Scripts

**canoehead, BSN, RN** · Nov 12, 2003

Some nerve- I would have done exactly what you did, don't even let them talk to a doctor.

EastCoast · Nov 12, 2003

Oh this always annoys me. I recently had a patient's girlfriend who took a script pad with my name on it and wrote herself for valium 40 MG. # 100. Take as needed. Like any pharmacist would fill that one. Of course they did call me and ask me why I wrote the script and it was then that we figured all this out. ANyway,,.. i pressed charges. It took a lot of effort and it made me a little nervous. The docs in the Ed were like 'why bother??'. To me it was the point that it was my license and DEA number. Who the hell did she think she was. Secondly, the other day my brother in law told me his friends wife got a script for percocet for a arthritic hip and she changed it to 140 from #40. what do they think when they do this???

Anyone i'ved treated that pulls crap like this never gets a script from me again. In the hospital i see a lot of: 'i'm going to sign out AMA unless i get more vicodin/dilaudid/oxy" (they like to be specific in this case) and i will usually tell the nurse what they have ordered is what they have ordered. I won't even bother to make a House Officer visit when they pull this stunt.

FlyingED · Nov 12, 2003

One day I was in triage, getting slammed and these two guys walk up, cut in front of everyone and start complaining. The one complaining spoke english, his friend, the patient didn't. The white guy was yelling about a script that wasn't filled at the local pharmacy. He was very rude and loud, I took the script and nodded in all the right places and examined the script, first I was thinking crap I have to call the Trauma PA to fix this. Then I realized that it was altered. That is why the pharmacy wouldn't fill it, they just sent him back to us for dispo.

Well, all this time the white guy is yelling about the inconvenience, blah, blah. I had had enough and quickly informed him that he needed to "Shut up" This script is altered and I am going to call the police to have them arrested. Suddenly the asian gentleman understood english and quickly started grabbing his friend and headed for the door. It gave me great pleasure to sit there smuggly faking a call to 911. I kept smiling and saying "You two, jail"

The audience around triage all stood smiling at the two as they scampered for the door. It is the simple pleasures in the ED that bring us back each day.

athomas91 · Nov 12, 2003

the area i work in now is the worst i have ever seen for rx

drug abuse - we actually have patients who come in saying "yeah, so what i may have a drug problem, but it is your job to treat my pain and if you don't i will sue you" we have at least 25-40 patients who are seen at least 2x/wk - have figured out the doc's schedules - know when the new inexperienced doc's are on etc.... sun nite we had one of them threaten both doc's, our pa, and try to start a fight in the lobby w/ security - real winners!!

either they are addicts - or they are selling - a 5/325 percocet can go for as much as 10$ on the street - oxycontin sells 1$/mg ex: an 80mg oxycontin = 80$ - amazing!!

Dave ARNP · Nov 15, 2003

Do your docs not write out the # and refills in LETTERS?

I would never let a patient walk out with a narc that I wrote that didn't have it SPELLED out for them. Not even my mother (She lost a MS Contin 60mg TID script one day). Things happen, and we don't need to feed the habbit.

Dave

teeituptom, BSN, RN · Jan 6, 2004

druggies and addicts are forever

We get script alterers all the time. We just tell the calling pharmacy to tear it up. If the police get called, then there is the possibility you will get called to testify in court. If there is one thing I hate more than druggies, Its republican lawyers, both defense and DAs.. Im tired of going to court and being treated like shit by attorneys.

athomas91 · Jan 6, 2004

md terminator - yeah, our doc's are very good about filling in # and refills - but some people are ingenious.....

we just started a system where it is a computer generated prescription - the doc signs it and we have embossers that must be used on the script - and the script says it is not valid if not embossed - so they are more difficult to cheat...

harry Krishna · Jan 15, 2004

This could also go on the take home pack thread....

A few months ago this guy was given a take home pack of percocet for dental pain. He walks out in front of the ER and proceeds to sell each tab for $5 a pop. A visitor notifies triage and the guy walks off. Then he has the cojones to return the next night, to the SAME ER, with the SAME complaint. Someone spotted him in triage and confronted him and he ran out of the ER.

MAGIK GIRL · Jan 15, 2004

Originally posted by FlyingED
One day I was in triage, getting slammed and these two guys walk up, cut in front of everyone and start complaining. The one complaining spoke english, his friend, the patient didn't. The white guy was yelling about a script that wasn't filled at the local pharmacy. He was very rude and loud, I took the script and nodded in all the right places and examined the script, first I was thinking crap I have to call the Trauma PA to fix this. Then I realized that it was altered. That is why the pharmacy wouldn't fill it, they just sent him back to us for dispo.

Well, all this time the white guy is yelling about the inconvenience, blah, blah. I had had enough and quickly informed him that he needed to "Shut up" This script is altered and I am going to call the police to have them arrested. Suddenly the asian gentleman understood english and quickly started grabbing his friend and headed for the door. It gave me great pleasure to sit there smuggly faking a call to 911. I kept smiling and saying "You two, jail"

The audience around triage all stood smiling at the two as they scampered for the door. It is the simple pleasures in the ED that bring us back each day.

strange how those miracles work isn't it. i had a similar experience only with a deaf mute. when the police did come, the doctor was with the patient trying to communicate. the pt saw the police and suddenly could hear and speak..... oh how he did cuss!

:roll

MAGIK GIRL · Jan 15, 2004

Originally posted by ER-RN2
The other night we had a patient who altered her narc script from 15 to 150. The pharmacy called to let us know that they would be calling the police (it's a felony), but the doctor told them go ahead and give her 5 pills because he felt sorry for her....but then she and her family members made a number of phone calls to the ER demanding more medication "because of the horrible pain". We didn't even let them talk to the ER doctor (partly because we aren't suppose to and because we were slammed with codes, etc) , told them to call their PCP the next day.
Has this happened to you?

i can't even imagine myself altering a script. i wonder... i know that we often threaten the pt with the police but can they really get arrested? :confused:

MAGIK GIRL · Jan 15, 2004

Originally posted by MD Terminator
Do your docs not write out the # and refills in LETTERS?

I would never let a patient walk out with a narc that I wrote that didn't have it SPELLED out for them. Not even my mother (She lost a MS Contin 60mg TID script one day). Things happen, and we don't need to feed the habbit.

Dave

where i work it varies. we usually don't give refills so some write out "zero" so "0" can't be changed. i have also seen only some write out in letters the number of pills. if i were the md (and am not) i think i would try to write out the letters.