MESSAGE
| DATE | 2007-11-06 |
| FROM | Ruben Safir
|
| SUBJECT | Subject: [NYLXS - HANGOUT] Narcotic Ordering
|
With regard to the Narcotic situation on the overnights, prior to my
working the overnights, a large amount of time and resources were spent
filling narcotic orders and I was instructed clearly from both Suzanne and
Tony that no Narcotics were to be dispensed except PCA's and Fentynl patches.
We had a rough go of it for a while, but the narcotic distribution on the overnight
is now only those items and the situation now managable and in accordance with
hospital policy and procedure.
After over 30 minutes, 51 still hasn't returned for the narcotic order. So I'm not
certain of the emergency. Less hysterics and a more rational and calm aproach towards
this problem improves patient care, not lessens it.
The only truly fustrating part of this is not any short coming in patient care, because
a plethoria of Narcotics are available to physicians even when nursing fails to stock
properly their narcotics, but that I'm being repremanded by the nursing supervisor
because as she said, "Ruben until you came on we never had a problem getting anything
from the Pharmacy. Wing gives us whatever we ask, any narcotics we need".
My shift is, for the most part, being run according to policy and is functioning
better for it. Drugs are being delivered every 2 hours, stats are being handled
better, nurses spend less time at the pharmacy and spend more time with patient
care.
Just now, as I'm writing this, a different unidentified nurse comes for the drugs
without an ID card and expected to have the narcotics dispensed. She is telling
me, with great hostility that she's been here for 35 years and everyone knows her.
I told her I need an I'd to dispense. It's the hostility which really is upsetting.
I've been doing my job according to policy and the hospital has been providing
better care because of it. It's inapropriate to make comments such as "on the
overnight we are a big family", as that would be a reason why Pharmacy should not
follow policy, or, "I've been here for 35 years and everyone knows me. Who are you
to come on board and change things". These kinds of remarks are not only inapropriate
and start to enter the murky waters of Coperate Complience issues.
I wasn't hired, nor do I work here in order to make a family. I have 6 children which
is family enough. And although I like to be friendly, I'm not here to make friends,
to play politics, or to the opposite. I know its a lot to ask of people, but I expect
conversations to remain strictly professional. I expect to do my job according to
hospital policy, and through judicious use of my professional judgement. I do not
prefer my arm to be twisted and statements of personal attacks made when policy doesn't
suite someone who's asking for something which they are not entitled to under hospital
policy, or for that matter, under state law or federal law, or even JAACO guildlines.
The overnight staff, although often reluctantly, has worked very hard to provide superior
serivce for the floors, especially floor 51 where for perhaps the first time they are getting
regular delivery service, on time, and my personal attention. Rather than taking jabs, perhaps
the administration should start to notice the wide and vast improvement in service that
Pharmacy is now providing and determine to work closer with us to continue to refine improvements.
Tonight's HIPAA PRIVACY.
All the floors should stock adequate narcotics in order to assure that they can cover all resonable
and expected events. They often do not do this and act as if the aquisiton of a sickle cell patient
on the 8th floor would be an unexpected event. If nursing is to irrationally decide that they can't
ask Physicians to change orders from one reasonable narcotic to another just as reasonable narcotic
which they have in stock, than as hospital policy is, and as one should also reasonably expect even
without this policy, they must order more broadly then they currently do.
The Nursing culture has been very negligent with regard to narcotic responsibilities. Our technicians
and pharmacist are constantly spending inordernate amounts of time sending out narcotics, taking in
narcotics. In and out, up and down, and for what reason? Why are narcotics being returned to us
just to be redispensed the enxt day when a cancer patient is on the ward? This is one of the major
contributers to our large error rates in the narcotic counts.
Ruben Safir
--
http://www.mrbrklyn.com - Interesting Stuff
http://www.nylxs.com - Leadership Development in Free Software
So many immigrant groups have swept through our town that Brooklyn, like Atlantis, reaches mythological proportions in the mind of the world - RI Safir 1998
http://fairuse.nylxs.com DRM is THEFT - We are the STAKEHOLDERS - RI Safir 2002
"Yeah - I write Free Software...so SUE ME"
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"> I'm an engineer. I choose the best tool for the job, politics be damned.<
You must be a stupid engineer then, because politcs and technology have been attached at the hip since the 1st dynasty in Ancient Egypt. I guess you missed that one."
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