Re: Re: Ohio's Law Close to being on Books - Re: Took the test

[Guest guest]

if i were doing the mixing.  I would have started over--(not re-mixing until i

found a step different in the process)  if after looking over what i did again i

didn't find there error, but still felt something was wrong.  I would definitely

tell the pharmacist that " i think something is wrong, but I'm not sure what " . 

then the pharmacist would look at it and see what the issue could be. 

This is a good question.

As a technician what would you have done in this case?

I brought this up with my class and some of the comments I heard were

Call the patient.

Grab it and destroy it before it got to the patient.

Tell someone higher up.

I have not included my response to these answers as I would like to know

what some of you think the Tech should have done.

Julette Barta CPhT, BSIT, MA Ed.

Pharmacy Instructor

CRY-ROP

PO Box 8640

1214 Indiana Ct.

Redlands, CA 92374

Cell 951-741-4011 Fax 909-793-6901

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Checked by AVG Free Edition.

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9:27 AM

[Guest guest]

First of all, a gut feeling is something a tech should NEVER ignore. After the

first pharmacist did not see any error and if I still felt there was a problem,

I would retrace my steps from Patient ID, diagnosis, allergies, UAD, and maximum

daily dose, reading, interpretation, entering,  calculations,

availability,labels etc.

 

I think, that KNOWING the UAD and MDD would tell me the MOST, IN THIS CASE,

 that this solution is off the mark (overdose). So when I presented it a second

time to the same pharmacist, who told me there was nothing wrong with it, I

would be able to point out the ERROR, using the resources with the UAD and MDD

facts.

 

For newbies UAD = Usual Adult Dose, MDD Maximum Daily Dose

 

However I am an educated technician and I know how to use the resources to look

up this information,. Many experienced on the job techs do this as well AND do

it very well. BUT a newbie tech, being trained on the job may not know how to

look up this information yet OR how to interpret it. And a newbie educated tech

may also not know how to interpret it. But you could look it up and SHOW it to

the pharmacist  (ie push it under hie/her nose). 

 

As a tech, I believe I have the right to refuse to make something that I do not

believe is a good product - as I stand by the pharmacists and pharmacy

Technician Code of Ethics. (I would probably only invoke this principle about

once in 10 years though!). So next to my last resort I would show it to another

pharmacist IF my second presentaion of facts of an error or possible error to

the first pharmacist still made me feel uneasy.

 

If showing to a second pharmacist did not do the trick either and I KNEW for

sure that the book or resources pointed to overdose, then I would back out and

REFUSE to make the IV. I would also be prepared to meet the director and face

possible termination, believing that I made the BEST decision for the patient

and myself. It is very possible that there is always another use for the drug

that is not FDA approved, for which is very legal in the professional setting to

use and it may have different parameters. This is called 'off label use'.

 

I do not  expect any pharmacist or technician to agree with me.

 

Respectfully,

 

Jeanetta Mastron CPhT BS  Chemistry

Pharmacy Technician Program Director 

Founder/Owner

 

 

 

 

This is a good question.

As a technician what would you have done in this case?

I brought this up with my class and some of the comments I heard were

Call the patient.

Grab it and destroy it before it got to the patient.

Tell someone higher up.

I have not included my response to these answers as I would like to know

what some of you think the Tech should have done.

Julette Barta CPhT, BSIT, MA Ed.

Pharmacy Instructor

CRY-ROP

PO Box 8640

1214 Indiana Ct.

Redlands, CA 92374

Cell 951-741-4011 Fax 909-793-6901

Internal Virus Database is out-of-date.

Checked by AVG Free Edition.

Version: 7.5.503 / Virus Database: 269.15.31/1130 - Release Date: 11/14/2007

9:27 AM

[Guest guest]

Hi J,

You know what, I did think of everything you wrote. But in the end, I

couldn't see that actual scenario taking place and preventing the iv

from being sent to the floor. By the time it got to someone high

enough to do something and humble enough to listen, I believe it would

have been mixed and sent by someone other than the first tech.

