Tuesday, October 30, 2012

No respect...

I feel like Rodney Dangerfield!!

I went into work last night for a couple of hours.  I never work on Mondays so I was surprised to see on my schedule the 2 hours of labor posted.

I drove 25 miles in the constant rain from Hurricane Sandy and bad drivers after completely bombing a psychiatric medicines test after working all weekend.

After coming in late and finally being able to clock in, I wait on a patient at the register.

Their prescription is not quite ready.  They berate me because they dropped it off 45 minutes ago, and seriously, how long does it take to slap a label on the bottle?!  Turns out it's too soon on insurance, and can't be covered for a couple more weeks, since it was just picked up a week ago.  After finding out the drug is $290.56 cash, they decide to wait for a couple of weeks.

Found out later that the patient was told all of this at drop-off.  *scratches head*

Another patient called in to speak with the pharmacy manager to file a complaint.

Oh no.

From what I could tell, the doctor prescribed a drug that would interact with a current drug.  The pharmacist called and explained, and got the drug changed to something else.  Filled it.  Boom.  Done.  The patient picked up the script and was apparently never told of the interaction or the changed medicine.

Wanted to know why the pharmacist couldn't speak to them personally when the patient came by to pick up the meds.

We filled 370 scripts yesterday with only 1 pharmacist and 5 techs.  Kinda busy.  Excuse?  No.  But the patient talked for 10 mins on the phone about the subject.  I'm surprised the pharmacist kept their cool for so long.  I don't know what else could have been done after the fact.  The patient may bring back the medicine due to the misunderstanding.  So much for looking out for your patients!

Last story, I swear...  We get these nice printouts if something is out of stock so as to remind us to order it and call the patient.  I was looking through the printouts to make sure everything was ordered, and found one that I could fill.  Changed the NDC, went on my way, and saw the patient had a coupon card for another drug they had ready.  Reprocessed and rebilled, then went to change the paperwork.

The pharmacist was like a ninja, looking over my should for any transgressions.

"What are you doing?"

"... Um.  Fixing this issue that I found?"

"Why are you digging through that person's profile?"

"...I just noticed it when looking for something else.  I thought I'd go ahead and fix it."

"Oh.  I thought you were just trying to make more work for yourself..."

 Thank goodness that "extra work" was done because the patient showed up 2 mins before closing.  Imagine if that prescription wasn't filled or if the coupon card wasn't applied before hand?  ...Right.  Any thank-you from the pharmacist?  Pshaw...

Just no respect...

Thursday, October 25, 2012

New Tricks!

So the pharmacy world is a-changing.  We have to take care of our patients now more than ever, it seems.  I haven't been to work in a week, but as soon as I arrived I received a new playbook.

My state has recently updated the controlled medication laws so that when a person picks up their medicine, I need to put some sort of ID on file.  Pretty nifty, but very time consuming until we get most people into the system.  We don't have any form of notification posted, so that will be fun explaining the new law update to the patients.  They're going to think that we're just making laws up as we go...

Also, my company has rolled out writing thank-you cards to patients.  I'm not sure what this entails since we're waiting on receiving the stock from district.

And last, my company is requiring that we call at least 35 patients 3 times a week to see if they want to have any refills.  We print out a report that has people that are due to have refills, and call them to see if they would like for us to go ahead and do that.  Some people are receptive.  Others are downright paranoid.

"Hi, this is WannabeRx from Mulpepper's Apothecary Shop in Diagon Alley.  May I speak to Ms. Dilys Derwent, please?"

 "This is she."

"Hi, Ms. Derwent.  We have started a new program here that shows us when patients are due to have prescriptions refilled and your name came up."

"Ok, what is it?"

"Well, actually, before I can continue, for your privacy, when is your birthday and address?"

"...How do I know this is Mulpepper's Apothecary?  You can't just give your information to anyone now-a-days."

"Um...  Oh.  Well..."

And that, my friends, is how you get into a HIPAA battle.  I can't tell her any information without verifying her identity; she won't give me any information without knowing that I'm not a thief attempting to steal her identity.

