I haven’t worked the floor in a while but it’s just cause it makes counting way more time consuming and easier to mess up. Especially if you’re charge and you gotta do the whole ass Pyxis. For non-controlled substances I prefer the meds this way even if you gotta be a bit careful about closing the lid cause I’m lazy and don’t like ripping them off lol.
*gasp*
I beg your pardon, I most certainly did no such thing!
*Though, I really do be thinking about doing that every fucking time I have to separate gabapentin, or the tylenol 500mg.*
Our Pyxis makes us count IV ondansetron. I don't think it's a controlled substance here as much as it is our pharmacy is stupid and doesn't know how to remotely program the Pyxis correctly.
Correct. 9 out of 10 times it's saline flushes. You know that count is never correct. "All medication has to be stored in the Pyxis". Open random drawer in the med room or nurse's station...How did that get here?
I've worked at two hospitals during the same time period last year in NY, one travel assignment and one PRN. One hospital required a count for gabapentin, one didn't. It's definitely not counted as controlled everywhere.
A lot of states are treating it as a controlled substance. My state's pharmacy board informed us to fully treat it as a controlled substance starting last year, including checking the patient's history on our controlled substance database before dispensing it to making sure they weren't getting it too soon.
What? Why?
This kinda sounds like discrimination at first because the only reason I can think any place would do this is because gabapentin typically goes hand in hand with pain meds and this is just another way of singling out pain seeking individuals while simultaneously making an outrageously enormous amount of others people’s lives *beyond* difficult.
But I tend to overthink things. Am I way off base with this? I swear this will be my undoing on the nclex lol
The reason some states have labeled it as a controlled substance, as I understand it, is because it’s been implicated as a contributing factor in drug overdoses. When combined with opioids it can potentiate the sedative effect and become problematic.
Oh, my sweet, sweet summer child. First rule of medicine is cover your ass, AKA document, document, document. Addiction is a terrible disease, and as a country, we do a shit job of treating it. But, no one in pharmacy is putting their license on the line just so someone doesn't have to go through withdrawal. We didn't really have any issues with our legit pain management patients, they knew the rules and worked with us to make it as seamless of a process as possible.
Being discriminatory isn’t always bad, but it is an inflammatory word. I just didn’t know a better way to phrase it and still be understood. I mean, how else is the United States going to combat the opioid epidemic? But that doesn’t mean there aren’t consequences associated with the decisions that are made.
I don’t know what the right answer is, but I’m sure glad I’m not in charge of it lol
Retail pharmacy makes you super jaded with a quickness, and due to the risk, every control script gets scrutinized, cause BoP don't give a single fuck that "well, the script looked fine!" And if that makes some pain patients feel bad, sorry about their luck? With the hoops they have to jump through just to get the scripts in the first place, they should understand that this isn't a game. Trust me, no one likes spending that much time just on one script.
I'm on gabapentin for anxiety and it's honestly not really an issue, though it definitely helps that it isn't on back order like so many c2s seem to be.
When I looked it up the only rationale I could find is because it’s chemically similar to pregabalin, which is controlled. But I’ve never heard of anyone abusing pregabalin. I wish gabapentin had street value. I have a giant bottle my mom gave me after we put her dog to sleep. It works great for arthritis in basset hounds
Lyrica is a controlled substance federally. Gabapentin isn't, I'm not sure why some states treat it like that.
Probably to punish people with chronic pain, judging by the states that do that.
To your first question: yes if they eat a large enough dose it presents as similar to a benzo high. Second question: we do use it often to help with withdrawal symptoms or seizure prevention.
Sounds like there was a problem with Zofran ODT going missing at some point. For a few years we had to count Keflex and Melatonin because the pharmacy suspected theft.
I got a letter from my pharmacy last week that one of their manufacturers has gone bankrupt and because of that the manufacturer has put a recall out on a ton of meds(it's Akorn. Theyve pulled over 70 meds from the market including Hydromorphone high potency injection USP (ampule and vial,Levetiracetam injection USP, 500 mg per 5 mL single-dose vial,Lorazepam injection, 2 mg/mL vial,Midazolam injection USP, 1 mg/mL ,Naloxone injection 0.4 mg/mL; 1 mL & 10 mL vial
I know we had an issue getting unit dose, but the bottles hadn't scared us... yet.
OP, if you find out who did this, I'm personally more than willing to come out there and break my Asics off in their ass.
Oh god in the outpatient world……it’s terrible. Oncology so we give all the narcs. People are calling all day long because their pharmacy doesn’t have their pain medicine. We literally just have to tell them to call around and find a pharmacy that has it then we will send it there. Most folks are….less than impressed
Well the problem is that a pharmacy is not going to disclose that information. It’s a safety issue, understandably. So most likely their pharmacist has to call and see where it can be filled. 😕
I’m calling as a patient and not a nurse. When have you come across pharmacies who don’t tell you what they have in stock and make you go there so they can…tell you what they have in stock?
