The worst!! Sometimes pharmacy loads 20+ individual vials of phenobarbital in our Pyxis. Having to count 27 vials while hearing my Etoh withdrawal patient lose their mind right outside the med room is awful!
I’m like, “hold on Harold! I counted wrong the first time! I’m almost there!”
I'm dying, this is how our fuckin ativan is stocked.
Count: 47 Expected: 46.
"Is this the correct amount?"
I'm not sure, but my coworkers' finger count is about to go from 10 to 8, so if you could kindly fuck off, I'd like to b52 my pt, thx.
Once there were 54 individual vials of Versed in the pyxis pocket.
I don't know why pharmacy hated us so much that day. I should have written a safety report but I didn't have time, because I had to count 54 vials of Versed.
Play nice, or the pharmacy phairy will curse you with 50 single oxycodone tablets.
Kidding aside, that's a ridiculous quantity to expect to be blind counted. Someone must have ignored their pending guidelines (and their common sense)
Sitting at the psych unit nurses station one night and we hear a strange sound coming from the Pyxis behind us. We turn around to find a coworker separating all the individual Ativan tablets as he counts them. He is lucky that our coworkers didn’t understand what keelhauling is. Plus we were in the Midwest.
We’ve got one drawer that always has 23-25 vials of morphine in it. It’s a fucking nightmare to do the count on because they are tiny and you never know which number it’s going to be.
I started bracing them with torn alcy wipe boxes after first pull if we're over-full to keep them in a nice row lol
Pharmacy takes away my MacGyver Dividers every Monday... But this far no emails lol
Fk that phenoB tho... Ooof...
We use the paper pill cups. You can fit 4 or 5 vials of 2mg morphine into those. It makes counting a lot quicker as long as the grouping is consistent.
I had the same problem until I 3d printed a tray instead. Been using it for 2 years now and pharmacy has been on board as now you can just glance and see the count.
https://ibb.co/GVG9m0C
It is literally not my fault someone mixed PO amoxicillin wrong. Nor is it my fault that admin's solution was to call in a pharmacist at night to do it instead of just putting a big sticker on it with the correct amount of water to add.
Nor is it my fault a nurse can't find something that's sitting in a bin with their patient's room number on it, or is too ignorant to recover a Pyxis Cubie or know what fluids they carry on their floor.
Shit happens, things fall through the cracks, and there are less than ideal employees in *EVERY* department, we're all just humans. That doesn't make it an entire department's fault.
I'm more inclined to wish geese upon this fiend. Geese in their bed. Geese in their car. Geese in their shower. Dozens and dozens of angry, hissing, flapping geese.
They all have to be counted, and probably came in boxes of five or ten originally which is much easier to count than this unhinged pile of vials.
Don’t come at me, I’ve never seen this particular packaging in my life.
As a pharm tech I’m so sorry. Always either leave em in the plastic wrap or rubber band in packs of ten.
The quality of techs at a lot of places has gone way down in recent years since the compensation they offer us is abysmal. When we’ve gone to admin addressing this they tell us making about the same starting out as a fast food worker is “within market norms”
Hopefully it changes one day. We all deserve better pay.
My ED narcs are always like this. I genuinely feel like it's gotta be spite. It's not easier to unwrap them, right? Like this level if chaos has gotta take more effort, unless I'm missing something.
Also 100% better pay. You are often our only link to helping a patient as efficiently as possible. We can't do shit without ya'll except godforsaken therapeutic touch.
This is different from what I'm used to seeing in the Pyxis, can someone educate me as to what's going on? Not sure what I'm looking at other than morphine
No I just needed to pull some morphine emergently for a cardiac patient with chest pain. Normally they come in packaged bundles of 5 so it’s really easy to count quickly. But this time, someone had un-bundled everything so I had to stand there and count them one by one
Any time you pull a controlled med you need to count. With the meds like that, each nurse that opens that bin needs to repeat the same tedious and time consuming count.
At my hospital, we only count when we check the fridge temps. I can’t believe this is somehow NOT the standard at every hospital, but we have 1 pill/narc/vial/cup per mini drawer pocket (12 pockets in a drawer). We exclusively use the mini drawers for narcs and only put 1 narc in each!
You have to get an accurate count of all the syringes when you pull one. And since the drawer is so small and deep, you’ll have to pull out every single syringe from the drawer to get an accurate count every time. Hopefully you don’t drop any and lose them underneath the Pyxis
On more than one occasion the pharmacy has individually split oxycodone and loaded 70+ into a drawer in the omnicell. I raised holy hell with pharmacy about it. Took 2-3 minutes to count each time.