Eventually, I figured that I could have her look at an old prescription bottle and read information off of there to show that I was legit.  It worked, but Ms. Derwent didn't want her prescriptions filled right then.  Decided that she'd call them in when they were out...  o.O

It makes we wonder if more of a hindrance than a help to call these patients who seem to be well-off regardless.  However, there were a couple of patients I spoke with that were very appreciative of the effort.  I guess you gotta take the bad with the good...

Tuesday, October 2, 2012

Professionalism

At my pharmacy school we have weekly meeting in the auditorium.  These meetings could be about the student government, various announcements, or professional speakers.

Professional.

All of the students naturally sit near the back of the auditorium.  Many of the students are studying for other courses or playing on their computers.  We got called out on it last week and an e-mail was sent from the Dean stating that we are professionals and should treat our speakers professionally.

Therefore, the entire SOP must sit in the front 8 rows of the auditorium so that we can pay attention and give appropriate feedback for the professionals.

We all knew why we were being moved to the front, but we also had to be chastised for 10 minutes like 5 year olds as to why we were being punished.  It was infuriating.

The actual lecture was interesting: how to avoid debt once you graduate.  Points to be taken from this lecture:
  • Open a line of credit so as to establish a credit score
  • Pay all of your bills on time
  • Put money away into a savings account, or even better, some account that has a higher interest
  • Try to get out of debt as soon as possible - don't spend all of the first paycheck on a Jaguar

Later on in the day there was cake for those who had a birthday in October.  This is sponsored by the student government, so it is free to the students.  Last month we celebrated months May - September, so there were numerous cakes.  A lot of the cake was left over, so I guess they didn't want to be wasteful this time.  Why worry though?  There are only ~30 students with their birthday in October.

I'm one of them.

I was excited about cake.  I enjoy cake as much as anyone else.  I had just taken my St Johns wort without water and it had gotten stuck in my esophagus.  I was happy to have such a delicious treat to wash down my medicine.

I casually stroll to the breakroom and wait in line for the cake.  I make note of how many people are partaking in this celebration who do NOT have birthdays in October.  Hm.  Probably ~40 people more?

Unprofessional.

By the time I get to the front of the line, there is no cake left.  I yell at everyone that they are "bitches and hoes who are selfish because they didn't leave any cake for who it was intended."

That oughta teach them about being professional.

Turn Around of Things

So things have looked up since the last post.  After my mental breakdown after the first med chem test and other assorted issues, I decided to start taking something to help with my mood swings and depression.

Enter: St. John's Wort

This is one of the most promiscuous drugs in the pharmacy.  It is all of the other drugs' businesses, and tries to control them.

I am not currently taking any other medicines, not even OTC, so I'm not terribly worried about it.

My mood has increased.  I've been able to focus more and study harder.  I've made more flashcards and gotten much better grades than I think I deserve.  Things are more positive for this pharmacy student.

I've also noticed that I've lost 6 pounds since taking this supplement.  That makes me wonder if that's what makes patients less depressed.  "You lost some weight!  Hurrah!!"  Awesome thing is that I still get to eat my pastas, cupcakes, potato chips, and ice cream and still lose this weight.  It's really not fair...

I haven't heard anything about my previous roommate.  They were offline for 1.5 weeks, and now won't speak to any of us.  I think they just want to forget about it.  Can you blame them?  As long as their safe and somewhat happy, I guess that's all I can ask for.

I have found this great tumblr for pharmacy students: I prefer you call me doctor

Monday, September 17, 2012

Helen

School has begun again and it is the same old trip.  I'm not working as many hours as previous, but the amount of coursework is staggering.  I'm trying to stay afloat, but it seems to be futile.  It seems as though I am not the only one.

One of my roommates last night attempted suicide.

She seemed fine afterwards, but only then did she realize how much she needed help.  We took her to the nearby hospital and called her parents 3 hours away.

She admitted how she never wanted to be a pharmacist and how her parents pushed her into this profession.  Her life dream is to be a teacher.

I'm sure that wasn't the only reason; that it was a multitude of others and that we barely scratched the surface.

