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Archive for August, 2010

I was taking down a script from a doctor’s office today, and I had the following “duh” moment:

Nurse Susie: “Hi, this is Susie from Dr. Gimmemeds’s office, calling in a new script.”
Me: “Ok, no problem, *grabs a script pad*…go ahead.
Nurse Susie: “Ok, this is for patient John Smith.”
Me:
*writes down the name*…ok, and what’s Mr. Smith’s last name?
Nurse Susie: “…uh, Smith.”
Me: “Oh god, I’m sorry, I meant what was his date of birth? It’s Monday, can you tell?”

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Fear the man, man

A few days ago, my technician tells me that I had a consultation waiting for me. So like usual, I walk over to see if the poor soul was in need of medical advice, or if they wanted to know if we sell flavored condoms.

I’m met with a middle-aged man with matted hair, a worn-out baseball cap, and wet (possibly sweaty) dirty clothes. He pretty much looks homeless. I’m unfazed by this, since I see people from all walks of life in this job, so I ask if he has a question for me. The following conversation ensued:

Me: “Sir, did you have a question for me?”
Mr. Wordvomit: “Yes ma’am, um…what are some signs of dehydration? And what do you do about it?”
Me: “Well, generally people will feel very tired, dizzy, sometimes nauseous, and they may get some cramping. Drinking fluids will usually help.”
Mr. Wordvomit: “So drinking plenty of water will help?”
Me: “Yes sir.”
Mr. Wordvomit: “Ok, sounds good…and uh…is it better to eat 2 or 3 meals a day?”
Me: *what the hell?* “Uh…generally speaking 3 is preferred, but you can do fine with 2”
Mr. Wordvomit: “Oh ok…so like 2 big meals? Cuz I just had some peaches today.”
Me: *this conversation needs to stop. SOON* “Uh…yeah.”
Mr. Wordvomit: “Ok…and hey, I’ve been feeling really shaky lately, like a lot of anxiety…do you know what I could do to help that? Is that just stress? Maybe I’m stressed.”
Me:
*if this dude is hoping that I’ll suggest that he take xanax, that’s NOT the answer he’ll be getting* “Maybe. Did I answer all of your questions?” *read: Can I go now??*
Mr. Wordvomit: “Oh, I had one more question (this is where I do a mental facepalm), and um…well…I can’t remember…oh yeah, there’s this man, I don’t remember his name, but this horrible, horrible, corrupt man —
Me: “Sir, is this a health-related question?” (translation: please stop talking and leave now)
Mr Wordvomit: —and he’s running for governor, but he’s a terrible man, because he wants to cut taxes —
Me: “Sir, if this isn’t a health-related question, then you might want to ask someone else”
Mr. Wordvomit: — oh, I’m getting to the health part (FACEPALM. MOTHERF*CKING FACEPALM) , anyway I’m homeless, and when they cut taxes, that’s less money that goes into my pocket, and he’s a very VERY corrupt and horrible man, I can’t remember his name, but anyway, um…so I think maybe all that pressure in my heart is coming from the thought of him becoming governor.
Me:
Mr. Wordvomit: “Oh well, I guess if he isn’t elected, then maybe all this will go away.”

And then he walked off.

What the hell?

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My store delivers meds to an assisted living home nearby. I had a fun conversation with one of our clients over the phone today:

Me: “BigPharm Pharmacy, how may I help you?”
Mr. SayWhat:
“Good afternoon! I’d like to have a refill on a medication for my wife, Sarah SayWhat. The prescription number is #123455”
Me:
“No problem Mr. SayWhat, I’ll put that in for you. Is there anything else I can do for you?”
Mr. SayWhat:
“…I’m sorry dear, you’ll have to speak up, come again?”
Me:
*louder* “Did you need anything else in addition to the prescription?”
Mr. SayWhat:
“…hang on…ok, I turned up the hearing aid, say that again dear?”
Me:
“Did you need anything else, Mr. SayWhat?”
Mr. SayWhat:
“Oh, no, nothing else that we know of!”
Me:
“Alright Mr. SayWhat, we’ll have that filled and delivered to you later today.”
Mr. SayWhat:
*pause*
I don’t know what you said, but you’ve got a very nice voice.”
Me: *cracking up* “Thanks Mr. SayWhat, you have a good day!”
Mr. SayWhat: “Ok, thanks dear!”

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I’ve officially crossed the one-year mark at being a pharmacist. I survived a YEAR of this crap? Wow.

