Is this on the $4.00 list??

My Week Part 2

2009-02-21T16:20:00.000-08:00

Lady comes in through the drive-thru and throws a hissy fit because her Dr.'s office called in a sixty day supply of one of the three meds that she always gets. She demanded to speak to me immidiately, wanting to know why I didn't call and correct the office....

Wow, because I have nothing better to do.

I told her that I have to prioritize the calls I make as I'm the only one on staff at the moment that can legally make a call like that--I wasn't even going to get into the techs being able to make that phone call as long as they were only leaving the request. I then told her if the office had called in something that she was allergic to, or called in something that would have had a serious interaction with something else I knew she was taking I would have called right away. I can't call the office because I feel she should have a 90 day supply for everything as that would not be my place as I am not the (almighty dumbass) doctor (who lets the cleaning service authorize faxed refill requests). Heaven forbid it be the mistake of the office.... She didn't like that answer very much. I apologized but added, if she was concerned about the number of trips that she made to the pharmacy (she only shows once every three months, and no there isn't an ambulation issue here) that she should call ahead to make sure everything is ready, including the amount that she is getting BEFORE she arrives. In the meantime I offered to call the office on Monday as it was Friday evening and see if a 90 day supply could be authorized. She seemed mildly satisfied though still disgruntled that I wasn't going to drop everything just to make sure she always got her 90 day meds.

As I roll my eyes to the ceiling for the thousandth time. Do you think I like feeling like an automaton, mindlessly filling scripts day after day? That I don't want to just change the quantity on a BID dosing from 30 to 60 when it has a years worth of bloody refills, or like to call because the twit behind the desk can't read the noting in the chart and calls in atenolol 30mg instead of 5omg? It's demeaning and I know the offices get pissy because I get to waste their time because of errors on their part that we all know they will never acknowledge. Going back to the lady in the drive-thru, the reason for my original bitch, I wish people realized the real reasons for my job and that minimizing the number of trips to my counter for the pure sake of their personal convenience is NOT one of them. You want 90 day scripts then harass your doctor. NOT ME!!!

My Week Part 1

2009-02-21T10:29:00.000-08:00

So, I started out the morning like usual being cold, tired, and lacking caffeine. The first person in the lane of stupidity otherwise known as the drive-thru to the rest of the world was a former patient of ours. He had moved to a neighboring state some time ago (a blessing from the powers that be mind you) and was back in town for some reason or another. He told my tech that he needed a transfer. Okay, fine. Not a problem except that the out of state pharmacy didn't open for a couple of hours due to time differences between the two states.

Pt. "You have to give me a tablet now. I've been out of the med for a day now" in a tone that said I'm spoiled and now it's your problem.

CitWC "I need to transfer the prescription first."

Pt. "No, I need a tablet now, I'm going to do errands."

At this point I wanted to ask him just how many pharmacies he passed between state A and state B before he darkened my doorstep again. Seriously, I don't give a damn about his business and if the Lamictal was so important, why is he over 24 hours past due. Bear in mind that this guy wouldn't even look at me while talking to me. I had to read lips from the profile of his face while trying to hear what he was saying through an ancient mic/speaker system with the wind blowing in the background. I wasn't going to fight him on this, not because I was afraid he was going to go to the manager or take his business elsewhere, or even call the dreaded corporate number. I caved because I would feel bad if he went about his errands and either seized while driving (don't ask me why he's driving if he's prone to seizing) or if he had a psychotic break and hurt someone all because I didn't feel like giving in to his pissy demands. Stupid reasons, I know. Moving on...

I gave him a tablet in a vial, didn't even bother to label it though I seriously considered just plunking it down on the drive-thru tray. I told him if he came back before 3pm he could find another pharmacy and not get his precious store savings points. I felt sorry for his current pharmacy because he was a problem child for us and I can only imagine what hell they've put up with because he's a new customer and holds that leverage for a time that all new people do.

When I finally did get a chance to fill and check his script, I had the joy of filling it with a different manufacturer so that tabs looked completely different. I know the patient has a tendency to err on the side of paranoia, sticker stating that "This is the same medication you've been getting" aside....

Some random gripes...

2009-01-31T19:05:00.000-08:00

Where to start?

Budget cuts. They suck. They make resonable people behave like children. Funny, I know the general public doesn't live under a rock. I would imagine that even some of my 'higher-end' customers are experiencing some of the negative side effects that have resulted from the down turn in the economy. Why then, are they so befuddled and then rude/angry/mean when our wait time creeps up above 20 minutes at night when the day staff is gone? I had my two interns occupied at various points of contact with customers and I was just coming back from the OTC shelves post recommendation to hear someone loudly proclaim, "Why do I have to wait so long for my prescription?"