She moved out of the apartment today.  Her parents wouldn't even help her pack.

I only hope that she gets the help she deserves.  I wish I knew more of what to do.

In psychiatric medicines today we watched a film called "Helen" about a woman suffering from depression and attempting suicide 3 times.  It hit just a little too close to home today.

Thursday, August 2, 2012

Memories...

I'm reading a few of the pharmacy blogs that I follow, and I saw posts about people just starting out in the pharmacy field.  Made me think of an incident when I first started working as a technician...

I had only been working for perhaps a month or so.  I knew nothing about any medications whatsoever.  I thought fluoxetine was for the flu, that GoLYTELY is pronounced as "golly-telly" (though thank goodness I never said it aloud...  It's "go lightly" for those who want to avoid embarrassment), and often confused Motrin, Aleve, and Tylenol and their generics with each other.

It took a while to build up the courage to answer the phone calls into the pharmacy.  One day I answered to a woman asking if a doctor called in a prescription for her husband.  They had: it was for Valtrex.

She asked me how much it cost, and more importantly, what it was used to treat.

Not knowing what it was for, I pulled up the "patient information" sheet that resides in the computer database.  The only thing it really said is that it is used to treat herpes.  I told her such.  She seemed a bit put off and surprised, and we hung up rather quickly after that.

I told the pharmacist about it later, rather proud that I had figured it out the computer system by myself and was able to help a patient without pestering another technician to assist.

The pharmacist looked at me with horror on their face.  I realized what a major mistake I had made (not to mention HIPAA, especially for that type of medicine), and now refer to any medicines of that caliber as general "anti-virals."

I hope I didn't cause marital stress.  I mentally cringe any time I think about this situation.  A lesson I will never forget...

Thursday, June 14, 2012

All Sales Final

It was a decent day at work...  Busy in the sense of numerous written prescription errors that we needed to call the doctor on, or just plain 'ole insurance overrides.  By the time I left for the day we had filled a little over half of what we usually do during the day but I was pretty zapped anyway.

One patient came to the drop off window, so I cheerfully asked if I could help.

I thought I was going to have my eyeballs scratched out of my skull.

The patient loudly exclaims that the customer service desk won't return their blood glucose monitor that they just bought!  They took it home, opened it, and tried to put in a test strip (with NO blood, mind you and thank-you-very-much) but the test strip and meter were 2 different brands.

I thought my heart was going to be ripped from my chest.

I knew that by law we were not allowed to return ANYTHING dealing with blood products, whether they have been used with blood or not.  It doesn't matter.  However, I blanked on this explanation and had the patient tell me how they decided to pick out this particular meter.

They had picked it out themselves for the person that they are taking care of.

How can you do this?!  I have to keep something I bought even though I am never going to use it?!  What terrible customer service...

The patient snatched the box from my hands and stormed off in a huff.

Once the patient had left, the other technicians and interns told me that there is a 1-800 number on the box for manufacturer returns.  They can return the devices, but BY LAW the pharmacy cannot return them.

I wish I could have thought of that a little sooner.

If only I wasn't fearing for me life, perhaps I could have thought of that little gem.

Not to mention, on the shelf right above this particular meter is a printed document stating that all meters and strips are NON-RETURNABLE.  If you would like to return any meters or strips, you MUST call that 1-800 number.

The irony is baffling.

Tuesday, May 22, 2012

Kansas Anti-Birth Control Bill

As I was perusing the interwebs last night I stumbled across numerous people complaining about a bill that the state of Kansas just passed concerning birth control.

"I've been on birth control (I chose to) for the last few years. I think it's bulls**t that certain states have laws that allow pharmacists to deny women BCP's if they believe it's immoral. Last I checked this is 2012, not 1960!"

"Controlling birth-control is another way to control women; something our society is very fond of. We're treated like inept children who cannot be trusted to function on their own. I can only get access to 1 month supply's at a time, and one of the arguments is that women might 'over dose' themselves on their BC so we shouldn't be given too many months supply at a time. I wish I was kidding.  It's controlling women, controlling our bodies, and owning us. Every woman regardless of opinion on BC should be furious with this."

