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Archive for the ‘the grind’ Category

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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Work has been killing me. They’ve cut hours at my place, meaning instead of having me plus 2 other technicians scrambling around to get shit done at peak hours, we now only have me plus 1 other tech scrambling around to get even MORE shit done, due to the lack of a 3rd scrambling person to help. So when you’ve got 3 calls on hold, two people sitting in the drive-thru, 2 more people waiting at the register, and more people in line dropping off new prescriptions, basic math will tell you that 2 bodies are NOT enough to cover all of that. And inevitably, when you finish ringing up everyone at the register and you FINALLY pick up those phone calls, the people on the phone are annoyed with you for being on hold for so long. Or when you finally finish with the people dropping off scripts and get to the drive thru, the people in drive-thru are annoyed with you for waiting so long. Or any other combination of events, take your pick. So at the end of the day, we’re drained out, and we’ve had people throwing pissy fits at us all day because surprise! We don’t have enough people to help! And when we don’t have enough people to help, people end up waiting longer, and when people wait for a long time, surprise again! They get impatient (and at times rightfully so) and throw bitch fits at us. And of course, when someone throws a bitch fit, it takes us even longer than usual to help them, because we have to take time to apologize and calm them down before we even begin to figure out what they wanted in the first place. I could freakin’ draw a graph on this whole situation if I wanted to…bottom line is that when we don’t have enough help, people end up waiting longer. When people wait longer, they get pissy. When people get pissy, it takes us even LONGER to help them out than usual due to additional bitch fit management measures that we have to take, and therefore it makes the people behind pissy person #1 wait even LONGER in line, quickly transforming them into pissy person #2…and it leads to a wonderful loop of bitch fits and increased wait times.

I don’t eat, I don’t use the bathroom, and I’m pretty sure all this is going to result in a coronary bypass operation in the next 10 years or so. So the next time you see your pharmacist and you wonder 1) why it takes so long to get some service, and 2) why she looks like she’d rather stab herself in the eye with a spatula than answer the drive-thru, think of me and my poor technicians who have to frantically run around like decapitated chickens. And no, I don’t know why we don’t stock flavored condoms, so please stop wasting my time so I can help the other 20 million people waiting in line.

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According to my shift supervisor’s intercom announcements, apparently I have:

  • Given birth to twins named Shakitha and Sharifa
  • Taken leave for Canada

Funny enough, I was ringing up a customer when he announced that I was moving to Canada, and the customer actually asked where in Canada I was going, because he used to live in Calgary. I had to break the news to the guy that I wasn’t going anywhere. I’m thinking by the end of the month he’ll be announcing alien abductions too.

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Yesterday my shift supervisor got bored and decided to make random announcements over the intercom. First he announced a fake birthday for an associate. Then he got on the intercom with the following:

“Attention BigPharm shoppers…we just wanted to say congratulations to our wonderful pharmacist on her engagement to uh…”Samuel”. A big congratulations to her!”

I dialed up to the front and asked him if he was retarded. I also told him he was a dead man. A couple of hours later, I decided it was payback time. I got on the intercom and flawlessly (and cheerfully) announced:

“Attention BigPharm customers…we just wanted to say congratulations to our shift supervisor J on the birth of his baby boy Maximilian Amadeus. If you see him around, please congratulate him on this wonderful addition to his family, and thank you for shopping at BigPharm!”

I think the next step is buying some cigars for the occasion.

