But It's Sooooo HARD

I love the mid afternoon lull. The lunch rush is over with and the after work rush is still about 45 minutes away. Granted you're still busy, but it's not nearly as chaotic as it can be.

Sipping on my Mtn Dew I grab a Rx off the fax, read it and immediately chuckle.

Patient Name : Morbidly Obese
Drug : Freestyle Lite Test Strips
10 MISC Vials (30 day supply)
Date: 7/30/09
Refills: One
Dispense as Written
Instructions: Use As Directed
Provider: Julie Dipshit, RN, CDE

Who can pick out the problems with this particular prescription?

First I have no idea what 10 MISC Vials (30 Day Supply) means. I assume that's a quantity of 100, but I'm really not too sure.

Second, a DAW? Seriously? What the hell have you been smoking?

Third, Use as directed? Now this may be okay for some of you, but in our area the insurances have begun cracking down hardcore on sigs that state this. To be honest, I actually understand this one to a point. People who are getting 200 strips a month but only test twice a day is a bit ludicrous. Plus it's very simple to fix.

Finally, the RN signed off on it. There was no doc listed anywhere on the Rx and I know CDEs aren't granted the power to write prescriptions.

So I grab a chair, my trusty old phone, make sure I have enough Dew to last me and dial the Diabetes Office this came from.

I had the pleasure of talking to another nurse that I shall call Hilda. I kindly explain the situation to her and state what I need done before I can fill this.

Her response? "So you want me to get the doctor to sign off on every single thing that comes out of the Diabetes Center"

Myself: "Well generally prescriptions have to have a providers name on it, so yes that is needed"

Hilda: "And you want to know how often she tests? Why can't you just use what we put on there"

I then explain to her the situation with insurances in the area.

Hilda: "I've been doing this for years and you're the second person I've had ask for this in that time. Do you realize how this is going to complicate the relationship between the CDEs and patients? It's going to take days to get these signed off on"

Myself: "It won't take days, especially since I'm sure the doc is already aware that this needs to be done."

Hilda: "But it just doesn't make sense." *SIGH* "I guess I can go get this done for you. Is there anything else you want done?"

Myself: "Yes, what's your supervisors name?"

Have I mentioned again how much I love nurses? I left out the fact she referred to herself as a CDE about twenty times during our conversation.

At least it gave me something to giggle after lunch.