"So I would be screwed if I lived in the states. I suffer from ovarian cysts and the only thing keeping me from unbearable pain and surgery to remove the cysts or in a worst case scenario my ovaries is the pill."

I feel quite passionate about this bill too, but I am sad that the government feels as though it is necessary.  The public looks at the pharmacy and sees it as nothing more than a dispensary.  A place to get the medicine that a doctor, PA, nurse practitioner, or dentist prescribed.  A place where a pharmacist has no business second-guessing what a health practitioner prescribed for.  A place where the pharmacist simply dispenses the medication, and has no emotion or opinion about it.


A pharmacist should be able to question the validity of a prescription.  If a patient is constantly refilling medications early, or too late, then maybe they are taking them improperly to begin with.  If they are taking numerous medications in the same drug class, that also needs to be looked at.  If they are doctor shopping and getting numerous medications, that should be flagged.


I agree that a woman should be able to decide what to do with her own body and should feel free to go wherever she welcomes to receive this treatment.  I do not, however, believe that a practitioner should be forced to do something that he or she is uncomfortable with.


From one of the excerpts that I found here:



"No person shall be required to perform, refer for, or participate in medical procedures or in the prescription or administration of any device or drug which result in the termination of a pregnancy or an effected of which the person reasonably believes may result in the termination of a pregnancy, and the refusal of any person to perform, refer for, or participate in those medical procedures, prescription or administration shall not be a basis for civil liability to any person.  No medical care facility, medical care facility administrator or governing board of any medical care facility shall terminate the employment of, prevent or impair the practice or occupation of or impose any other sanction on any person because of such person’s exercise of rights protected by this section."

Basically, from my understanding, it is saying that a medical professional has the right to refuse service to a patient due to their religious and/or spiritual affiliations and beliefs.

Hm.  Okay.  I understand that aspect of the bill.  Freedom of beliefs should be enjoyed by all people.

The only issue that I take with this bill is the "...the refusal of any person to perform, refer for, or participate...."

So a medical professional can refuse the service AND not be obligated to refer the patient who would do such a service?  That seems quite childish and unprofessional to me.  "I don't believe that what you're doing is right even though it is your choice to make about your own body, so I'm not even going to help you find someone who would.  :-P !"

A medical professional is a person who wants to help a patient as much as possible and do what they can to complete such tasks.  However, a professional should not feel as though they are threatened of being fired, demoted, or just blacklisted for doing what they feel is right for themselves.

If the bill removed the "referring" clause, I think I could stand behind this idea.

P.S. - I am a female who has been taking oral contraceptives on and off for the past 3 years.  I take it for the lovely cramping, acne, and PMS issues (severe depression and anger), as well as a contraceptive.  I have taken Plan B before and have no issue providing it to patients.

Please let me know your thoughts.

So much to say!

So many things have occurred since my last posting.  I have finished my first year as a pharmacy student.  I passed all of my spring semester classes, and was only 0.10 points from making Dean's List.  I'm so happy to be done with the year though.  Now I get to crochet and read as much as my heart desires!

My school is a tad different than most pharmacy schools.  Instead of completing internships and rotations during the summer between school years, we do them during the semester on a designated day.  However, we are trying the summer rotations this year.  I am completing my retail phase right now and will participate in the institutional phase (hospital) in the fall.

I am with a local, somewhat private pharmacy / knick knack store that has 2 other locations within the state.  They cater to a much older crowd, and I like it in a lot of ways because there is not a lot of red tape to go through to do what you feel is best for your patient.

"Oh look, we're running low on [drug].  We'll order some more, but in the meantime give [patient] our last #15 and we'll owe them the rest when it comes in."

No three day loans!  You can loan them as much as you want!  And the on-orders come every day of the week!

The patients know the technicians and the pharmacists, and will sometimes just stop by to chat.  It's truly surreal...

However, given that it is largely populated by the elderly generations, there can be some short fuses for all parties involved.  Needless to say one technician is no longer with us in the pharmacy because things became a little too heated.

