The Pharmacy Chick

Flying the coup in retail

Doofus-o-mania..must be the water!

Filed under: Uncategorized — pharmacychick at 5:25 pm on Wednesday, March 30, 2011

When it rains it pours.  Doofuses among us run rampant.  This one, we can file under “fool me once, shame on YOU, fool me twice, shame on me”. 

Its Monday afternoon and I am returning from my all-too-short lunch and I see one of my long timers (we will call him Wigged out…Wiggie for short) sitting in the wait room.  Tho he has never been a FAV of mine, (too many narcs..too many docs- not a good combo), he has at least always been pleasant when he is sober.  This day he picked up a nice cocktail of genericVicodin and Diazepam.  (Note..I didn’t spell it VICODAN..it has never been nor ever will be spelled that way.  learn to spell it correctly all ye who prescribe).  He picked up the rx and went on his merry way. I was not involved in the filling, dispensing or counseling of this patient. I did however, say hello as I walked by.

A couple of hours later, the phone rings and its Wiggie.  The tech takes the call and passes it to me. “You better take this one, he thinks we made a mistake”.  He proceeds to tell me that the tablets inside the bottle do not match the descriptor on the side.  “These are yellow and it says they should be blue”.  My first thought was damn, he got 5mg instead of 10mg…We were slammed so I asked him to return the product and I will replace it.  Shortly thereafter he returns and I open the bottle and sure enough there are yellow tabs inside.  I set them aside, replace the drug, make appropriate apologies,  document the discussion and leave it for MyManFriday who was the filling pharmacist.  I wrote a post it note  “Diaz 5mg? make sure all rx scanned  for accuracy”.

Since it was a very busy monday, I set it aside and didn’t do anything else with it.  I’ll talk to Man Friday tomorrow…

Most of tuesday passes when the phone rings and its Friday on the line.  “The tablets inside that bottle that Wiggie returned aren’t Diazepam 5.  they are cyclobenzaprine by WHAZZIT labs,  a product WE DONT CARRY. 

Well well well, we have a new game on.  Wiggie has moved from routine drug seeking to faking rx errors to obtain more diazepam.  Game over BUCKO.

We left him a message to call us (knowing darn well he wouldn’t be THAT stupid). Then called the prescriber, cancelled any rx’s he had on file and marked his profile as terminated.  We figured we had seen the last of Wiggie.

Well he was indeed THAT stupid.  He called on wednesday and attempted the same ruse… with the same rx!!!  When informed that not only had we fixed the “error” but we were on to his scam because what he returned was something we dont stock.  He hung up on Man Friday.

But to take the cake…drumroll please……He called on Thursday and wanted to fill some rx’s he had on hold.  In the sweetest voice I could muster I said “Wiggie, you can’t fill prescriptions here anymore.  ”

He had the audacity to ask WHY.

Well Wiggie, all the docs know what you did.  And so do the pharmacies around us.  Good luck with your next venture.

 

Doofus of the day: Weekend Edition.

Filed under: Uncategorized — pharmacychick at 9:34 am on Tuesday, March 22, 2011

For once, Doofus of the day is not Pharmacy Chick.  No, I didn’t assume the wrong gender, nor did I ask if a fat chick is pregnant.  The Doofus of the day goes to Miss Jane Doe who thought that a pharmacist would be either blind enough or stupid enough to bring in a prescription so obviously altered that NOBODY would fill it.

2pm:  the phone rings, some chick on the other end wants to know if we have oxycodone 5.  Its been in short supply of late and these phone calls aren’t all that uncommon, either by a pharmacy or by a patient.  We confirm that we do indeed have “some”.

2:30 pm this blonde 21year old presents a prescription.  Immediately my suspicion is peaked when I look at the prescription and see that every thing on it has been traced.  In all my years as a pharmacist there is only ONE physician that I have ever filled for that ever traced over stuff on his hardcopy, and it was a pediatrician.  Either he was a little OC or he was just “different”.  THIS was NOT that doctor.  I have filled hundreds, if not thousands of scripts for Dr X and she has never ONCE traced over her name or the patient name, let alone everything on the face. 

She sees my careful inspection of the hard copy and  says ” oh, my daughter played with the prescription a bit”…puhleeze, do NOT even go there.  Clearly the prescription had been washed/bleached/erased and the drug had been changed, as was the quantity and the sig.  You could even still see a bit of the ink remaining in background where she couldn’t wash it all off.   I told her ” I think I best check with the doctor on this rx”.  She immediately backpedaled and said.  Oh thats ok, I’ll just take it to my “regular pharmacy”…not buying that either.  And she reached towards me to get the prescription.