Gee, let me think?? This customer was not blind, as I watched her beady little eyes scan the lines of people and the two 'employees' at the end of each line, never mind the drive thru that was completely neglected and then spy me racing back to the pharmacy with hopes that I don't get another question from someone in line. There was clearly no one behind the counter to take the prescription, let alone fill it and this twit wants to know why there's a longer wait time. This wasn't the first time that night I heard stupidity flowing from a customer's mouth like diarrhea either.

My 'help'. Help is usually a good thing, but not when one is visibly pregnant and thus moves like she's stuck in sand. I understand the tired, achy, all over not fun that is pregnancy but this one normally moves like a sand sloth when not incubating a developing clump of cells. There is never a sense of urgency with movement, thought, or motivation. That kind of laid back 'tude may come in handy in the future if she finds a nice quiet store that never breaks fifty scripts a day...Still, I'm glad that she could cover for the sick call or I would have been in even deeper shit. The other intern will be the first blind pharmacist that ever gets licensed to my knowledge. He couldn't find a bag of meds if it was the only one in a drawer, after studying a map of how to get there. Yet, I'm still greatful for the help, as I know the night could have been much worse.

Drug shortages. Fine. We can always work with alternatives, but only if the docs ever return calls with some sort of authorization, preferably without the 'Are you stupid, of course it should have been changed' attitude. Trust me, I don't like not having prescriptive authority in these cases anymore that Dr. Badass likes to spare me a second of his precious time.

Budget cuts again. We are being forced to cut across the board. It's not pretty. I truly hope that it doesn't take as long as it's being predicted to see some up swing in the economy besides the profits that are being seen in the fast food sector. I don't like the thought of the statin and BP lowering med scripts that will surely follow.

I guess that's it for the moment. It's been a long month, moonlighting when I can. Might as well pad the coffers while I can, especially since no one else seems to want the shifts I'm picking up. Glutton for punishment I suppose. Hopefully I won't wait so long to post next time. Heck, I might even have some good material for once. Bad times make for some funny situations simply because of the nature of the times.

New sometimes sucks

2009-01-01T19:37:00.000-08:00

I hate the new year. Not for the insurance change over that causes so many so much frustration. I hate the new year because it always reminds me how completely alone some can be...even when surrounded by friends or family. Just one of those things I was thinking about. Go figure.

A Black Friday Indeed

2008-11-28T14:13:00.001-08:00

My condolences go out to the family of the Wal-Mart worker who was killed this morning when he was trampled to death by over-zealous customers. I hope that his family fights for some sort of solution to prevent this type of stupidity from ever occurring again.

That said, I have to ask, "WHAT THE FUCK IS WRONG WITH PEOPLE THAT CONTINUE TO WALK--NO RUN OVER A MAN'S BODY JUST SO THEY CAN GET THE LATEST AND GREATEST DEAL ON BLACK FRIDAY?!?!!!"

I'm too sick to type everything else that I need to say in order to somehow explain the sadness and overwhelming anger that reading this article created. I need to go throw up now, excuse me.

Not a fan of the days BEFORE the holidays...

2008-11-26T07:32:00.000-08:00

Guess what folks? As the holidays approach everyone somehow kicks it into overdrive and gets busier by exponential factors. Strange but normal...What I don't understand is the mentality that so many seem to have in that they wait until the last two days before a major holiday to request/pick-up their meds, or worse yet, realize that they've been out for a week and it's now a five alarm emergency. My patients don't seem to fathom that doctors have families too, and for that matter so do I. Don't darken my pharmacy counter or screech to a halt in my drive-thru at 9:59pm and expect me to be full of holiday cheer to see you there.

I have to say that working the week before and or the few days after a holiday are a royal bitch for anybody, in any field. Anybody would rather be home prepping for the holiday itself, or visiting with loved ones. Working the day after just plain sucks because you would probably like a day to wind down from all the holiday fun/weird/anger inducing family interaction. For those who have to work the actual holiday, well, my heart goes out to you. I know it has to be done in some cases, but really some sort of rotation has to happen so that the same doesn't get the shaft every year.

In any case I wish everyone a warm and happy Thanksgiving, and for those of you who don't celebrate the day of gluttony and family, have a great Thursday okay?

In other news, I am impressed with the comments and subsequent posting at The Angriest Pharmacist's page on a note I sent a while back. As one poster put it, regarding my post, we have created so many demons that it will take a lifetime to exorcise them all. Talk about an uphill battle...

Any typos I must give credit to my kitten--she has discovered the laptop and all it's glory. It's now a place to crash and or a place to chase the mouse pointer. Not to mention there are so many keys that she can step on and not even realize the chaos that will ensue.

