Things that make my blood boil

You know, things were going somewhat okay recently, save for some front store drama reaching back and pulling me unwillingly into it. The pharmacy staff was finally, for the most part, getting along together, Terry included.

So I decided to take advantage of the good vibes and try to talk to Terry about a few things that needed fixed around the pharmacy.

There are two main things that have been making me very angry about Terry. The first is the way Terry staples our labels. It may sound trivial and stupid, but Terry puts TWO staples through the patient's information AND the drug name. Always has. I asked Terry to follow our previous protocol (two staples going down the side in the blank spaces). Terry asked why the other method didn't work, and I explained that it was difficult to tell the patient what medication they were getting, let alone to see that it's the correct patient to begin with. We'd talked to Terry about this a few months after Terry came to us, and Terry seemed receptive to this change back then. Terry seemed receptive this time, too, but Terry didn't even attempt to do it right this time. So, I got a staple remover, and every label that Terry put together (which was probably 90% or more, because I was running back and forth between the drive-thru and drop-off) I dismantled and put together the correct way. It slowed us down significantly, but it proved the point that it's much easier to read the information when the staples aren't in the wrong place. If Terry can't fix it next week, I'll be doing the same thing all week.

The second thing that really makes me angry about Terry is the refusal to clean up after themself. Terry has this problem with dirtying dishes, littering drawers with crumbs, refusing to vaccum, and refusing to empty the trash. The trash can next to Terry's station is Terry's favorite place to throw milk jugs with spoiling milk that wasn't emptied out, half-eaten food, etc, and when I went to change the bag the other day, I thought I was going to have to put my head between my knees to stave off the nausea. The stench from something Terry had left to rot had managed to penetrate the plastic bag and make a nice little home inside the trash can. I had to take all the bags out back then go in search of Lysol disenfectant spray. I created mushroom clouds inside the can, around the can, and around Terry's station, repeatedly. I think there were at least 3 actual clouds in that part of the pharmacy. Yesterday, when I changed the can after yet another quart of milk was haphazardly thrown into it, I could smell the stench back again. I don't know if maybe I'm more sensitive to it, because I'm the one who had to clean it up, but nobody else could smell it as bad. I'm going to have to go in search of a new can this next week.

This makes me even more angry, because when I talked to Terry about the stapling issue, I also discussed the reluctance to touch the trash. Terry promised to take care of it, but obviously, Terry didn't. Terry has family members at home who basically take care of Terry's needs, but there's no reason that Terry, a grown adult, can't do these things themself. It's ridiculous for me to have to spend more than half my week, let alone more than half my day, cleaning up messes Terry has conveniently decided to ignore. It's getting pretty upsetting to have to bring in my own cleaning supplies from home. I'm no way a neatnik or a neat freak, but at least I know how to clean up a mess I make. I just think that in a confined environment such as work, there should be no excuses for things being filthy.

So that's the latest update from CPhT's pharmacy. We'll see if next week when I get really strict with Terry, and I do mean REALLY strict, if Terry finally gets a clue.

Very quick

I find it extremely funny that the only people who complain and tell us it's false advertising/scamming/anything else in that vein when we refuse to honor gift card coupon offers are the ones on Medicare who read the fine print on EVERYTHING but the coupon, and upon telling them WHY we can't offer it to them (federal law, if you're not familiar with pharmacy workings), INSIST that their Medicare part D plan is NOT a Medicare plan. Just a(n) Aetna/Blue Cross/AARP/etc plan. Quit bitching, you're already getting $4 (sometimes less!) generics.

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.

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.

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.

Update

So, let's call my PIC Terry from now on.

Terry brought up to me the other day that my other technician has been showing less and less interest in working in my pharmacy. I told Terry that it was true; and that since my tech has been skipping shifts back with us to work for my front store manager, that I was going to have a talk with her. Terry said maybe they should have a discussion, so Terry could try to iron out their differences, as they still do not work together when not absolutely necessary.