All that aside, I feel very welcomed into my rotation site.  I feel more accepted there in the 2 weeks I've been there than in 10 months at my workplace.  It truly makes a huge difference depending on the people that you work with.  If I hadn't just received health and 401K benefits at my workplace, I would seriously consider asking to be hired onto my rotation site...

Tuesday, March 27, 2012

Biggest Critic

Tonight was awful.  I'm so happy to have a day off tomorrow because I'm in just a... depressed mood about myself.  I'm my biggest critic in anything.  If I say or do something that I later realize was the slightest error, I will replay it over and over in my head.  I guess it's kind of a punishment.  I can't ever let anything go, even if it's all fixed and no harm, no foul.

Tonight I worked the troubleshoot queue.  A prescription came up that said someone in the pharmacy had called the doctor to alert them of a prior authorization.  Okey doke.

I noticed in the rejection that the insurance would pay for #10 in a 30 day fill.  Ah, the prior authorization must have gone through!  At least they'll cover #10...  *checks prescription*  Doctor had written for #90?!  That must be a typo...  *fix to #10 and fill!*

It gets filled.  The floater pharmacist verifies and bags it.  The patient picks it up and I tell them what the insurance will cover.  They say that it's supposed to be a maintenance drug, but whatever.  They are pleased with a $0 copay and leave.  If that's what insurance will cover, then so be it.

Later on I ask the stable pharmacist about the quantity and dosage and am told that we were waiting on the prior authorization because it is for maintenance.  That low dosage is to keep it in their system at all times.

I feel guilty.  I feel upset.  I feel stupid.  I feel like I've let down my pharmacist, the one who depends on me to make their job easier.  I've just increased their workload ten-fold.  I feel so disappointed.

I call the patient later on when possible and let them know of our mistake.  They understand (patients up here seem to all the time...  it's quite amazing) and say that they will bring it back so we can resubmit the claim to the insurance for #90.

The pharmacy manager comes by to do some shopping and the whole story is relayed to them.  The look of...  well... not surprise, because who could be surprised that it was me who released the prescription?  Disappointment.  Frustration.  Exhaustion.

The patient brought it back and we resubmitted it.  Now we wait for the prior authorization.

I'm never working the troubleshoot queue again.

However, no one else ever does either.  I've never seen other techs working on it.  Prescriptions can be stuck in there for an hour if the pharmacist is too busy before it will show up on their screen again....

Yes.  Tomorrow's day off cannot come soon enough....

Monday, March 19, 2012

Stupid classes and their stupid requirements...

I am so mad right now.  I need to be careful to not write back anything horrendous to the teacher, so therefore, I am going to rant about it instead.

We have internship during the school year.  I am with the health department.  I have been having a great internship in which I'm involved in numerous different sections of the department and get to see lots of ways we help patients.  Awesome.  I'm involved in numerous projects and see different things each week.  Wonderful.

I have been getting 100s on all of my papers in this class.

Well, for this one paper I wrote how I was "bored" because the preceptor left me alone for half an hour (and really for more like 1.5 hours, but I was being nice) and I had nothing to do.  That's because I had finished what they wanted me to do and were elsewhere.  I didn't have my computer to work on anything else.  What am I supposed to do, start roaming around the hallways or look through their desk to find something else?  Umm...  no.

Then we had a class where we talked about cultural competency.  I got a freakin' 60% on this paper.  WTF.

"I am concerned that you were "bored" when your preceptor was not available to you.  Perhaps you need to be a little more assertive in finding things to do or explore.  Have you had an opportunity to be involved in any of the clinics such as STD or immunization clinics?  Your description of Professor ***'s "game" was interesting but [I] would have like[d] to see you explore a bit more of how the concept this [of] game was illustrating may be helpful to you in your practice."

Ok, for one, I have already been a part of the STD and immunization clinics.  Did you NOT read my other papers?  Another, me writing about how that game presented how people have difficulty communicating and how it can lead to stereotyping and racism should have been all I needed to describe what I got out of the lecture.  Being racist and sexist = bad for pharmacy business.  Apparently I have to spell it out and make it idiot-proof.

