The Pharmacy Chick

Flying the coup in retail

Who ELSE would like to beat up on the pharmacist?

Filed under: Uncategorized — pharmacychick at 5:32 pm on Saturday, December 19, 2015

Its time to head back into posts about pharmacy for a bit.  Pharmacy Chick has certainly had her fill of stupid human tricks and doctor errors the last few days.  And without exception I seem to have to don boxing gloves to fend off the attacks. Am I to be everybody’s babysitter, overseer and keeper?  Shall we commence with some of the stories?

A refill comes in from a patient.(note: Patient orders this med..not me, the doc, or our autofill feature)  It needs a Doctor approval, which we get ON THE SAME DAY. We fill it, patient picks it up, goes home and calls us up and says ” you filled the wrong prescription”.  (note: WE FILLED wrong rx).  I pull hard copy and tell patient that a) patient punched in number with date and time it arrived…b) it was filled correctly by staff and c) dispensed and signed by patient.  ” What exactly did we do wrong Ma’am?”  Thats not the one I wanted.   ” That doesn’t appear to be the pharmacy’s error”.  She complains that we have POOR customer service.  How is filling her prescription exactly as she ordered it POOR CUSTOMER SERVICE?

A doctor sends in an E-script for a patient with the same drug (Prednisone) with 3 ( count them!) 3 different sigs, all slightly different, over a period of 30 minutes.  I call back to determine which pray tell is the RIGHT one? I get a snarky nurse who says ” WELL the LAST ONE ! isn’t that obvious?”  Not exactly. Maybe I should have done all 3.

A clinic sends over a E-script for a patient.  We fill it, the patients wife comes in , picks up her own and her husbands Rx ( with appropriate counseling).   Hubby calls back and says he wasn’t supposed to get this rx.  I( again, pull hard copy , verify it was for this patient) tell him that it was a new order from his doc, and if he has a question about the rx he may want to call the office…which he does and the med assistant says ” we sent no such rx to your pharmacy”…. Mama Bear goes in to full alert and contacts said Med Assistant and ask her ” why would you tell your patient that you sent ” no such rx to the pharmacy?” Because we didn’t…” would you like to see the E script you actually did send?” I produce the document…to which she says “I don’t know why we sent that”  Well it doesn’t matter why, you did. Well he doesn’t need it, you can just refund him.   “(WTF)  and shall you reimburse the pharmacy for refunding the patient for  a medication you ordered unnecessarily …and denied ordering at all?”

A Dr escripted a RX for buproprion HCL 100mg tabs. I filled it correctly.  He meant to order SR 100mg  It went to patient.  What agency should I report a med error to? If this had happened to me I’d have a report 9 pages long to account for this error.

Another Rx came in for Nortrel 0.5/35. It was NOT a refill request, it was a new order.. We filled it, but noted that it was a different dose from the 1/35 that pt had before.  Pt was counseled and I noted the dose change.  ANOTHER error from the doctors office.  Patient elected to leave rx here since she was sure it was wrong. It was. They sent over another rx in about 2 hours. No calls, no explanations, no ” hey thanks for catching that”..

A patient brought in a computer generated script from ER doc for Amoxil 250mg suspension..get this  Dispense 187.5ml give 13.1 ml bid.  WTF?  Really?  first off she is 7 years old and this is essentialy 750mg of amoxil twice daily for a 7 year old. and secondly, doesn’t anyone read these rx anyway?  Dad asked if we had chewables instead of liquid which she hated.  I asked them if they had discussed this before they left and he said  no.. ” Ill call, but it will delay the rx considerably…and the dose is pretty wonky. I need to check on that too”.  Sure enough the doc admitted he hadn’t even looked at the rx, he just signed it and changed it to chewable 25omg 1 bid # 14.   ANOTHER clinic error. At least the doc was  nice about that.. ” I better look better at these computer rxs”

A irate customer fills out a survey…this is what is wrong with OUR pharmacy and why he hates us: a) we are in the back of the store and don’t have a drive thru–well it is a grocery store sir and if you want us to remove the freezers, the  entire back room and the loading dock behind the store then we can manage that drive thru for ya. most pharmacies ARE in the back of the store. b) auto fill “never ” works. well if you call filling your prescriptions and letting them sit til they are re-shelved and ignoring your 2 reminder calls as ” never working” then ya, I guess it never works for you. and c) we are too stupid to figure out his insurance .when ya enroll in medicare, you get new insurance right?  that means you get new coverage and a NEW CARD.. which you really should give to us and not throw away. He transfers to competitor. We aren’t upset.