This opened up a great hole for me to stick in my 10 cents about how Terry has been behaving towards not just my tech, but myself. I felt like I got some of the things that needed said out of the way.

However, Terry proceeded to tell me my tech had been lying to our Pharmacy Supervisor. I got a little angry(angrier maybe?) inside, because I know exactly what Donna (my tech) said to the supervisor. I dialed the phone for Donna. I heard what Donna said to the supervisor, and I can vouch for the things Donna said happened, because I have witnessed them.

For the sake of working in a non-hostile environment, I have been trying to be nicer to Terry, since I did get a quasai-apology for some of the hot-button issues, but it doesn't seem like that's enough anymore.

This weekend almost completely ruined any of the new dentente we'd reached. I was off, but I came in to cover for someone yesterday who couldn't make their shift. It seems that this weekend, Terry managed to make all hell break loose, and Terry wasn't even there.

On Thursday, we got in a special order for someone. Instead of giving them the full quantity, Terry inexplicably shorted them close to half of the order. I asked the patient if they had received a holdover supply, since we'd had a few in stock. They said yes, and they could not tell me how many they got. I tried to call the patient's wife at home, and she was not there. The patient called me back when they got home and had me speak to their wife, who just had not answered the phone. They came back a short time later for the rest of the order, and the patient screamed at me, and told me they would be talking to my boss. Problem is, Terry is my boss, and is also the one responsible for the shorting. The patient blatantly lied to me and the pharmacist, claiming that we had not asked if they had received any. The pharmacist laughed at the patient, and said that she'd witnessed it, but the patient kept insisting he was right, and we were wrong, and he'd be talking to my supervisors. I finally told him to go ahead, because that supervisor is the one who was responsible for the shorting.

About an hour or so later, a patient came through the drive-thru, and asked for his son's prescription. Guess what! Terry had filled the narcotic script under the mothers' name. We took about 10 minutes to fix it.

A little while later, we started the CII monthly inventory. We didn't bother to stop and figure out why everything seemed to be off. We left about 8 flags in the book as to things we need to go back to and investigate why we are over/under on those.

These things did not happen before Terry came into our pharmacy. Terry is very knowledgeable, to the point of knowing very random tidbits off the top of their head. However, seemingly simple things, such as accuracy, get lost in the process of trying to live up to CorpoPharm's policy of getting the patient out as quickly as possible, even if they are not present at the time. It's very difficult to clean up Terry's messes, and we are thinking it is going to be time to have Terry dig themself out of their mistakes. It's getting a little ridiculous to keep explaining to people that they can still rely on us, but some things may take a little more time. There are people who absolutely refuse to come in under Terry's watch, and Terry is now blaming some of the errors being committed on some of our techs/interns. It's not fair, and it's going to have to stop.

So, that's life in this CPhT's pharmacy lately. Hopefully, I'll be able to post again soon. It's just been one thing after another, and I come home ready to curl up at the end of every shift. It put a strain on my life away from the pharmacy for awhile, but that is even slowly coming back. We will see what happens with Terry. We have all come to the point where we are going to let it go back to Terry.

Sorry for the neglect

Let's get honest here. It's hard to come up with a bunch of rants and post them all the time, although I do get quite a bit of good fodder daily at work. But there's a reason I haven't been posting. If people I work with see this, they may or may not be able to identify me. That's fine. I think it's more important to come out with the truth and at least have a sounding board for it, rather than spending every day silently pissed off.

See, a few months ago, Corporate decided to replace a pharmacist with a new one. Corporate has been doing this all over in our chain, and it's getting ridiculous. For the first month, our new pharmacist was great -- a charmer, funny, nice, and great with the customers. But after the first month, things went absolutely downhill. The new pharmacist became some sort of monster. For the first time in my years at my store, things weren't good at all. There are fights, requests to keep employees apart, and a lot of drama. This pharmacist has also brought taboo subjects (such as sex, religion, poltics, etc.) into our workplace, and this is something that we frown upon, and our ethics department in human resources would have a huge issue with if we decided to pursue calling them and letting them in on just how hostile a work environment it is becoming.