I really want to write a nasty email to this professor.  I'm not the first person to get a bad review due to "not being involved" and truthfully writing about how I felt.  Others get penalized for writing how they never get any experience with patients, and are told off because "rawr rawr rawr you should be with your patients and be more active in your internship rawr rawr rawr."  Apparently I need to badger my preceptors to get them to have me do stuff, even though there is ABSOLUTELY NOTHING TO DO.  I just want to point out her poor grammar and thump her on the forehead.  I don't feel that I can say anything though because she will hold a grudge and that will affect my future grades.

We are encouraged to write about our feelings and experiences.  And NOT WRITE ABOUT WHAT WE THINK THE TEACHERS WANT TO HEAR.  I feel as though I have been lied to.

Monday, March 5, 2012

A rose by any other name...

I was working on something arbitrary when I overhear this exchange:

Technician: "Yes ma'am, can I help you?"

Lady: *mumble mumble* "Willow bark."

Technician: "I'm sorry, what was that?"

Lady: *mumble mumble* "I'm looking for willow bark...."

Technician: "Umm...  Ok.  What is their date of birth?"


Funny thing is, you can almost be guaranteed that some child, somewhere, has the name "Willow Bark."

Wednesday, February 29, 2012

Leap!

Just goes to show how stressful school is when I'm contemplating quitting, suicide, or self-harm when I fail a quiz for the third time in a row.

It's freakin' pharmaceutics.  Industrial pharmacy.  IT SHOULD NOT BE THIS DIFFICULT.

However, it will be extremely difficult for me to make a B in this course now.  How sad.

Work is hard.  We left the pharmacy in disarray yesterday.  The shipment was not put on the shelves.  There were still 25 fills to complete, and the pharmacist still had ~20 to final check.  I'm sure the pharmacy manager was thrilled this morning when they opened....  -_-

In other news, I'm doing rather well in my other courses, all things considering.  I'm looking at making at least Bs in everything, whereas last semester I was praying to pass with a C.  It's nice to have a buffer.

We're having legislature day next Monday in where everyone is going to the capitol to view what sort of bills they're thinking of passing.  One is requiring prescribers to check the controlled substances database to avert people from doctor shopping before they even get to the pharmacy.  Seems to be doing well and has numerous supporters.  Another is attempting to change pseudoephedrine back into a prescription, which is not getting much backing.  However, seeing how a new meth lab is found every night on the news in this state, much less the city, I don't see why not...

A couple other bills they're looking into:
  • creating a MTM and setting out funding sources for this program and requiring 3rd party payers to pay a fee to pharmacists
  • expanding immunization types to pharmacists
  • include pharmacists and pharmacies in defining "health care provider"
  • prohibit pharmacists from refusing to dispense medications without a valid reason
  • prohibit pharmacists from refusing to dispense medications unless they have told their employer the reason why they decline to dispense
  • prohibit tobacco sales from pharmacies
  • allow unlicensed personnel to administer medicines when patient is unable to do so
  • examine cases with unintentional overdose death
  • prohibit a person from having more than 2 Rxs for a specific controlled substance or any with a similar therapeutic use if they are filled within 72 hours of eachother, unless patient can provide an affidavit from prescriber
  • have pharmacies submit info to the controlled substances database within 24 hours instead of once a week
  • require name and address of person picking up for someone else if medicine is controlled
  • permit pharmacists to prescribe certain medications without an order by a prescriber
  • require Medicaid to annually review and adjust rates paid providers
  • require prescribers to prescribe Naloxone with opioids
So yeah, more than a couple, but I thought they were interesting.

Monday, February 13, 2012

Oh Silly Dreams...

I have Monday mornings off from class, so I usually get to sleep in a bit more than usual.  It was certainly welcomed after I worked for the past 4 days.

However, my brain doesn't want to shut off!  I dreamt that I was still at work.  It was awful.