Middle of the Road

2008-11-04T20:55:00.000-08:00

Yep, that's usually where I sit. Not tonight. Tonight, I'm moving to an island somewhere for the next couple of years. Not because Obama won. Nor would a win by McCain change my mind. What then? you ask...Really, I'm scared of either one. I did vote and no, I won't share as to which party. I just wish that for once the two opposing parties could work together, not for party goals, their ways and means provided by lobbyists and supporters but for the good of the actual country. I am sending up a prayer for my country before I go to bed this night. Perhaps a difference can still be made, for the better and not just for those who can afford it. I hope that we are strong enough as a country to weather the coming storms....

Go Bananas

2008-09-09T20:28:00.000-07:00

Just a quick bitch because I'm beat and my head feels as if a silverback is beating on it.

Why, why, WHY do people feel that it's okay to throw a tantrum that would make a 2 year-old proud when they pull through the drive-thru and find out that we don't have a particular medication in stock? I get that you don't want to come back tomorrow and yes I make every effort to have enough in stock at all times but my patient load is increasing every day. The lines that really piss me off are as follows:

"Gas is x-dollars a gallon--do you know how much this second trip is going to cost me??" Actually I do as I pay the same price/gallon as you do and really if you had called ahead (if gas is such a hardship in your H3) I would have been happy to have you come in tomorrow.

The real kicker is the next one:

At 8am: "I drove an hour from location X to get here and you didn't have the decency to call me and tell me that you didn't have medication Y. What kind of a pharmacist are you?" "Why didn't you call me at home then?"

Well, I did call your phone number on file which is actually your OFFICE where I left you a polite message to call me regarding one of your prescriptions. I didn't leave anything more revealing than that because I don't know who has access to your OFFICE voicemail...A message that you ignored and instead claimed you didn't receive.

Not only that, I left the message at 9pm, after you left my store at 8:30pm saying you would be back in a few days, not 10 hours later--By the way, who checks their OFFICE voicemail before they get to the office less than twelve hours from when they were last there anyway? Why didn't I call you at home??--Give me the f'ing number and I will next time--I won't leaf through the yellow pages for every Tom, Dick, and Harry with your last name and make a guess as to which one of the three entries could be you potentially violating YOUR HIPAA rights asshole. (It's bad enough I have to chase down doctors this way when they don't see fit to put an office phone on their script pads.)

One more thing--if one more two-legged excuse for the missing link wants to rant and rave about how far they drove to get here I will come across the counter/through the drive-thru window and go postal on their ass. Why do you make the 'pilgrimage' to my store when you pass six other perfectly good pharmacies along the way? Is the stupid coupon so much more important than the safety of having all your prescription information in one place? Is the $100 spent on groceries that earned you $0.05 off on your 13 gallons of gas really going to save you so much money that you can retire early? Never mind that you killed two gallons getting here in noon-time traffic and wasted another quarter gallon and quarter-hour waiting in line at the drive thru?

I have to leave now, my systolic pressure is through the roof. Good night.

I must be sniffing glue

2008-08-20T19:51:00.000-07:00

I spent an evening this week at a law CE and left feeling like a student again. Not a bad thing. Since then I've been so much more productive. Hell, I even sat down and did another one tonight. No, I'm not on crack, but I would swear I was. Weird huh?

Pin the tail on ASS, not ME

2008-08-10T21:19:00.000-07:00

Okay, I have had it. Mother fucking HAD it!!

Here's the sitch:
Lady comes to my counter and the first thing out of her mouth is "You filled this wrong!" Okay, I'm listening. She hands me an open, no a mangled Prempro package with the little dial-a-pill case and her receipt and just stares at me. Here we go....

Looked at profile, patient has been getting Premarin 0.3mg for the last year or so and was recently switched after a refill request to Prempro 0.3mg. Not unheard of, especially since she was rattling on about her last appointment saying that the doc had adjusted some of her meds but she didn't know which ones at the moment. Oh Goody. Next thing I do is pull the script. My partner filled it for the correct med that was FAXED in using the latest in E-PRESCRIBING software. Okay, not seeing the error just yet so I tell the patient, even show them since it was printed clear enough that a blind guy could read it, that it's not our error but I'll be happy to call the doc and see what happened. Here's the kick in the teeth...

"Oh, you don't have to call her, I'll do that, it's not a problem. What I want to know is when you're going to refund my $50 dollar co-pay?"

Umm, when hell freezes over twice?

Patient: "Oh, I'm not upset about the error, it wasn't yours, and I understand that these things happen because I'm a health care worker but I want my money back. That's not fair." Of course it's not. Life isn't fair or did you miss that memo? If you want your $50.00 co-pay back go take it out of your doc's lazy hide. You yourself acknowledged the DOCTOR'S ERROR. Why is being taken out of my hide??? This rant could go on forever. Never ending bullshit short, I ended up refunding her $50 but sure as hell didn't credit her insurance. The dumb bitch even had the nerve to whine to the front-end cock that I gave her 'trouble' and to top it off she handed me the Prempro to dispose of! While I'm hold the Prempro in a death grip that could produce diamonds I casually asked her why she opened the package when she had said that she wondered why the packaging AND THE NAME OF THE DRUG were different(????) instead of just calling us and asking....I'm still waiting for an answer on that one. She just gave me the 'Oh no she knows I'm brainless deer in the headlights look' and walked away.