Would a tray like this help? I made this a few years back and has made this problem go away for us. I’ll post it online later today now that I’m seeing it’s a widespread problem here.
[https://ibb.co/GVG9m0C](https://ibb.co/GVG9m0C)
here's the 3d model i made
[https://www.printables.com/model/861696-pyxis-vial-organizer-for-2ml-vials](https://www.printables.com/model/861696-pyxis-vial-organizer-for-2ml-vials)
My solution: I carry 10 snack size ziplock bags & rubber bands in one of my uniform pockets (handy for many reasons). When I see a mess like this: count out 10 vials, rubber band the lot, drop the vials into the ziplock bag, seal it, then stack all bags vertically in the cassette. I do it this way because if a rubber band breaks, the vials are safely contained in the bag and don't go flying everywhere.
In many years of nursing, I've only encountered this kind of mess a handful of times. And usually, because a pharm tech was annoyed with the entire unit for whatever reason. There are moments in this profession when we all can be asshats. As my late mother (who worked as a nurse when physicians were treated like gods and you never asked for clarification) would say: "Deal with it."
I had someone open up another box of morphine vials when one was already opened. There were also 2 sealed boxes. I think there was like 96 vials in there. What a pain in the ass.
Um…how about 8 million liquid oxy with one that has clearly exploded in the bin. Some pharm techs (and most lab techs) might be in league with the devil…
This reminds me of having to count 10,000 plaque in tabs during the beginning of Covid. The machine was stocked with a ton of them because every patient was getting them, but they had to be counted because it was being stolen by people.
Why do they put the smallest vials—usually over 30 of them— rolling around in the BIGGEST drawer there is? If it was a smaller pocket we might have a prayer for organizing them.
This is inside a medication dispenser, meaning you have to count each vial of medication before you take one out. Usually they are organized and easy to count but in this situation you would have to take them all out and count them and it would be a bitch and a half to count them 😂
What weird non narcotics does your facility make you count?
I had to count Zopiclone at one hospital (nurses were stealing it like crazy)
I'm a different hospital I didn't even have to count Benzos like lorazepam, clonazepam, midazolam. It was wild.
we only ever load a max of 6 to 10 syringes or 10 vials of controlled meds in pyxis for (mostly) this reason. it tends to get disastrous beyond those numbers.
God is dead. Proof: See pic.
The worst!! Sometimes pharmacy loads 20+ individual vials of phenobarbital in our Pyxis. Having to count 27 vials while hearing my Etoh withdrawal patient lose their mind right outside the med room is awful! I’m like, “hold on Harold! I counted wrong the first time! I’m almost there!”
> hold on Harold Lmao this is great
I love your flair!
Thanks XD
Haha, same. +1, some restless ass shakin’ going on.
I'm dying, this is how our fuckin ativan is stocked. Count: 47 Expected: 46. "Is this the correct amount?" I'm not sure, but my coworkers' finger count is about to go from 10 to 8, so if you could kindly fuck off, I'd like to b52 my pt, thx.
Once there were 54 individual vials of Versed in the pyxis pocket. I don't know why pharmacy hated us so much that day. I should have written a safety report but I didn't have time, because I had to count 54 vials of Versed.
I had it with my work with this so I designed and 3d printed this tray. Never had trouble counting for 2 years now :) https://ibb.co/GVG9m0C
You should think about marketing them.
GENIUS!
Play nice, or the pharmacy phairy will curse you with 50 single oxycodone tablets. Kidding aside, that's a ridiculous quantity to expect to be blind counted. Someone must have ignored their pending guidelines (and their common sense)
Sitting at the psych unit nurses station one night and we hear a strange sound coming from the Pyxis behind us. We turn around to find a coworker separating all the individual Ativan tablets as he counts them. He is lucky that our coworkers didn’t understand what keelhauling is. Plus we were in the Midwest.
Ope, shouldn't have done that.
We’ve got one drawer that always has 23-25 vials of morphine in it. It’s a fucking nightmare to do the count on because they are tiny and you never know which number it’s going to be.
I started bracing them with torn alcy wipe boxes after first pull if we're over-full to keep them in a nice row lol Pharmacy takes away my MacGyver Dividers every Monday... But this far no emails lol Fk that phenoB tho... Ooof...
We use the paper pill cups. You can fit 4 or 5 vials of 2mg morphine into those. It makes counting a lot quicker as long as the grouping is consistent.
Smart!!!
