Today's tidbit of info (from your nurse)

[inthemindofanurse]

Yes, we have to verify your medications at every visit. Yes, even though you were here yesterday. "Nothing's changed" is not an acceptable answer. "Whatever is in your list is what I'm taking" is not an acceptable answer. Here is why:

Computers are not perfect, people are not perfect! Mistakes happen and when it comes to your medical record it could cause your life!

If we are your primary care and your cardio adds/stops a medication you may assume that they have informed us when they didn't (the fax didn't go through, the voicemail couldn't be heard fully, the medical records clerk put the new medication in Susan Greens chart when it should have been in Susan Greenes chart) Or you may have forgotten that it was the cardio who added a medication and thought it was your primary who added it. When a medication is given to you, forgetting one click can prevent it from ending up in you medication list.

See this example:

You went to the doctor on 1/3/15 for your yearly exam, the nurse went over all of your med list and made sure everything was correct. On 4/19 you came in for a sinus infection and was given an antibiotic and nasal spray. On 7/30 you went to donate blood and your iron was too low so you started taking supplements. On 9/13 you went to the eye doctor and was given some eye drops (the doctors office sent us the note and we added the eye drops to your med list) you went to pick up the medication from your pharmacy and it was $213 so you didn't get them. On 12/29 you went to your primary care for your yearly exam and when the nurse went to verify your meds you told her it was all the same, so she went on to the next task. You came into the doctor the next week to review your lab work and when the nurse went to verify your medication list you told her you were just here last week and they checked it then.......see where I'm going here? You are not still taking an antibiotic and nasal spray, you have added an iron supplement that's not on the list, you are not and have never used the eye drops.

I know its obnoxious, I know it seems tedious. But please know that it is important. Huffing, rolling your eyes, and getting annoyed with me won't get you out of the office faster.

[Mudder]

There is no need to talk to most of us as if we are 5 years old. If you came into my area of expertise I would be a little more patient with your lack of the exact protocol. I understand that is for our own safety in regards to our medications. However when people are in a doctor's office usually they are there because they don't feel well, please give them a break. Take it as an opportunity to teach, not scold.

[outlaw]

Yes, we have to verify your medications at every visit. Yes, even though you were here yesterday. "Nothing's changed" is not an acceptable answer. "Whatever is in your list is what I'm taking" is not an acceptable answer. Here is why:

Computers are not perfect, people are not perfect! Mistakes happen and when it comes to your medical record it could cause your life!

If we are your primary care and your cardio adds/stops a medication you may assume that they have informed us when they didn't (the fax didn't go through, the voicemail couldn't be heard fully, the medical records clerk put the new medication in Susan Greens chart when it should have been in Susan Greenes chart) Or you may have forgotten that it was the cardio who added a medication and thought it was your primary who added it. When a medication is given to you, forgetting one click can prevent it from ending up in you medication list.

See this example:

You went to the doctor on 1/3/15 for your yearly exam, the nurse went over all of your med list and made sure everything was correct. On 4/19 you came in for a sinus infection and was given an antibiotic and nasal spray. On 7/30 you went to donate blood and your iron was too low so you started taking supplements. On 9/13 you went to the eye doctor and was given some eye drops (the doctors office sent us the note and we added the eye drops to your med list) you went to pick up the medication from your pharmacy and it was $213 so you didn't get them. On 12/29 you went to your primary care for your yearly exam and when the nurse went to verify your meds you told her it was all the same, so she went on to the next task. You came into the doctor the next week to review your lab work and when the nurse went to verify your medication list you told her you were just here last week and they checked it then.......see where I'm going here? You are not still taking an antibiotic and nasal spray, you have added an iron supplement that's not on the list, you are not and have never used the eye drops.

I know its obnoxious, I know it seems tedious. But please know that it is important. Huffing, rolling your eyes, and getting annoyed with me won't get you out of the office faster.

Unfortunately you are dealing with a group that doesn't want to put any effort into maintaining their health. They are more than willing to turn over the responsibility of that to others. Then, when a mistake is made, and one of them suffers, the lawyers get involved to place blame on the medical professionals that have to navigate around these "helpless seniors". You are wasting your energy if you think you will ever convince these entitled people to take responsibility for their own health.

[Boomer]

A doctor I know makes it better for his patients -- and easier on the nurse --- by having the office staff give the following instructions when the appointment is made and again with the reminder call:

"Please bring your medications with you to the appointment." -- It is made clear that means in the original labeled container from the pharmacy and to also bring supplements.

His waiting room is filled with people holding little bags, looking like they have packed their lunch.

This system is not perfect, of course. But it sure helps -- everybody. His practice has a large percentage of geriatric patients.

OP, could the possibility of trying this in your office be something to bring up for discussion with the doctor?

[FosterMomma]

I haven't used a Village pharmacy yet but where we come from, you get a list of the past 12 months prescriptions every time you fill a new one. I always put that new list in my purse... it has brand name and dosage so there is nothing to remember. Great system.

[golfing eagles]

To the OP. I get where you are going and I know you are a good nurse and you care about your patients......and what you are saying is valid and very important, but what Mudder said is pretty good advice too.

