mistakes in prescriptions!!

[nenah]

it must happen that doctors would perhaps make mistakes when giving prescriptions. when you see such cases, what do you do? surely altering what the doctor wrote down must be illegal?!! but at the sam time so should be innaccurate prescription!!

wut would a pharmacist do?

[Zoggite]

Nenah,
Mistakes on prescriptions are an everyday occurance for most community Phcists, unfortunately.What's worse is that the Law tends to be harsher for Phcists who haven't picked up on an error, than on the doctor who made the mistake in the first place:
"The General Medical Council had traditionally been less stern on doctors who had erroneously prescribed than the Royal Pharmaceutical Society had on pharmacists who erroneously dispensed or failed to question the prescription, with the result that "pharmacists are regularly disciplined in cases where the original error lies with the doctor, who escapes any form of disciplinary sanction." said Lord fraser of Carmylie, chairing a Statutory Committe hearing once.
Here's how I deal with scripts that worry me:
1. Whatever you do, DO NOT TELL THE PATIENT THAT THE DOCTOR HAS MADE A MISTAKE. It doesn't serve any purpose, it certainly won't help your relationship with surgery staff, or with the patient. Say something like "I just need to check" or "just to be on the safe side" etc...
2. When you do decide to contact a prescriber about a Rx, say something like "could you just confirm this dose?", rather than "you've got the dose wrong!"; Give them a way out without loosing face...
3. Make a record of whatever intervention you've made, and any outcome;
4. NEVER EVER try to cover up any mistakes you might have made, it just makes matters worse;
I know I've said it before, but... it's always better to ask once too often than once too few, so take those extra 2 minutes to check in the BNF etc... or you might live to regret it!!!

[admin]

Nenah,
Mistakes on prescriptions are an everyday occurance for most community Phcists, unfortunately.What's worse is that the Law tends to be harsher for Phcists who haven't picked up on an error, than on the doctor who made the mistake in the first place:
"The General Medical Council had traditionally been less stern on doctors who had erroneously prescribed than the Royal Pharmaceutical Society had on pharmacists who erroneously dispensed or failed to question the prescription, with the result that "pharmacists are regularly disciplined in cases where the original error lies with the doctor, who escapes any form of disciplinary sanction." said Lord fraser of Carmylie, chairing a Statutory Committe hearing once.
Here's how I deal with scripts that worry me:
1. Whatever you do, DO NOT TELL THE PATIENT THAT THE DOCTOR HAS MADE A MISTAKE. It doesn't serve any purpose, it certainly won't help your relationship with surgery staff, or with the patient. Say something like "I just need to check" or "just to be on the safe side" etc...
2. When you do decide to contact a prescriber about a Rx, say something like "could you just confirm this dose?", rather than "you've got the dose wrong!"; Give them a way out without loosing face...
3. Make a record of whatever intervention you've made, and any outcome;
4. NEVER EVER try to cover up any mistakes you might have made, it just makes matters worse;
I know I've said it before, but... it's always better to ask once too often than once too few, so take those extra 2 minutes to check in the BNF etc... or you might live to regret it!!!

I agree with all of this, but have my doubts about number 4. I know someone who ended up at the statt comm. After their interview with the society inspector they said "I have been totally open and honest with you, yet you've treated me like dirt. I would have been better off lying about this, and trying to cover it up". The reply from the lovely inspector was "You're right".

I know you have to stick to number 1, but don't you find that annoyying? We often take all the verbal abuse, do all the leg work, help the person (even save them from harm) and we have to lie to the customer so they still have this lilley white image of their GP.

[Linnear]

I know you have to stick to number 1, but don't you find that annoyying? We often take all the verbal abuse, do all the leg work, help the person (even save them from harm) and we have to lie to the customer so they still have this lilley white image of their GP.

I think this is part of the reason we get treated like sh*t. We have to basically cover up any errors by GPs so they seem infallible.

Worse still if we make an error because we cannot and should not cover that up!

Life's a bitch, huh?

[Zoggite]

I think this is part of the reason we get treated like sh*t. We have to basically cover up any errors by GPs so they seem infallible.

