This week we honor the nurses in our lives who work so hard to keep us well and care for us when we do get sick. These women and men dedicate their lives to the health and comfort of others. In honor of all they do, please thank a nurse this week. And if you are a nurses, we thank you.
The week-long celebration occurs annually from May 6th through May 12th, ending in Florence Nightingales’ birthday. Nightingale is recognized for her contributions to the nursing profession. She is credited with pioneering nursing education and was instrumental in healthcare reform after her work in the unsanitary conditions of battle during the Crimean War. Today, a medal is awarded annually in her honor to those nurses who follow in her example of courage, dedication and innovation.
The counter is covered with meds, some in bottles, some in blisters, other just popped out and sitting in the storage container in which everything was stored. As Scott looks over the pile in front of him, he sees that many of medications are past their expiration dates. There’s even one in a glass bottle that dates back to 1969. The mess in front of him is exactly one of the reasons this patient is being moved into long-term care.
Many people can manage their medication therapy well on their own. But over time, more prescriptions are added, others are discontinued, and over-the-counter items are bought in case they’re needed but never actually used. People being to build up a store of pills and patches, creams and drops that make it increasingly more difficult to know what to take and when. And when it’s apparent that someone needs help, they move into a facility along with their entire stash of medications that now need to be sorted and packaged according to compliant standards.
Multi-dose packaging is about more than just organizing medications. It is also about looking at a patient’s complete therapy in order to find duplicate medications and drug interactions. We wish even the people living at home would convert so we could keep an eye on their medications before they got completely out of control.
Merriam-Webster dictionary defines “pharmacy” as “a store or part of a store in which drugs and medicines are prepared and sold.” But we aim to be so much more than that because we know your residents need so much more than that.
It’s a problem we often hear – a facility calls to order an emergency supply of incontinence products because the family member that usual brings them is away or simply forgot to pick them up this time. It’s a hassle for the facility and for the families too. Value time that could have been spent visiting is instead spent running errands and carting around cases of adult briefs. The task is not only time consuming but can also be embarrassing. Let us bring these supplies directly to you along with your regular meds, discretely and without any hassle. Why wait until there’s an emergency? Why not make it a habit?
And then there are those other things doctors ask for –wrist braces after falls, anti-embolism stockings for diabetes, wound dressing and gauze. What size do you need? What compression? He told me it needs silver? We know these products come with many options. That why our staff is trained to help you sort it out and get what the doctor intended to ask for. And yes, we can deliver this stuff too. Don’t forget about other helpful tools like elastic shoelaces and grabber tools. If it’s not in stock, we can order it for you to give residents every opportunity to maintain their independence and live richer, more fulfilling lives.
When we say we deliver 365 days a year, we mean it!
Last winter one of our drivers was out on the road during a snowstorm with a medication that absolutely had to be there that night. He found that many of the roads he tried to turn down had not even been reached by the plows and were impassable, even in his SUV. After and hours of detours and trying to get through the snow, he finally managed to flag down the local fire chief. “I have to get to this address,” he explained. After a little hesitation, the chief agreed to help him get to the house.
Luckily, this type of severe weather is not a daily occurrence. But when it happens, we watch the forecast and the roads to send our drivers out as quickly as we safely can. We take pride in their dedication to getting emergent medications out in a timely manner to ensure that a patient never has to go without. Thank you to our drivers. We could not be who we are without all of you.
The fax machine beeps and buzzes until its silence leaves you satisfied that your prescription order has gone through. With full belief that the medication will arrive from the pharmacy later that day and, with a million other tasks on your mind, you set all thoughts of that fax aside and continue with your day.
Our process however, is just getting started. The data from your fax comes straight into DocuTrack, our electronic server and best friend in organization. First, each order is looked over by a supervisor. Can we read it? Is the patients name there? Do the directions make sense? Good. Time to sort. Orders are separated by department and time needed into neat little electronic folders.
The fax is then passed on to a data entry technician, who turns it into a usable piece of data in our system. After patient information, insurance plans, and drug details are typed into the computer, the order goes through check number one, verification. We all like to believe we’re perfect, but even the most conscientious technician can fall victim to human error, not to mention technological glitches. So a pharmacist checks their work, examining every detail like a jeweler pricing a fine diamond. Do the directions match exactly what the doctor wrote? Is the quantity correct? Are there any patient allergies or interactions? Not until the check is complete does the pharmacist give the technician permission to proceed, moving the order into the second phase of its completion, production.
Production is a lively area where busy technicians scurry about gathering medications to complete their orders. While one works on those day to day orders, like the fax whose journey we’ve been following, others focus on full monthly orders with due dates passing like train cars, one following right behind another. A pharmacist stands at each station, checking orders as they are completed. Since the order has already been verified, this second set of eyes can focus on the medication. Color, shape and other details are carefully considered before this pharmacist gives the order its final approval.
Finally the driver, the friendly face you will see at the completion of your order, sorts deliveries based on their geographic area and scheduled delivery time. After a busy day, you can cross one more thing off your to do list when the medication arrives at your door.
It’s one of the most common questions we hear from nurses and residents alike: “How do I dispose of all these extra meds?” Over the past few decades, different regulatory agencies have come up with different recommendations for the best way to get rid of unwanted medications. Especially when it comes to long-term care providers, the regulations can become very unclear. We’ve done some reading in an effort to simplify and condense the mass of information.
First, let’s make sure we’re up-to-date. For environmental safety reasons, flushing medications down the sink or toilet is a thing of the past. Of course as with any rule, there are always some exceptions. Certain narcotics are considered especially harmful and should be flushed to avoid danger to children and pets. You can check out a full FDA list of medications that fall under that category here .
Good news! For disposal of other medications not on that list, there are plenty of options for assistance. Some police departments (including Greenwich, Darien, and Wilton) offer drug drop boxes. A complete list of drop boxes in Connecticut can be found at the Department of Consumer Protection website . The DEA also hosts national take-back days, the next to be held on April 26th, 2014. Plus, your local pharmacy can often assist you with medication disposal, so don’t hesitate to ask if you have any questions.
Often the easiest, and quite frankly most fun, means of disposal is destruction. To destroy unwanted medications, place them in a bag and mix with kitty litter, used coffee grounds, or another unpalatable substance. Add liquid to create a concoction so disgusting, no one would ever think to dig through it for pills. Be sure to seal the bag carefully (you can duct tape for extra protection) and shred or cross out all identifying information from the dispensing container before throwing it away.
One last caveat before we reach the end: controlled medications. These can be tricky because take back programs can’t always handle them for you. The DEA is working on comprehensive guidelines which, fortunately, are supposed to be released sometime in 2014. Unfortunately, they were also supposed to be released in 2013, so it’s hard to be completely optimistic. For now, discard these medications by working with the pharmacy or directly with the DEA or by destroying them as outlined above.
The key to controls is documentation: be sure to fill out a form indicating the drug and quantity disposed of and have a nurse and at least one other witness sign. Every agency has a specific idea of how best to deal with unwanted meds, but all have a common goal: public safety. As long as you can show that you are taking the initiative to deal with medications safely and prevent diversion, they’ll likely be on your side.