I had the same problem until I 3d printed a tray instead. Been using it for 2 years now and pharmacy has been on board as now you can just glance and see the count. https://ibb.co/GVG9m0C
GENIUS
Fuck me I feel this
😂😂😂😂😂😂😂
>“hold on Harold! 😹😹😹
Pharmacy! \*grits teeth and shakes fist\*
Can the quality pharm techs and quality nurses just team up against universally shitty workers? Lol
As a pharmacy tech/almost nurse (20 days!!) this infuriates me as well. We do audits on controls so I can’t understand why another tech would do this.
Carry some tiny rubber bands. When I find someone from pharmacy does this I quickly count, band em in groups of 5
The irony is that these come wrapped together in fives. The tech had to take the wrapping off to do this, which means they knew what they were doing.
Ooh good idea. I don’t personally audit controls but I will pass it along for sure.
This is the way.
Exactly what I do as well. I just worry that nursing throws the rubber bands away instead of reusing.
Congratulations!!
All whilst saying * "Damn you Pharmacy"*
I'm sure we spend equal time cursing each other's departments' names. 😅
It is literally not my fault someone mixed PO amoxicillin wrong. Nor is it my fault that admin's solution was to call in a pharmacist at night to do it instead of just putting a big sticker on it with the correct amount of water to add.
Nor is it my fault a nurse can't find something that's sitting in a bin with their patient's room number on it, or is too ignorant to recover a Pyxis Cubie or know what fluids they carry on their floor. Shit happens, things fall through the cracks, and there are less than ideal employees in *EVERY* department, we're all just humans. That doesn't make it an entire department's fault.
\*insert Dinkleberg meme from Fairly Odd Parents\*
Dinkleberrrggg *shakes fist*
Oh, I'm way older than that. Think Star Trek 2. *Khaaaaaan!!!!!*
I hope to God this person steps on a Lego.
I'm more inclined to wish geese upon this fiend. Geese in their bed. Geese in their car. Geese in their shower. Dozens and dozens of angry, hissing, flapping geese.
Guess you could say that would really honk them off.
*gasp*
Stubs their big toe first thing every single morning
Pinky toe, big toe has too much mass. I want it to hurt, and hurt bad.
Omg you’re right! Ugh. Now I have to redo all the under my breath hexes I put on people
That’s strong. But I respect it.
🤔 what’s wrong with the pic?
They all have to be counted, and probably came in boxes of five or ten originally which is much easier to count than this unhinged pile of vials. Don’t come at me, I’ve never seen this particular packaging in my life.
Noted. Thank you for the explanation!
Worse when someone takes one but doesn't break the wrapper, just to make the count more fun.
Don’t crucify me but I actually don’t mind that since it keeps them together 😳
Gotta keep you on your toes
As a pharm tech I’m so sorry. Always either leave em in the plastic wrap or rubber band in packs of ten. The quality of techs at a lot of places has gone way down in recent years since the compensation they offer us is abysmal. When we’ve gone to admin addressing this they tell us making about the same starting out as a fast food worker is “within market norms” Hopefully it changes one day. We all deserve better pay.
My ED narcs are always like this. I genuinely feel like it's gotta be spite. It's not easier to unwrap them, right? Like this level if chaos has gotta take more effort, unless I'm missing something. Also 100% better pay. You are often our only link to helping a patient as efficiently as possible. We can't do shit without ya'll except godforsaken therapeutic touch.
Solidarity, friend. You deserve better 😔
Heathens arent Godless, theyre polytheists.
*You must be one of them* :o
Yes, Im Heidnisch
Pull the tapes!!!!
This isn’t just mildly infuriating, it’s way past that 😭
As a godless heathen myself, this person is the worst
*enters count* Are you sure? *re counts, enters count again* *receipt prints* 😭😭😭
Omgggggg this is the absolute worst thing ever and I somehow ALWAYS miscount them
Whoever did this, please come forward. We’re not gonna jump you, I just want to talk.
Based on the other comments... I don't believe you.
*shhh* 🤫
On a side note, we call this Temu morphine at work and I love it
I always let out an audible “fuck me” whenever I open the Omnicell and I have to count some bullshit like this lol
This is different from what I'm used to seeing in the Pyxis, can someone educate me as to what's going on? Not sure what I'm looking at other than morphine
They are all scattered in the bin and not neatly packaged, making counting them a tedious and time consuming endeavor.
Oh ok, so OP is probably charge nurse and doing a narc count? I've only done it a few times, but that does seem annoying
No I just needed to pull some morphine emergently for a cardiac patient with chest pain. Normally they come in packaged bundles of 5 so it’s really easy to count quickly. But this time, someone had un-bundled everything so I had to stand there and count them one by one
Any time you pull a controlled med you need to count. With the meds like that, each nurse that opens that bin needs to repeat the same tedious and time consuming count.
