Policy finally gives credit where it's due: nurses

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James M. Berklan, Editor
James M. Berklan, Editor

If there is one group of people who have earned the right to be cynical, it is long-term care professionals. Coming from a journalist, this is no underqualified assessment.

If you've worked in long-term care for any length of time, you've noticed that no matter how hard you try, there is usually someone running around with a straight pin, ready to burst your balloon. Surveyors, auditors, politicians — they all know how to make you wince.

That's why a recent federal regulatory occurrence struck me as remarkable. In brief, you asked for something … and you got it.

I'm referring to the U.S. Drug Enforcement Administration's decision to allow long-term care nurses to be “agents” of doctors and other prescribers of pain medications. The American Society of Consultant Pharmacists described the Oct. 6 DEA announcement of its change of position as a “stunning turn of events.”

The net result is that long-term care nurses can bring quicker treatment and relief from pain to their residents. Previously, pharmacists would have had to wait for direct oral or written instructions from a doctor, no matter the hour of day or pain intensity.

New policy will allow caregivers to expedite unanticipated medication orders, or in cases where a doctor doesn't have access to a fax machine or some other means of transmittal.

Yet while the DEA has taken steps in the right direction, it hasn't done enough, long-term care professionals maintain.

Nurses will not be allowed to authorize so-called Class II narcotics, which often help individuals fresh out of surgery, or near the end of life. Morphine, for example, is in this class.

The policy also does not address the use of chart orders or pre-populated fax-back forms that are so helpful to smooth, efficient long-term care operations.

But it does potentially create more paperwork. And policy language also suggests that any nurse/agent still must telephone the pharmacy when asking for prescriptions on behalf of a physician. Providers also would like to see authority conveyed to nursing positions, such as director of nursing or charge nurse, rather than just individuals.
Cynicism, it seems, can take a break, but advocacy efforts cannot afford the luxury.