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

[Guest guest]

Hi !

 

A. Turn her ASS in!

 

B. I know it is highly possible that someone ELSE would be required/asked to

make that IV. AND  that my ASS would be on the line. But I would also have to

LIVE with myself If I contributed to the death or other harm to the patient

because I 'knowingly' made some product that I felt was going to cause harm.

 

C. As I said I would have to prepare for termination. This is the PRICE we pay

for our actions.

 

Allow me to remind or inform you of the 'good citizen law' being challenged in

California right now/recently. A young woman sees her friends in an auto

accident. Fearing that the car is to explode she pulls the two out of the car to

safety. One suffers permanent spinal damage that she and her doctors/attorneys

say was sustained because of the 'non-medical' decision to MOVE the victim from

the car 'incorrectly'. They state that the young woman/good citizen did not use

good judgement and contributed or may have caused to the injuries.So this woman

NOW in the State of CA has been deemed NOT immune to the good citizen law and

the law has been, for the most part, redefined. NEW CA good citizen law makes it

a 'crime' to help someone if you do not know how! So let me put it in other

words, what if the car was to explode? What if her friends perished? Would she

then be liable by the families for not trying to save them from the car before

it exploded? What a

crock! What a catch 22!

 

Similarly: IF I were to make an IV that I KNEW or Believed would harm the

patient and it did I would be liable (just as the tech in the REAL scenario) and

if I refuse to make it I am doomed to lose my job. However should that patient

die or otherwise become harmed if someone else made that IV while I was

terminated for not making it;  I could try to  save my name, my job and SUE the

very people who would not listent to me, while they were also being sued by the

patient or the patient's family, because they did make the IV . Wow! That sounds

like a catch 33! {is ther such a thing?}     

 

As I said I do not expect any tech or pharmacist to agree with me.

 

I do so honestly appreciate your input and that of others.  I have only the Code

of Ethics to backup my decision AS LONG AS I have proof in a  resource book to

base my decision and knowlege on. Should I misinterpret that information I

should be sued as one could say that it is out of the scope of practice for a

tech. YET NO ONE is saying that NOW about the TECH who questioned something out

of the scope of her practice!!!    

 

I personally believe she did all that she could do legally! Ethically I would

have stepped aside and told the pharmacist to make it and shove it out the door!

If you get my drift!

On the other hand this tech had NOTHING to base her gut feeling on, solely

intuition, no education and sounds like little experience. So she could not

argue the point! She should be honored, not fired for what she did do by

informing the pharmacist UNLESS she is the one who made the original error

itself.

 

If an error is in the prescription the doctor should have prevented the

error and the pharmacist should have caught it if the tech did not. IF the error

is in the preparation the tech could have prevented it and the pharmacist should

have caught it. At the moment I cannot recall in this case where the original

error occured. For some reason I want to say the the miscalculated it and

informed the RPh that something was wrong. The pharmacist did not catch teh tech

error.     

 

 

Jule Barta, you raised an interesting discussion, but I believe now you owe us

your opinion!

 

Welcoming other/all opinions!

 

Great discussion!

 

Jeanetta Mastron CPhT BS

Pharm Tech Educator

 

 

 

 

 

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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11/14/2007

9:27 AM

[Guest guest]

You asked for my opinion. I have always told my students never to do

anything they thought was unethical or illegal.

If I felt there was something wrong, I would have rechecked my calculations,

walked myself through the steps and or remade the IV.

I would have questioned the order and asked the pharmacist to explain it to

me so I understand why it is or is not ok the way it is made.

At the moment the tech questioned the pharmacist she did exactly as she

should have done. Even though I feel legally she did the right thing in the

end she made the IV and has to live with the fact that it ended up killing

the girl.

If someone was going to lose their job by refusing to fill a prescription

that may cause harm to a patient then that is not a pharmacy or pharmacist I

would want to work for and I would call the labor board instantly and file a

suit.

In Ca everyone is sue happy and will sue you for looking at them funny. You

are dammed if you do and dammed if you don’t.

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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9:27 AM

[Guest guest]

Hi Jeanetta,

Is answer A in response to my example? If yes, I'll comment later in a

separate post.

We are all speculating here really. A gut feeling is just a gut

feeling. I can't honestly say I know any pharmacist who would seriously

respond to a new tech's gut feeling. Speaking for myself, I would have

redone the calculations and when my answer differed from what I was I

given I would have asked the pharmacist to check the math again. I have

done that before and have never had a pharmacist refuse. We have to use

the systems of checks and balances that we have available to us. If the

pharmacist wouldn't check the calculation against mine, I would have

gone to a resource book to check the dosage. Also something I have done

in the past without a problem. But that is me. I'm confident with

myself and my knowledge about my job.