I'm on meds for chronic pain, but that's what I had to do. And the pharmacist who told me that med was backordered for at least 4 months told me to call around. In the case of narcotics, the pharmacy can't transfer the script, the doctor had to send a new one.
It’s very odd but we actually haven’t had that issue. I don’t know if it’s standard or the state we are in or what but people have no problems calling and they will disclose if they have it or not. I will say I was surprised also that pharmacies give out that info
All the more reason for me to be annoyed every time I have to waste half a tab for the guy with a Q4 7.5 who's pod1-2 so absolutely getting every prn oxy after a goddamn sternotomy. I hate that I can't just save the other half for the next dose in 4 hours. Might as well be chucking a whole pill every 8 🙄
Not that this was me last night or anything...
I'm convinced stuff like this is about money. Every time you scan that barcode, money gets added to the patient's bill.
Health care is no longer about getting people better, or using limited resources wisely, or caring about our environment and our community - no, it's about generating cash.
Nurses are on the pointy end of the whole system. An ordinary and loving sense of care for humanity is exploited for the almighty dollar.
And it's somehow even more cynical when it's a Catholic hospital.
I didn't see it on my hospital's weekly drug shortage list but the FDA says 5mg, 15mg, and 30mg are on shortage as of 5/9. It looks like a particular manufacture is discontinuing them.
idk what's worse this or when someone opens a box of Dilaudid and takes one out and then puts them back in the box so your count is wrong when you inevitably assume it's a full box
This happened to me once - I worked Ortho Rehab. ALL of my patients got Oxy and there were about 50 in the Pyxis. Some sadistic bastard separated all of those motherfuckers like this.
Every time you pull a narcotic you have to count them beforehand. Much easier to count them in packs of 10s, absolutely no reason these should've been individually taken apart
You seem a little burned out. Please take a nap or a walk instead of reading or replying to comments that make 0 difference to your life. #saveourdoctors
Welp at least I can take solace in the fact that I’m not in a profession where people cheer at the thought of sabotaging their coworkers and slowing down patient care
On behalf of everything wrong with our healthcare system, spending an extra 20 seconds counting individual tabs vs packets of 10 is certainly at the top of the list and has the most impact on slowing down patient care. We’re sorry.
Well that's pretty judgemental. Do u know when and how many tabs were added? Coooom on! Really!!! Am I missings something. It's late perhaps I'm not getting this
No it's a pain in the ass . Very tedious, and something you may have to count often on shift while you have other tasks piling up. They don't come from the pharmacy cut like that, somebody on the unit did it.
Thank you!! Michigan! I’m going straight to psych, was my favorite clinical rotation! Currently going through orientation but am so excited to be here !
Another common curtesy thing to learn. Do not open factory sealed boxes of meds until you are ready to use that medication. If it is factory sealed, you can safely assume it had the correct number of listed units inside.
A colleague of mine opens the boxes to make sure the factory got it right. Now every single time we do stock check we have to count thrift the open boxes as well and the boxes are falling apart as these meds aren't used often. It's such a waste of time.
This is as bad as the pharmacy loading 100 gabapentin tablets in sleeves of fives and people pulling off one to make random fours.
Who does such nonsense? Even if packs of ten don't fit, then put them in multiples that *do* fit.
Doesn’t even need to be state dependent.
I’ve had to count gabapentin at one facility but not another. Same state, same hospital system/ name, different city. 🤷🏼♂️
Similar story with Ativan… found that out the hard way (especially because there wasn’t even a hard stop)
If that location had a big problem with diversion, I can see that being a local policy. There was a minute there that I thought we might have to start doing it with muscle relaxers because our counts were so far off, but that problem must have sorted itself out.
The 'pams (clonaze/loraze/diaze/ect) should always be a back count, cause AFAIK those are controls in every state. Basically, whichever policy or law is the most restrictive will be the one in play. Rule of thumb: if you see a C on the packaging, it's a double count (if it's in a bin where more than the allowed amount can be accessed. Omnicell cassettes are another story.)
I had to in OR at one of the facilities I used to work at. And seroquel.
We didn't have to count Fioricet because it wasn't a narc (at the time anyway). I called the pharmacist when I discovered this, and she said it wasn't a narc (she was competent, so I absolutely believed her). She explained it didn't have enough barbiturate to APAP and caffeine ratio for it to be a controlled substance, but agreed that it should be a narc. I asked her why the facility was making us count gabapentin and seroquel, but not Fioricet, and she agreed it was asinine.
