[NPInfo] RE: NPInfo Digest, Vol 20,
Issue 6 Prescription pads questions
Anne Chamberlain
aec417 at comcast.net
Sat Nov 3 09:06:23 PDT 2007
Anne C. wrote:
So what are people doing for tamper-proof prescription pads? I contacted
Med-Scripts and they will not provide script pads for me because I am an NP
(working independently) and they will only provide if there is a doctor's
name on the pad too. I explained that in the state of Washington that we
are legally able to practice independently and I don't need to be
"associated" with a doctor. She said that they are "sponsored" by the pharm
reps and the pharm reps have told them that they can only provide this way.
When I asked her for a list of the pharms that "sponsor" them, she said I
would have to approach my own pharm reps and talk with them about it. I
asked her HOW do I know WHO to contact if they won't provide company names.
They refused to provide the sponsors so that I could follow up further. So,
how I am (and I'm sure others like me) supposed to meet the new legal
requirements AND what would others suggest as far as how to get this
remedied?? To end the conversation she called me "sweetheart" which twisted
me even more!
Barb wrote:
This doesn't make sense to me. Our practice got our Rx pads from a printing
company and we each have our own pads with only our names on them. We use a
printing company called PrintSource, they are not pharm sponsored, and they
actually knew about the need to switch to tamper resistant paper before we
did.
Laura wrote:
You pay for them as I did. I ordered mine from Medical Arts Press. Laura,
NP, Missouri
Anne responding:
Barb - I will check out Print Source. Didn't know about this one.
Laura - I already tried Medical Arts Press - they are currently not taken
new orders "until further notice". Any other ideas I'd appreciate. I think
what really bothers me is that we are prescribing all the medications out
there just like the docs are, but yet Medi-Script refuses (via their
pharmacy reps) to provide their service to us.
I will pay for them, if needed. That's actually not my issue. I guess my
real concern is that Medi-Scripts and the drug companies are withholding
product from me (and others) because we are NP's and not MD's. Seems
wrong.
-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of npinfo-request at nurse.net
Sent: Friday, November 02, 2007 4:13 PM
To: npinfo at nurse.net
Subject: NPInfo Digest, Vol 20, Issue 6
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"Re: Contents of NPInfo digest..."
Today's Topics:
1. RE: that PMR pt (Rogers, Barbara)
2. RE: NPInfo Digest, Vol 20, Issue 5 Presciption Pads -
MediScripts (Anne Chamberlain)
3. RE: that PMR pt (Gail Barthold)
4. RE: Rozerem (Priscilla Merrill)
5. RE: that PMR pt (Diana Galler)
6. Re: Telemedicine Projects Aim To Boost Health Care Quality
inAfrica- applicants wanted for telemed (Calif NP)
----------------------------------------------------------------------
Message: 1
Date: Fri, 2 Nov 2007 17:11:02 -0400
From: "Rogers, Barbara" <BB_Rogers at fccc.edu>
Subject: RE: [NPInfo] that PMR pt
To: "NP Info" <npinfo at nurse.net>
Message-ID:
<EDC5E68BF1B51F4F95B993268270609473CC35 at medadmexch1.medadmin.fccc.edu>
Content-Type: text/plain; charset="iso-8859-1"
I do not understand why he did not have ongoing oncology fu. Am I missing
something? Prostate cancer considered low risk and was followed by urology?