A man and his girlfriend bring in two rx’s from the urgent care next door. He is new but the girl said ” Ive been here before”  . Great, I collect the rx and HIS insurance info, (both medicaid patients) and I see the prescriptions, one for her and one for him. These rx from urgent care are very complete. All patient info is preprinted on the form, so I find her in the computer at a different address than he is at but verify that they are living in His address now .  I fill his but hers rejects ” coverage terminated”. I page her back but nobody comes.  Eventually they find their way back to the blood pressure machine and I say ” Connie, your insurance is terminated”….and she ignores me. I say louder ” MAAM,  I have Tom’s rx ready but yours rejected “.  She looked at me as if I had grown horns and said ” I didn’t give you a prescription”. I pick up the 2 documents they gave me and I said . “here are the two prescriptions you gave me–one for Tom and one for Connie.”  I am not Connie. and I think we only gave you one prescription.. “No, Tom gave both of these to me”. ANOTHER Dr error… The clinic gave a patient someone else’s prescription.  At the very least its a HIPAA violation and at the worst he may have received someone else’s medication. I called the clinic to tell them of this error and this is their reply” oh dang, I wondered where that went”.

alrighty then..

You know, its hard enough trying to keep my head above water and manage not making my own mistakes. and I have to wade thru everyone else’s muck too. I read the Facebook page ” this is a Pharmacy not a fast food restaurant” most days and I am astonished at the errors coming from  drs offices nation wide.   E-scripts  and Technology haven’t reduced errors, they have magnified them exponentially with ridiculous decimal quantities, redundant and repetitive prescribing, and auto sig population with absurd verbiage that makes no sense whatsoever and patients often walk away with scripts in their hand that were also sent somewhere else electronically and end up with duplications. Doing a DUR becomes a nightmare when I look at a patients profile and see 6 scripts for every drug a patient takes with multiple refills because the office sends a new one every 3o days +6 refills. by the end of 6 months Joe Blow has 6 mirtazapine, metformin, lisinopril, fosamax etc etc etc..  rx’s  with refills on his profile..and all of them filled exactly once. AND because people believe in and trust technology, ( like that doctor did) hard copy rxs aren’t being verified for accuracy before handing off to patients and they aren’t being looked at before being e-sent…

 

Oh the Joy…

and speaking of Joy,  Have a very Merry Christmas to all of my readers who Celebrate the season! Happy Hanukkah ( which just passed) and Kawanza and New Year and  Festivus for the Rest of ya! 🙂

 

One book and some old memories

Filed under: Uncategorized — pharmacychick at 3:25 pm on Sunday, December 13, 2015

Reading thru my Facebook feed several months ago I found a story about a man who found a puppy who had been abandoned in a hole in the bottom of a slot canyon in Arizona.  In short some sick human abandoned a puppy in a hole in a place that only a very experienced rappeller would ever be able to find it.  Amazingly enough he was found in the nick of time.  As the story progresses the man who rescues and keeps  the dog works thru some serious issues in his own life, abandonment by his abusive father, a mentally ill mother, intense bullying from schoolmates and finally some kind of resolution. I found an uncomfortable similarity  to his story…his was worse, but the long lasting effects were not.

As I read thru his struggles  thru his youth I began to realize that we have a name for what we both went thru as kids…bullying.  Of course in the 70’s, they didn’t call it that. It was just kids play.  “sticks and stones can break my bones but words will never hurt me”.. WRONG. Words can hurt the most and cause everlasting damage.