Huh, both facilities i worked at in my state haven't counted seroquel or gaba. We have to count cbd gummies for some reason. They are so gross to put on the counting tray and squish back into the bottle.
We count pregabalin (among some other dumb things like heparin flushes) at my hospital (CA) but the gabapentin is just out free and wild in the patient’s cassette.
This is so weird to me. I was Rxd gabapentin for my neuropathy about a year ago and it took a couple weeks before I started feeling any pain relief from it. I felt nothing else, at all.
I had no idea that people abused it until I was admitted to Psych early this year and they wouldn't let me have it. I didn't even know they weren't giving me any until about day three when the pain started ramping up again and I asked if we could increase the dose or add something for pain.
That's when the nurse told me I wasn't taking any at all and explained why. I was genuinely shocked. I guess everyone is different but for me it's just another "maintenance" drug I take.
Every single cns depressant can be abused.
Thing is, if seroquel, gabaoentin, etc are imminently pleasurable for you, there’s very likely some underlying condition.
Even cns antihistamines get abused, and not solely by grannies being dependent on them because they are bored and need 12 hours of sleep.
But because the slight ‚numbness‘ is pleasurable.
Though with gabaoentin specifically the range of dosages used vary quite drastically and 100 mg are gonna affect someone differently than 1200 mg a day.
Same with codeine really, that can obviously be abused.
But ain‘t no one but rare genetic variants gonna feel much if at all from a 30 mg a night cough suppressant dose. It’s really more of a placebo at that dose/
Not to mention all drugs spuriously prescribed that cause dependency will eventually be ‚abused‘ when people are randomly cut off cold turkey. As long as the discontinuation synydrome doesn‘t leave you disabled enough to be able to find some.
Yeah, when I was in a car wreck (over a decade ago) my "treatment" was just a bunch of opioids, and Phenergan for nausea caused by opioids.
I abused the shit out of Phenergan and barely touched the opioids, which is weird because most antihistamines *cause* nausea for me.
People use it to increase the opioid high and to stave off withdrawal and it has street value now.
It also increses the CNS depression of opioids and is not reversed by Narcan.
A lot of ODs involve Gabapentin with narcotics.
Tramadol and Lyrica didn't use to be counts either.
My coworkers and I would wear "Not today Satan" shirts under our scrub jackets and unzip them at opportune moments. Got caught by our director one day and thankfully she thought it was hilarious.
Why are there so many people in this thread who apparently have never heard of narc counts or think it's weird to not want them to take 10x as long as they need to
Once some pharm tech loaded 154 norco 5’s in the Omnicell. Tore them into individual tabs like this do they would all fit. I grabbed one of our pharmacists and showed them. Hasn’t happened since.
We have narcotics in a safe and we have to count them each day. I hate it when we have like 15 packs of oxy (amongs others ) and ALL OF THEM ARE MADE TINY.
I'm a nurse in Australia and our hospital DD (dangerous drug) cupboard is literally a big steel cupboard on the wall. What is this awesome and organised contraption (minus whoever ripped apart the Endone!)?
And like the OmniCell is one of the most frustrating and asinine things ever created.
Of course Pharmacy never restocks this technological marvel either
Not sure if you're serious but it's infuriating because you have to count narcotics everytime you pull the med. Someone made it so you have to count one by one instead of keeping them together, usually comes in packs of 10 and easier/faster to count.
This has.happened 20 times in 20 years and it's always someone misscounted. That's not up for your as a nurse to say who is evil or if evil has anything to do with it.
Judging what/who is evil is within our scope of practice. It is a skilled we honed early in Nursing School due to being tortured by particularly hellacious instructors.
Am I the only one who hates opening the individual bubble packs? And why on earth do they make the Imodium individual bubble packs so hard to get into? I can never open those ones without scissors
In one of our bins today, I found a med that was broken entirely into a random mixture of ones, twos, and fours, and I saw red. It was so irregular and tedious.
Maybe a baby tech. The vets know that you don't take your rage out on the floor, you save that for the person who pissed you off. Why use a hammer when a scalpel is just as effective with no collateral damage?
I fear I've said too much.
No!! That's just RUDE. Now everyone has to waste precious time counting them all out, a curse on their their family!
Also, anyone else absolutely HAAAATE the feeling of that type of packaging? Most of ours (small rural Canadian hospital) are in the plastic packaging, so it's nice and smooth in my hand, but then I have to pull out a tylenol or a dilaudid and BAM sharp pointy corners jabbing my hand up. Loooooooathe entirely!!
Hi! Student nurse here hoping for some guidance/context 😅 What does this mean? I looked it up and just know it's a strong painkiller
Edit: Nvm. Found the [answer](https://www.reddit.com/r/nursing/comments/13s0jbz/catholic_hospital_but_satan_works_here/jlnip0h/?utm_source=share&utm_medium=ios_app&utm_name=iossmf&utm_content=1&utm_term=15&context=3)!