Barbara Rogers CRNP, MN, AOCN
Adult Hematology-Oncology NP
________________________________
From: npinfo-bounces at nurse.net on behalf of Paula Sumner
Sent: Thu 11/1/2007 8:06 PM
To: NP Info
Subject: Re: [NPInfo] that PMR pt
no family here, son in ohio. the doc and i cared for him in AL (past 3
weeks). I don't know what his future is, but i expect him back on hospice.
he had no resp sxs at all. Everything about him was not as one would expect
it.
paula
Carla Anderson <carla_rayne at yahoo.com> wrote:
Was he a fall risk in assisted living? Did he have famiy there? Did he
have secondary lung cancer with siadh syndrome? Did they do a CT scan that
showed a lung cancer? and then ever a PeT scan? Who was caring for him in
the assisted living? Family everyday, or did he have hospice? Carla
Anderson, Oregon
Paula Sumner wrote: he had prostate ca several years ago and surgey. what is
weird i that he had spine films and chest films-negative except his
compression fracture last spring. He was failing in his apt so we put him in
asst living-had a lot of muscle pain, was incontinent since prostate
surgery, was bowel focused and needed help stooling. The pred nisone we
started last week pretty much eliminated his pain, but his legs were weaker
r>l, dev foot drop. that is when we admitted him. CXR shows a cavitation in
a lung, ct scan shows his manubrium almost eat up (never c/o pain there), a
mass in the kidney and maybe liver, and in his spine! paula
"Rogers, Barbara" wrote:
Paula
Do you know what the primary cancer is?
Barb
-----Original Message-----
From: npinfo-bounces at nurse.net
To: npinfo at nurse.net
Sent: Wed Oct 31 17:47:42 2007
Subject: [NPInfo] that PMR pt
That pt I asked for info on PMR about (and got the only list reply: send to
rheumatology) -he dev foot drop so he was admitted to the hospital--has
mets! what a shock. we came to like this guy, and care about him-it is just
stunning news. Paula
Paula J. Sumner RN, MSN, HTP, CHt
Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2 3500
Westgate Dr., Suite 504-G Durham, NC 27707 919-490-4656
http://paulajsumner.byregion.net <http://paulajsumner.byregion.net/>
Referral ID#10102918
http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
http://www.letstalkcounseling.com/sites/paulasumner
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Paula J. Sumner RN, MSN, HTP, CHt
Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2 3500
Westgate Dr., Suite 504-G Durham, NC 27707 919-490-4656
http://paulajsumner.byregion.net <http://paulajsumner.byregion.net/>
Referral ID#10102918
http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
http://www.letstalkcounseling.com/sites/paulasumner
__________________________________________________
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Carla R. Anderson, FNP-C
Healing Presence Family Practice, PC
carla_rayne at yahoo.com
503 819 9726
_______________________________________________
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Paula J. Sumner RN, MSN, HTP, CHt
Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2 3500
Westgate Dr., Suite 504-G Durham, NC 27707 919-490-4656
http://paulajsumner.byregion.net <http://paulajsumner.byregion.net/>
Referral ID#10102918
http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
http://www.letstalkcounseling.com/sites/paulasumner
__________________________________________________
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------------------------------
Message: 2
Date: Fri, 2 Nov 2007 14:18:45 -0700
From: "Anne Chamberlain" <aec417 at comcast.net>
Subject: [NPInfo] RE: NPInfo Digest, Vol 20, Issue 5 Presciption Pads
- MediScripts
To: <npinfo at nurse.net>
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Message: 3
Date: Fri, 2 Nov 2007 14:38:28 -0700
From: "Gail Barthold" <gbarthold at fosscare.org>
Subject: RE: [NPInfo] that PMR pt
To: "NP Info" <npinfo at nurse.net>
Message-ID: <8B98D0794755AD4EA573D6A8AA2C3E4E446B8E at exch.fosscare.org>
Content-Type: text/plain; charset="us-ascii"
I am a GNP, who is also the DON of a Nursing Home, and we were taught to not
have throw rugs with the elderly. More broken hips occur from catching toes
on the edge and falling. If he is bed bound, I would put a fall pad at the
side of his bed in case he gets restless. You could try hip guards but some
new research has found that they didn't help as much as first thought. With
your description of his disease, I would expect that he will progress fairly
quickly and will probably need more care than an AL can provide. An Adult
family Home or Nursing Home will probably be needed. I would bring Hospice
in as soon as possible. It always seems that it is started to late. All of
that is if he does not want to pursue treatment but it would seem that that
would be more palliative. Gail
-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Carla Anderson
Sent: Thursday, November 01, 2007 9:13 PM
To: NP Info
Subject: Re: [NPInfo] that PMR pt
One suggestion if it is possible as he is weak, make sure his studio in the
AL has thick carpets with a thick pad, if he is not trying to roll a
weelchair over. If they wont let you alter the rugs, get some thick fluffy
portable non skid rugs in the bathroom and around the room, so if he falls
he will not break a hip/arm. My dad broke two bone, and he had no
osteoporosis, and the floors were like rock. He had only been there the one
night, and I told him to take his walker from the bed to the bathroom, but
he did not and fell. And that led to his death 3 days later. He could not
recover, perhaps had a clot. It mortified me that places for seniors had
floors like cement. Carla
Paula Sumner <nurse_healer at yahoo.com> wrote: no family here, son in ohio.
