filled in that machine before the medications leave the pharmacy. I think a PP was right when they said that if an eror was made you could potentially be held liable by knowingly participating. I'd be sure to document each and every attempt you have made to right the situation and I would also contact the Maryland State Board of Pharmacy. If the Board becomes involved then it wont matter if your CEO and the Pharmacist dont care...they'll be forced to comply or the pharmacy will risk losing its license to dispense medications. I also wouldnt be suprised if that pharmacist didnt lose his license for allowing that. If you go to the Maryland Board of Pharmacy website and click "contact us" there is a link to email regarding "complaints against a pharmacist, technician, or pharmacy." If you email them I'd be sure to mention all the individuals (by name) that you have gone to trying to get this problem solved. I'd also include a list of errors made by the pharmacy that your staff have caught. This is just a huge safety issue and I cannot believe no one is taking it seriously!

If nursing just isnt for you and your heart just isnt in it then I'd say you are making the right choice...I dont think someone could last long in nursing if its not what they really wanted. If you are switching just because you think that pharmacy is going to be easier or that you wont have to deal with alot of crap as a pharmacist then I'm sorry to tell you that you're in for a rude awakening. I have worked in pharmacy (2 different hospitals and 1 retail pharmacy) for a total of 7 years and I agree with the other poster that said that retail pharmacy will ruin you. Dont do it if you value your sanity. Hospital is also not a walk in the park either...doctors will yell at you for "questioning" their orders, you will never be able to get anything up the the floor fast enough to satisfy the nurses, and unless you get a job as a clinical pharmacist you will likely spend most of your day in the basement of a hospital sitting in front of a computer entering orders. Pharmacies are also usually understaffed and I can tell you that pharmacists are not treated with nearly the respect that they deserve. I'm not trying to discourage you but I'm just telling you that this is reality. I also considered pharmacy and even started my prereqs before I decided to change to nursing. Yes, the money is better than nursing but to me it wasnt worth it! I recommend voluteering in a pharmacy or shadowing a pharmacist before you make this decision. Also note that pharmacy school is even more difficult to get into than medical school so your grades need to be fantastic. We have a technician who makes extremely high grades and he tried for 2 years to get into pharmacy school with no success...he then applied to medical school and got accepted to 3 different schools on his first try. In any case, good luck with whatever you decide to do!

I am not sure exactly how it works, but we were told that both the student nurse and the instructor are liable in clinicals...and we are held to the same standards as a practicing nurse would be. This is so untrue. Even licensed nurses who are brought before the State Board of Nursing are only held to the standard of what a reasonable prudent practitioner with the same level of experience and education would have done in the same situation. You will learn this when you take Leadership and Management. You cannot be expected to know everything that a practicing nurse would....that's why you're in school! At my school we did not go to clinical until out 10th week and even then we went to a nursing home where the patients were not acutely ill. We also had a partner, "picked up" our patient the day before so we could prepare, and we weren't allowed to do ANYTHING without discussing the proper procedure with our instructor first.

Your instructor is ridiculous. Yes, you made a mistake. Yes, she needed to discuss it with you and help you understand where you went wrong. But all that crap about lecturing the whole class and yelling and saying you didnt care about your patient? Seriously? That's just stupid. She should have applauded you for how you handled the situation...you got the RN, helped the patient, and fessed up. That takes alot of guts. It would have been easy to just not tell anyone what happened. Admitting to and taking responsibility for your mistakes tells me that you DO care and that you DO have the makings of a good nurse. Don't listen to your instructor...she's way out of line.

I didnt study very much in nursing school. 4-5 hours the day before the test (interspersed with various TV and food breaks of course). I also didnt read my textbooks at all. What will really get you is the paperwork and prep for clinicals. We did alot of pre-clinical prep in my program and the care plans were a nightmare....we're talking 15+ solid hours working on a care plan. Our instructors required VERY detailed care plans and alot of them wouldnt allow us to use care plan books at all so we would have to go looking for journal articles and stuff and that takes FOREVER. That may not sound too bad but it will get you when you have 3 different classes/clinicals going at once. Of course, we can all tell you what our experience was but this all depends on how much study time you need, your program, and your instructors. The instructor and how picky they are really makes all the difference. I was able to work a little...like 4 days a month which I scheduled according to when assignments were due and when I had tests. I also planned an out of town wedding and got married during nursing school.

I didnt think nursing school material was exceptionally difficult either. I could study the day before the test and make A's and B's. However, I did feel that nursing school was very stressful, exhausting, and time consuming and I think that is what alot of people probably mean when they say "difficult." The farther you go along the more they will expect from you. In my program the paperwork just got more and more heavy as we went along and thats what really made it bad. First semester was stressful because everything was so new and we had to learn to a new way of thinking...to "think" like a nurse...but it was nothing compared to later semesters. Don't get too comfortable just yet...it may come around and bite you later.

