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Prescribing privileges! A terrifying but fantastic voyage.

February 24, 2010

My peers and I have just received our prescribing privileges. We did some learning about safe prescribing and completed a short exam to ensure that we would survive in the real world. I have been writing orders, including those for some serious medications in the hospital setting, for 2.5 years. When I first heard of ‘writing orders,’ I was offended that we were meant to ‘order’ around the nursing staff. I’ve gotten used to the idea of being responsible for making serious decisions and am starting to come to terms with consequences; I’m fortunate to find myself often working within a team; pharmacists, nurses, and other physicians are often part of the system of checks and balances.

Still, it’s kind of frightening to hold the mighty pen that can write a life or death prescription. Usually it’s not that exciting, but adverse reactions, side effects, and other negative outcomes do happen. On the other hand, I feel great about being able to do a complete visit with almost any patient and not having to run around the clinic looking for someone to sign a ‘script. Freedom! It makes me more efficient, but I also waffle a little more about decision-making since I know only the pharmacist will be the only one to make sure I didn’t do anything crazy.

Our prescribing rights came with a duplicate pad; this is a magical and dangerous tool, used to write narcotic prescriptions such as those for morphine. In palliative care, it is as handy as a hammer to a carpenter; a necessary tool for the job. In addictions medicine, it can be like a rusty nail embedded in your foot.

So, now, I can order almost any medication under the sun; methadone, which I’ll write about shortly, is one exception. It’s exciting but terrifying! I’m evolving towards being a ‘real doctor’ in the same way that Pinoccio craved to be a real boy. I’m glad none of my body parts succumb to elephantiasis when I make a mistake or am not confident. (or is it Dumbo I’m thinking of?!)

8 Comments leave one →
  1. February 24, 2010 11:29 am

    Congrats on the prescribing privileges; one more step forward. Sounds scary on a number of levels.

    By a ‘duplicate pad’, for those of us who are non-doctors, is that like a receipt book with the carbonless copy?

    • February 24, 2010 9:28 pm

      yep, one blue copy for our records, one white copy (with forgery prevention devices) for the patient

      they used to be called triplicate pads when they were, uhm, triplicate; people still refer to them by this name.

  2. February 24, 2010 3:07 pm

    Great post.

    Also Congrats on getting prescribing privileges. Just remember to say these words the next time you’re at a party “Seriously baby, I can prescribe anything you want” 😉

    I’ll be interested to hear you’re thoughts on Methadone. My parent’s were both pharmacists and they had a lot of dealings with the local methadone clinic in their pharmacies area and the suburb they worked in was a high drug abuse area. I got to hear a lot of what went on and their take on it.

  3. February 28, 2010 8:53 am

    Great post to share. Congratulations by the way. I’m sure at first it will be a bit terrifying to prescribe something but I bet you’ll get use to it.

  4. Dr. House permalink
    March 1, 2010 2:43 pm

    How to buy prescription drugs? My doctor prescribed vicodin for a while back, my back hurts, I think it is a great help, but in my country it is difficult to find, it is paramount to have my information on it and found information about findrxonline the medicine, because it provided me.

    • March 1, 2010 9:59 pm

      Dr. House, don’t you mean, that your LEG hurts?!

      p.s. even though this is SPAM, this is too funny not to approve.

  5. Rob Hughes permalink
    March 3, 2010 8:25 pm

    Congrats! The next step is e-prescribing…

    • March 3, 2010 11:57 pm

      I wish! We are using Profile which I don’t think has that capability. It would be very very nice to have; some clinics fax the scripts to the pharmacy but that would be too much extra work for the office at this point.

      one day…

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