Tales From The Nursing Shortage; Part VIII

Star Trek says that "Revenge is a dish best served Cold," but I think it's more like "The best Revenge is Living Well."

One of the places I work has a State Monitor because the previous administration pretty much ran the place nearly into the ground. As part of their agreement with the State, they are paying an independent "expert" RN to drive down from Dallas and observe anything we do and be a "Resource Person" when we have questions.

With this RN, it's more like completely ignore anyone is not an RN themselves; and God forbid one of the lowly males has a question. I asked her a question one time and after she was done rolling her eyes and making dismissive noises, she berated me publicly for five minutes and followed me around the rest of the day, commenting on everything I did and savaging my work. And that's fine -- she has her opinion, and I have mine (which is almost always backed up by state regulations or Department of Health procedures, as she quickly found out.) But I don't complain, I keep my head down, and I do my work.

So one of the things she got all over me for was re-using a single-dose vial. This is one of the things that's different in Dialysis from regular Nursing. When we give medications, they're almost always IV push. One of these is Epogen, a synthetic hormone to make red blood cells so the patients don't get anemic. (Just one of the many things the kidneys of a Dialysis patient used to do for them, but don't anymore.) Your average patient receives between 2,000 and 10,000 units of Epogen every treatment (that means three times a week.) Epogen costs about roughly $1.15 per unit.

So these patients are receiving anywhere from $2100.00 and $11,000.00 in medications per treatment. So if you think we're about to throw away a single dose vial with thousands of dollars of unused medications in it, you're out of your mind. The CDC agrees, and has given Dialysis clinics a 4-hour window to re-use a single-dose vial.

So this State Monitor came over and told our Administration that "Single-dose means Single-Dose -- we don't re-enter vials!" and they bought into it. I didn't disagree -- I'm just the temp, why make waves? I did bring it to my supervisor's attention at the time, and he told me to just follow her directives and they would double-check on the regulation.

Now here it is six weeks later, and the Vice-Presidents from Corporate were asking about our medications procedures, so they all walked over to my station. One of them asked about dating and timing the bottles when they are opened, and I told them I did, except for the single-dose vials which are thrown out.

"You throw out the single-dose vials?"

"Well, yes, the State Monitor told us to." And I recounted the conversation to them. You should have seen their faces go white as they calculated the amount of money lost in the last six weeks by this idiot Monitor. (Fortunately for them, I had continued to re-use the Epogen vials, so we were only losing about a $1,000.00 a month, instead of tens of thousands a day!)

So they've started an investigation into this State Monitor to see what other "inaccuracies" she might have told the staff as well.

Heh. Life is sweet. Sometimes you just have to wait for it.

~~JD~~