I want to draw and quarter every asshole that starts their conversation out with "You filled this wrong!" and I later find out that THEY are so fucking in the wrong that they would wish I HAD filled it with something really wrong and really hurt them. At least then they would have an excuse.
Being in the health care field doesn't mean shit. For all I know the janitor calls in the scripts and the doc is out golfing while the MA makes the diagnosis.
For the sake of all that is holy, Doctors are not!!! And neither for that are pharmacists, or nurses, or fucking CNPs. Therefore, if you make an error, OWN UP TO IT. Have some professional integrity for fuck's sake.
And one other thing, if you use anything electronic, check your work BEFORE you send it out for God, Mother, and Country to see!!! Even if you handwriting is piss poor, it beats a mangled sig that doesn't make sense or like the above example the wrong freaking drug being used.

Okay, I'm done. One more day and I'm on vacation. At that point I won't care if the whole store burns down. The Workaholic will be out of the building.

Say What?

2008-08-07T06:52:00.000-07:00

I had a very large, rotund gentleman motor up to my counter yesterday in one of those itty-bitty scooter chairs the store provides for those who have difficulty ambulating around the store and ask the following:

"Where's the Ecstasy at? Or did I miss it?"

Now both myself and my technician standing nearby did a double take and sort of giggled because our minds immediately seized up at the thought of this very polite Jabba-the-hut type man using the X for any type of fun in the sack. We politely told him that that substance was illegal to possess and sell, so we wouldn't have any here at the store.

Now it was his turn to do a double-take. He explained that he must have been mumbling or we didn't hear him right--he was looking for the 'exter-C' which I decided must have been his pronunciation of 'Esther-C' which I promptly walked out and found for him on the shelf. He then motored away still belly laughing all the way. Wow.

HIPAA SCHMIPAA

2008-07-31T17:41:00.000-07:00

I was off today. I offered to fill Dad's Medrol Dose Pak prescription at the evil competitor in my home town instead of him getting blasted by his crappy prescription plan. At the pick up counter the little tart minding the counter refused to give me the prescription because I denied a need for counseling. Hmm, let's think a bit here....

The prescription is for my DAD, in other words, NOT FOR ME therefore I don't need counseling and it would be a glorious HIPAA violation if I really gave a rat's curly tail.

She still wanted to question my refusal and looked over at the pharmacist on duty even after I told her that I myself was a licensed pharmacist. Honestly people do I have to dig my license out of my wallet for proof. I have to admire her willingness to follow the regs regarding a new prescription but please, lighten up on the whole OBRA '90 will you folks??

Other Blogs of Note....

2008-07-27T09:54:00.000-07:00

Check these blogs out. They have been conceived by those who have walked this path before me and are much wiser than I. Their stories will shock and amaze you, and in the case of the newly christened DrugMonkey (formerly DrugNazi) will make you cry, or at least sit there dumbfounded. I've posted links to the various blogs over there to the right. Thanks for playing!

2nd post for the night...

2008-07-26T20:14:00.000-07:00

For any who are curious, or just unlucky enough to stumble onto this page, I'm hoping to leave a lot of my work related baggage here instead of taking it home with me. Never mind that I would have to be home to blog anything, details aren't important here. Hopefully I will present some of what I encounter at work in a manner that will at least entertain some and make others stop and say to themselves...'hmm'. Really I just want to sleep at night and not have crazy weird work related dreams/nightmares.

Feel free to share if you too have encountered something similar or if you have an experience that just takes the cake. TTFN!

Is this drug $4?

2008-07-26T19:57:00.000-07:00

Me: 'Thank you for calling Pharmacy X, pharmacist speaking, can I help you?"
Caller: 'Is this a pharmacist?"
Me: No, I answer my phone that way for grinnies..."Yes, can I help you?"
Caller: If I tell you the name of a drug, can you tell me if it's on your $4 list?
Me: Go ahead...
Caller: "Omeprazole 20mg." Pronounced by the caller as follows.....Ohmepra-zole-ay twenty em-geese.
Me: No, I'm sorry but it's not.
Caller: But it's generic isn't it?? Why isn't it $4 dollars?? My doctor said it was on your list!
Me: I'm sorry but you were misinformed. I can give you an out-of-pocket price quote, but I can't give an insurance quote without having the prescription here.
Caller: "Okay, well how much would it be with my insurance?"

Honestly I don't know why it was a postal worker that went over the edge first.....