Module 30: Override & Bedside Realities: Ethics, Safety, and Speed
Mastering the “last 50 feet” of medication safety, where perfect orders meet the complex, chaotic reality of the patient’s bedside.
From the Control Tower to the Tarmac
Up to this point, you have mastered the skills of a pharmacist in the “control tower.” From the safety of the central pharmacy or your remote workstation, you have learned to be an expert air traffic controller: you manage flight plans (medication orders), ensure correct routes (dosing), check for collisions (interactions), and give the final clearance for takeoff (verification). This is a critical, systems-level role that ensures safety on a massive scale.
But what happens after the plane has been cleared for landing? What happens on the ground? This module takes you out of the control tower and places you on the tarmac. This is where the perfect flight plan meets the chaotic reality of the airport. The jet bridge won’t connect (an IV pump is beeping), the baggage is missing (a critical med isn’t in the ADC), or a pilot needs to use an emergency runway (a nurse needs to override the Pyxis).
Your role now shifts from a remote controller to a hands-on, rapid-response problem solver. By the end of this module, you will have the playbook to manage these real-world logistical and clinical emergencies with a calm, systematic approach that balances the urgent needs of the patient at the bedside with your unwavering commitment to safety.
What This Module Will Teach You
This module provides a tactical playbook for the most common and stressful “after verification” problems you will face every day.
30.1 Pyxis/Omnicell Override Etiquette
You will learn the critical framework for evaluating override requests from Automated Dispensing Cabinets. We’ll cover the handful of true emergencies where an override is justified versus the common scenarios where it introduces unacceptable risk.
30.2 “Missing Med” Escalation Tree
Master a systematic, step-by-step process for troubleshooting a “missing medication” call from a nurse. You’ll learn to rapidly diagnose the problem—was it never sent, sent to the wrong place, or is it a documentation issue?
30.3 Bedside Troubleshooting
This section teaches you how to be an effective consultant at the patient’s bedside. You will learn to perform boundary-aware checks of IV lines, pumps, and smart pump guardrails to help nurses solve common infusion problems without overstepping your scope of practice.
30.4 Tube System Failure Playbook
Every hospital’s pneumatic tube system fails. You will learn the contingency plan: how to triage medication deliveries, manage expectations, and understand the policies and safety rules for hand-carrying STAT medications to the floor.
30.5 Documenting and Preventing Recurrence
Learn to apply a “mini-Root Cause Analysis (RCA)” mindset to every problem you solve. We’ll cover how to properly document these events and, more importantly, how to identify system-level trends to prevent the same problem from happening again.