I worked in retail pharmacy as a Pharmacy Technician for three years and I agree that the situation of someone knowing that you had a prescription ready or that it had refills, which pharmacy it was at, and all that identifying information is pretty unlikely. Also, unless its a narcotic who would want to steal your medicine anyway? The pharmacy staff also generally becomes pretty familiar with their patients also. Now the narcotics, that's a different story. At the pharmacy I worked at we did check IDs for every narcotic that was picked up (unless we knew the patient well). We would let immediate family pick up for their relatives and check IDs with them too (again, these were usually patients we were familiar with). If someone came by to pick up a narc for someone who was not immediate familiy then we would sometimes allow them to pick it up (generally this was a case by case basis...if it felt sketchy then we wouldnt let them or we would attempt to contact the patient by phone.) Occasionally we would have an incident where we would have a patient say that they never got their meds, that someone else picked them up, etc. This was usually when we went back to the pick up signature log and compared signatures and they suddenly "remembered" that they did pick it up. Also when stuff like that happened we would put a note in the name line of their profile that said "Check ID" and it would print out between their first and last name on their prescription label. The technicians all knew that if that appeared on the label that that patient was the only person who could pick up their prescriptions-no exceptions. The pharmacist is responsible for control of narcotics and preventing narcotic diversion and has the right to refuse to dispense medications to protect his license in a situation like this. Therfore we could do the "Check ID" thing even if the patient didnt want it...and many times they didnt because they wanted to get extra narc refills by saying that they didnt get them because someone else "stole" them. If anyone is worried about someone picking up their stuff then just ask the pharmacy...I'm sure that the pharmacy I worked at isnt the only one that has that capability. It would be ridiculous to "check ID" for every prescription...think about how long you have to wait in line in the drive-thru as it is! In any case we had very few incidents and probably only 10-15 "check ID" patients and this was a pretty busy pharmacy. Unless you have a specific reason to fear that someone else is going to try to pick up your stuff then I wouldnt really worry about it.

Try sitting through a pharmacology class where your instructor, instead of trying to learn the names of the drugs she is teaching you about, just says the first 3-4 letters of the drug name and just makes up the rest! Example: "carbenzapime"...yes, that was supposed to be carbamazepine (generic Tegretol). This is especially irritating when this woman gave me no points on an assignment (we had to come up with a post-MI drug regimen for a patient) because he was African American and I put him on and ACE inhibitor and "African Americans don't respond as well to ACE inhibitors." How many African American patients have you given ACE inhibitors too?! She also gave one of my friends a zero on an assignment because "Clonopin" is not a drug. Well neither is "carbenzapime!" lady! Hypocritical much?

I wouldnt get pregnant in nursing school...it was stressful enough without worrying about finding time to schedule doctor's appointments and worrying about morning sickness at clinicals! Plus I cant imagine the stress would be good for the baby.

If I'm not visably soiled then I wear my scrubs out after work all the time. I observe standard precautions and thats good enough for me. Plus, we're caring for these patients with nasty infections....where do you think most of them got them? Yep! Out in the environment and THEN they came to the hospital where I take care of them! Bacteria dont just spontaneously appear in healthcare facilities...they get brought there from other places and that same person who had them was probably picking through the fruits at the grocery store right next to Nancy Nurse in her scrubs a few weeks earlier! There are nasty bacteria everywhere and the handle of the shopping cart and the money that we handle is just as gross as any hospital floor. Who do you think is cleaner...Joe Bob that went to take a crap in the grocery store bathroom and is now shopping for produce without washing his hands or the nurse in scrubs who was cleaning up c-diff poop all day and wore a gown and washed her hands about 50 times? The media is the problem here. This is ridiculous just like all this swine flu crap. And look what happened...our ER's all full of people who think they've got the swine flu and we cant even take care of the people who actually need it!

I think you're reasoning for not waking the patient was sound although I do understand that its important to medicate before pain becomes severe. I think you could argue this either way. I liked another person's suggestion of asking the patient what they prefer...do they want you to wake them up or not. Ask them and then chart their response (although I wonder if it would be enough for JCAHO if they said they did not want want to be woken?). If you're having to wake them for vitals then you might as well go ahead and reassess pain though.

Thank you very much. Your post was really helpful! As far as going to other units...I don't believe that the L&D nurses at my hospital are floated to other units. At least I've never seen them do so. I wouldnt be suprised if I will spend a day or two in NSY/NICU and PP during my orientation to the unit just to see the whole spectrum though.

I just graduated and got hired as a new nurse on L&D. In my program we took our OB class in the second semester (so over a year ago) and I feel VERY rusty. I'm really excited about this job and I want to be prepared but I know I wont have time to re-read everything before I start orientation. I know book knowledge will only get me so far, but do any of you experience L&D nurses have any suggestions for important topics to review before I start my new job?