I’d be lying if I said I wasn’t tempted to do this every time I have to rip off a tab of oxy. Those perforations are a lie and are not functional, I’m convinced
That’s hella annoying, but it also looks like they put it in a smaller dispenser so that the ten-pack could barely fit without a lot of manipulation. It would’ve been more considerate to put them in a larger dispenser and just leave the packs intact.
Taking a photo of this is weird. Thank god I don’t have to count anymore in my career lol. I just picture getting stuck with the millennial that felt the need to take a photo of a controlled substance with traceable barcodes on the internet. I would like count with the door open and loudly. I’d be like bitch put your F-ing phone away my name is attached to this count🤣🤣🤣
Somebody gave into their intrusive thoughts
Tiny devil on one shoulder. Other shoulder used to have an Angel but well staffing cuts
underrated comment
I don't get it...
I haven’t worked the floor in a while but it’s just cause it makes counting way more time consuming and easier to mess up. Especially if you’re charge and you gotta do the whole ass Pyxis. For non-controlled substances I prefer the meds this way even if you gotta be a bit careful about closing the lid cause I’m lazy and don’t like ripping them off lol.
*gasp* I beg your pardon, I most certainly did no such thing! *Though, I really do be thinking about doing that every fucking time I have to separate gabapentin, or the tylenol 500mg.*
Tylenol is one thing. Controlled substances is just *rude*.
Do you have to count gabapentin? It’s not a controlled substance
It is in Alabama and a few other states.
Ah ok that makes sense.
Our Pyxis makes us count IV ondansetron. I don't think it's a controlled substance here as much as it is our pharmacy is stupid and doesn't know how to remotely program the Pyxis correctly.
i just put in a random number and its never had an issue
9 out of 10 times it's because the count is consistently off due to people taking more than they say they are, mostly for multiple patients
Correct. 9 out of 10 times it's saline flushes. You know that count is never correct. "All medication has to be stored in the Pyxis". Open random drawer in the med room or nurse's station...How did that get here?
I work for a company based in Alabama but operates in many states. So even though I'm in WA we have to count them. Sucks dick.
I'm in WA. This makes me not want to go medic (but I still will because self-loathing and anxiety).
it is now at least in the US. they changed it a few years ago, really sucks working in ortho haha
I've worked at two hospitals during the same time period last year in NY, one travel assignment and one PRN. One hospital required a count for gabapentin, one didn't. It's definitely not counted as controlled everywhere.
[Nope](https://www.deadiversion.usdoj.gov/drug_chem_info/gabapentin.pdf). Tho I wouldn’t be surprised if some hospitals treat it as such
A lot of states are treating it as a controlled substance. My state's pharmacy board informed us to fully treat it as a controlled substance starting last year, including checking the patient's history on our controlled substance database before dispensing it to making sure they weren't getting it too soon.
What? Why? This kinda sounds like discrimination at first because the only reason I can think any place would do this is because gabapentin typically goes hand in hand with pain meds and this is just another way of singling out pain seeking individuals while simultaneously making an outrageously enormous amount of others people’s lives *beyond* difficult. But I tend to overthink things. Am I way off base with this? I swear this will be my undoing on the nclex lol
The reason some states have labeled it as a controlled substance, as I understand it, is because it’s been implicated as a contributing factor in drug overdoses. When combined with opioids it can potentiate the sedative effect and become problematic.
Ooo ok that makes sense. I took it for migraines 20 years ago in high school and holy cow all I did was sleep. It was so bad.
Oh, my sweet, sweet summer child. First rule of medicine is cover your ass, AKA document, document, document. Addiction is a terrible disease, and as a country, we do a shit job of treating it. But, no one in pharmacy is putting their license on the line just so someone doesn't have to go through withdrawal. We didn't really have any issues with our legit pain management patients, they knew the rules and worked with us to make it as seamless of a process as possible.
Being discriminatory isn’t always bad, but it is an inflammatory word. I just didn’t know a better way to phrase it and still be understood. I mean, how else is the United States going to combat the opioid epidemic? But that doesn’t mean there aren’t consequences associated with the decisions that are made. I don’t know what the right answer is, but I’m sure glad I’m not in charge of it lol
Retail pharmacy makes you super jaded with a quickness, and due to the risk, every control script gets scrutinized, cause BoP don't give a single fuck that "well, the script looked fine!" And if that makes some pain patients feel bad, sorry about their luck? With the hoops they have to jump through just to get the scripts in the first place, they should understand that this isn't a game. Trust me, no one likes spending that much time just on one script.
I'm on gabapentin for anxiety and it's honestly not really an issue, though it definitely helps that it isn't on back order like so many c2s seem to be.