It could be that at this moment in time, I am not working with a very

objective pharmacist. To say she is arrogant it being nice. For

example, last week I got a prescription from a male patient for Accutane

that was out of date. I entered it the computer and walked the hard

copy over to the pharmacist to tell her it was out of date and she would

have to call the doctor to change the date and reinitiate the I Pledge

process. She tells me that the rules are different for men and women.

I tell her she's wrong but it's her license. She comes back to me a few

minutes later to tell me I Pledge ok's the script. I know she lied and

never called. There wasn't enough time in between my walking away from

her and her walking back to me to call it in. Now I'm mad that she is

being this stubborn about it. So I pull out the I Pledge book and show

her the law where it says in black and white for all patients regardless

of gender prescriptions for Accutane and its generics must be filled

within 7 days of the office visit. She read it and then told me (I

swear) " Well that's a gray area. " She dispensed that prescrition

anyway.

NJ

On Mon, Dec 22, 2008 at 9:38 PM, Jeanetta Mastron wrote:

First of all, a gut feeling is something a tech should NEVER

ignore. After the first pharmacist did not see any error and if I still

felt there was a problem,

I would retrace my steps from Patient ID, diagnosis, allergies, UAD, and

maximum daily dose, reading, interpretation, entering,  calculatio ns,

availability, labels etc.

 

I think, that KNOWING the UAD and MDD would tell me the MOST, IN THIS

CASE,  that this solution is off the mark (overdose). So when I

presented it a second time to the same pharmacist, who told me there was

nothing wrong with it, I would be able to point out the ERROR, using the

resources with the UAD and MDD facts.

 

For newbies UAD = Usual Adult Dose, MDD Maximum Daily Dose

 

However I am an educated technician and I know how to use the resources

to look up this information, . Many experienced on the job techs do this

as well AND do it very well. BUT a newbie tech, being trained on the

job may not know how to look up this information yet OR how

to interpret it. And a newbie educated tech may also not know how to

interpret it. But you could look it up and SHOW it to the pharmacist 

(ie push it under hie/her nose). 

 

As a tech, I believe I have the right to refuse to make something that I

do not believe is a good product - as I stand by the pharmacists and

pharmacy Technician Code of Ethics. (I would probably only invoke this

principle about once in 10 years though!). So next to my last resort I

would show it to another pharmacist IF my second presentaion of facts of

an error or possible error to the first pharmacist still made me feel

uneasy.

 

If showing to a second pharmacist did not do the trick either and I KNEW

for sure that the book or resources pointed to overdose, then I would

back out and REFUSE to make the IV. I would also be prepared to meet the

director and face possible termination, believing that I made the BEST

decision for the patient and myself. It is very possible that there is

always another use for the drug that is not FDA approved, for which is

very legal in the professional setting to use and it may have different

parameters. This is called 'off label use'.

 

I do not  expect any pharmacist or technician to agree with me.

 

Respectfully,

 

Jeanetta Mastron CPhT BS  Chemistry

Pharmacy Technician Program Director 

Founder/Owner

 

 

 

 

This is a good question.

As a technician what would you have done in this case?

I brought this up with my class and some of the comments I heard were

Call the patient.

Grab it and destroy it before it got to the patient.

Tell someone higher up.

I have not included my response to these answers as I would like to know

what some of you think the Tech should have done.

Julette Barta CPhT, BSIT, MA Ed.

Pharmacy Instructor

CRY-ROP

PO Box 8640

1214 Indiana Ct.

Redlands, CA 92374

Cell 951-741-4011 Fax 909-793-6901

Internal Virus Database is out-of-date.

Checked by AVG Free Edition.

Version: 7.5.503 / Virus Database: 269.15.31/1130 - Release Date:

11/14/2007

9:27 AM