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Nutrition Support Blog: I Am As Mad As Heck about PN Shortages and I’m Not Going To Take It Anymore

Posted by SF8N at Feb 01, 2013 01:35 PM |
February 1, 2013
Nutrition Support Blog:  I Am As Mad As Heck about PN Shortages and I’m Not Going To Take It Anymore

by Joe Krenitsky, MS, RD

In the 1976 movie Network, a prophetic satire about the direction that the news and television industry was heading, one of the lead characters is Howard Beale, a veteran newscaster who “goes over the edge” when he learns that he is about to lose his job.  Mr. Beale urges his viewers to “get mad” about the state of the world, and get out of their chair, go to their window and yell, “I am as mad as ‘heck’ and I am not going to take it anymore!”  I think that I understand the level of frustration that it takes to reach this point, because we are still experiencing shortages of multiple basic components of parenteral nutrition.  Currently we are about out of trace elements, IV phosphorus, potassium acetate, still rationing multivitamins, lipid emulsion and out of zinc.

I have read some of the reported reasons for the current shortages, and realize that this is a much bigger problem than just the nutrition components.  One look at the FDA page of the current drug shortage index gives you some idea of the scope of the problem.  The fact that the number of drug shortages increased each year from 2007 to 2011, rather than begin to resolve in a year or two is troubling, and for me, defies common sense to think that all of the “manufacturing problems” occurred by chance.

I have been very pleased to see ASPEN working to bring attention to the issues at hand and help resolve some of the shortage problems.  ASPEN was recognized in July 2012 by the American Association of Medical Society Executives, and awarded the 2012 Profiles of Excellence (PoE) Award for its achievements in parenteral nutrition safety and drug shortages advocacy.  The details of ASPEN’s involvement and a list of their achievements may be found at the link below.  The samples of media coverage included (below the list of ASPEN’s achievements) is worth reading, because it details many of the issues involved, and efforts to help resolve the problems.


Aspen’s site to report PN component shortages and the result of their PN shortage survey are at the link below:


I would like to think we are nearing the end of our problems with availability of PN components, but our most recent round of shortages actually suggests that things are getting worse and not better with time.  At our meeting today we discussed what else can be done to shed light on the problem and work towards a resolution before people come to harm from the lack of essential PN components.  Perhaps we have reached the point where we need to think about going to the window (or contacting our elected representatives) in unison to yell as one voice, “we are not going to take it anymore!”?

(BTW – Network is rated 64 among the 100 greatest American Films)

“Things have got to change. But first, you've gotta get mad!... You've got to say, 'I'm as mad as *heck*, and I'm not going to take this anymore!' Then we'll figure out what to do about the depression and the inflation and the oil crisis. But first get up out of your chairs, open the window, stick your head out, and yell, and say it: "I'M AS MAD AS *HECK*, AND I'M NOT GOING TO TAKE THIS ANYMORE!"

                                                              -- Network, 1976, Metro-Goldwyn-Mayer (MGM), United Artists

(*Please excuse the unavoidable edits of the quote*)


Questions or comments on this blog?  Email Joe at jk3x@virginia.edu

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