Friday, 15 May 2009

Sherlock Nurse and the Case of the Missing PODs

Nurses. Bless them. Sure they're not the sharpest tools in the shed, but they're tools nonetheless. Ok, I'm gonna skip the part where I go: "I've got nothing against nurses - some of my best friends are nurses (Ha!)" and go straight to what happened today to spark this rant.

It's Friday afternoon. I want to go home. I pick up a dispensed TTO (discharge script) for checking. I happily check each item and realise that two items that were meant to be relabelled (aspirin and mirtazapine) are not present. The labels for relabelling are present in the tray but not the PODs (patients own drugs that needed new labels stuck on because of changed directions etc). I ask the dispenser what happened to the PODs. She shrugs her shoulders and explains they never came down to pharmacy. I check the PODs tray by the PA (pharmacy assessment) bench but they aren't there.

The dispenser goes on to tell me that she tried contacting the ward and that a staff nurse had come down in person to the pharmacy and told her that there were no PODs in the POD locker. Ok.

The dispenser then tells me that the patient has not received their dose of aspirin or prednisolone this morning because of this. Ok.

However, upon looking up the dispensing history for the patient on the computer, we find that all her medications were freshly dispensed and delivered to the ward two days ago. This included a full box of mirtazapine and a relabelled aspirin. Ok.

The dispenser finally informs me that the patient is also on gabapentin and that this was not ordered for on the TTO. Thus if there are no PODs whatsoever in the locker, then the patient will not have any gabapentin to go home with. Ok.

So basically, I'm thinking that this patient is not only going to go home with an incomplete set of medications, she's also going to suffer from a blood clot, steroid withdrawal and a seizure. Great.
So I phone up the ward and request to speak to the nurse looking after the patient. The person who answered the phone is the nurse looking after the patient. Score. I ask her - in a very polite and professional manner - WTF is going on. She explains to me that she checked the patient's POD locker and that it was completely empty. Like zilch. No drugs whatsoever. And then - get this - she then tells me that this isn't the first time it's happened. That often medications do not get delivered to the ward. Basically that pharmacy is to blame for all the world's woes. At that point I had an "Oh no she di'n't" moment, but I kept my cool.
I then explain to her - in a calm and pleasant manner - that we f*cking dispensed new boxes of medications for the patient two days ago and how the hell could they not have any in the POD locker. I also tell her about the gabapentin not being ordered. She suggests that she go and ask the patient to see if they have any at home before we dispense a new set. Good idea, Sherlock nurse. Why are you in nursing? You should be a rocket scientist or something. Sheesh. She then says, "The patient was on gabapentin 100mg, right?"
No, nurse Sherlock. The patient is on 600mg three times a day. Close but no cigar. Dumbarse.

So anyway, she keeps me on the phone for a good five minutes then returns with the following message: "Umm...actually..we found the PODs. They were on the desk."


"After you told me that you'd dispensed them two days ago, I had another look and I found them."


Ok. Don't get me wrong. She was pleasant and apologetic about it. But I didn't care. No, she wasn't going to get away this time. No, for too long I have allowed nurses get away with their incompetencies: I have allowed them to trample over the good name of pharmacy and display themselves as the victors of healthcare. When they have criticised pharmacy or displayed blatant ignorance about drugs, I have merely smiled and turned the other cheek. But not this time. No, they needed to learn their lesson.

I told her off. I scolded her for "the inconvenience caused and for wasting my time". I told her that "drugs should not be stored on a desk but locked away in a cupboard". I told her that "This is not to happen again".

Go me.

But like seriously. How can they be so stupid? And have the audacity to question pharmacy's ability to deliver medications to the ward. WTH do you think we do with the medications once we dispense them? Throw them away? Donate them to orphans? Make a fort out of them? For godsake. The fact that the computer obviously says we dispensed and checked them means that they would have been dispensed and checked then delivered to the ward (or collected by you incompetent nurses). What happens after that is up to you. The ball is in your court. Whether you decide to put them in the POD locker, fridge, on the desk or in the broom closet is entirely up to you. Pharmacy has no hand in the matter. We merely give you the medications then you go and play hide and seek with them. Don't blame us, you tools.

Nurses. Bless them.

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