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? > > 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."