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Week in review

This has seriously been a weird week at work. Just a few snippets for now, but in this past week alone, I’ve had the following happen:

  • I had seriously one of the most EXTREME druggies I’ve ever seen wander into my pharmacy. It’s a long story, but I’ll definitely blog more about this one later
  • I had a guy storm in to pick up his meds…he walks in and says with a thick foreign accent “I need my medication.” My technician asks for his name, and he goes “YOU KNOW YOU HAVE MY MEDICATION, I DON’T WANT TO TALK TO YOU, JUST GIVE IT TO ME.” I come around and tell him that we need his name to give him his damn medications, because 1) we’re not psychic, and 2) unless you’re Johnny Depp, I won’t have any clue who the hell you are. He says “You want to know my name? Here, HERE’S MY ID, JUST GIVE ME MY MEDICATION”, and proceeds to dig his ID out of his wallet and throws it at us. He continues to bitch me out, only to find out that his meds weren’t even at my store. When I told him they were at a different store, he claimed that he was going to have his lawyer talk to the staff at the other store tomorrow, and threatened to have his lawyer talk to me too if I didn’t get  the situation taken care of. Because threatening to sue me for “bad service” will TOTALLY have me shaking in my boots. One way or another, I had his meds transferred to my store and got him the hell out of there so that he wouldn’t harrass anyone else. I’m sure his lawyer will be thrilled to hear from him. 😛
  • A guy came up to my counter telling me that his daughter fell in one of the aisles. I followed him over, and I saw his daughter on the ground, clutching her elbow, with a box of cough syrup lying next to her. She said she slipped on the box of cough syrup. I MIGHT have believed it if it was just a bottle lying on the ground, but a box? The other part is that our floors are carpeted, meaning they would probably provide a decent amount of friction if someone were to “slide” on a box of cough syrup. I decided that I didn’t want to have ANY part in this mess, and immediately called a manager to the aisle to assess the situation. Next thing I know, all sorts of district bigwigs are in the store, helping this lady up, offering to give her over-the-counter stuff to help with her elbow, all while filling out an incident report. After everything calms down and they leave the store, I find out from my manager that when they watched the surveillance tape, it turns out there was no box of cough syrup on the ground to begin with…she was just walking down the aisle and straight up fell out of nowhere. Thanks for wasting our time while making a sad attempt to milk some money out of us.
  • A shoplifter got busted at my store on New Year’s Eve. He tried to walk out with $130 worth of merchandise stuffed in his pants, his jacket, and some of it in his hat. My manager brought back the basket full of all the stuff that he tried to steal, and it seriously weighs as much as 3 gallon jugs of milk in a basket. LOTS of stuff. It would’ve been impressive if he got away with it, and if he was stealing good shit, but the contents of what he stole is what puzzled me…the $130 of stuff that he stole consisted of SHITLOADS of shampoo and conditioner, nail clippers, foot creams, and nail files. What the HELL are you going to do with all that, and who the hell are you selling it to? I found out later that apparently people will steal random mundane things like this, and sell it for cheap at flea markets. Crazy stuff.

All in the last week of the year. Looks like 2009 wanted to have a little extra fun before 2010 came in, haha. 😛

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Today’s roundup of interesting patients:

  • One poor lady with a busted lip and a broken tooth…I immediately got a bottle of hydrogen peroxide to help clean her up, and my technician directed her to the nearest emergency center to make sure she didn’t need stitches or anything. She came back later with a script for some antibiotics after being treated at the emergency center, hehe.
  • One girl at the drive-thru who was about to undergo surgery. Most people just hand me the scripts, and don’t really talk about what they’re getting them for. She handed me her scripts and said “Yeah, I’m going in for surgery on Thursday, but it’s not bad surgery…I’m getting the fun kind.” I asked “Fun surgery?”, to which she happily replied (like she’d be waiting all day for someone to ask)”Yeah, I’m gettin’myself ENHANCED!”…she was really excited about it, haha.
  • Comment of the day: A girl at the drive thru who was given some Imitrex injectable solution, but the pharmacy she went to 1) failed to give her any needles, and 2) failed to give her any instruction whatsoever on how to use the medication. She also pointed out that she had to be at work at a nearby strip club (she wasn’t a stripper, she just worked in the boutique), so I couldn’t spend TOO much time instructing her. So I sold her some syringes for the injectables, and quickly gave her instructions on how to use it…I asked if they told her if she was supposed to inject it into her arm or into her stomach, and she said “They just told me that if I put it in my arm, it’d leave a bruise?” I figured out that it was to be injected in the stomach…so in order to demonstrate, I had to lift up my shirt a bit to show how to pinch the area, to which I apologized for having to show some skin. She replied “Oh trust me, where I work, I’m used to seeing people expose themselves.” I should’ve known, haha.
  • 2 crackheads, plus one other possible druggie. Freakin’ druggies, get the f*ck out of my pharmacy and stop wasting my time. A good day at work is when I don’t get any druggies disrupting the peace in my little pharm corner. Jerks.