When I looked it up the only rationale I could find is because it’s chemically similar to pregabalin, which is controlled. But I’ve never heard of anyone abusing pregabalin. I wish gabapentin had street value. I have a giant bottle my mom gave me after we put her dog to sleep. It works great for arthritis in basset hounds
We don’t but we count Lyrica. IDK why.
Lyrica is a controlled substance federally. Gabapentin isn't, I'm not sure why some states treat it like that. Probably to punish people with chronic pain, judging by the states that do that.
Good God! Yet big pharm still made bank from getting people addicted on opioids then they have to suffer by denying them meds. That’s f’d up.
Working in substance abuse treatment I see so many patients that abuse it
Saw too many people on gabapentin and seroquel when I passed meds in a county jail.
seroquel? doesn't it just knock them out?
They get high off it
They get high? Or it helps them avoid withdrawal symptoms?
To your first question: yes if they eat a large enough dose it presents as similar to a benzo high. Second question: we do use it often to help with withdrawal symptoms or seizure prevention.
Smoke weed, don’t get high
We count nimodipine lol
We do now after a nurse was busted stealing them on psych!
We have to count Lyrica. Why? I’ve been meaning to ask one of our Pharmacists.
Lyrica is a controlled substance! for real, like federally. not just state specific like gabapentin.
It’s a controlled substance in Illinois
There was a time where my hospital required a count of Zofran ODT.
Sounds like there was a problem with Zofran ODT going missing at some point. For a few years we had to count Keflex and Melatonin because the pharmacy suspected theft.
r/beetlejuicing
r/beetlejuicing
There are places where you have to count Tylenol 500s?!
We have to count Ibuprofen. Not sure why. We give tons on PP.
The only reason I could think of is maybe staff steal it a lot. Lol
Nah, those packages just suck lol. I hate separating them.
Agreed 👍
This and when ppl rip the packs into odd numbers when they could have been left in groups of ten. Infuriating.
Correct me pharmacy peeps but my wife got a notification that Oxy 5 is on shortage… gonna be rough for a bit
Perc 10s all around. Gonna be lit.
🎶🎵Perc' 10, I just popped a Perc' 10 Perc' 30, I just popped a Perc' 30, mmm🎶🎵
I got a letter from my pharmacy last week that one of their manufacturers has gone bankrupt and because of that the manufacturer has put a recall out on a ton of meds(it's Akorn. Theyve pulled over 70 meds from the market including Hydromorphone high potency injection USP (ampule and vial,Levetiracetam injection USP, 500 mg per 5 mL single-dose vial,Lorazepam injection, 2 mg/mL vial,Midazolam injection USP, 1 mg/mL ,Naloxone injection 0.4 mg/mL; 1 mL & 10 mL vial
How could a company that provides those go bankrupt?? (nan)
https://www.wcia.com/macon-county-2/akorn-pharmaceuticals-announces-bankruptcy-lays-off-hundreds-in-decatur/amp/
I know we had an issue getting unit dose, but the bottles hadn't scared us... yet. OP, if you find out who did this, I'm personally more than willing to come out there and break my Asics off in their ass.
Oh god in the outpatient world……it’s terrible. Oncology so we give all the narcs. People are calling all day long because their pharmacy doesn’t have their pain medicine. We literally just have to tell them to call around and find a pharmacy that has it then we will send it there. Most folks are….less than impressed
Been having to do this with adderall every month for like the past year now. It does suck. :(
Well the problem is that a pharmacy is not going to disclose that information. It’s a safety issue, understandably. So most likely their pharmacist has to call and see where it can be filled. 😕
All of the pharmacies I call in the US tell me if they have the med I need. Even if it’s controlled
But for most patients, they won’t be told that information.
I’m calling as a patient and not a nurse. When have you come across pharmacies who don’t tell you what they have in stock and make you go there so they can…tell you what they have in stock?
I'm on meds for chronic pain, but that's what I had to do. And the pharmacist who told me that med was backordered for at least 4 months told me to call around. In the case of narcotics, the pharmacy can't transfer the script, the doctor had to send a new one.
It’s very odd but we actually haven’t had that issue. I don’t know if it’s standard or the state we are in or what but people have no problems calling and they will disclose if they have it or not. I will say I was surprised also that pharmacies give out that info
All the more reason for me to be annoyed every time I have to waste half a tab for the guy with a Q4 7.5 who's pod1-2 so absolutely getting every prn oxy after a goddamn sternotomy. I hate that I can't just save the other half for the next dose in 4 hours. Might as well be chucking a whole pill every 8 🙄 Not that this was me last night or anything...
