Tuesday, October 21, 2008

Interesting.

I was looking through my Site Meter, and I decided to look at the stats, referrers, etc. I thought I'd share some of the Google/Yahoo!/other search engine results that were interesting.

  • Months down the line, I am STILL getting a ton of hits from my posts about the Actavis Totowa recalls from digoxin. There are Actavis, Actavis Totowa, Actav, and digoxin referrals all through there

  • There were also a fair amount of referrals from an entry I wrote about a Factive coupon I wasn't even thanked for using. Funny.

  • "Lose your pharmacy tech license" via Google. Oddly enough, this has never been discussed here to the best of my recollection.

  • There were a TON of referrals, almost as many as the Actavis Totowa ones, asking the pros & cons of e-prescribing. I wonder if it's medical professionals, or just patients, looking into it. Hopefully, a mixture of both! I like promoting e-prescribing, as long as the doc looks into it and knows what they're doing.

  • "Why does the pharmacy tech look at me strange when I fill Lorcet?" via Google. Easy answer - we've been taught to scrutinize controlled drug scripts, and sometimes when you get large quantities, it sets off warning bells in our heads. Not saying you're an addict, but we deal with them every day, and sometimes, it's hard to shake the thought of the possibility.

  • "Pharmacy tech pin" via Google via Microsoft. Again, never discussed. Haha.

  • "Sorry works pharmacist" via Google. Weird.

  • "Pros and cons of pharmacy drive through" via Google. It's just a big con, folks!

  • "I hate my job procter & gamble" via Google. Another weird one.

  • "Nursing sucks pharmacy tech is better" via Google. I'll have to ask my tech in nursing school if this is true, and I'll let you know what she says.

  • "Pharmacy technician anecdote" via Google. This one just appeals to me! I don't know why, but I really like it.

  • "I hate being a pharmacy technician" via Google. Don't we all hate it at some point or another?

    So that's my list. Some of them are funny, and some of them are just odd. I'm just happy for the traffic, any way they get here.

    As for pharmacy life, we are still experiencing trouble with Terry. Terry came in last week and asked myself, my intern Madison, and another intern, Tom, to clean up the pharmacy in case our supervisors stopped by. Uhhh, what?? Terry worked with two technicians, Mark and Kaya, this weekend, and they had no time between filling all of 175-ish scripts to do it? The pharmacy was a disaster! I spent the entire evening cleaning up, and as soon as I did, Terry messed it all back up again. I was ready to kill Terry for it. I had to leave the pharmacy area and just go for a walk in the store because I was afraid I was going to lash out. I tried not to say very much because I knew it would be bitchy and spiteful. I just can't see how if *I* work the weekend, no matter who with, I can get everything done, clean, and make calls for our various CorpoPharm programs.

    I just don't know how much longer I'll be able to deal with this. I've talked to our supervisor, Alex, at length about the issues. Problem is, he and Terry are old friends, and he won't see how miserable we all are, and trust me -- every single person in the pharmacy is miserable. I guess the next step is Alex's boss, Stephen, then possibly their boss, Ethan. Something has gotta give, and if it doesn't, I'll start looking for jobs. I truly don't want to leave CorpoPharm, because I love everyone there, excluding Terry. We were a tight-knit, great group before Terry. We are still a tight-knit, great group excluding Terry, because Terry isn't interested in the same things the rest of us are. It's just getting harder and harder to find a reason to get up and go into work every day.
  • Friday, October 10, 2008

    Don't lost trust in your doctor

    At CPhT's pharmacy, we are experiencing a problem.

    Terry (surprise surprise!!) is basically telling people they don't agree with what the doctor is prescribing, and what they would have prescribed. There are a few issues there. I'll list them out.

    1) Terry does not have a doctorate of medicine/CRNP license/prescriptive authority/ANYTHING, so no matter what he thinks, the doctors' opinion is the one that matters.

    And yeah, the doctors are wrong on occasion. There are times that Mr. Smith is getting x drug from Dr. Stupid and Dr. Worse tries to hand him drug y, which is a Level 1 Interaction. But, we're talking about average patients here, getting average medications for illnesses. It's not usually chronic patients whose doctors are having their medications questioned. Although, it has happened with chronic patients.

    2) Terry does know a lot about the drugs, but Terry does NOT know WHY the doctor selected the chosen drug.

    Maybe the patient has neglected to tell us of their penicillin allergy, therefore rendering Terry's choice of Augmentin useless. Maybe a few weeks ago, they went to XYZCHEAP Pharmacy with their $4 generics, and got a bottle of cephalexin, and it just didn't work as well as the doctor had hoped, and they are choosing something else.

    ... Sorry, I ran out of steam/am running out of time before I have to get ready to leave for work, so I'm going to cut to the main story.

    Go back a few weeks ago. We had a child come in with bronchitis. The nurse practicioner did pick a suboptimal drug regimen (a drug not technically indicated for bronchitis), and Terry told the parents that the drug was not a good one. Terry called back, and they told Terry that they'd really chosen another family member. That drug had some issues, according to Terry, so they called the office AGAIN, who said it was REALLY supposed to be drug #1 called in. Following so far? Drug #1 called in, then they said no, it was #2, then they said, no, it was really #1.

