The New York Times highlighted the sad truth that many struggling nursing home residents are suffering because of new regulations intended to limit abuse of prescription drugs. The disagreement centers around the circumstances under which needed drugs can be ordered for residents by nurses, instead of doctors.
Most nursing homes do not have a medical doctor on staff. That means that on many occasions, patients in severe pain would not be able to see a doctor for a day or two or more without being rushed off to the hospital which is both costly and poses health dangers itself. In those instances, nurses would call the pharmacy and get the necessary medication to help ease the suffering resident’s pain while waiting for the next available doctor examination.
However, the United States Drug Enforcement Administration has begun cracking down on that practice-pharmacies can now only dispense medication with a written or faxed prescription from a doctor. The goal of the strict regulations is to crack down on illegal use of drugs. But, that means that in the interim, those nursing home residents simply must endure without the necessary medication. Doctors and nursing home administrators keep urging the Department to take steps to correct the problematic administrative rules. Following a recent Senate Special Committee on Aging hearing, several Senators have urged the US Attorney General to find a solution.
D.E.A. officials insist that the law is a matter of safety for all involved, including residents. They explain, “What we see are nurses unilaterally calling in prescriptions, or pharmacists dispensing controlled substances without a prescription, then trying to get a doctor to sign a prescription for a patient he never saw.”
The problem is most pronounced when patients are first moved to nursing homes from hospitals. For example, one doctor explains how one of his recent patients made the move following a hip fracture. The woman woke in the middle of the night in extreme pain, but after several calls, fax attempts, and delays at the pharmacy, the medication was still not coming. In the end, the doctor had to inform the staff to take the resident back to the hospital.
However, one problem may be that nursing homes are simply not providing enough direct doctor/patient contact. One advocate explained, “If people are so sick that they desperately need pain medication, they should be seen by a doctor. The absence of doctors in nursing homes has been a problem for decades.”
Our Chicago nursing home lawyers at Levin & Perconti understand the extreme fragility of situations such as these. It is both vital to ensure that proper oversight is provided of controlled substances so that negligent nursing home staff members do not inadvertently harm patients. However, it seems unconscionable that suffering seniors are forced to wait in their pain simply because of paperwork timing. The appropriate balance is likely two-fold: increase residents access to doctors and flexibility in the nursing home laws that allow for necessary medication to reach the residents who need them as soon as they need them. In that way nursing homes can best provide for the needs of their vulnerable residents.