the doc and i cared for him in AL (past 3 weeks). I don't know what his
future is, but i expect him back on hospice. he had no resp sxs at all.
Everything about him was not as one would expect it.
paula
Carla Anderson wrote:
Was he a fall risk in assisted living? Did he have famiy there? Did he have
secondary lung cancer with siadh syndrome? Did they do a CT scan that showed
a lung cancer? and then ever a PeT scan? Who was caring for him in the
assisted living? Family everyday, or did he have hospice? Carla Anderson,
Oregon
Paula Sumner wrote: he had prostate ca several years ago and surgey. what is
weird i that he had spine films and chest films-negative except his
compression fracture last spring. He was failing in his apt so we put him in
asst living-had a lot of muscle pain, was incontinent since prostate
surgery, was bowel focused and needed help stooling. The pred nisone we
started last week pretty much eliminated his pain, but his legs were weaker
r>l, dev foot drop. that is when we admitted him. CXR shows a cavitation in
a lung, ct scan shows his manubrium almost eat up (never c/o pain there), a
mass in the kidney and maybe liver, and in his spine!
paula
"Rogers, Barbara" wrote:
Paula
Do you know what the primary cancer is?
Barb
-----Original Message-----
From: npinfo-bounces at nurse.net
To: npinfo at nurse.net
Sent: Wed Oct 31 17:47:42 2007
Subject: [NPInfo] that PMR pt
That pt I asked for info on PMR about (and got the only list reply: send to
rheumatology) -he dev foot drop so he was admitted to the hospital--has
mets! what a shock. we came to like this guy, and care about him-it is just
stunning news.
Paula
Paula J. Sumner RN, MSN, HTP, CHt
Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2 3500
Westgate Dr., Suite 504-G Durham, NC 27707
919-490-4656
http://paulajsumner.byregion.net Referral ID#10102918
http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
http://www.letstalkcounseling.com/sites/paulasumner
__________________________________________________
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Tired of spam? Yahoo! Mail has the best spam protection around
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*****************************
Paula J. Sumner RN, MSN, HTP, CHt
Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2 3500
Westgate Dr., Suite 504-G Durham, NC 27707
919-490-4656
http://paulajsumner.byregion.net Referral ID#10102918
http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
http://www.letstalkcounseling.com/sites/paulasumner
__________________________________________________
Do You Yahoo!?
Tired of spam? Yahoo! Mail has the best spam protection around
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_______________________________________________
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*****************************
Carla R. Anderson, FNP-C
Healing Presence Family Practice, PC
carla_rayne at yahoo.com
503 819 9726
_______________________________________________
NPInfo mailing list
NPInfo at nurse.net
http://lists.nurse.net/mailman/listinfo/npinfo
*****************************
Paula J. Sumner RN, MSN, HTP, CHt
Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2 3500
Westgate Dr., Suite 504-G Durham, NC 27707
919-490-4656
http://paulajsumner.byregion.net Referral ID#10102918
http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
http://www.letstalkcounseling.com/sites/paulasumner
__________________________________________________
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Carla R. Anderson, FNP-C
Healing Presence Family Practice, PC
carla_rayne at yahoo.com
503 819 9726
_______________________________________________
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------------------------------
Message: 4
Date: Fri, 2 Nov 2007 18:09:03 -0400
From: "Priscilla Merrill" <prispunnyfnp at metrocast.net>
Subject: RE: [NPInfo] Rozerem
To: "'NP Info'" <npinfo at nurse.net>
Message-ID: <004701c81d9c$fad584e0$6600a8c0 at Priscilla>
Content-Type: text/plain; charset="windows-1250"
Thanks, very helpful and appreciated. Priscilla (retired USAF-R NC Colonel
who thanks you for your service, and happy early Veterans Day!)