But in all seriousness, I can definitely say I’ve learned a lot over this first year out in the field. And it definitely wasn’t easy. I’d say I didn’t fully feel “in tune” with my working style up until about 2 months ago. Lots of kinks. Lots of lessons learned the hard way. Here’s a few pearls of wisdom that I’ve learned from my first year of working as a full-blown licensed pharmacist (*sniff*…I’m such a big girl now):

  • Never assume that anything is self-explanatory to a patient. It’s one thing when a patient doesn’t know what the term “hypertension” means, but it’s an ENTIRELY different matter when you hear stories about someone shoving a suppository up their ass WITHOUT unwrapping it first. I thought that was just an urban legend that we learned in pharmacy school (and thus they taught us to make sure we write “UNWRAP and insert rectally”), but apparently enough of my colleagues have heard/seen this happen that it still floors me that anyone would forget this step. You don’t assume that you eat a piece of candy without unwrapping it first, so why should something that goes up your ass be an exception?
  • Always put the patient’s health first. My company’s policy is that prescriptions MUST be rung up back in the pharmacy, meaning patients can’t just grab their meds from us, take it up to the front registers, and ring up their meds along with their potato chips and cigarettes. Pharmacy items get rung up in the pharmacy department, no exceptions. I had a patient who has HIV…our pharmacy closed at 6 pm, but he didn’t get out of work until 7:30 pm, and therefore wouldn’t be able to make it in time to pick up his medication. When it comes to HIV patients, they need to be 95% compliant with their medication, otherwise the effectiveness PLUMMETS to practically zero, so I knew that skipping even just a day of medication could be bad news. I asked the manager if he could hold the patient’s medication at the front store so he could ring up the patient there after the pharmacy department had closed, and told him I’ll fully take the blame if corporate gives us trouble for it. I’ll take the bitchfest from corporate over hearing that a patient fell seriously ill because he wasn’t able to pick up his script.
  • Never underestimate the stupidity of people. NEVER.
  • Don’t take it personally if someone bitches at you. You’ll never make it out of this job alive if you do.
  • Know when to cut your losses. Like when some dude is SUPER convinced that a random bottle of elephant penis oil is going to help him grow hair and win back his ex-wife. And he keeps on coming up with rebuttals to EVERYTHING that you tell him, regardless of the fact that he came to YOU for your “medically trained” opinion, when your opinion is “That bottle you’re holding is $25 worth of bullshit”. If you know for sure the product isn’t going to harm the patient, sometimes you just gotta give up and say “I guess you can try it”…if you don’t, you’ll end up going back and forth for hours with an idiot who seems to think that extractions from an elephant’s genitals are going to turn him into Brad Pitt.
  • RESIST THE URGE TO TAKE A BASEBALL BAT TO YOUR DRIVE THRU. RESIST.
  • Resist the urge to punch certain people in the face.
  • Don’t bitch out the insurance reps…they’re just doing their jobs, and they’re not the ones writing some of these god-awful insurance policies that our poor patients have to suffer with.
  • Don’t worry about not being able to recognize a druggie. After some time, you’ll know it when you see one. Bloodshot eyes? Smells like they haven’t bathed in a few days? A crumpled script written for 120 vicodins, 90 xanax, and 90 somas? Talking WAY too much about some “surgery” they had 2 days ago? Oh dear, you might be AWWWWFULLY sick and in pain! Or you’re popping these things like tic-tacs and waking up in a gutter with a hooker. Get the hell out of my pharmacy, dude.
  • Attitude is EVERYTHING. I know I write about all the nutty people I see at my job, but I actually don’t get too many angry asshole types *knocks on wood*. Maybe I’m in a decent part of town, but I believe that being friendly and helpful SIGNIFICANTLY cuts down on your asshole volume in a pharmacy. Insurance doesn’t cover a patient’s medication? Don’t just say “Your insurance won’t pay for this, it’ll be $243.99″…say “Your insurance won’t pay for this, and it’s a bit expensive ($243.99), but we can try to call your doctor to see if he/she is willing to change it to something that your insurance DOES cover.” Or instead of saying “Your total is $149.99…I don’t know why it was $40 last month, but now your insurance is charging $149.99”, call the insurance company ahead of time, so you can tell the patient “Your total is $149.99…I understand it was $40 last month, but I called your insurance company for you, and it shows that your deductible has restarted.” At that point, they might bitch about their insurance company, but at least they’re not bitching AT you. Some pharmacists might complain that it’s extra time spent (talking to insurance is never a quick conversation), but to me, those extra minutes spent calling the insurance company saves you WAY more time compared to the impending bitchfest that will come if you didn’t take that extra step. Bitchfests (and the ensuing pointless arguments) ALWAYS eat up WAY more time than a quick call to insurance will.
  • Smile. Say hello. Show that you care. Treat your patients like more than just “Rx #246039”. This is why I actually have patients coming back to me to fill me in when they successfully bring down their blood sugar, or if a medication I had suggested actually worked. Some patients might not be picking up prescriptions at all, but they’ll come by to ask me questions about their medications, or ask me about some new medication they’re discussing with their doctor. Or some just come by just to say hi to me when they’re browsing through the store. One of the most valuable lessons I learned from one of my preceptors when I was in pharmacy school is that your practice is what you make it out to be. I could make myself into an automated counting and verifying machine, or I could step out from behind my counter now and then to actually talk to my patients and check on how they’re doing. Deciding to put the “fill fill fill!” mentality on the backburner in favor of actually developing a good relationship with my patients is probably one of the best things I’ve done for myself.