I'm not sure I'd agree with that (surprise, surprise!); in my experience I have gained more respect from members of the public by not blowing my own trumpet and slagging off other health professionals, even if they were in the wrong. The truth will always come out, whether you try & cover it up or not; and when all the dust has settled, people will remember who treated them with respect and who tried to pull the wool over their eyes...
As you see, I'm still the same Zoggite the rose-tinted spectacled Pharmacist!

[Jeff]

I know you have to stick to number 1, but don't you find that annoyying?

No we don't - the bit in the Ethics guide about doing nothing to suggest to the patient that their doctor was infallible was removed a few years ago.

Which does not mean that I'm suggesting that you tell a patient that their GP is a plonker - unless of course you feel that it is the patients best interest to do so.

Jeff

[admin]

No we don't - the bit in the Ethics guide about doing nothing to suggest to the patient that their doctor was infallible was removed a few years ago.

Which does not mean that I'm suggesting that you tell a patient that their GP is a plonker - unless of course you feel that it is the patients best interest to do so.

Jeff

I thought it was seen as unprofessional if you made any derogatory comments about someone's GP? Aren't you still supposed to protect the "Dr patient trust" etc ?

[Jeff]

I thought it was seen as unprofessional if you made any derogatory comments about someone's GP? Aren't you still supposed to protect the "Dr patient trust" etc ?

It's no longer expressed in our code of ethics - I think someone at the RPSBG might have decided protecting the patients trust in Dr Shipman was not a good idea.

Jeff

[admin]

It's no longer expressed in our code of ethics - I think someone at the RPSBG might have decided protecting the patients trust in Dr Shipman was not a good idea.

Jeff

Good point Jeff. I still think they wouldn't look too kindly upon it, if you went over the top though.

[Fattoo]

Re: mistakes in prescriptions!!

Well, all what have been said is correct. It is the real life. It is how pharmacists should act.

However, If you have just graduated and you have all these dreams of professional relation between health staff, you are really going to be depressed. It is not easy to cover and manage GPs errors and still be considered the one who make mistakes and the one who is less in knowledge in comparison to PGs.

Nobody has tell us about such thing during our study. I have been working as a hospital pharmacist for two years and half. It still hurts me. What I did not find an answer for is "WHY PHARMACISTS ARE WEAKER THAN DOCTORS???"

[admin]

Re: mistakes in prescriptions!!

Nobody has tell us about such thing during our study. I have been working as a hospital pharmacist for two years and half. It still hurts me. What I did not find an answer for is "WHY PHARMACISTS ARE WEAKER THAN DOCTORS???"

It's something you will just get used to. I felt the same way when I started, and used to get upset because I thought I was starting a career. Now I just see it as a job. I still do my best, help people when I can etc, but just see it as a way of making a living. I've been disappointed far too many times now, so just let it go over my head. I don't expect anything, so am never disappointed.

[xiongliang0]

Re: mistakes in prescriptions!!

Whatever you do, DO NOT TELL THE PATIENT THAT THE DOCTOR HAS MADE A MISTAKE

I think it is very very necessary, to Patients, to Pharmacists, and to Doctors.

[johnep]

Re: mistakes in prescriptions!!

The other day received script for oxybutinin. was counselling pt re action in stopping trips to the loo, when she exclaimed 'the dr told me these were for severe pain'.

returned from surgery with script for oxycodone.
johnep

[Steve G]

Re: mistakes in prescriptions!!

I had a script the other day for oxybutinin liquid, 2.5mg/5ml, take 3 teaspoonfuls tds, for a 11 year old. 3mg tds I could understand, but 7.5mg tds is high for an adult, let alone a child. Got in touch with the surgery, and surprise surprise it should have been 5ml tds.

[Zoggite]

Re: mistakes in prescriptions!!

That's OK, I had a script last year for an 84-year old male diabetic patient for Ocytocin injections that should have been Oxycontin!
Over the Easter Bank holiday weekend, I had one for 200ml paracetamol susp. 500mg/5ml for a 9-week old baby, half a spoonful every 6 hours, and
one for Nozinan injections, 125mg to be given over 24 hours via syringe-driver, that should have read 12.5mg/24hrs...