It's been quite a while since I worked in a hospital, so forgive my next

comments if they sound dumb. But isn't there usually more than one

pharmacist on duty even in a small hospital? Where were the other

pharmacists or more importantly what were they doing while this new tech

had a question and/or gut feeling about the iv? Where were the other

techs, the more experienced ones? Why didn't she ask one of them to

check the calculation? And just for the sake of argument, if she was

the lone tech working with the lone pharmacist, couldn't she have called

the floor or had the doctor paged to check the dose? I call doctor's

offices all the time when the medications they prescribe don't have the

proper directions just for clarification and then make a notation of

date, time and who I spoke with on the hard copy.

NJ

On Tue, Dec 23, 2008 at 11:04 AM, Jeanetta Mastron wrote:

Hi !

 

A. Turn her ASS in!

 

B. I know it is highly possible that someone ELSE would be

required/asked to make that IV. AND  that my ASS would be on the line.

But I would also have to LIVE with myself If I contributed to the death

or other harm to the patient because I 'knowingly' made some product

that I felt was going to cause harm.

 

C. As I said I would have to prepare for termination. This is the PRICE

we pay for our actions.

 

Allow me to remind or inform you of the 'good citizen law' being

challenged in California right now/recently. A young woman sees her

friends in an auto accident. Fearing that the car is to explode she

pulls the two out of the car to safety. One suffers permanent spinal

damage that she and her doctors/attorneys say was sustained because of

the 'non-medical' decision to MOVE the victim from the car 'incorrectly'

.. They state that the young woman/good citizen did not use good

judgement and contributed or may have caused to the injuries.So this

woman NOW in the State of CA has been deemed NOT immune to the good

citizen law and the law has been, for the most part, redefined. NEW CA

good citizen law makes it a 'crime' to help someone if you do not know

how! So let me put it in other words, what if the car was to explode?

What if her friends perished? Would she then be liable by the families

for not trying to save them from the car before it exploded? What a

crock! What a catch 22!

 

Similarly: IF I were to make an IV that I KNEW or Believed would harm

the patient and it did I would be liable (just as the tech in the REAL

scenario) and if I refuse to make it I am doomed to lose my job. However

should that patient die or otherwise become harmed if someone else made

that IV while I was terminated for not making it;  I could try to  save

my name, my job and SUE the very people who would not listent to me,

while they were also being sued by the patient or the patient's family,

because they did make the IV . Wow! That sounds like a catch 33! {is

ther such a thing?}     

 

As I said I do not expect any tech or pharmacist to agree with me.

 

I do so honestly appreciate your input and that of others.  I have only

the Code of Ethics to backup my decision AS LONG AS I have proof in a 

resource book to base my decision and knowlege on. Should I misinterpret

that information I should be sued as one could say that it is out of the

scope of practice for a tech. YET NO ONE is saying that NOW about the

TECH who questioned something out of the scope of her practice!!!    

 

I personally believe she did all that she could do legally! Ethically I

would have stepped aside and told the pharmacist to make it and shove it

out the door! If you get my drift!

On the other hand this tech had NOTHING to base her gut feeling on,

solely intuition, no education and sounds like little experience. So she

could not argue the point! She should be honored, not fired for what she

did do by informing the pharmacist UNLESS she is the one who made the

original error itself.

 

If an error is in the prescription the doctor should have prevented the

error and the pharmacist should have caught it if the tech did not. IF

the error is in the preparation the tech could have prevented it and the

pharmacist should have caught it. At the moment I cannot recall in this

case where the original error occured. For some reason I want to say the

the miscalculated it and informed the RPh that something was wrong. The

pharmacist did not catch teh tech error.     

 

 

Jule Barta, you raised an interesting discussion, but I believe now you

owe us your opinion!

 

Welcoming other/all opinions!

 

Great discussion!

 

Jeanetta Mastron CPhT BS

Pharm Tech Educator

 

 

 

 

 

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]

Dear ,

A YES is in reference to your pharmacist who failed on purpose NOT to

follow law pertaining to ACCUTANE. wrote: " " She read it and

then told me (I swear) " Well that's a gray area. " She dispensed that

prescrition anyway. " "

I had a behind the scenes email discussion with Fred Shakelford who

stated the same thing. Not sure if I posted his response to my

question as to what does he think. I thought I had.

But YES turn her ASS in!

Easier said than done since you have to work with her....but patient

safety comes first. There are ways this can be done anonymously.

Right?

