Great comment from a nurse about managing the drug shortage

This comment (made on the last post about the national injectable drug shortage) is great on several levels:

I am an Lpn at sch on the gyne ward.. I haven't noticed that my patients are suffering any more since the cut back on IV meds.. the use of gravol supps for nausea, regular use of oral analgesics and pain and nausea rating on rounds has I think ensured patient comfort..Patients seem hesitant at first but are reassured that if the oral or pr routes don't work we will go with the intervenous option. I wonder if Pre op clinic could instruct patients on the shortage so that they are less apprehensive post op when their nurse suggests something other than IV drugs..

• It's feedback from a front-line care provider telling us about how care-givers are perceiving the situation's effect on their patients' care.  

• The nurse tells us that pain and nausea rating is done in order to ensure patient comfort.

• We get some insight into how patients are being affected by the changes.  They may be anxious about the effectiveness of pain-killers or anti-nauseants being given other than intravenously.  The nurses on this ward are reassuring patients that they will switch to intravenous medications if the alternate forms aren't adequate.  I don't know if there has been formal training in a "script" to use when explaining the situation to patients, but I suspect that having such a script may be useful for nurses when counselling patients about these changes in practice.  This would also ensure that patients receive a consistent message across the entire health region.

• Finally, what a great suggestion to prepare patients preoperatively!  Hearing about our change in medication practice in advance would certainly be easier than hearing about it when a person needs relief from pain or nausea.  Transparency? Check! Respect for patients? Check!

Sounds like the gyne ward staff at SCH have some great ideas.  Maybe a gemba walk is in order...