“Oh, not before I take a copy of this!”…as I scanned the RX into the copier.  ” YOU CAN’T DO THAT!”  she exclaimed.   “Oh yes I can, and before you can get to any pharmacy nearby, I will have notified every pharmacy in the county  AND your physician”.  “Have a good day”. 

‘YOU BITCH!”   she screamed, grabbed the offensive script from the counter and stomped off.  True to my word,  I called every pharmacy I could and the DR. who was wondering why I didnt’ call the police right then…she already knew I was suspicious..you think that she was going to wait around?  The dr knew the patient, she had stupidly used her real name on the script. I guess she couldn’t wash that off.

I had sunday off, and waiting for me monday was the phone number of the Sherriff’s office.  Aparently the Dr decided to act on my call and wants to prosecute the girl. 

Good move Doc.

Ripping Grumpy off: Tools of MY trade.

Filed under: Uncategorized — pharmacychick at 9:27 pm on Thursday, March 17, 2011

Dr Grumpy posted today on HIS tools of the trade.  If you havent read it you can read it here: http://drgrumpyinthehouse.blogspot.com/2011/03/secrets-of-jedi-masters.html

Pharmacy chick has no need of a reflex hammer.   On second thought some of the hammers on Grumpy’s post might come in handy.. in an entirely new use, but one that might not be conventional….or legal….

Moving on.  In a blatant attempt to ride the coat tails of Grumpy’s success and innovative post ideas I offer my own only semi plagarized “tools of the trade”:

Pharmacy has its own tools…., namely the counting tray and spatula.  Every pharmacist will admit that they probably have a specific spatula that they will always grab when they have to do the duty. I am no exception.  That is not to say that I’ll rip it out of the tech’s hand if she/he happens to be using it, but I will generally whine if I can’t find my favorite.

Ive had a variety of both spatulas and trays dropped off at PC pharmacy over the years.  With the demise of freebies from drug companies, they have been eliminated but I still keep a tidy supply for future use.  There are some however that are complete crap.  I mean,  they have to meet some kind of critera in order to make the “big show” and end up on the counter.

Go to fullsize imageThe tray might make it on the counter because it is an acceptable solid color but the spatula???? WTF is that plastic thing?  NO pharmacist would use that “spatula”..and I use that term lightly.  The tray must have  the thumb tab to raise the hinge.  (which it does) . I have a couple without the thumb tab and its a pain in the arse to use. This tray comes as close as possible to the all time favorite:  The Turquoise Abbot Counting Tray.  It was probably the mainstay of pharmacies everywhere.

eBay Image 1 Vintage Abbott Lab Counting Tray in Box w/InsertSeen here, it has graced the counters of pharmacies all over the US, and probably the world.  Nobody has ever made a tray this perfect.

Go to fullsize imageThis is a loser on two levels.  1)  I dont like any transparent counting tray.  Its only redeeming value is that its a ambidextrous tray for the 1 in 10000000 pharmacists who thinks they need to shove their tablets to the right.  In 23 years of practice, I have met only one and he brought it own tray…which he absentmindedly left behind.  I had to mail it to him.  I’m left handed and Ive managed quite well with a standard tray.  2) the spatula has that tweezer on the end which serves no purpose but to pinch the user.  I have a couple of these in a drawer.  And, in that drawer they will stay. If I am going to get pinched, it better be by a handsome  man and NOT by a piece of equipment. It does have a nice taper blade however.  I am , after all counting tablets not frosting a cake.

Go to fullsize image We got a fair number of these with inserts for advertising.  My tech ripped the ad out of one and inserted her kid’s picture.  But the tray lacks a thumb tab…PC needs a thumb tab.  The spatula is another technological wonder.  It has a spring loaded cotton picker in the end.  Again,  worthless piece of equipment.  It never picked cotton very well and when the spring sprung the cotton picker flopped around poking anyone who got too close. 