You catch more flies with honey than with vinegar.

I think the problem here is less what the OP is saying and more how people are reacting to how it is said, but the focus seems to be on the latter

Both yesterday and today, she drew negative reaction to her posts, but if you just read the factual part without inferring tone or intent, she makes very valid points. We've all seen well meaning posts on this site that could have been worded better, but that should not diminish content.

Part of the problem is also perspective. When an individual reads what she said, they are thinking "I don't think that happens" And in that individuals experience it probably hasn't. But the OP is coming from the perspective of the other side of the check-in counter, which is vastly different. I don't know her experience, but I've had about 300,000 patient encounters. Trust me, everything she said DOES happen

For example, you would never think anyone would do the following: A patient brought in her pill bottles, 5 of them. Right over the pharmacy label she put an Avery label, and the 5 bottles now read heart pill, BP pill, white pill, blue pill, and ? (I guess that was potluck surprise med) Another, when asked to bring her pills, brought in a bag of 10 different types of loose pills. I asked her how she knew which one to take when, and she responded "They all end up in the same place anyway"

Remember, Villagers in general do not reflect the patient population as a whole. We generally have worked hard, achieved some degree of financial success, have lived longer and probably are more intelligent, on average, than a cross section of population elsewhere (Of course, there ARE exceptions).

When describing what she does to reconcile meds, remember a lot of what goes on in the doctor's office is mandated by state and federal regulations as well as insurance companies. There are "quality assurance" measures to be met, and medication reconciliation is one of them. (Of course the nurse can spend 20 minutes trying to rectify the list, but if she forgets to check the box on the EMR that she did it, as far as regulators are concerned, it never happened.) This of course makes it tempting for someone to check the box without doing the work if they are "ethically challenged". When my mother was in the hospital 5 years ago, I watched a nurse do exactly that right in front of me.

If you don't think many patients "roll their eyes and sigh" when going over this stuff, believe me, they do. Maybe not YOU, but many. In addition, a lot of patients treat nurses and staff much differently than they do the doctor. I have left the exam room after seeing the sweetest lady imaginable, only to have my nurse tell me how rude she was. I worked with the same nurse for 28 years, and for Cheryl to say someone is rude, they were VERY rude

So if you think there was some frustration and venting that can be read between the OPs lines, maybe you can understand it. Plus her practical advice was sound as well.

[Bonny]

Wasn't there already a thread running about this ?? :confused:

[Nucky]

There was a thread running about this but the lady with the good point and the bad very attitude forgot to write down the exact name of the thread...nobody's perfect..point is there is little chance of me remembering everything anymore. I have to have a list to find my list's. A little compassion should be shown to all patients in a doctor's office. I tend to seize up a little when at the doctors and usually forget something I wanted to speak with him about. I'm totally guilty, I am the patient this woman is speaking of...I'm just the N.J. model. Since yesterday I made a list for my wife & myself of all medications and the info is now in the purse, the wallet & the car. Much appreciated great job bringing this very important issue alive. But I would also be the one who would match your wise A** words in your office if you spoke down to me or someone who seemed feeble and needed a big brother to come to their aid verbally. How dare you, remember who you work for. During my life I have noticed during the ups and downs of living that people tend to lash out at others when they have a problem brewing at home or in a relationship...if this is the case for you I hope you seek counseling and a staff wherever you go for help that is kind with their words & actions. With all due RESPECT.

[golfing eagles]

Again, I don't see anything that the OP said today that could be construed as "talking down" to people. All I see is an explanation of why it is important to bring a list or the original pill bottles. Did anyone read something that I missed?

[golfing eagles]

[/COLOR]


Thank Goodness none of those folks are from Ohio.

LOL His response was a bit uncalled for, but as you know, he has some very reasonable posts as well.

Bad day???

With all there is to do in TV, maybe he can find something to do today to improve his mood, and tomorrow may be a better day

[Barefoot]

..... where we come from, you get a list of the past 12 months prescriptions every time you fill a new one. I always put that new list in my purse... it has brand name and dosage so there is nothing to remember.
Mia, I suggested this same thing on a similar thread yesterday. It's a great way to keep track of meds.
I assumed Florida pharmacies also provide this list of the past 12 months of prescriptions but maybe not.
Perhaps it's an Ontario thing.
Of course it works best if you always deal with the same pharmacy, or if you keep track of all the pharmacy lists.
Tuck them in your wallet to accurately keep track of brand name and dosage.

[asianthree]

My list is easy. NONE. Not script or over the counter. But do not keep your med list in your car. If someone breaks in finds your list and it's off to your house to get them to sell.

[golfing eagles]

My list is easy. NONE. Not script or over the counter. But do not keep your med list in your car. If someone breaks in finds your list and it's off to your house to get them to sell.

Assuming they have a contact at the DMV to get an address from the plate #.
I think I'll leave a list that says only oxycodone on the front seat face up, leave the windows and doors open, leave my front door ajar and have a bottle labeled oxycodone on the counter, filled with potassium nitrate of course:cryin2: