Elgin Mental Health Center Medicine Policy Unchanged

By Hahn, Brad | Daily Herald (Arlington Heights, IL), September 27, 1999 | Go to article overview

Elgin Mental Health Center Medicine Policy Unchanged


Hahn, Brad, Daily Herald (Arlington Heights, IL)


Byline: Brad Hahn Daily Herald Staff Writer

The Elgin Mental Health Center has no immediate plan to change the way it disburses medication to patients, even if some hospital staff say the system is unsafe.

A handful of nurses complained to their bosses last year, saying existing policy forces them to rush and take shortcuts when passing out medication.

The hospital named a committee of EMHC staff to look into the matter, and the group returned roughly six months later with a list of potential solutions.

Suggestions made by the EMHC Medication Work Group were not easy to implement and today, eight months later, nothing is changed.

Hospital administration and the Illinois Nurses Association, which represents EMHC nurses, agree the existing system is safe, and there is no need for change.

But those who raised the issue, and remain at the center of the controversy surrounding it, say it is only a matter of time before risky procedure at the hospital snatches the license of a nurse or the life of a patient.

"Neither of them can come together," said registered nurse Doug Tomsha of the union and administration. "It's like they're passing the ball back and forth and they're really not taking into account what is in the best interest of the patient."

A 28-year veteran of EMHC, Tomsha said he and other nurses must choose daily between obeying hospital regulation and fulfilling an obligation to patients.

Specifically, he takes issue with a policy on eight of the hospital's 15 units, where nurses have one hour at the end of their overnight shift to distribute medications to patients.

The setup, he says, forces nurses to hurry through work that can take more than 1 1/2 hours if they follow procedure.

To reconcile that reality with expectation, staff members skip safeguards meant to ensure patients get the right medication, such as immediately signing off on drugs given out, Tomsha adds.

Other nurses say the timing of the medication distribution also at times forces patients to take up to seven or more pills on an empty stomach, even when the drug is to be administered with or following meals.

The practices, they say, add up to mistreatment of patients.

"It's a tremendous, tremendous issue," said a 20-plus year veteran nurse who requested anonymity "If you follow their policy verbatim, there is no way you can get it done."

At the root of the problem is the scheduled time for handing out patient medication in relation to hospital shift changes.

Morning medications are to be distributed at 8 a.m., and state policy allows staff one hour on either side of that time to get the drugs to patients.

Shifts also change daily at 8 a.m., which means either the exiting night nurses or incoming day staff must handle the task in about an hour.

As it stands, the night shift takes care of the chore in a majority of the units before leaving at 8 a.m.

Workers not only are rushed, some say, but forced to do the most crucial part of their job at the tail end of an overnight shift.

If an error is made, the results can be deadly and the nurse likely will be held responsible, they say.

"There are potential side effects (of getting the wrong medication), including death," said Elizabeth Crown, senior health sciences editor at Northwestern University.

Though unable to specifically address the EMHC debate, Crown said medication errors can have severe consequences. For instance, even an aspirin, when mixed with a blood thinner, can be lethal, she said.

A medication error at EMHC could have no effect or cause a death, depending on the drug, she said.

"The medication could increase symptoms, the patient may start hearing voices all over again," she said of the range of possibilities. "The voices may be magnified and they go into a rage and kill the nurse - who knows? …

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