When I was a toddler I was abused ( molested)  by a neighbor.  He was an old man who lived across the street. He lived with his sister and her husband. Its too disgusting to write about the details but I was in my twenties before I told my mother about what happened and one detail brought back memories that she knew I was speaking the truth.  On one occasion he almost got caught and he tossed me in the bathroom and told me to get dressed.  I put my panties on backwards.  My mother remembered that day and couldn’t figure out how SHE could have dressed me that day…if she only knew….  She was devastated when I told her the news.

When I was in 2nd grade I got glasses.  I was the only person in my class to have glasses. I was teased mercilessly by some of the boys… FOUR EYES!… my teacher came to my rescue only to make it worse because I was now TEACHERS PET.

I developed a little earlier than some of the girls in my class so by the 5th grade I was starting to bump out in places that used to be flat.  The boys would poke at my chest every day and call me ” STUFFER”  implying that  I stuffed my bra with kleenex.  When I finally started my period  in the 6th grade, I sobbed because I had something else I had to manage and hide at school. I was never among the kids that had money or pretty clothes.  We weren’t destitute but  since my brother and I shared clothes ( he got my hand me downs), it was pretty gender neutral clothing.  I hated going to school.  I spent most recesses alone.

Things got really complicated in junior high.  I was awkward, ugly, sensitive and had very few friends .  One teacher befriended me, told me how pretty I was and would take me home after school….after a diverted trip in his pickup.  It was ” OUR SECRET”…  Ill spare you details, but to this day seeing a red Ford pick up truck creeps me out.  I never told my mother about those molestations because I believed it was an embarrassment.  If you ever think that a 12 year old ” should know better”  doesn’t understand the mind of a 12 year old girl who thinks she is ugly, unloveable and undesired.  By the time I was in college I wanted to say something but I knew I would have my name and my family drawn thru the mud so I kept  my mouth shut. Im 52 years old and the only person who knows what happened is Mr Chick.  There is probably many girls with stories to tell about this man, but it appears nobody ever did.   By junior high,  the circle of friends that would last thru high school were developing.  Cliques had formed and if you were in the “right” group, you were cool, if you were not, then you didnt matter.  Guess which one I was in.  I might as well have been invisible.

By high school,  I was used to my isolated existence. For the most part I was left alone. There was a classmate whose mother made her wear a uniform to school every morning and I always felt sorry for her but looking back we were about the same …isolated and alone.  Looking back I wish I had been more brave to make a friend.  I once asked a boy to a dance..the kind where the girl asks the boy…and I was rejected.  I never made that mistake twice.

I was on the moon when I was asked out by a boy who worked at the same restaurant I worked at after school. I should have known better when he only asked me out because he had been told mistakenly that I “put out”.  We kept dating for a long time but I  was pretty offended by that.  He became as much of a bully as any other kid  in my life when he started pressing me to do things I knew I shouldn’t.  When I finally relented it was the most miserable day of my life to date.  From that time to the day when I finally got strong and courageous to leave him, he would use guilt and  oppression to get his way.

A person can stay that way, they can be and play the victim their entire life.  Some act out and become exactly like their bullies.  Others  do the opposite and champion for the causes.  And yet others do what I did, hide it, suppress it and try to let it die somewhere in their past.  The problem is I have learned is that it never really dies.   It does shape us to some degree.  I certainly have more friends than I did when I was a kid, but the ones I have are platonic and I don’t trust anyone with the intimate details of my life.  Certainly NO one knows about this part of my life.   It even took years of being married before I was actually half accepted that I was acceptable ( and loved) by  my spouse.. to this day I don’t understand why he loves me. I am an introvert and happier listening than speaking. I don’t like to have attention brought to myself and prefer the company of the servants than the masters of the house.

I truly believe that the demons are at rest. They are very much alive. They don’t die, but they seem contented to remain dormant where they cannot do any harm. I am a happy person now.  I am what i am, and I can’t be anyone else.  I don’t even know what possessed me to spill all this out, but I do know that for those people who say ” you cant possibly understand what Ive gone thru…”…I can say..

yes, yes I can.