    As I could imagine, the mother of the child was getting pretty upset at this point. They had some of drug #1 at home, and Terry said to use that, and in the meantime, Terry would try the doctor again, and if they refused to see it as Terry thought it should be, the mother could have her cousin's sister's dogwalkers' fiance (herein known as C/S/D/F) call us, and Terry would tell the C/S/D/F what to prescribe. Terry did not receive a call back from the doctors' office, nor the C/S/D/F, and the mother calls, after Terry leaves. It's me, my favorite pharmacy, and my 6th year intern who's filling in while she's on her off block on her rotation. Terry did not leave a note, and I was helping a customer elsewhere, when I hear Meg (pharmacist) and Diana (intern) freaking out. I caught a few snippets of the talk, and I finished with my customer, and rushed over. I told them the story, as far as I knew, and Diana related what I told her to the patient's mother. She was still PISSED (don't blame her) that nothing has been resolved, but she doesn't know if she can get the C/S/D/F to call at this point. I had to go call Terry and ask what the dose of Terry's favorite drug would be, and I had to call the pediatrician back. The nurse checked the chart and told me that drug #1 is what they ordered and wanted. She also told me that the doctor that was in that night was going to call the mom as soon as he was done with his visits, because the mom flat-out refused to speak to any practitioners ever again. I then proceeded to tell her what Terry had done, because it wasn't fair for them not to know why this mom was making crazy demands and freaking out. I think I was right to do that, because I wanted the doctor to have the full knowledge that their knowledge was being questioned. Basically, they picked a dose, and went with it, of drug #1. A few days later, they did the max. adult level for drug #1. For an 8 year old.

    Fast-forward to yesterday. The 8 year old's sister has now caught the bronchitis. The doctor wisely selected a drug that is indicated for bronchitis. However, the patient has developed enough airway constriction that they decided that the OTC meds mom & dad were giving her is just not cutting it, and they needed to give her a corticosteroid. The patient's mom wanted to talk to Terry, but she wasn't home, so she had to call back. The dad decided not to pick up the corticosteroid because they just weren't comfortable with it. Finally, when Mom called Terry back, she was convinced enough (I believe) to pick it up.

    Our intern and I were debating when Terry was not yet in yesterday (Terry had a half-day for a doctors' appointment) what kind of parenting it takes to stop trusting the doctor. I know Terry did not instill anything positive about the doctors' office and staff to these parents, but when your kid can't BREATHE?? You're just going to let them go?? Seriously?? I'd almost go as far to call that negligent parenting. The drug is safe, the doctor even prescribed a little below the dose for mg/kg/day as they wrote it out on the script for the parent, and yet, mom & dad don't trust it, because Terry doesn't trust their office. At some point, you have to trust the doctor and just bite the bullet. We told Dad it was a safe dose for that patient's age, and everything that we could to alleviate fears. But no, daughter is going to suffer until Mom can discuss the pros & cons of the corticosteroid. Just suck it up and be a good parent.

    Was it wrong of Terry to do this? We all think yes. I don't think that it's exaggeration to say that none of us are happy about the way Terry is going on. At the rate Terry is questioning prescriptions from doctors, soon enough, NONE of them are going to want to deal with us.

    Wednesday, October 01, 2008

    Phew

    It's been nearly an entire month. One day short of it. I feel like so much has gone on within that month, yet it's hard to put into words, because I don't want to give too much away towards showing who I am. The PIC DOES surf the net and read some of these type of blogs, after all.

    So, what's happened? First things first, Donna finally had enough and quit. She didn't give us two weeks to replace her, more like two days. I've been working by myself with the pharmacist until late in the afternoon, whenever we can snag an intern after classes end. It's been difficult, but so far, we've managed with just slight issues about being too busy and understaffed.

    Also, my intern that does not get along with the rest of us gave up a shift to work for another store in the chain. It's not a big loss, because we had a few people who were coveting that time slot, and it's working out for the better, because there's less snarky comments being made.

    We finally got an application that was viable for us for a new hire to replace Donna. We started Kaya last week, and she's catching on quickly, which I'm really excited about. I actually know Kaya outside of work, and was surprised when she applied. I was happy, because she and I had always gotten along, and it looks like she will be joining this CPhT's team until she graduates school.

    We've had our share of weird customers over the past month, and there were really no exceptions. We've had people coming in to ask if we have those round Percocet 10/325 generics or the long ones, because the round ones just don't work as good as the long ones. Or so they say. Needless to say, those people are ones we aren't going to be thrilled to see if they keep coming back. We've had a lot of people angry about some new company policies, and the local doctors' still don't understand that the OTHER new policy is not our idea, and they keep getting angry with us.

    It's just been weird lately. I've been feeling pretty crappy towards work at all. Kaya's going to be making a similar wage as me in a few months, and this is after 4 years of service on my part. I like Kaya, but I don't think I should be making what a first year is making. I feel like we are in a rut, and we can't get out. Terry is causing a lot of this rut, because ALL of us are feeling it.

    Maybe next time, I will have more good news. We'll see.