Just another day at the pharm. 😛

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I’ve started working full time at my pharmacy. I’m still trying to get used to the idea that I’M the one who calls the shots now, and that if something goes wrong, people are looking to ME for answers. Yikes. Here are a few highlights from my first two weeks of working as a big girl on my own in the pharmacy:

  • Some blond chick came in with a massive cold sore on her lip, asking what I’d recommend over the counter. I told her Abreva, and she immediately shot it down, saying it doesn’t work. Then she asked if using tea tree oil or rubbing alcohol would work. I told her I didn’t know about the tea tree oil, but the rubbing alcohol would probably hurt a bit, because it would burn. Her response? “Girl, I’ve been putting Lysol on this thing.” Then she proceeded to ask me if it’s okay to use Lysol, asking if she’s going to die from it or anything. I said she probably wasn’t going to die unless she actually swallowed it. She asks me if I want to take a closer look at the cold sore. I politely decline. I ask her if there’s been any sort of discharge coming from the sore, in which she responds “Ack, that kinda grosses me out when you say that.” Because asking me to take a closer look at your cold sore isn’t gross either. She goes back to asking about what to do about the cold sore…after she shoots down all of my OTC recommendations, I tell her she might want to see a doc instead, and suggested either Zovirax cream or acyclovir tablets, pointing out that the tabs would help more if this is a recurrent problem. She says “Oh, I don’t swallow pills.” I suggested that if it’s a problem, she can break them in half. She says “No no, I don’t swallow pills, period. It just doesn’t happen.” Mentally I’m thinking “You must’ve swallowed SOMETHING to get that nasty cold sore on your lip.”
  • During my second week EVER of working on my own as a pharmacist, a DPS officer waltzes into my store asking to seize some forged prescriptions for an investigation. The officer noticed my deer in headlights look, and jokingly said “I should probably yell at your manager for leaving you here by yourself the one time a DPS officer shows up.”
  • Druggies provide an endless amount of entertainment (and sometimes anxiety) for me on the job. Just last night, a guy rolled up through my drive through right around closing time. I open the window to ask if I can help him, and I see this scraggly looking shirtless dude in his 20s in the driver’s seat. He gives me a confused look, then shuffles through some junk in his car, and without saying a word, hands me two crumpled prescriptions. I look at the scripts…one has an antibiotic and a pain medication written on it, and the other has a muscle relaxant and a codeine cough syrup written on it. Cuz you know, when you’re sick enough to need antibiotics, pain killers, muscle relaxants, and codeine cough syrup, it TOTALLY makes sense to drive around town shirtless at 10 pm.
  • Every time I get a script for an antibiotic with dosing that’s typical for an STD, I always mentally think “Uh oh, someone’s got CHLAMYDIA.”
  • Someone took a crap in my store. No joke. The guy came to the back asking where our restroom was…my tech points him in the right direction, and tells him he’ll page someone to unlock the door for him. 10 minutes later, our floor manager comes to visit us back in the pharmacy, and he tells us that someone just took a crap IN FRONT of the bathroom door…because apparently no one came quickly enough? Gross.

So that’s my life at work so far. Countin’ pills, gettin’ paid, answering people’s questions about everything from UTIs to sore throats to swine flu. Thus begins my first real career. As long as I don’t get too many people taking a dump in my store, I think I’ll be alright. 😛

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