The Pharmacy Chick

Flying the coup in retail

One Wild weekend

Filed under: Uncategorized — pharmacychick at 6:31 pm on Tuesday, January 19, 2016

I wish I could say that my past weekend involved scantily clad ME next to a pool with an umbrella in my drink or 18 holes in a sunny resort.  That would be just too easy. No.  My weekend started with Mr Chick coming home from work and doing his very  normal and usual routine….eating dinner out of the fridge.

Let me start by saying that when we both work, the last thing I want do to is cook so I grab something quick from the fridge and so does he. I had  arrived home before he and I had snacked on something.  He grabbed some leftovers and chowed it down and sat on the couch to watch some TV.  About an hour later his face was all screwed up and he was complaining about having a stomach ache.

“Surely it wasn’t your dinner…it was fresh leftovers”.  “no, I think I ate something NOT so fresh at lunch” When asked WHAT it was, he said he had used a pretty old packet of ranch dressing from his work fridge.  When asked HOW old, he said…”I dunno, 8 months?”.Oh Gawd…  So true to form about 2 hours later he barfed up everything…and then some.   Food poisoning.  Nice. But instead of feeling better after barfing up all the offending food, he continued to puke all night long and into the next am.  Nobody got any sleep..I mean who sleeps when your spouse is dry heaving every 15 min? He emerged the next morning looking worse for wear ( we both did frankly) and  he parked his butt on the couch and watched football, eating nothing but 2 crackers and some water.  He never felt any better so my thoughts moved to NORO virus.  He had just had his first colonoscopy so maybe he had been infected with all that pooping the previous couple of days…But it didn’t get better.

He disappeared up stairs for a while and when he didn’t come down I went to check on him and found him in bed curled up in a fetal position.  “Ive never been in this much pain” ” Well you did barf  hundred times last night, your  muscles are fried”. And I went back down stairs. 15 minutes passed and he hobbled half way down the stairs and said ” I think I need to go to the urgent care”.  Now Mr chick is known for having the “worst colds” and maybe being a little wimpy in the illness department but at no time in our 30 years of marriage has he announced that he wants to go to the hospital. “I think I may have appendicitis”..” all the pain is right here” as he points to is lower right side…

Well Shit damn hell.

If thats the case, we ARENT going to urgent care. We are going to the Emergency Room.  7 pm.

Going to the ED is a bit of a crap shoot.  You can sit there in agony for hours behind every Tom Dick and Harriet or you can be seen right away.  I prayed on the way there that we would get the latter not the former.  We all have heard stories…and I have written stories about people who use the ED as their primary care. Its a fact people so no nasty comments…There is a difference between Emergency care and Urgent care…   Graciously however it was a slow evening, we were taken in  and when they saw his agony they put him on a stretcher and wheeled him into a quiet and dark place.

After an IV was put in and some blood was taken the doc came in, did his initial work up, and thought the same thing Mr Chick did ” Sure looks like that, but we need to scan it to be sure”.   They did, and it was. They admitted him that evening and Mr Chick sent me home. “there isn’t anything you can do here, go take care of the dogs” OH yea, the dogs!  They had been tossed outside before dinner had been fed to them. It was now 9pm. He got a nice dose of Dilaudid and went to sleep.

I started texting people right and left and tried to find someone to work for me, get paperwork going for sick pay, feed the dogs, call Mr Chicks insurance for intake, get gas ( who knew I was on fumes?)AND to complicate things even more, we were going on vacation in a week…would we be able to go?? I mean everything was paid for and technically non refundable…even the golf clubs had already been shipped. So much to think about and deal with. Sleep wasn’t going to happen for me.  Where is  MY Dilaudid LOL.

Im not sure what time I eventually got to sleep but with the texts coming in from everywhere and the fact my brain was on full alert Im sure it was deep into the night. But at 6 am the alarm went off and got ready, fed the dogs and went back to the hospital.  Surgery was scheduled and Mr Chick looked only slightly better than death warmed over but fully set on hydromorphone.  As our friends rallied around me ( “its an appendix..not a cancer diagnosis” I said..but they wouldn’t be stopped..” you aren’t going to be alone”) They prepped and wheeled him away.  I am blessed with pretty awesome friends.

