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PAs now can no longer order schedule I and II in HCA hospitals


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So, I just received an email from my medical director stating that we the midlevels can no longer order schedule I and II drugs in the hospital and have to ask the Drs to order it for our patients. I know that we can't write Rx for out patient use but this is completely new and I can see how it would affect pt care. Can you imagine chasing the Dr who is in the middle of the code to order some Morphine for your patient who is on the floor with kidney stone pain. This is an HCA hospital in Georgia. Any body out there experiencing this in other HCA hospitals or any other hospitals?

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So, I just received an email from my medical director stating that we the midlevels can no longer order schedule I and II drugs in the hospital and have to ask the Drs to order it for our patients. I know that we can't write Rx for out patient use but this is completely new and I can see how it would affect pt care. Can you imagine chasing the Dr who is in the middle of the code to order some Morphine for your patient who is on the floor with kidney stone pain. This is an HCA hospital in Georgia. Any body out there experiencing this in other HCA hospitals or any other hospitals?

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So, I just received an email from my medical director stating that we the midlevels can no longer order schedule I and II drugs in the hospital and have to ask the Drs to order it for our patients. I know that we can't write Rx for out patient use but this is completely new and I can see how it would affect pt care. Can you imagine chasing the Dr who is in the middle of the code to order some Morphine for your patient who is on the floor with kidney stone pain. This is an HCA hospital in Georgia. Any body out there experiencing this in other HCA hospitals or any other hospitals?

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oregon used to be like that before we got sch 2 dea script rights...totally sucked....you learn really quickly to write for a lot of stadol, talwin, nubain, etc which are scheduled but not sch 2.

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oregon used to be like that before we got sch 2 dea script rights...totally sucked....you learn really quickly to write for a lot of stadol, talwin, nubain, etc which are scheduled but not sch 2.

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In Texas, as a paramedic, I can administer Fentanyl and Morphine and any Schedule II on an ambulance w/ no online medical direction or supervision (all standing orders), but as a PA I cannot touch them or have my name in any way associated with them.

 

Something is not right there. Maybe it's because paramedics have all the fun with a two week pharmacology class and PA's well.... they are just "assistants..." ;)

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In Texas, as a paramedic, I can administer Fentanyl and Morphine and any Schedule II on an ambulance w/ no online medical direction or supervision (all standing orders), but as a PA I cannot touch them or have my name in any way associated with them.

 

Something is not right there. Maybe it's because paramedics have all the fun with a two week pharmacology class and PA's well.... they are just "assistants..." ;)

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In Texas, as a paramedic, I can administer Fentanyl and Morphine and any Schedule II on an ambulance w/ no online medical direction or supervision (all standing orders), but as a PA I cannot touch them or have my name in any way associated with them.

 

Something is not right there. Maybe it's because paramedics have all the fun with a two week pharmacology class and PA's well.... they are just "assistants..." ;)

 

All the mind can do is stutter.

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In Texas, as a paramedic, I can administer Fentanyl and Morphine and any Schedule II on an ambulance w/ no online medical direction or supervision (all standing orders), but as a PA I cannot touch them or have my name in any way associated with them.

 

Something is not right there. Maybe it's because paramedics have all the fun with a two week pharmacology class and PA's well.... they are just "assistants..." ;)

 

All the mind can do is stutter.

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I am not sure, but I remember that this battle has been fought before.. I think the answer to it was to get administration to reconize te distinction between a PRESCRIPTION. And an ORDER in the inpatient/hospital setting, where in the orders would be, by hospital staff rules, countersigned almost immediately. Certainly you could order " per verbal order of Dr Jones".

 

A good case can be made for your being able order schedule IIs, especially in emergent situations... Like an ongoing acute coronary syndrome, or fractured large bone, or renal or biliary colick... Is your boss willing to support you on this? What do your credentials state?

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I am not sure, but I remember that this battle has been fought before.. I think the answer to it was to get administration to reconize te distinction between a PRESCRIPTION. And an ORDER in the inpatient/hospital setting, where in the orders would be, by hospital staff rules, countersigned almost immediately. Certainly you could order " per verbal order of Dr Jones".

 

A good case can be made for your being able order schedule IIs, especially in emergent situations... Like an ongoing acute coronary syndrome, or fractured large bone, or renal or biliary colick... Is your boss willing to support you on this? What do your credentials state?

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I was able to write post-op Sch. II narcotics in an HCA facility back in the mid-80's IF it were written as ...."per Dr. Such and Such". I don't understand the statement above about "have my name in any way associated with them". You can write all the orders that you want, they just may not get carried out. I also don't understand why prescriptive privileges have to be so convoluted. If you can order such a medication I would think that you should be able to administer it. Don't the two go hand in hand?

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I was able to write post-op Sch. II narcotics in an HCA facility back in the mid-80's IF it were written as ...."per Dr. Such and Such". I don't understand the statement above about "have my name in any way associated with them". You can write all the orders that you want, they just may not get carried out. I also don't understand why prescriptive privileges have to be so convoluted. If you can order such a medication I would think that you should be able to administer it. Don't the two go hand in hand?

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if it sounds like your dream job and they list looking for an NP ...I would still apply. worst case they throw out your resume. maybe in a cover letter recognize the advertisement language and explain how you might be a better fit .... its probably unlikely this would impact a later hire at the same institution.

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if it sounds like your dream job and they list looking for an NP ...I would still apply. worst case they throw out your resume. maybe in a cover letter recognize the advertisement language and explain how you might be a better fit .... its probably unlikely this would impact a later hire at the same institution.

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  • 4 weeks later...
oregon used to be like that before we got sch 2 dea script rights...totally sucked....you learn really quickly to write for a lot of stadol, talwin, nubain, etc which are scheduled but not sch 2.
Yeah - and all are crappy drugs too. But I guess you gotta do what you gotta do.
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I see this was originally posted 1 mo. ago. However, I too work in an HCA hosp in the ED in VA. we can order and prescribe sch 2. Perhaps the difference is, I am actually an EMcare employee? For what it is worth, the administration at my particular hosp. is not very impressive.

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