An excerpt from Nurses are Nuts.
The pharmacy department plays a vital role in hospitals. They prepare and dispense medications. Sometimes the pharmacist will receive an order from the doctor on a med whose written dosage he is not sure of. In some cases, the pharmacist will call the nurse in order to get clarification on this. The problem here is that the nurse did not write the order. The nurse does not have the authorization to write the order. The appropriate thing for the pharmacist to do is to call the doctor on this. We, in turn, tell the pharmacist to call the doctor. The pharmacist knows that this should have been done in the first place. The problem here is that the nurse has wasted valuable time talking to the pharmacist about something he should have never been called on, but this situation happens frequently. Here, we have a situation where the pharmacist is hoping that the nurse can do the doctor’s job.
There are cases when the nurse tells the pharmacist what he thinks the doctor’s order may be, and if the pharmacist thinks it makes sense, he will go with what the nurse suggested. In this situation, the nurse has helped the doctor also. The doctor has been helped because this saves him a call from the pharmacist. When the pharmacist calls the nurse, it does not matter how busy the nurse is; the nurse must talk to the pharmacist. If the pharmacist is in the nurse’s presence, and the nurse asks the pharmacist to get him extra linen, the pharmacist will not get into trouble for refusing to help. The pharmacist will sometimes ask the nurse to check with the doctor to get a clarification on a particular medication order that the pharmacist thinks is wrong. The pharmacist should have to question the medical order. Sometimes the nurse will call the doctor to get clarification that is needed, which saves the pharmacist from doing his job. Things like this happen over and over again, and nurses are nuts for allowing it to keep happening.
There are times when the nurses are out of a certain medication, and when this happens, the pharmacy is the one who should come to restock the medication. This does not always happen, but sometimes the pharmacy will send the medication to the nurse’s station, making the nurse restock the med. This should not happen! The nurse may not be able to get the med in a timely manner to stock it. The med could be taken by someone, and if that happens, the nurse would probably get blamed. The pharmacy is responsible for stocking narcotics. In most cases, the nurse is not there to verify the count of the narcotic being stocked by the pharmacy. If the pharmacist makes a counting mistake, which has happened before, the nurse bears the blame when she goes to remove the narcotic if the count if off. The nurse should always be involved with the pharmacist to verify the count when the narcotic is being stocked.
Medications that have been given and medication orders are routinely set up to the pharmacist. Sometimes the penmanship on these orders is not clear. It is not uncommon for the pharmacist to call the nurse to ask her if she can understand the medication order that the doctor has written. The nurse will always try to help the pharmacist understand the order. The problem here is that the nurse may interpret the reading wrong or may not understand the written order herself. What the pharmacist should do in cases like these is call the doctor himself to get clarification on the order.
When the pharmacy department fills the Pyxis machine, a nurse should always be with the person filling the Pyxis to make sure that the medication count is correct, but this is not always the case. A Pyxis is an automated medication dispensing system. Nurses are nuts for letting this happen.
The pharmacist is very important, and his job is vital, but if the nurse does not help the pharmacist, the nurse will get in trouble. There are medications that should be dosed by a pharmacist to give to patients. The pharmacist does not always do this. When it is not done, the nurse has to do it since the patient must get the ordered medication. Medications are held in a machine called a Pyxis. The pharmacy department puts these medications in the Pyxis. There are a lot of times when the medication the nurse goes for is not in the Pyxis. In this case, the nurse has to call the pharmacy so that they can put the medication in the Pyxis or leave their department and go to a Pyxis in another department. At times, the nurse may badly need the medication. This should never happen. The pharmacy should always make sure that the Pyxis is filled. If the patient takes a turn for the worse because he did not get the medication on time, it is the nurse and not the pharmacy who will get in trouble.
There are times when the pharmacy is supposed to be monitoring an intravenous medication that the patient is getting. An intravenous medication is one that is set up on a pump and goes through the patient’s vein. A lot of times, the pharmacist will call the nurse and ask the nurse what the pump is set at instead of coming to check the pump itself.
There have been times when a patient has left the hospital to get a prescription filled at a pharmacy, and the pharmacist is not too sure what quantity to fill the prescription. The outside pharmacy usually calls the nurse to get clarification on the prescription when it is the hospital pharmacy that should be called about this matter. The nurse should not be called about this.
There are times when the pharmacy department is filling the Pyxis machine (a machine that dispenses medication), and the nurse must get in there to give an emergent medication to a patient. When this happens, the pharmacy department sometimes will not stop filling the Pyxis machine to allow the nurse to get her medication in a timely manner. This is unacceptable behavior on the part of the pharmacy department because the nurse’s medication administration is very important, and some of the medications that the pharmacy fills the Pyxis with, the nurse does anyway. Nurses do not get paid extra for being a pharmacist. Nurses are nuts for letting these things happen.
Anthony Langley is a nurse and the author of Nurses are Nuts.
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