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...

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...

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

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.

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...

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.