Go to fullsize image HAHAHAHAHAHAHAH.  Supposedly the 4 in 1 pharmacy tool.  it claims” The 4-in-1 Pharmacy Tool is a portable handheld device designed to assist busy pharmacists with the repetitive tasks of opening medicine bottles and counting pills to fill patient prescriptions. The tool breaks moisture-induction seals, removes cotton from bottles, acts as a spatula for counting pills and has tweezers for sanitary hands-off retrieval of any stray pills accidentally spilled during the filling procedure.”  It also appears to be a handy mouth guard for those pharmacists who take the job home at night and grind their teeth…

Go to fullsize imageHonestly I cannot imagine.  But they want $50 bucks for it. At least the handle is wood …Rosewood specifically…PC likes wood handled spatulas.  We are getting closer. 

Pharmacists toolkitUm  for Survivor…Pharmacy Edition?  Actually I am not sure it would be a good idea to give a retail pharmacist close access to a tool of this design. I like the taper blade but one bad day and there may be bloodshed and where do you hide the bodies in a pharmacy?  At least we all know Universal Precautions from our blood borne path class.

Wooden counting spatulaOuch, another redundant effort to improve a simple spatula. But it may do a nice job of cleaning fingernails or picking noses…carefully.

Go to fullsize imageTOO LONG….

Go to fullsize imageToo short. Too wide.

Go to fullsize imageWrong Profession.

So, you might ask..WHAT DO you use Pharmacy Chick?  your hands?  Well, no, but I did know a Rph in my early days who counted with his fingers, like a sieve.  He was nearly retired.  I think that was a sound decision on his part.  My perfect spatula is a vintage Ceftin spatula I have had for all my years.  I have absconded  with it from every pharmacy I have ever worked in.  Traditional in design, it has a smoothly sanded oak handle and a perfect length tapered blade.  It has suffered many indignities over the years including a bent tip from a few too many stabs in safety seals but it feels perfect in my hand. It doesn’t scratch the tray, and the finish doesn’t cause splinters. (yes I have had some really cheap woodies that the paint came off and caused splinters)

This is the perfect PC spatula.  Simple in design.  About a 6 in tapered blade. Smooth wood handle, feels good in my hand.  Any tablet should be honored to be counted with such a lovely device.

And now you know all my “tools of the trade”.

 

Note to Self 3-16-2011

Filed under: Uncategorized — pharmacychick at 6:48 pm on Wednesday, March 16, 2011

Pharmacy Chick,

You are certainly on a roll.  Please,  unless he is standing before you buck naked with all the family jewels displayed for the world to see, never assume you know the gender of the person you are looking at.  Especially if that person looks like a man…and he his presenting a script for a woman.. because when you implicated that the person dropping OFF the script was not the patient by basis of gender,  you looked mightily silly when said patient announced that yes indeed SHE was the Patient in question.  Be grateful that SHE was gracious and had a sense of humor and that “it happens all the time”. 

Next time you may not be so lucky.

Pharmacy Chick

p.s.  your techs are STILL laughing at you …

Monday’s cross cultural experience.

Filed under: Uncategorized — pharmacychick at 5:16 pm on Monday, March 14, 2011

Monday is the one day per week that Pharmacy Chick gets a lunch.  A quick 30 minute foray for gastronomic relief…today I decided to go to my favorite little Japanese restaurant in my center.  I’ve eaten there for 15 years.  The head sushi chef calls me Doc.

I get seated, order my usual, California roll, tempura, salad, no rice and a Coke.  There is Japanese art on the wall, Japanese music overhead, Japanese people eating sushi at the sushi bar.

I ask the waitress (owner’s wife perhaps?)  “Ive seen the devastation in Japan..do you still have any family there?”

Her reply…” Dont know..I am not Japanese, I’m Korean”, smiles and walks away.

My bad.

Moving on…..

Growl.

Filed under: Uncategorized — pharmacychick at 12:40 am on Saturday, March 12, 2011

Folks, I am in one pissy mood.  People should be happy that I dont have to work tomorrow.  I came to work with a fine attitude only to have it dashed to threads before the gates were even thrown open.  No details will be forthcoming, but suffice to say I had some steam to blow off.  Tech extraordinare noticed it immediately and kept her distance…it was a very quiet first hour.

When I am wallowing in a pissy mood one of the things I am sadly lacking at this moment in time is empathy….and since I can’t dump at work, I do it here. So here are some of my bad mood observations:

1.  For the record, I am sick and tired of people asking me what I recommend for a cold or a headache..SERIOUSLY?  Ya’ll are all grown up right? If you can’t figure out what to take for the 50th cold you have had or the 300th headache you have had in your life, I am not sure I can help you.  You really lose me when all you can say after I actually DO make a recommendation is ” I’ve tried that, it didnt’ work”…or “What about (pointing to something else)”.

