My mom receives pain meds (Norco) for her pain from MS. Yesterday at 4pm she asked for her pain meds at her nursing home and the nurse said that they were out and waiting on the pharmacy to deliver. Next day, still no meds, she was in pain all night and constantly asking for them. Next day I call and the meds are supposed to be there by 3pm. Still not there at 8pm. I call and threaten to call the state in the morning if her meds are still not there. At that point they decide to go get them from a special locked place they have at the nursing home. Why didn't they do that right from the beginning? This is the second time this year they ran out of her meds. How can this happen? They blame the pharmacy but I'm not so sure. Is this common or is this something that should be reported?
1. Your mother was left in pain. She shouldn't have been. If that was the fault of the system the NH is using, they need to tighten up the system.
2. Suddenly discovering that they did have some after all in their magic cupboard makes me narrow my eyes. You only have the nurse's word for it that the pharmacy supply hadn't been delivered. It's not impossible that only that day's meds mysteriously "went astray" and for "some reason" the staff didn't want to ask for replacements.
But don't make any accusations: report what happened and ask how it will be prevented from happening again.
It was terrible that your mom was in pain for that long.
I would ask the administrator to complete an incident report ( an internal document) and ask the admin to bring it to the Center's Quality Assurance Committee for their review.
Then ask then what steps they are going to take so that this type of episode doesn't happen again for anyone in their care.
I'm so sorry to hear what happened with your mom's pain meds. I would report it as well. That does not seem in line with proper patient care. Its like you said if they had an emergency stash, why wouldn't they use it right away? Your mom needed that medication. I wouldn't let this slide and report it.
Next time if, God forbid, this happens have the staff call the NH/rehab doctor, let him know the situation, and ask him/her to write for another pain med- even if it's a different strength. The nursing staff can either give the patient a stronger pill cut in half (the pill must be scored and not a time released formula so it can be cut in half properly) or the pharmacy can cut the pills in half for the NH to administer. The NH should inform the pharmacy that they will only need enough pills to last 2-3 days or long enough for the pharmacy to restock and provide the correct dose to the NH for your mom, but enough to get her through a few days.
My guess is that the folks left in charge are caught between a rock and a hard place. They don't want to elevate the problem for whatever reason until you make it more comfortable for them to do so than not.
I got a lot of lip on why it didn't happen properly but bottom line until I complained nothing happened. I hesitate to complain for fear I might make the situation worse but when your loved one is in pain and you are the one trying to help them it makes it very hard to do nothing.
Raise it first with the NH staff and if your get no satisfaction go to the state.
Pharmacies do frequently run out of medication which is a good reason to order a few days early for everyone.
Pharmacies tend to run their inventories very low to save money so this can happen a lot. It has happened to us several times with very common drugs not narcotics.
Often the NH staff will "borrow" from another patient till the new supply arrives. i don't know if this is legal or not but it does go on.
As for the emergency stock, every nurse in the place who has access to medications should know about the emergency stock. The nurses on duty when your Mom was admitted should have been questioned.
Note to all caregivers. Make sure you always have a list of your loved ones current medications with you at all times. When admitted to any facility ask the nurses to confirm all medications are available and have been provided. Question any aditions or deletions and understand the reason for the change.
Hospitals generally have their own pharmacy so being out of stock is an not usually an issue, but the time it takes the Dr to write the order, the pharmacy to approve it and send it to the floor can take several hours. You need to do these things on admission because you have be advised not to visit for a couple of weeks when admitting a dementia patient to a NH.
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