I was working at the cash register, checking out patients and sending them on their way.  An older lady came up and gave me her name, "inaudible gibberish" and said she was here to pick up her prescriptions.  I asked her 3 times to repeat her name, and each time she became more aggravated.  I never did find out what her name was, but the doctor had never called in the medicines.

Right at that moment she asked me where the gibberish ice was.  I had never heard of such a thing.  She claimed that this was the worst service that she's ever gotten before, and would have me fired.  Luckily, another customer knew what she was talking about and took her to the vitamins.  For ice.  WTF?

Five minutes later she comes back to pick up her EIGHT prescriptions, which were actually ready!  I was shocked.  I asked for her name again - "gibberish"  She once again got super pissed at me and wanted to speak with the manager.

I never found out her name.

I have work again tomorrow night, but after that I'm done for the rest of the week.  I'm very excited, considering how often I've worked recently.  However, the only reason I have so much time off this week is due to the large amounts of tests and quizzes.  Bah.

Tuesday, January 31, 2012

Been Busy But...

Hey I've been busy with studying for tests and attempting to finish numerous projects.  Even though we're only 2 weeks into the new semester I feel like I've been thrown into the deep end.

Just wanted to update: the penicillin VK parent never came back to talk to the PIC.  Guess we'll never know what we dispensed to them...  *shrug*

I work 4 days this week, then essentially 7 days the next week.  Shoot me now.

Wednesday, January 25, 2012

I Guess Doctors and Parents Know Better...

Tonight was a good night.  There were some people that were grumpy, but overall we got everything done and it was nice and relaxing.

At some point a person came up to discuss their concerns about a medication they got 5 days ago with the pharmacist.  They didn't believe that they received reconstituted penicillin solution.

No matter how much the pharmacist claimed that it was penicillin, they argued.

Apparently it smells like cough syrup?  And that it has alcohol in it?  I'm pretty sure you can't even dispense a medicine with alcohol in it to a child...  That whole crazy "drink-when-you're-21" law...

The parent said that the child had to go to the hospital because the medicine was not working.  I assume they meant it wasn't working against whatever infection the child has.  I was not nearby during this conversation since I dislike confrontation.

The parent said that while they were at the hospital they showed the medicine to the doctor.  The doctor told them it was not penicillin.  I guess they were looking for something more like a suspension, like amoxicillin or augmentin.

We had mixed 2 bottles of penicillin solution and put it into an amber bottle.  We do this so parents have less to worry about, and don't become confused when we throw numerous bottles at them.

The parent is going to bring the medication back on Friday to talk with the pharmacy manager.  The parent says that we are wrong, and that when they bring it back, we will have to test it to make sure that it is penicillin.  Like we have that sort of testing equipment....

The parent's last parting words were that they would have their lawyer contact us.

I know that we are correct.  I know that the drug is right.  However, it still scares the crap out of me that there is that 0.000000012% we may be wrong...  I don't know what would happen if we were wrong...  I heard in class today all these horror stories of pharmacists approving improperly prepared medications.  Those were compounds though, not reconstitutions...  I just hope this turns out well.

Sunday, January 22, 2012

Better Times

K, so I looked up that profile where that kid would go to the hospital if I absolutely did NOT give them the medication RIGHT THEN.

It was albuterol for a nebulizer.  It looked like they had something similar back in November.  That was roughly 75 days ago.  The fill itself was for 60 days.

Hm.  Looks like you waited till the last minute to get a refill, and the doctor accidently sent it somewhere else.

You lose.  Better luck next time!

Friday, January 20, 2012

Lessons in Life

So I had the past couple of days off from work, but I started again today!  And it sucked...

I came in the pharmacy and the pharmacist immediately said how relieved they were to see me!  It had been quite busy all day.  They were barely holding above the water.

I inputted a few prescriptions and saw that they kept being returned for being incorrect.  I fixed them the best I knew how, and resubmitted to the pharmacist.  They kept being returned...

Our computer system has a nifty function of letting the pharmacist highlight the field they find incorrect, and they may possibly put in a comment for the tech on how to fix it.  This can help to teach us what to do, certain keystrokes, or if we simply misspelled a word.

