What do you do about doctors who don't write scripts for narcotics/sleeping pills etc

[Blackcat99]

We sometimes have doctors who say they are going to send in new scripts right away. The problem is that they say they are going to do it and then they don't. Of course, the resident and the family members are upset because so and so is in pain and the doctor didn't write the scripts. What do you do to get your doctors to write scripts?

[CapeCodMermaid, RN]

There has always been a federal law stating a script must be sent before a med is dispensed. The DEA only recently started to enforce it because there aren't enough drug lords to arrest and we all know how nurses steal meds and little old ladies with new hips are at the top of the list of people who abuse narcotics.

[kmarie724]

Call and fax and call again. Ask the pharmacy to call. Fax over the form pharmacy faxes to us stating they need a script. Call again and again.

[Psychcns]

In addition to the above keep a log and give to your DON. I think it should be addressed at a higher level.

Or maybe when the doc says she will send in the script and doesn't start calling every hour.

[Blackcat99]

Thanks to all for your great comments and suggestions. I wonder what the state inspector would say if they came in and saw that so and so had not received their scheduled narcotic pain medication for 10 days? I wonder if the state would give the nursing home a citation or something because of it?

[JBMmom, MSN, NP]

Ten days?!?! That's ridiculous, guess I'm luckier than I knew to have the MDs at our place.

[LadysSolo]

When someone is admitted, I ask "would you like to write for this now or at 3AM when I call you?" I believe in being pro-active and having pain, bowel, and sleep meds already ordered - you KNOW you will need them.

[LTCangel, ADN, BSN, LPN]

When someone is admitted I ask "would you like to write for this now or at 3AM when I call you?" I believe in being pro-active and having pain, bowel, and sleep meds already ordered - you KNOW you will need them.[/quote']

At our facility, when I have a new admit coming, especially if its late, I make sure to communicate to the nurse giving me report that hard scripts must be sent for any narcotics. When the resident arrives, the first thing I do after assessing the resident is getting their meds verified and ordered stat from the pharmacy. Unfortunately, it still takes a while for them to arrive. If we need refills for narcs or if we get a new order over the phone our doc will have us to fax a form to his office or to his home if its after hours and he then fills this in and faxes it to the pharmacy. I have to keep bugging the pharmacy sometimes to make sure I get the meds in a timely manner but oh well, it's their job. We are lucky in that we have a very nice, caring Doctor who is the Medical Director of our facility. Ten days is unacceptable!!

[traumaRUs, MSN, APRN]

Eprescribing is the best way to go....

[wyogypsy, RN]

The Medical Director gets big bucks for that job. Your administrator and DON need to sit him/her down and have a come to Jesus meeting; or have the company's Medical Director give them a call. I know it isn't always easy to find a replacement Medical Director, but 1) it is the law that we provide care for our patients including pain management; 2) one of the main focuses nationwide, especially in LTC is on pain management; and 3) if it was his mother or dad he would not want them to suffer. I certainly wouldn't hesitate to tell him/her that.

[CiscoNurse]

I usually meet them out in the parking lot with my hoodie on

[Strive2Survive]

I usually meet them out in the parking lot with my hoodie on

I literally laughed out loud!!!

[kbrn2002, ADN, RN]

Well...we can take a telephone order for the med but the pharmacy won't send it without a written script. Exception to the rule; If it is after hours the doc can call the pharmacy and authorize a small amount of the med until the written script gets there, or if the on-call has a fax machine they can fax the script to pharmacy. I work in LTC so no docs on staff, and good luck getting an on-call willing to phone pharmacy or fax a script without an argument. Usually I can talk them into it, but we have one on-call that is notorious for not prescribing narcs and nothing can be said or done to convince him otherwise. I have actually had to put a ticked off family member on the phone with him once and he still wouldn't do it, just told them "wait until office hours and call your primary." That poor resident had a very uncomfortable night.