Here’s to a year of good times, bad times, and always plenty of madness. I’ve made it through my first year and I haven’t turned into a raging alcoholic or started on antidepressants or antianxiety meds, so I think that means I’m gonna be alright from here on out. 🙂

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This morning I opened up the pharmacy to a clusterfuck of stuff going on. I was alone, and as soon as I opened, I had cars in BOTH lanes of the drive-thru, a doctor on the phone calling in a new prescription, and 3 people at the register. Allll for lil’ ol’ me to take care of. I frantically called a manager to the pharmacy for backup (to at least ring up the people who were waiting at the register)…turns out one of the people at the register was here for a flu shot. Surprise!

Of COURSE flu shot season would officially start today at 10 am. And of course this guy would be super prepared and make an appointment right at 10 am. And of course he had an online confirmation that he’s got an appointment. And OF COURSE it was nowhere to be found in my computer that this poor guy had made an appointment, because my messaging system was DOWN ALL DAY yesterday, so I had NO freakin’ clue that this guy was going to walk in, expect me to stick him with a needle, and walk on out.

Thankfully this guy was one of our regulars, and also one of the friendliest clients that we’ve got, so he patiently waited while I ran around trying to find all of our flu vaccine supplies that I had absolutely NO preparation for. I found the flu vaccines in the fridge, and had him fill out the proper paperwork so I could poke him in the arm and let him be on his way. I found vials and I found pre-filled syringes. I’d never actually used the pre-filled syringes before, but I figured they would probably make my life easier, right? I opened up the package insert, and didn’t see any instructions for using the pre-filled syringes…my logic was that if there’s no instructions, then these things should be pretty self-explanatory for a trained health care professional. I’ve seen other pre-filled syringes where you just uncap and stick ’em, so I figured this should be easy. Wanting to get this guy out as quickly as possible (the poor man had already been waiting for a while), I rang him up for his shot, put on some gloves, and prepared myself to inject.

I notice a cap on the pre-filled syringe. No biggie, I just twisted it off. I’m pretty decent at giving shots..I’ve got a pretty steady hand, I do it quickly, and I get compliments from even the most needle-phobic patients. I told the guy to relax his arm, and pressed down on the plunger. Wow, that didn’t look like it hurt at all! This may be my best flu shot yet!

Oh wait. It didn’t hurt because THERE WAS NO F*CKING NEEDLE ON THE SYRINGE. I had just squirted flu vaccine fluid all over this dude’s arm. What was supposed to be a good professional action of me injecting this guy with a year’s worth of flu protection turned into me squirting his arm with fluid like an annoying 2nd grader with a water gun. EPIC. FAIL.

Once again, it was with a HUGE stroke of luck that this guy was one of our friendly regulars, so he laughed it off, and waited again for me while I decided fuck it, I’m doing this the old fashioned way with a vial and an empty syringe. Goodness knows if it were anyone else, they’d probably be running for the hills at this point before I came anywhere near them with a needle. I went and got a regular sterile syringe WITH a needle on it, drew up half a milliliter of flu vaccine from a vial, jabbed the guy’s arm, and let Mr. Nice Guy be on his flu-free merry way.

I swear I went to school. And graduated with an “advanced” degree. Really.

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Dear Mr. Former Asshole,

I heavily emphasize on the “Former” part of your nickname, because you have NO idea what you’ve done for me today. All the way back in January, I screwed up on one of your scripts…long story short, I accidentally deleted it, and that led to a frenzy of me apologizing for losing the script and frantically calling the doctor over and over (the office was closed, so it was hell just trying to REACH an on-call doctor for help) to get the script dictated all over again. I apologized repeatedly, took full responsibility for the error, offered to reimburse the cost of the medication once the error was corrected, AND gave a gift card for the inconvenience. You in turn chewed me out, and repeatedly called me throughout the evening to remind me of my screw-up, even after I had repeatedly told you that I was doing everything I could to make things right. I was already feeling down about the mistake (and it was totally my fault, I’m not denying that), but you were rubbing it in.