2.  Yes there really such a thing as a dumb question.  Holding 3 bottles of shampoo…” what one of these is the best?”  I hoped he was kidding. 

3.  For the 1000th time ” for HOURS OF OPERATION press 1″..quit bypassing my IVR to find out what time we close.

4.  It appears that my patience is inversly porportional to the opportunities where I need it the most.

5. I really wish I could HONESTLY answer this question: ” Do you mind if I ask you a question”.  if i say yes, will you go away?

6. Telling me your sick dog/daughter/groceries/melting icecream is in the car will not make me fill your rx any faster.

7.  Called a pharmacy on the West  Coast today for a copy. It was closed…must have been beachside as it was Tsunami related.  Customer just couldn’t grasp that. The Drug:  Viagra.  ah, get over it.

8. they  really should rename Friday…Narcoday.  Thats about all we do on fridays anyway.

9.  some drunk reeking of booze, filling his chlordiazepoxide and naltrexone trying to convince me he is going to quit drinking THIS time.  I am not buying it .

10. Last but not least.  When the clock finally ticked 9 pm, I became totally deaf to the phone ringing…Whoever you were…sorry, the door was already locked, the computers were off and the money was closed out.

Saturday has to be better…grrrrrr

Even Pharmacy Chick can be a error victim

Filed under: Uncategorized — pharmacychick at 1:38 pm on Monday, March 7, 2011

Lest you think that pharmacy errors only happen to the common folk… A couple of years ago I had my appointment with my Dr and brought in my Rx to have filled.  Tho not prohibited,  we generally do not fill our own prescriptions, unless we dont have a choice.  I handed it off to my man Friday to fill.

Occasionally I get migraines, most often in the spring and fall.  They seem to be triggered by light, so when the sun is low and hitting directly into my eyes, I get more migraines than when the sun is high overhead. Can’t explain it.

I picked up my rx, brought it home and put it in the medicine cabinet.  About 4 months later I had a headache (dont need it very often you see), and opened it up. My first thought was ” hmmm I dont remember our generic fiorinal was oval….its always been round”…further observation of the bottle showed that it had been filled for Fioricet (generic). 

I did bring it to Friday’s attention.  Was it a clinically significant error? No, but it still was an error.  He took a Rx written for one product, and filled it..and checked it …for another. 

It can happen to all of us…even to PC.

The 15 minute mistake.

Filed under: Uncategorized — pharmacychick at 5:55 pm on Wednesday, March 2, 2011

Tho I wont tell you where I DO work, I can say without any reservation that I do NOT work for Rite Aid…and THANK YOU GOD for that.  I have a couple of them on either side of PC pharmacy and they hate their life now.  “Sandy”  said ” I dont care, give them the $5.  the script will be ready when its ready”.  If you haven’t already figured out what I am talking about, its WRONG-aid’s decision to launch a program for a 15 minute guarantee to have a prescription ready or you get $5 in store credit. 

Aside from the obvious problems with this “program”….  What bonehead thought this up?  Seriously?  Not a pharmacist for sure..and most certainly NOT risk management attorney, because if either of them were involved they would have axed this program at its very introduction at the think tank of Rite aid…which now I think may not be much of a tank at all…maybe a small puddle.

Lets go over some basics. 

1. Is $5 worth having your butt sued for a prescription error worth it?  Uh, nope, not in my lifetime.  I am responsible for my own license and treat it like its worth everything I own…because  EVERYTHING I OWN WAS PURCHASED WITH MY LICENSE.

2.  A “guarantee”.  Even domino’s pizza got wise and dropped the 3o minute guarantee after car accidents occurred from frantic pizza drivers….

3.  Would you , as a patient, feel really good about having your LIFE sustaining drugs treated like a fast food item?  Thrown together to beat the clock?

If I were a Rite Aid pharmacist, I’d have called the board of pharmacy by now…..While that 15 minute RX just sits and gets properly typed,  properly counted, properly interpreted, and properly checked and properly counselled.

There will be repercussions. I dont normally dig the board of pharmacy much.  Generally their interest lies elsewhere than in the working condition of the pharmacist, They claim they are all about patient safety ( and making sure that I haven’t missed one single temperature entry on my log during their 4 hour audits.)  However, there if there is ANY LINK WHATSOEVER between pharmacy working conditions and  patient safety, this has to be the one floating to the top.

I am most interested in seeing what happens next.