I have front store employees expressing disgust for this pharmacist, I have customers calling ahead to ask what pharmacist is there so they can specifically avoid the new pharmacist, and I have coworkers expressing fear that their jobs could very well be on the line. I have been told to watch my back by my other pharmacists. The new pharmacist has no say in whether I stay or go, for the most part, and I am not really that afraid, but I will say this -- we have made a pact that if one of our Core Group goes, and it fucks things up for the rest of us, that we will leave, too. There are about 10 of us (give or take; I'm not positive anymore since people are in an out) that work in our pharmacy, and there's a good 5 or 6 of us that have agreed to seek other employment should one of us be tossed.

It's funny, because one of our pharmacists, and a close friend of mine, has been having trouble sleeping because of all the issues in the pharmacy, and lately, I notice myself having more and more trouble. I'm unable to sleep, I wake up in a bad mood when it's the new pharmacist's day to work, and I spend my day wishing I'd've taken a vacation day rather than drag myself out of bed.

Our main supervisor has been informed of some of these issues, and there's a tentative sit-down meeting planned between a few of my coworkers, myself, and our supervisor to really discuss some of the major issues at hand. I'm not opposed to bringing other higher-ups into this. Everyone tells us that this new pharmacist is one of Corporate's Sweethearts, but if they could see what a week in the lives of any of us is like, they'd quickly rethink that proclamation they've seemed to make.

I truly love the pharmacy profession, and I know I want to spend my life in retail pharmacy practice. But I can't do my job under the conditions we're under right now. I've been offered a job in our front store by the managers for my hard work, but it's not worth it to me. I want to be in the pharmacy helping people, and I get a teensy bit more respect back there than I ever did in our front store. But it's becoming more and more enticing as things keep deteriorating.

So, to anyone reading this particular rant -- any ideas? We all are struggling, and it looks less likely every day that Corporate will do anything about this. I don't want to have to leave, because it was our home long before it was this pharmacist's. But we are all sick and tired of being miserable. So, help!

Why pay $60 instead of $6? Hiding something?

A woman came into the pharmacy yesterday (one of my first back since my extended-long weekend vacation) and my pharmacist waited on her because I was stuck in insurance-hold hell. She told us she had an insurance plan we did not accept and told us she didn't think anyone who accepted it would fill her script. She was fairly nice, but even from IHH, I could tell she was bad news. Just the tone of her voice screamed it out. She kept herself together while Marie added her into our system and processed her script. It was for Lorcet 10/650. 30 day supply from a fairly new doctor in town. It came out to nearly $60, and her copay would have been, if I am not mistaken, between $6 and $12 on the insurance. Her male friend paid for it. While we were filling it, the act started. She started moaning and groaning and whining and complaining that she was in pain. She even started to hobble after it was done. She walked straight up with a smile on her face and no complaints when she approached Marie. It's a safe bet that if I could have gotten on the phone with her insurance company and asked when she'd last had it filled, it would have been within the past 30 days.

Needless to say, we have a flag on her file that says she has prescription coverage, and to be careful when filling for her. She said, as she was leaving, that she just didn't think anyone would fill her rx. Wouldn't fill it, or would see it had been previously filled, is what Marie and I asked ourselves. It's sad to say, but we are seeing more and more cases like this woman sauntering into our pharmacy. There are a lot of people who are not telling us their primary insurance, and when we stumble upon it somehow (usually by a competitor calling us to inquire about them), finding out their game. We had a doctors' office call us about a suspicious patient last night, one who I remembered playing games with us before. Saying that he'd left his 100+ rx of Percocet on the front seat of his car and it had been stolen, et cetera, et cetera. Asked me to fill it again, and I refused, because he told me he didn't want to pay cash, and there was no way his insurance would pay a day later. He has only been back sporadically since.

I wish there was a way for these people to realize they need to get some help. It's just a shame they will never find out until it is almost too late, if they ever do find out, whether it be jail or worse.