Fast forward 7 months, to today. That last incident has LONG passed, it’s pretty much forgotten, and I’m just doing my job as usual. You show up in my drive-thru to pick up your medication, and I get your script for you. You ask me “Do you remember me?” I say I do. You ask me “Do you remember what happened last time?” I give an acknowledging “Yes, but we’re cool now” smile and say “Yup, I do.” Then you do the unthinkable: you apologized. You told me about how around that time I screwed up on your script, you had taken another script to a competitor pharmacy (the location was more convenient for you at the time), and how they had REALLY royally f*cked up your script there. They had actually given it to the wrong person (without double-checking the patient’s identification information, AND without having the person sign for the pickup), and it was also for a controlled substance, which is REALLY big trouble when those get in the wrong hands. When you had asked them to call the doctor to verify the the prescription and to obtain a new one (since the original was given to the wrong patient), they half-assedly tried to get the other guy to bring back the wrong medication, and made half-assed efforts to contact your doctor. Apparently they effed up so badly that the tech who was handling the script actually got fired. You told me while the folks at Competitor Pharmacy were mucking around, you immediately thought about how you chewed me out when I was doing everything I could to get the script back so I could have it filled and ready for you. You told me you now realize how much of an effort I was making to help you out and make sure everything was squared away with the doctor before I filled your script over again. You told me you were sorry about how you acted, and how you were DEFINITELY doing all your business with my store from here on out, because we’ve treated you well, and now you know how much we do to make sure we get everything right.

Mr. No Longer an Asshole, you have NO idea what that means to me. Because not only did you apologize, you actually acknowledged that I was truly trying to help you out and to get everything back on track with your medication. That apology was already worth a pound of gold to me…those of us in retail NEVER hear people to say sorry for chewing us out (and we don’t expect them to), but you did more than that. You actually recognized the work I put into my job to make sure everything I provide for you is accurate and safe for you. Because amidst moments where I feel like the only thing I’m good for is counting by fives and pointing out where the hemorrhoid creams are, you made me feel like my efforts actually paid off. And for that, I can’t thank you enough.

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Apparently I got lucky last week and dodged a flurry of crazies, because my techs told me that after my shift, ALL sorts of nutty people came in.

  • There was a fly-by robbery. There’s an ATM positioned right next to the front door of the store, and a guy was just minding his own business, withdrawing some cash from the machine. As soon as the cash spit out, another guy snatched away the money and ran out the door. I can’t even imagine the FML moment the poor dude must’ve had as the robber literally bolted out the door with his cash.
  • A lady came in asking to use the restroom. Since our restroom is locked (for loss prevention purposes), my technician walked the woman down to the door to unlock it for her. Most normal people would thank us, walk into the restroom, end of story. But no…this lady made my poor tech PINKY SWEAR (her exact words, pinky swear) to go in with her and to watch the door, because she “doesn’t trust him”. Who’s him? We don’t know. My tech was generous (maybe TOO generous) enough to actually sit outside the door and keep watch, while she overheard the woman mutter to herself while she did her business. She washed her hands, and let my tech be on her way. My tech thought that was the end of it. Then while she was working back in the pharmacy, the same woman walks up to the consultation window along with a man (my tech told me the first thing she thought was “Holy shit, there IS a ‘him’!”), and the woman taps on the counter and in a boastful tone says “Consultation pleeease.” When the pharmacist (my poor co-worker) went over to the window, the woman pushes two pairs of sunglasses towards her and asks “Which sunglasses are better, the white ones or the black ones?” Are you f*ckin’ kidding me?? The  consultation window is for health and medication consultations, not freakin’ fashion advice. From what I was told, my poor co-worker just tried to give her a quick and vague answer so she could be on her way. Apparently the couple also came back saying something about how they couldn’t find some sunglasses, but the woman already had a pair sitting on her head. Eventually she called a manager to somehow get him to help us out a bit, where all he could do was take down their names and phone numbers, and said we’ll call them if we happened to find these missing sunglasses. And from there the nutcases went off into the night.

Yeeeah. I definitely lucked out. Let’s hope I keep up this nutcase-free streak. *knocks on wood* And if I jinx myself by posting this, I guess it’ll be up on this blog soon enough. 😛

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