Jeanetta

>

> 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]

Dear ALL,

 

I stand by this comment that I have made:

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

ignore. "

 

wrote: " I can't honestly say I know any pharmacist who would seriously

respond to a new tech's gut feeling. "   My response is this: YES every

pharmacist should double check whatever a tech is questioning! If a tech is

questioning something it could be based upon fact, knowlege or experience, and

then there is just plain 'gut feeling'. This tech had a gut feeling, she said I

think there is something wrong but I don't know what it is. I  call that a gut

feeling. I did not imply that a pharmacist should take the advice of a tech and

do what a tech suggested based upon gut feeling (other than double checkthe

order and what is being done/produced by the tech). What I said/implied was that

a pharmacist should double check the work of the tech or check out the concern

of the tech no matter what.  Just wanted to clarify what is meant here as 'gut

feeling' and asking a pharmacist to ACT. A Tech shoul dnever have to feel alone,

like there is no one who she/he can turn to. A tech should NEVER keep his or her

CONCERNS to him or

herself. He or she should ACT on them by informing the pharmacist. Techs do not

make judgemental decisions by law. The perform routine tasks that are based upon

previously made decisions by pharnacists that together make protocol. ANY THING

that deviated from protocol or requires a decision is the responsibility and

duty of a pharmacist, NOT a technician.

 

Now to be sure about this I am not saying that techs should react to gut

feelings all day long nor continually. Techs should have much more education,

training, knowlege, experience to have to rely on 'gut' feelings all the time.

But if a tech is feeling like there is just something wrong and they do not know

what it is, then it is not knowlege based it is based upon feeling and that is

gut to me, and nust be reported to the pharmacist, who is expected to review

everything and address the techs concern.

 

YES my answer to A Turn her ASS in is an answer to your posted ACCUTANE

scenario.

Fred Shackleford also agreed to this. Not sure if I posted his thoughts as he

asked me to.

 

ALL discussion is 'speculation' based upon our own experiences. ALL opinions,

and only those respectful of each others, are to be posted.  This forum is not

the only forum that has entertained such 'hot' topics asking for opinions and

'what would you do in this scenario "  and it won't be the last. All we can do,

individually, is point out the rational, rationale and the irrational

expectations of ourselves in a given scenario. If one disagrees with us they

should point out the fallacies in law or in practice respectfully,  So yes we

ARE all entertaining speculation at this time because NONE of us 'were there'

when the deed occurred .

 

CHAIN of COMMAND is VERY important in hospital setting. I find it unlikely that

a technician would call a doctor to discuss the doctor's order in a hsopital.

Back in the day we called for clarification of a doctor's handwriting,but enen

then we contacted the nurse and rarely the doctor directly. With more an more

electronic hospital scripts, there are less clarifications due to

poor handwriting.  But today we call the nurse who then clarifies with the

doctor or has the doctor clarifiy with the pharmacist. WE as techs do not

actually 'discuss' the therapeutics of the order; whether it is right or wrong

with a doctor; it is the pharmacist who would do that and also to discuss any

clarification and/or change with a doctor. We may assist the pharamcist by

getting the doctor or nurse on the phone.  This does not mean that there are not

some techs who are 'allowed' by pharmacists to do so, but in most hospitals only

the pharmacist clarifies order

therapeutic correctness or appropriateness . I addition in every state ONLY a

pharmacist can change an order and by law only a pharmacist can discuss patient

therapy with a doctor or nurse or other healthcare practioner.

 

YES usually there are other pharmacists on duty. Again Chain of Command is

important. Sometimes specific pharmacists are assigned to work with the techs.

In this case a tech would be required to work with the assigned pharmacist and

only ask another pharmacist in an extreme emergency, like a stat order, or if

the tech did not agree with the assigned pharmacists decision - looking for a

second opinion. This latter action of course should be the exception to the

rule.  If techs are frequently challenging the decisions of the same specific

assigned pharmacist, and if they are usually correct then perhaps the pharmacy

needs to replace that specific pharmacist. Likewise if a specific tech is

questioning the pharmacists and is usually wrong, then perhaps the pharmacy

should replace that tech. Why? Efficiency and Safety, Less interruptions = less

medication errors., Proven /Simple and Effective measures.

 

  I hope that I have answered and addressed your concerns and questions. 

From what I can tell you actually do not disagree with me or others. We who have

been posting have all said the same things:

1. Double check order

2. Double check our work/calculations/supplies/labels etc

3. Look up the information UAD, MDD etc in reliable resources

4. Point  out our concerns to the pharmacist

5. IF we still question this, get a second opinion from another pharmacist.

 

I actually do not see where we disagree regarding the scenario that Jule posted.

 

Regarding the scenario that you posted from you work, that is another matter.

Looking forward to your response to " turn her ass in " .

 

Take care,

 

Jeanetta Mastron CPhT BS

Pharm Tech Educator

Founder/Owner of this site

 

  

 

 

  

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