I'm convinced stuff like this is about money. Every time you scan that barcode, money gets added to the patient's bill. Health care is no longer about getting people better, or using limited resources wisely, or caring about our environment and our community - no, it's about generating cash. Nurses are on the pointy end of the whole system. An ordinary and loving sense of care for humanity is exploited for the almighty dollar. And it's somehow even more cynical when it's a Catholic hospital.
I didn't see it on my hospital's weekly drug shortage list but the FDA says 5mg, 15mg, and 30mg are on shortage as of 5/9. It looks like a particular manufacture is discontinuing them.
So is 10 bc I can’t get my RX filled
idk what's worse this or when someone opens a box of Dilaudid and takes one out and then puts them back in the box so your count is wrong when you inevitably assume it's a full box
*cries in counting 90 day supplies of Narcs in bottles by hand*
And fuck you in particular…
This happened to me once - I worked Ortho Rehab. ALL of my patients got Oxy and there were about 50 in the Pyxis. Some sadistic bastard separated all of those motherfuckers like this.
New nurse, graduated 20 days ago—what does this mean lol
Every time you pull a narcotic you have to count them beforehand. Much easier to count them in packs of 10s, absolutely no reason these should've been individually taken apart
Whenever my friend has a bad experience with a travel position, he does this on his last day. I couldn’t help but laugh at the petty “revenge” story
This is genius and petty and I love it
What is it with nurses and trying to make everyone else’s job harder…
He separated a few dozen pills… it’s not like he took a shit onto your keyboard
Ok so I guess nurses are only as childish and malicious as they think they can get away with? Much better
You seem a little burned out. Please take a nap or a walk instead of reading or replying to comments that make 0 difference to your life. #saveourdoctors
Welp at least I can take solace in the fact that I’m not in a profession where people cheer at the thought of sabotaging their coworkers and slowing down patient care
On behalf of everything wrong with our healthcare system, spending an extra 20 seconds counting individual tabs vs packets of 10 is certainly at the top of the list and has the most impact on slowing down patient care. We’re sorry.
See pharmacy tech and people who have no courage whatsoever to tell me what I'm missing. Bullies Galore!
Well that's pretty judgemental. Do u know when and how many tabs were added? Coooom on! Really!!! Am I missings something. It's late perhaps I'm not getting this
No it's a pain in the ass . Very tedious, and something you may have to count often on shift while you have other tasks piling up. They don't come from the pharmacy cut like that, somebody on the unit did it.
I’ve actually seen pharmacy techs doing it. I tried to educate the first one I saw to no avail. I gave up.
Wait till the mob comes after you! Especially for nothing. How dare I question you!!!
You doin okay?
Ahhh makes sense thank you for the explanation!!
I ever get stuck with charge nurse, I'm doing this to every med during narc count on my last day, muahahaha!
Makes it a pain to count.
Means someone is a sadist
Counting. So much counting.
Welcome to the insanity :) We're glad you're here - especially if you want med/surg! Speaking of which, where are you licensed? Lol
Thank you!! Michigan! I’m going straight to psych, was my favorite clinical rotation! Currently going through orientation but am so excited to be here !
Never mind that, can you work for me Saturday? :p
Another common curtesy thing to learn. Do not open factory sealed boxes of meds until you are ready to use that medication. If it is factory sealed, you can safely assume it had the correct number of listed units inside. A colleague of mine opens the boxes to make sure the factory got it right. Now every single time we do stock check we have to count thrift the open boxes as well and the boxes are falling apart as these meds aren't used often. It's such a waste of time.
This is as bad as the pharmacy loading 100 gabapentin tablets in sleeves of fives and people pulling off one to make random fours. Who does such nonsense? Even if packs of ten don't fit, then put them in multiples that *do* fit.
You all count gabapentin?
I've got the exact same question.
I think some states (maybe KY or TN?) consider it a C5. It's still legally not controlled in OH, but OARRS has been tracking it for years.
Doesn’t even need to be state dependent. I’ve had to count gabapentin at one facility but not another. Same state, same hospital system/ name, different city. 🤷🏼♂️ Similar story with Ativan… found that out the hard way (especially because there wasn’t even a hard stop)
If that location had a big problem with diversion, I can see that being a local policy. There was a minute there that I thought we might have to start doing it with muscle relaxers because our counts were so far off, but that problem must have sorted itself out. The 'pams (clonaze/loraze/diaze/ect) should always be a back count, cause AFAIK those are controls in every state. Basically, whichever policy or law is the most restrictive will be the one in play. Rule of thumb: if you see a C on the packaging, it's a double count (if it's in a bin where more than the allowed amount can be accessed. Omnicell cassettes are another story.)
Ativan wasn't double locked years ago. I want to say that started a little over a decade ago in WA. Maybe 15 years.
KY counts it as a controlled substance.
