Deciding Factors

I recently had a conversation with a nurse – we were reviewing medications together to look for ways to simplify medication regimens based on resident specific factors. If they choke on Lactulose, we will try to give other laxatives. If they sleep in during the morning, we will schedule the medications at noon. If they are dozing off during the day, we will look for ways to minimize medications that cause sedation.

We were also chatting about physicians. I don’t consider it gossip. It is a fact of life that we have to work with physicians with different personalities, preferences and sometimes their ability to take on additional workload without giving us a hard time.

We sometimes have to bribe them to attend important meetings with treats, lunches and other rewards.

We were creating work for physicians by changing medication orders… for the ultimate outcome to improve resident care. But we had to evaluate if it was too much work for the physicians. We had to see if we could save some recommendations for a later time.

But why wait? If it is important to consider now for the resident, it is important enough to bring it up now. Why should it matter that Dr. XYZ may be angry or unable to process all the orders?

In fact, that is often the rate limiting step – when will the physician come in to review the orders? When will the physician come in to assess the resident? When? That is the deciding factor.

But should physician be the deciding factor? Shouldn’t it be the resident and his or her clinical status or quality of life that is more important?

That is my thought for the day!


Published by


My name is Cynthia Leung and I am a practicing pharmacist in Kingston Ontario, Canada. This blog is for me to share my ideas, opinions and perspectives on how medications are used in our health care system. Note that these posts are my own opinions and do not represent the opinions of my current or former employers and / or organizations that I may belong to. Any possible case scenarios described in my posts would be modified to maintain patient confidentiality. This blog is not a platform for professional advise for patients or health care providers and the content is not meant to support any clinical decisions or replace professional opinions. Also the images are either taken or created by the author, or adapted with permission. I hope you will enjoy reading my posts!

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.