-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of doc
Sent: Friday, November 02, 2007 1:49 PM
To: NP Info
Subject: Re: [NPInfo] Rozerem
Priscilla: I work in a Psychiatric practice and both my doc and I use Tenex
for PTSD noc-mares. We choose Tenex over other antiandrenergic
interventions - less side effects. It doesn't work 100% of time --as we
find with all meds. I can find other citations for you if you would
like...contact me off list
Guanfacine (Tenex)- Action similar to clonidine but has a longer half-life
and less sedation. More selective alpha-agonist. Not recommended for
children <12 y. Effects alpha2-adrenergic receptors only.
1. Antiadrenergic Agents
Because autonomic hyperactivity may be a problem in patients with PTSD,
antiadrenergic agents may be effective pharmacotherapy. Three agents in
particular--clonidine (Catapres), propanolol (Inderal) and guanfacine
(Tenex), have successfully reduced nightmares, hypervigilance, startle
reactions and outbursts of rage. Primary Care Treatment of Post-traumatic
Stress Disorder
JENNIFER TRAVIS LANGE, CAPT, MC, USA, CHRISTOPHER L. LANGE, CAPT, MC, USA,
and REX B.G. CABALTICA, M.D.
2. Adrenergic agents such as clonidine (Catapres), propanolol (Inderal)
and guanfacine (Tenex) are sometimes used to help with hyperarousal,
hallucinations and illusions as well as nightmares commonly associated with
PTSD
Pat M
----- Original Message -----
From: "Priscilla Merrill" <prispunnyfnp at metrocast.net>
To: "'NP Info'" <npinfo at nurse.net>
Sent: Friday, November 02, 2007 5:29 AM
Subject: RE: [NPInfo] Rozerem
> I'm not familiar with this one. Do you have any sources? I only know
> it
> as
> an old bp med that I haven't seen used in my entire years of practice.
> I'd
> be very interested if this is true but would never try it as hearsay.
> Thanks,
>
> Priscilla
>
> -----Original Message-----
> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On
> Behalf Of doc
> Sent: Thursday, November 01, 2007 8:21 PM
> To: NP Info
> Subject: Re: [NPInfo] Rozerem
>
> Lisa: Tenex 1mg @ hs will stop Ptsd nightmares....Pat M
> ----- Original Message -----
> From: "Lisa Meyer" <meyerlm at chartermi.net>
> To: "NP Info" <npinfo at nurse.net>
> Sent: Thursday, November 01, 2007 6:55 PM
> Subject: [NPInfo] Rozerem
>
>
> All of the sleep tips and info has been awesome! THIS is why I belong
> to this list. Thanks to all. One more question. Can those of you
> with experience rx'ing Rozerem share your experiences? I have a
> couple of students with PTSD who have nightmares (multiple per night,
> every night) and
>
> am wondering if anyone has seen benefit in similar patients with
> Rozerem?