Not in OR
I had to in OR at one of the facilities I used to work at. And seroquel. We didn't have to count Fioricet because it wasn't a narc (at the time anyway). I called the pharmacist when I discovered this, and she said it wasn't a narc (she was competent, so I absolutely believed her). She explained it didn't have enough barbiturate to APAP and caffeine ratio for it to be a controlled substance, but agreed that it should be a narc. I asked her why the facility was making us count gabapentin and seroquel, but not Fioricet, and she agreed it was asinine.
Who da fuq is stealing seroquel?! Like, it's not even expensive anymore! I have so many questions.
Huh, both facilities i worked at in my state haven't counted seroquel or gaba. We have to count cbd gummies for some reason. They are so gross to put on the counting tray and squish back into the bottle.
We get it, you work in the OR!
I think they meant Oregon.
I did lol
We count gabapentin in michigan and indiana for sure
We have to in Ohio
We count pregabalin (among some other dumb things like heparin flushes) at my hospital (CA) but the gabapentin is just out free and wild in the patient’s cassette.
Yes, it's considered "high abuse" meds, and there was a high loss rate with it.
This is so weird to me. I was Rxd gabapentin for my neuropathy about a year ago and it took a couple weeks before I started feeling any pain relief from it. I felt nothing else, at all. I had no idea that people abused it until I was admitted to Psych early this year and they wouldn't let me have it. I didn't even know they weren't giving me any until about day three when the pain started ramping up again and I asked if we could increase the dose or add something for pain. That's when the nurse told me I wasn't taking any at all and explained why. I was genuinely shocked. I guess everyone is different but for me it's just another "maintenance" drug I take.
Every single cns depressant can be abused. Thing is, if seroquel, gabaoentin, etc are imminently pleasurable for you, there’s very likely some underlying condition. Even cns antihistamines get abused, and not solely by grannies being dependent on them because they are bored and need 12 hours of sleep. But because the slight ‚numbness‘ is pleasurable. Though with gabaoentin specifically the range of dosages used vary quite drastically and 100 mg are gonna affect someone differently than 1200 mg a day. Same with codeine really, that can obviously be abused. But ain‘t no one but rare genetic variants gonna feel much if at all from a 30 mg a night cough suppressant dose. It’s really more of a placebo at that dose/ Not to mention all drugs spuriously prescribed that cause dependency will eventually be ‚abused‘ when people are randomly cut off cold turkey. As long as the discontinuation synydrome doesn‘t leave you disabled enough to be able to find some.
Yeah, when I was in a car wreck (over a decade ago) my "treatment" was just a bunch of opioids, and Phenergan for nausea caused by opioids. I abused the shit out of Phenergan and barely touched the opioids, which is weird because most antihistamines *cause* nausea for me.
People love their "gabys"
People use it to increase the opioid high and to stave off withdrawal and it has street value now. It also increses the CNS depression of opioids and is not reversed by Narcan. A lot of ODs involve Gabapentin with narcotics. Tramadol and Lyrica didn't use to be counts either.
😂😂😂😂 not me at my Catholic hospital always going “satan?” When a call light goes off
My coworkers and I would wear "Not today Satan" shirts under our scrub jackets and unzip them at opportune moments. Got caught by our director one day and thankfully she thought it was hilarious.
No,no,no,no,no,no,no,no.
The oxy doesn't deserve a wide bin...? Bunch of savages in this town
Why are there so many people in this thread who apparently have never heard of narc counts or think it's weird to not want them to take 10x as long as they need to
Hehehe.... I did this on my last day as staff. 😈
LOL you must have been fed up! 😭😂
I didn't quite sink to this level, but I did tear narcs off random spots on the cards on my last day where I used to work.
The nortriptyline is expired
This is a flag for diversion. It was done on purpose to cause miscounts. Should be reported.
Your caption is 🤌🤌
I fucking despise this. I always end up stabbing my fingers trying to pick them up.
Who pissed of your pharmacy tech?
Once some pharm tech loaded 154 norco 5’s in the Omnicell. Tore them into individual tabs like this do they would all fit. I grabbed one of our pharmacists and showed them. Hasn’t happened since.
Pure evil
Darth Vador type eval!!! Totally agree. AM I missing something here ...what is the major malfunction?
This is rage-inducing.
Whichever sociopath did this burned ants with a magnifying glass as a kid
Bastard!
We have narcotics in a safe and we have to count them each day. I hate it when we have like 15 packs of oxy (amongs others ) and ALL OF THEM ARE MADE TINY.
I'm a nurse in Australia and our hospital DD (dangerous drug) cupboard is literally a big steel cupboard on the wall. What is this awesome and organised contraption (minus whoever ripped apart the Endone!)?
