Sunday, August 5, 2012
Sorry, That's Unacceptable
Me: Hi, I'm calling in an emergency narcotic prescription for my nursing home patient, Terminal Cancer.
Pharmacist: Which facility?
Me: The Local Nursing Home, Lake Forest.
Pharmacist: What do you need?
Me: Terminal is a hospice patient. He's in alot of pain tonight. I would like to increase his dilaudid PCA from his current continuous dose of 0.7mg to 0.9mg per hour.
Pharmacist: Have you called in an emergency prescription for dilaudid before?
Me: Yes, the DEA number on the script the hospital sent a few days ago was wrong, so I had to phone in the original dose.
Pharmacist: Unfortunately government rules state that you can only call an emergency dose once for a patient and a given medication. You could fax us a hard copy though.
Me: But it's three in the morning, and I don't have a fax machine at home. Where am I going to find one at this hour? Could I scan and email you a script?
Pharmacist: Sorry, that's unacceptable. You could give an order for a different medication. Would you like to change the PCA to morphine? We would fill that.
Me: The patient didn't get enough relief with morphine in the past. That's why he was put on dilaudid in the first place.
Pharmacist: I'm sorry doctor. That's all I can do. Unfortunately the new government rules on narcotics are making everybody's life more difficult, especially the patients.
I pause in shear frustration.
Pharmacist: Maybe you should just send him to the emergency room. That's what everybody else does!
Posted by Jordan Grumet at 10:52 AM