I love getting hate mail from people who try to defend what I bitch about. Here is a good one:
Most CNMs have Master’s Degrees…hardly career college.
My response to that:
Then learn your shit so I dont have to correct your errors. If you have a “masters” degree, then obvously you should have some brain cells in your noggin so I dont have to waste my time correcting your fatal fuckups. I get my shit in order before I speak with a doctor about a medication, so you should have your shit together before you speak with me about medication.
Lets rehash the whole CNM/PA/NP issue shall we? For those of you who arent in the medical profession, heres a quick breakdown:
CNM: Certified Nurse Midwife – Basically someone there when you have a baby. Why they gave these people the ability to write prescriptions is beyond me. Their scope of practice is about a half dozen drugs.
NP: Nurse Practioner – At one time could prescribe everything a doctor could except C-2 narcotics (Morphine, Ritalin, etc). Thats changed.
PA: Physicans Assistant – A NP but could write triplicate Rx’s for Morphine, etc.
Now PA/NP’s are interchangeable.
Back to the rant:
How many pharmacists in the crowd have saved a CNM/PA/NP/Whoever-they-are-allowing-to-write-Rx’s-now-days/etc asses from something severe. Say like confusing hydroxyzine with hydralazine, or my favorite lamictal with lomotil.
I had a NP sit there and argue with me that hydralazine was for itching. This was a white chick too, so there wasnt any accent (dont get me started) or language issues. She was dead set that hydralazine was for itching. Well, I guess if you take enough of it you wont have an itch anymore.
Now this isnt a bash on all NP/PA’s, because i’ve met some of them that really know more than the Dr they work under. This is just a bash to all the stupid ones with the ego of a doctor, but without the schooling or balls to back it up.
Lets move on now to Home Health Nurses. I had a nice call day before yesterday from a Home Health Nurse that went something like this:
Her: “We have a problem here”
Her: “I am supposed to give this person 10mg of methadone twice daily, but you dispensed the 5mg tablets”
Me: “What does it say on the label”
Her: “Take 2 tablets (10mg) twice daily”
Me: “So whats the problem”
Her: “These are 5mg tablets!”
Me: “Yeah, you give 2. 5 + 5 = 10”
I swear, thats how the conversation went. When I hung up, I walked into the back room, sat down, and sobbed for the medical profession.
Another fun story involves a tube of Regranex. Now most pharmacists out there are rolling their eyes at this point, because Regranex comes in a 15gm tube (small), and costs about 500 bucks a pop. Its used for chronic wound healing, and has a mathmatical formula to specfiy how much to squeeze out based upon the wound dimensions. Its like width x length x 0.6 = inches to squeeze out.
So I managed to jump through the hoops to get this covered for this poor lady. Spent a few hours on the phone, and the insurance company decided to auth a few months of treatment to see if it’ll work. I call up the patient, and talk to the home health nurse:
Me: “You know how to apply this right?”
Me: “Its width x length x 0.6 = inches to apply – change with saline dressing after 12 hours”
Her: “Ive done this before”
Her: “Okay, just making sure”
Drug goes out, and I get a call a day-and-a-half later. Its the home health nurse:
Her: “I need another tube of Regranex”
Me: “uh, why? This should last you for 2 weeks”
Her: “I used it all up”
Me: “But the wound is
Her: “I used it all up”
Me: “You realize thats 500 bucks a tube right?”
Her: “Will another tube be sent out today?”
Now at this point I get the patient on the phone (who is very kind and sweet). She tells me the dumb twat was just latering it on like neosporin and used up the whole tube. I come unglued. I speak with her manager, and proceed to give her both barrels. It took me an act of God to get this shit covered, and a fucking dumb ignorant twat just blew what small chance I had. What burns me up even more is that I asked the dumb hoe if she knew how to apply it, and she blew me off.
Ive been scarred by home health nurses ever since. The real pushy and demanding ones are the worst. When they start off the conversation with “You need to do…” my brain shuts off, and I just lay into them. I’m not their bitch and i’m not going to do their job for them.
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