Union president defends nurses after audit findings

Wed, Oct 22nd 2014, 10:34 AM

Bahamas Nurses Union President Jannah Khalfani last night refuted allegations that some nurses hoard drugs and supplies on the ward level and disobey the directives of physicians.
Those claims are included in a recent forensic accounting report of the Public Hospitals Authority's (PHA) supply of pharmaceutical drugs and medical supplies
The report reveals that at the end of 2013 there was a $10 million difference in pharmaceutical inventory between the physical count and what is reflected in the Princess Margaret Hospital's (PMH) computer system.
The auditor also points to alleged irregularities with how doses are administered to patients in some cases.
The report says, "Although some controls exist at the procurement and storage levels for the securing of pharmaceutical drugs, little control continues through to the ward level for the distribution of pharmaceutical drugs and medical supplies.
"A substantial amount of those people interviewed opined that drug and supplies shortages intensified at the ward level, pointing to nurses who do not record dispensed drugs, disobey the directive of physicians and provide different doses to patients, and hoard drugs and supplies.
"One interviewee described the ward level as a 'black hole' for pharmaceutical drugs.
"This increased the risks to patients and wasted the PHA's assets."
When contacted for comment, Khalfani said, "To that, I would first like to say I know of no cases in existence or no incident where a nurse didn't follow a doctor's instruction pertaining to drugs being prescribed and drugs being administered to a patient.
"However, what happens is if a doctor orders a drug that may not be in the pharmacy, once the nurse finds out that the drug isn't available, the nurse will then contact the physician and say the pharmacy doesn't have that drug."
She explained that, in such cases, the nurses would usually give the doctor the option for the use of similar drugs.
"The physician would then say to give or not to give," she said.
"The point I'm making is the nurse doesn't do anything on her own. She doesn't change any physician's order.
"The physician must give another order, or he will tell her to go ahead and use whatever is there.
"The verbal order would be documented when the doctor returns to the ward.
"No nurse would arbitrarily change a physician's order. That doesn't happen."
When asked why that scenario was not reflected in the audit, Khalfani said, "I don't know. Does it have a big implication on the story?"
As it relates to claims of nurses hoarding drugs and supplies, Khalfani said it is the pharmacy's responsibility to collect unused drugs and supplies from the ward.
"The pharmacists again, they are responsible for coming on the ward and collecting the unused drugs from the ward and taking them back to the pharmacy," she said.
"That has nothing to do with the nurses, you know. If the drugs stay on the ward and you have an accumulation of drugs, the pharmacy is responsible for coming to the ward, collecting the drugs and taking [them] back to the pharmacy.
"The nurses are not hoarding anything. The nurses have no reason to hoard any drugs. If the drugs are there it's because the pharmacy hasn't come to collect [them]."

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