>
> Lisa
> _______________________________________________
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> NPInfo at nurse.net http://lists.nurse.net/mailman/listinfo/npinfo
> *****************************
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>
> _______________________________________________
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------------------------------
Message: 5
Date: Fri, 2 Nov 2007 15:28:44 -0700 (PDT)
From: Diana Galler <galdena at sbcglobal.net>
Subject: RE: [NPInfo] that PMR pt
To: NP Info <npinfo at nurse.net>
Message-ID: <654053.31105.qm at web81211.mail.mud.yahoo.com>
Content-Type: text/plain; charset=iso-8859-1
The key here, Paula, might have been the compression fx. It could have been
mets at that point causing it. With a previous hx of prostate cancer and a
compression fx, a work-up should have been done at that time.
Dena Galler
Paula Sumner wrote: he had prostate ca several years ago and surgey. what is
weird i that he had spine films and chest films-negative except his
compression fracture last spring. He was failing in his apt so we put him in
asst living-had a lot of muscle pain, was incontinent since prostate
surgery, was bowel focused and needed help stooling. The pred nisone we
started last week pretty much eliminated his pain, but his legs were weaker
r>l, dev foot drop. that is when we admitted him. CXR shows a cavitation in
a lung, ct scan shows his manubrium almost eat up (never c/o pain there), a
mass in the kidney and maybe liver, and in his spine!
paula
"Rogers, Barbara" wrote:
Paula
Do you know what the primary cancer is?
Barb
-----Original Message-----
From: npinfo-bounces at nurse.net
To: npinfo at nurse.net
Sent: Wed Oct 31 17:47:42 2007
Subject: [NPInfo] that PMR pt
That pt I asked for info on PMR about (and got the only list reply: send to
rheumatology) -he dev foot drop so he was admitted to the hospital--has
mets! what a shock. we came to like this guy, and care about him-it is just
stunning news.
Paula
Paula J. Sumner RN, MSN, HTP, CHt
Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2
3500 Westgate Dr., Suite 504-G
Durham, NC 27707
919-490-4656
http://paulajsumner.byregion.net Referral ID#10102918
http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
http://www.letstalkcounseling.com/sites/paulasumner
__________________________________________________
Do You Yahoo!?
Tired of spam? Yahoo! Mail has the best spam protection around
http://mail.yahoo.com
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*****************************
_______________________________________________
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NPInfo at nurse.net
http://lists.nurse.net/mailman/listinfo/npinfo
*****************************
Paula J. Sumner RN, MSN, HTP, CHt
Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2
3500 Westgate Dr., Suite 504-G
Durham, NC 27707
919-490-4656
http://paulajsumner.byregion.net Referral ID#10102918
http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
http://www.letstalkcounseling.com/sites/paulasumner
__________________________________________________
Do You Yahoo!?
Tired of spam? Yahoo! Mail has the best spam protection around
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*****************************
Carla R. Anderson, FNP-C
Healing Presence Family Practice, PC
carla_rayne at yahoo.com
503 819 9726
_______________________________________________
NPInfo mailing list
NPInfo at nurse.net
http://lists.nurse.net/mailman/listinfo/npinfo
*****************************
Paula J. Sumner RN, MSN, HTP, CHt
Healing Touch, Hypnotherapy, Emotional Freedom Technique, Reiki-2
3500 Westgate Dr., Suite 504-G
Durham, NC 27707
919-490-4656
http://paulajsumner.byregion.net Referral ID#10102918
http://www.justanswer.com/home.asp?r=HolisticNurse&bn=2
http://www.letstalkcounseling.com/sites/paulasumner
__________________________________________________
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------------------------------
Message: 6
Date: Fri, 2 Nov 2007 16:05:26 -0800
From: "Calif NP" <np at c-zone.net>
Subject: Re: [NPInfo] Telemedicine Projects Aim To Boost Health Care
Quality inAfrica- applicants wanted for telemed
To: "NP Info" <npinfo at nurse.net>
Message-ID: <001901c81dae$0eb11360$6b00a8c0 at DEBWK1>
Content-Type: text/plain; charset="iso-8859-1"
applicants wanted for new telemed 'position', top pay, must be able to
multi-task, work well with others when distracted/bio-tasked, etc.!
scroll down for picture of work site/station.......
------------------------------
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