Since there are two prn pain meds, you have to indicate when to use each with a pain scale (e.g., tylenol prn mild pain 1-3, oxycodone prn moderate to severe pain 7-10, etc)
This. If you would read and know( and follow) the rules set forth by your hospital and the joint Commission; you wouldn't get these phone calls
FYI the patient was globally aphasic
phun with doctors http://thecynicalpharmacist.blogspot.com
The m in mg for tylenol looks like a u (micrograms)
Micrograms is written as mcg in prescriptions for that exact reason, so I don't think that is it. I agree that it is because the indication has not been properly specified. It could even be because she's missing the word "for".
Or because she wrote brand names and not generics, depending on how picky the pharmacy is.
I agree that some of the problems the pharmacy has may seem trivial and it may be obvious what you meant, but I think it is very good that medicine has redundancies and double-checks to improve patient safety. I'm glad the pharmacy double check to make sure they order is being filled correctly and that patients/other providers are given proper instruction as to how the medicine is to be used in order to minimize the chance for adverse events.
same here! as a soon-to-be pharmacist, it's my job to make sure things are clear and written properly, because otherwise it'll be my license on the line. some of the things i've seen working in a pharmacy as a student are pretty crazy...
Gasp - no pain scale...How could you?!
One is generic, one is brand name? Or maybe you are supposed to specify the relationship between q4 and q6 (can they overlap)? I guess everyone else is probably right, though...I'm a med student.
Yeah, but sometimes brand names are in there for a reason...
I'm guessing the overwriting on the 5 for the narcotic is verbotten - for all that I believe that 5 mg oxycodone is the smallest pill available. While it seems like it would be obvious to anyone with a working brain that no one would rewrite a prescription for the smallest dosage possible, I suspect there are either state regulations about overwritten characters, or chain or individual pharmacy rules about that.
Yes, the smallest tablet size is 5 mg, however 2.5 mg (1/2 of a 5 mg tablet) is a fairly common dosage, especially in the elderly.
The 4 was written over a whited-out number.
I'd say this... If not, then maybe the q's look like 8's
I read all the comments on several medical blogs (ie grumpy, things patients say, and a few more) and I noticed that ppl are way more snooty/judgemental/rude on your blog than any of the others. Maybe it's that the other blogs police their comments more? But I can't help but think it's because you're a woman and ppl feel they have more of a right to talk fine to you. It's disappointing and confusing when I juxtapose it to the respectful comments/criticism that u see elsewhere. I mean after all that hard work and still... But this could be my imagination
Yeah, that could be. I know Michelle au had to disable her comments for a while. I just try to ignore people who are rude. I figure it's more about their issues than mine.
The answer is that I didn't include a Pain scale.Although I've worked in a lot of hospitals that didn't require a pain scale. And it's especially ridiculous where I work because a lot of the patients can't talk or communicate or are very cognitively impaired, so they obviously can't give an accurate pain score.
@Katertot... Maybe it's because in the post she specifically asked people to point out what they thought she did wrong? Not saying everyone's nice all the time, but a lot of Fizzy's posts are written to provoke comments and discussion...
Fizzy joint com. specifically requires parameters. If it isn't based on a 10 point pain scale, then you need to give some other parameter upon which each is to be given.
Or, IDK, have a nurse with more than two brain cells in their head.Safety is not just about being as nitpicky as possible at every stage. It's about employing competent professionals who share implicit knowledge about how shit works.Seriously.