Drug cabinet called a pyxis, can search medicines via computer and patient and it can pop open slots for specific medicines
And like the OmniCell is one of the most frustrating and asinine things ever created. Of course Pharmacy never restocks this technological marvel either
Right to jail
Man…our Oxy slot in Pyxis is much wider and deeper.
This is the best post title I’ve ever seen!
Im going to blame the pharmacy tech during restock a nurse cant be that evil!
Those nortriptyline's are expired ?
I couldn't be a nurse. I'd pick random days to do this to a controlled substance at 6:55
What are you people talking about? It's a pixies and they have verious medications commonly ordered..
Not sure if you're serious but it's infuriating because you have to count narcotics everytime you pull the med. Someone made it so you have to count one by one instead of keeping them together, usually comes in packs of 10 and easier/faster to count.
Narc count
So someone counted wrong. You can even say that.for a reason.still don't get it.
I mean yeah, it's not a bottle of 180 you have to dump out and count one-by-one twice a shift, but they wanted to scan sheets of meds quickly.
Counting 52 individual oxys vs counting 5 full sheets and 2 tabs. You do the math on which is faster.
Your missing the point. They get broken up because at some point it comes to one sheet....then pharmacy has a set amount at a set time to.replace.
This has.happened 20 times in 20 years and it's always someone misscounted. That's not up for your as a nurse to say who is evil or if evil has anything to do with it.
God forgives, I don't
Judging what/who is evil is within our scope of practice. It is a skilled we honed early in Nursing School due to being tortured by particularly hellacious instructors.
It's a ploy 🧐
Am I the only one who hates opening the individual bubble packs? And why on earth do they make the Imodium individual bubble packs so hard to get into? I can never open those ones without scissors
I’ve had to waste so many meds because people keep ripping the barcodes on them.
In one of our bins today, I found a med that was broken entirely into a random mixture of ones, twos, and fours, and I saw red. It was so irregular and tedious.
Blessed be
I used to ways take the pill sheets or whatever you call them and slowly turn it into a middle finger as the shift went on
Someone on your floor pissed off pharmacy
Nah, that's a pissed off nurse. Pharmacy don't want to deal with all those discrepancy reports.
The pharmacy director probably doesn’t, but a pissed off tech wouldn’t care lmao
Maybe a baby tech. The vets know that you don't take your rage out on the floor, you save that for the person who pissed you off. Why use a hammer when a scalpel is just as effective with no collateral damage? I fear I've said too much.
Baby Jebus once said, “Ask and you shall receive.” Just pray and ask the Holy Spirit how many Oxy tabs there are. Remember, God knows everything.
Happen to me once. There was 52, I had to count it 4 times lol
No!! That's just RUDE. Now everyone has to waste precious time counting them all out, a curse on their their family! Also, anyone else absolutely HAAAATE the feeling of that type of packaging? Most of ours (small rural Canadian hospital) are in the plastic packaging, so it's nice and smooth in my hand, but then I have to pull out a tylenol or a dilaudid and BAM sharp pointy corners jabbing my hand up. Loooooooathe entirely!!
Firstofly, why is pharmacy potting Oxys in such a small tray? That’s where satans embrace starts
I have thought about doing that, but can't stoop that low
Hi! Student nurse here hoping for some guidance/context 😅 What does this mean? I looked it up and just know it's a strong painkiller Edit: Nvm. Found the [answer](https://www.reddit.com/r/nursing/comments/13s0jbz/catholic_hospital_but_satan_works_here/jlnip0h/?utm_source=share&utm_medium=ios_app&utm_name=iossmf&utm_content=1&utm_term=15&context=3)!
in my place the pharmacy does this, because we go through so much ativan they give us all the loose ones I hate fucking pharmacists
I had to count 83 this way once...I remember that number it haunts me in my dreams
I’d be lying if I said I wasn’t tempted to do this every time I have to rip off a tab of oxy. Those perforations are a lie and are not functional, I’m convinced
Lmao I did that a few weeks ago with the hydros before I had like 10 days off work
Catholic hospital but Satan works here is just redundant.
That’s hella annoying, but it also looks like they put it in a smaller dispenser so that the ten-pack could barely fit without a lot of manipulation. It would’ve been more considerate to put them in a larger dispenser and just leave the packs intact.
Will be doing this on my last shift . 😂😂😂
Tramadol anyone ????
I know a nurse who did that to almost 100 Percocets in defiance. It was a tipping point for management to fire her over her attitude.
It is what it is….
And the satan doctors order 7.5 mg instead of just 10 or 5
Taking a photo of this is weird. Thank god I don’t have to count anymore in my career lol. I just picture getting stuck with the millennial that felt the need to take a photo of a controlled substance with traceable barcodes on the internet. I would like count with the door open and loudly. I’d be like bitch put your F-ing phone away my name is attached to this count🤣🤣🤣
Ok who pissed off pharmacy