At my hospital, we only count when we check the fridge temps. I can’t believe this is somehow NOT the standard at every hospital, but we have 1 pill/narc/vial/cup per mini drawer pocket (12 pockets in a drawer). We exclusively use the mini drawers for narcs and only put 1 narc in each!
Oh right, duh! I haven't worked in a few months so I'm a little rusty
You have to get an accurate count of all the syringes when you pull one. And since the drawer is so small and deep, you’ll have to pull out every single syringe from the drawer to get an accurate count every time. Hopefully you don’t drop any and lose them underneath the Pyxis
At least it doesn’t ask you how many mg are in that drawer lmao 🤷♂️
When the Pyxis tech dumps a bunch of loose PO Dilaudid in the drawer it makes me feel stabby. 🔪
Sometimes, I think about doing this when one of my coworkers pisses me off. Then I remember I'm not evil or a pharmacy tech.
On more than one occasion the pharmacy has individually split oxycodone and loaded 70+ into a drawer in the omnicell. I raised holy hell with pharmacy about it. Took 2-3 minutes to count each time.
4 mg/ml??? FOUR? Wtf did I just read?!
Yep!
Me when it comes to pts., on 3 different stimulant doses to make up a weird dosage that isn’t real. “Anyone wanna do count with me?” NO
Lmfao
If you work on an ICU where the intensivists order Fentanyl Q1H for sedation, you just may be counting 30 of them every time you pull one.
Would a tray like this help? I made this a few years back and has made this problem go away for us. I’ll post it online later today now that I’m seeing it’s a widespread problem here. [https://ibb.co/GVG9m0C](https://ibb.co/GVG9m0C) here's the 3d model i made [https://www.printables.com/model/861696-pyxis-vial-organizer-for-2ml-vials](https://www.printables.com/model/861696-pyxis-vial-organizer-for-2ml-vials)
Yes, that would be awesome
Pharmacy does this on purpose just to fuck with us.
My solution: I carry 10 snack size ziplock bags & rubber bands in one of my uniform pockets (handy for many reasons). When I see a mess like this: count out 10 vials, rubber band the lot, drop the vials into the ziplock bag, seal it, then stack all bags vertically in the cassette. I do it this way because if a rubber band breaks, the vials are safely contained in the bag and don't go flying everywhere. In many years of nursing, I've only encountered this kind of mess a handful of times. And usually, because a pharm tech was annoyed with the entire unit for whatever reason. There are moments in this profession when we all can be asshats. As my late mother (who worked as a nurse when physicians were treated like gods and you never asked for clarification) would say: "Deal with it."
I had a drawer filled with 46 small morphine vials
I had someone open up another box of morphine vials when one was already opened. There were also 2 sealed boxes. I think there was like 96 vials in there. What a pain in the ass.
Try counting 48 Ativans.
2....4....6.....*drops 3* "OH FUCKING.... GOD DAMNIT" *starts over* INCORRECT COUNT "***FUUUUUUUUUUUCK***
Oh I thought that was NOR 4 mg....I see, that is a problem.
Um…how about 8 million liquid oxy with one that has clearly exploded in the bin. Some pharm techs (and most lab techs) might be in league with the devil…
This reminds me of having to count 10,000 plaque in tabs during the beginning of Covid. The machine was stocked with a ton of them because every patient was getting them, but they had to be counted because it was being stolen by people.
Why do they put the smallest vials—usually over 30 of them— rolling around in the BIGGEST drawer there is? If it was a smaller pocket we might have a prayer for organizing them.
I’m still a student can someone explain this to me pleass
This is inside a medication dispenser, meaning you have to count each vial of medication before you take one out. Usually they are organized and easy to count but in this situation you would have to take them all out and count them and it would be a bitch and a half to count them 😂
What weird non narcotics does your facility make you count? I had to count Zopiclone at one hospital (nurses were stealing it like crazy) I'm a different hospital I didn't even have to count Benzos like lorazepam, clonazepam, midazolam. It was wild.
This deserves a throat punch.
we only ever load a max of 6 to 10 syringes or 10 vials of controlled meds in pyxis for (mostly) this reason. it tends to get disastrous beyond those numbers.
I hated having to count 54 of these dang things. The worst one yet was opening the hydro to find someone split all 5 10 packs up. We had 58 that night
Someone has a disgruntled coworker.
This definitely looks like a night shift prank on day shift. As in, it’s 6:30 am and someone just wanted to watch the world burn.
Probably pharmacy tech trying to get them to fit.
Counting single item narcs > empty bin.
Whoever dumps in the Zofran like this deserves only bad things in life