MESSAGE
DATE | 2007-11-07 |
FROM | Ruben Safir
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SUBJECT | Re: [NYLXS - HANGOUT] Narcotic Ordering
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On Wed, Nov 07, 2007 at 03:45:27PM -0500, einker wrote: > I guess you are having a bad day. What was the fall-out following this > email? >
If I hadn't tracked down the spervisors by staying after the overnight shift which ended at 8AM until 10Am there wouldn't even be a discussion. BUT, essentially the fall out is that if I beg for a clarification I'm not essentially obligated to fill any narcs order that comes to the pharmacy.
Furthermore, the entire policy has been turned upside down and the Pharmacy is supposed to now fill, day and night, all narcotic orders directly out of the safe which would amount to hundreds of them a day.
I'm looking for a different position at this point. I've had my fill here. Mark had almost gotten me a job where he works as a system administrator for webair. I'm hoping they get back to me.
Ruben
> On 11/6/07, Ruben Safir wrote: > > > > 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" > > > > "The tremendous problem we face is that we are becoming sharecroppers to > > our own cultural heritage -- we need the ability to participate in our own > > society." > > > > "> 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." > > > > (c) Copyright for the Digital Millennium > > > > > > -- > Regards, > > Evan M. Inker
-- 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"
"The tremendous problem we face is that we are becoming sharecroppers to our own cultural heritage -- we need the ability to participate in our own society."
"> 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."
© Copyright for the Digital Millennium
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