We played word games on our computer and I  dashed into work to check on things–” Good god woman, what are you doing here, we are fine, get back to the hospital”. … and pretty soon, my little restaurant buzzer that they gave me went off ( pretty cool technology) and he was done and in to recovery. He tends to wake up pretty slowly so an hour and a half went by before the buzzer went off a second time telling me he was going back to his room.

By the time we got there he was awake and the first thing he said was ” Wow, I feel so much better, I have no pain at all”

Well I guess that was a sign of a successful surgery. Believe it or not, we were in the car going home by 7 pm that night. We could have stayed an extra night but that was just more money and Mr Chick was in a happy place with that appendix in the trash somewhere..

24 hours from ER to Home.  He’s resting comfortably ( a cliche for sure) and life is getting back to normal, and we are going on vacation saturday  morning!

Override Mania and workflow fails.

Filed under: Uncategorized — pharmacychick at 5:01 pm on Tuesday, January 5, 2016

One of the jobs that we pharmacist s have to do on a minutely basis…is the dreaded override.  As much as I love having my techs at the computer doing the “input” , its actually faster and easier if I am working the input station and they doing the count/pour/label station.  I ll do the check station and they’ll do the sell station.  I have found it works magnificent if I am doing every other station ( funny that they have 6 “stations” in our workflow model and 2 -3 employees… hmmmm. Ive tried to condense it to fewer.  The tech does the intake ( get the basic info and tell them when it will be ready..hint hint…go away for a while)…I do the typing…tech counts…I check and bag…tech sells to patient..I counsel.  Done.Simple huh?

Well PharmacyChick Pharmacy wants to start a new workflow and throw a wrench into what we have proven to work fast and efficient.  They want all the techs to do Intake…typing ( while the patient stands there–and the line grows– to get a paid claim and a price–which I absolutely abhor)……and another tech  counting…and all we do is check and sell…yes they want me to be the checker at the cash register to improve my visibility and my accessibility.  Nice. A 60 dollar an hour cashier.

Now that would be fine and dandy if the computer system that we had actually worked in a fashion that would condone such a system…but it doesn’t.

Imagine a linear ( as most are) pharmacy.  Intake is at one end way down  .hereA…………………………………………..and check and pick up is way down ……………………….here B. Im at I am at B and tech is at A.  without a doubt every single rx we have needs to have an override especially since our system has had an upgrade that requires an override to “alert” us that the patient has had that medication last month.  So if you bring in your refill for Lisinopril 10 and want a refill, the tech inputs the  number and calls me over for an override that says ” Alert: last refill date 12-7-3015 override ____code here..  So important..because no label will come out until that override is done.

So I walk 3o feet 250 times a day to do an override that I could do myself if I was at the station I believe I should be at.  Instead I am at a cash register ringing up a rx standing around whilst Mrs Ethel Frumpkin is fumbling with her checkbook ” Oh I know its in here somewhere” Or Joe “cash is” King is digging out pennies for exact change.

Tech Extraordinare will get sometime 12 windows open with overrides on each one while I am languishing at the cash register while Peter Par is sharing is most recent golf score with me..hole by hole…” and I chipped in from the bunker on 12″

They ( the powers that be that never work in  a pharmacy) say all this in in preparation for the IMPROVED ( read: undertrained and under supported computer system they are installing sometime this year) Ok. I get that.  But what good is it to use a workflow designed for computer 2 if we are using computer 1 and 1 doesn’t work the way that 2 does?

No one seems to want to answer that question.

So I tried it for a few days and decided that it doesn’t work.   Of course the boss man doesn’t like me much for going back to the way I like since he thinks we need to get ready for computer 2 and he already knows I hate to change BUT I will embrace change if it actually works for the better of the department and the patient.  To that end NONE of that is happening yet>

Some comments from customers:

” why is this taking so long? Cant I just drop this off and come back: I have an appointment”

“Ive never had to wait this long to drop off my prescription.”

” Here, ( he tosses bottle over the counter and over the head of the person in front of him), Im leaving” See you later”

And of course the non verbal…eye rolls, huffs, hands on hip, looking at watch or phone..

Yup, going back to what works…