The Real Nurse Jackie

Everything old is new again

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So there I was, out having a blast on Cinco de Mayo, enjoying an “adult beverage” and some really great food with plans for NOT working for the rest of the evening, and I get an emergency text from my boss.

Apparently the OIG just had just released a report related to psychotropic drug use in long-term care facilities and we needed to analyze it and send out our thoughts before the end of the night to one of our board members, who weirdly/coincidentally would be interviewed the next morning by CBS News on that topic!

First of all, may I say that the timing of the release of the report was a total buzz kill! Then, when I read the report, well … it was sobering to say the least. The entire “new” study was based on a time frame from January 2007 until June 2007. OK, been there, done that!

We know, we know, universally we all didn't know about all of the side effects and adverse events back in 2007, all right? Since that time, stronger black box warnings on those drugs have come out (originally 2005, but “put on steroids” in June 2008), and the updated F-tags (specifically F-329) training didn't even begin until late 2006 (December). So how was practice supposed to change in early 2007?  Even CMS disagreed with some of the conclusions of the study. Yes, you read that right!

But hang on to your Xanax, kids. You might need it. Because once the media gets a hold of the report and don't read (and understand) that the data is from early 2007 and then also applies it to 2009 policy (like who does that in research?), look out. So here we go again with how we dump the poor old people into these homes of horror and do something terrible to them. 

Can we do better? Of course. Are we trying? Yes. Should we give psychotropic drugs when not medically justified? Absolutely not! We are working on educating not only our own, but (hopefully) the psych consultants who see our patients so that they know what we can and cannot tolerate for the people we respect and protect on a daily bases.

So don't get too excited about this report, and others that might come out like it. “Stuff” like that happens when the politics are behind it.

And for goodness sakes, Mr. Mass Media, before you report on a “just released” study, how about reading the whole thing?

Just keeping it real,

Nurse Jackie

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The Real Nurse Jackie

The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, a 2012 APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse who also is the director of clinical affairs for AMDA - The Society for Post-Acute and Long-Term Care Medicine. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.


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