I had no comments.

The pharmacist started to become more frustrated with me on a particular prescription because I couldn't determine what they wanted me to type.  Understandable.  By the time I fixed the prescription it had been sent back and forth at least 5 times.

There were numerous prescriptions in fill, more in check-point, and even more in visual verify.  People that called on the phone to speak to the pharmacist were on hold for 10 minutes at a time.  Too busy.

A parent came through the drive thru and asked about prescriptions sent in for their child.  I only saw one prescription here, and it wouldn't be able to be processed through the insurance until tomorrow.

Parent: Ok, what about the other prescription?
Me: I'm sorry, I don't see another prescription here for you...
Parent: The doctor called in another prescription.  I watched them.  I saw them call it in.

At this point they are getting a tad frustrated with me.

Me: Ok, let me check one other place. *search host system* Yes, it looks like it was called into [sister store 10 minutes away]
Parent: ...Alright.  Would you be able to transfer it here?
Me: I could, but we are quite busy right now.  It might take a few hours for it to be ready, or even as late as tomorrow.
Parent: But if they don't have this medicine, they will have to go to the hospital!
Me: I understand that, but unfortunately it may take a while.
Parent: Know what.  Forget it.  We'll just get the prescription down in [sister store 10 minutes away] and transfer all our prescriptions down there.
Me: Ok. *hangs up*

I see now that that was my mistake.  I should have tried to get it done sooner.  The pharmacist was so flustered though I didn't want to put pressure on them to finish a prescription right now.

The parent came into the store and chewed us out.  The pharmacist said that I was mistaken, and we could have it ready in 45 minutes.

The parent left and went to [sister store 10 minutes away] and, true to their word, transferred the remaining prescriptions down there.

I was so upset for the next couple of hours, it was horrible.  I'm still quite upset.  I'm going to look up the patient tomorrow and see if this was a refill or whatnot...  May give indication on how appropriate their tongue-lashing was...

However, I guess it really doesn't matter.  There's nothing that I can do about it anyway other than live on to another day.  Many people weren't given that luxury today.

I just feel like perhaps this isn't the profession for me...  Working in a science lab by myself with only music and no deadlines seems like heaven right now...

Thursday, January 12, 2012

Think Before You Speak...

Two 15-16 year old boys come up to me to ask for advice.

Boy: *blinks furiously but stares off in another direction* Um...  Where would I find prescription muscle relaxers?

Me: They're a prescription...  They're behind the counter.

Boy: *still doesn't look at me, and keeps blinking* Yes, so how would we get some?

Me: They're a prescription.  You have to have a prescription to get them.

Boy: Oh, man! *walks off*

Moral of the story:  Drugs are bad, mmmmkay?

On a more positive note, we've been very busy for that past 3 days I've been at work!  Also, it's supposed to snow tonight and tomorrow so people are trying to pull together all of their medications in preparation.  And with insurance issues due to the new year, the wait times can get pretty long.

There are at least 5 other people waiting in line and we are in the 5 PM rush so there are plenty in fill and input.  A lady comes up with her driver's license in hand, doesn't wait in line, and doesn't really wait for me to acknowledge her.  I had just called the next patient up and she interrupted, asking if she can buy Claritin D.

Me: Well, of course you can, but I was about to help this person.  If you wait in line...

Lady: Are you kidding me?  You seriously just can't hand me the box?

Me: Unfortunately not...  You have to purchase it here at the pharmacy...

Lady*practically shouting at me* That's ridiculous.  The other girl just told me I had to show my driver's license...  Know what?  Forget it.  We'll just go to [competitor].

Me:  Ok. *shrug*

I mean, seriously?  Can you not wait your turn?  I'm pretty sure you just walked up to the pharmacy, and not have been waiting for a while like everyone else.  And the pseudoephedrine law has been in effect since... *quick Google search* ...2006?  Where have you been?

Anyway, school starts up again on Monday!  And it seems as though I'm going to be working a bit more often...  The people up where I am now are just so much more... understanding and practical than I'm used to.  I still have no idea where I'm going to get writing material.