Pet Peeves for the month

How hard is it to remove the foil after you open a bottle? Seriously, just tear the lil fucker off. It's such a pain in the ass when someone just folds it in and you have a waiter and you can't dump the shit out.

While we're on it, I'm gonna kill the person who's putting empty bottles back on the shelf. Nothing better than going to grab some Lisinopril/HCTZ only to pick up the capped vial and find out its empty. To the jackass who does this (and I know who you are) here's what I'm gonna do. I'm gonna go to your house, find all your condoms and then carefully remove them from the package. Then when you're getting your freak on and you reach for your 'sealed' condoms you'll find them empty. How's that for a cock block.

Then there's the pharmacist who constantly undercuts me. Patient calls in his Trazodone 22 days early tell him no because, now here's the shocker, its 22 days early! Patient asks to speaks to the pharmacist who okay's it 'just this time'. Never mind the fact that he does this every month, but what the hell do I know.

Fuck Phil Collins. We have to listen to light rock at work. No idea why as personally I think we should be listening to some metal or something to keep our asses pumped up, but I digress... Anywho the station we listen to plays, on average, six Phil Collin songs an hour. I know I counted one weekend. The only thing I hate more than Phil Collins is U2. Thank GOD they don't play much U2.

Amerisource can flat out go to hell too. When I order Ibuprofen 800mg Amneal brand, and you confirm that's what I'm getting, I better damn well get Amneal brand Ibu 800mg. No Interpharm, no Par, I want the fucking brand I order. I click No-Sub, and then I'll get Qualitest brand. Retards.

And finally fuck nursing homes/docs who send discharge orders five minutes before close. The pisser is we do the meds for the nursing homes so we know precisely when they leave the facility. They could leave at 8am, but we'll still get the order at 7:55pm. And the one time you don't do them, that's when they actually need them. Typical.

Ok I feel tons better now... oh shit Phil Collins just came on the radio...

Condense those Directions!

Alrighty we'll play a game from an actual script I received today.

Drug: Nitroquick 0.4mg Tablets SL
Directions: Take one tablet under tongue and lay down. Take a second tablet
in 5 minutes if the symptoms are not relieved. If symptoms are not gone in 5
minutes, take the third tablet and call 911. Do not take more than 3 tablets
without calling 911.

Now you have 3 lines with 30 characters per line to condense this (spaces count). Good luck<

Politeness and Patience

I was asked the other day by a manager of Walgreen's, ugh I feel dirty for saying that, what one my strongest aspects was. This is a total bullshit question as they have no idea who you are so you could say 'well I can cure cancer with my farts' and they'd have to take you at your word. For some reason my mind cleared and the first thing that came out of my mouth was my ability to have patience and to always be polite.

Now think how many times you'll call another pharmacy or doctors office and you'll have someone answer the phone with their spiel. Now think of how many times you'll hear someone kind of snarl or reluctantly pass off the call as if you just asked them to name the contraindications of Viagra and Nitrates. We've all done it, even on our worst days.

Now think of what happens when you call some place and the other person is polite and lighthearted. How much easier is it to talk to a person whom is like that? Every time I answer the phone, no matter what kind of shit we're dealing with, I do it in a happy and pleasant voice. If you're going to call and bitch at me because you're copay went up, I'll calmly and patiently discuss with you that it is not our fault but rather your insurance company.

A few weeks ago I had a gentleman literally screaming at the pharmacist and I calling us a racist and several other derogatory terms (speaking of which I need to blog about that) while calmly and politely took his abuse. Afterwords our newest future pharmacist asked me how I could take such abuse and still treat the man with respect. I replied that there would be no point in arguing with him as his point was set in his mind and it really wasn't worth my effort to try and change it.

I have had good patients come in who, this one time, are completely shitfaced and unreasonable. The next time I see them often they will thank me for not 'biting their head off' while they were like that. Every one makes a mistake and I generally allow patients one fuck up. Usually if you remain calm and patient you can eventually break through whatever problem you are working on and everyone is happy.

Obviously this does not work all the time. I have been very firm with patients, I have been very cross with patients. Usually this is only when it is warranted (i.e. telling me its not my business what medical condition you have when your insurance requires an ICD-9 code). There's a time and a place for such actions and when you know when to use them they are quite effective.

So those of you whom are embarking in the pharmacy world for the first time, take note. These two little things can make your life a helluva lot easier. Then you can start a blog and bitch about it when you get home like me! :)

What is it with...

What is it with news outlets and tropical storms this year? On the front page of CNN.com right now the headline article is:

New Orleans keeps wary eye on Gustav

Seriously? Then they go on to say:

Tropical Storm Gustav could hit New Orleans area by weekend -- or nowhere near

So they kind of contradict themselves in the same article. Its the same thing with Fay. I remember an article about it last week that in big letters said:

Deadly Storm: Fay could strengthen to a Hurricane 1 status before landfal

Ooooh it could strength to a Cat 1 storm, batten down the hatches! It was a monster thunderstorm. Whoopy do (no offense to those who were affected by it, just using it as a point) It's not as if it was a category 5 storm, it was a friggin' Tropical Storm. It didn't destroy Flordia, as some media outlets in inadvertently suggested. It was a nasty storm, yes, but not the mankind killer it was made out to be.

Pretty soon you'll see headlines like:

Cloudy skies could signal deadly hurricane on the horizon

Speakin of which the sun just went behind the clouds, I should go board up my windows!

Tastes Like Candy

A comment in my most recent thread has brought up a question that we often wonder while at work. Just why are Tramadol and Carisoprodol not controlled substances?

You can't use the 'well the abuse potential is lower' bullshit because anyone who deals with it knows it's a load of crock. Our worst patients are the tramadol customers who are often verbally and physically abusive while in the store. The Lortab patients, while can be equally bitchy, usually just try and sneak in an early fill, but generally don't get pissed at us.

We once had a patient who was getting 300 Carisoprodol every three weeks. 300 fucking tablets. Granted we should not have been dispensing those to him (that's another story), but that is utterly amazing. The guy would come in and would be higher than a fucking kite.

And yet these are not controlled by the government. Sweden has yanked Carisoprodol off the market. The EU is in the process of doing the same thing. In America though its only slightly more restricted than the candy on our shelves (heavy on the sarcasm here). Then again this is the same country that allowed drugs like Vioxx and Baycol to find their way to the marketplace. Shit maybe I should just move to Sweden.

If anyone can give me a logical explanation to this, my ears are open.

I Love My Tramadol

We have a gentleman whom has his prescriptions filled here. Of course his pride and joy is his beloved tramadol. He happens to call us about 15 times a day (this is no exaggeration, we usually have a tally chart up daily). We give him a 30 day supply of his tramadol, he calls on day 3 asking for a refill. For privacy sake we shall call him Fucktard.

So Fucktard, today, has called 13 times so far. Once he called three times, asking the same question, within five minutes. Fucktard is obviously on some other planet, and I'm surprised he can remember his own name.

My question is, can I treat him like a little kid? I would so love to tell him that if he calls one more time, we're not gonna be able to fill his tramadol for another week. Ethically I know this is wrong, but Fucktard annoys me. In fact as I am writing this I am being told that Fucktard is on the phone asking for a refill on his tramadol. I shall let him sweat it out on hold for a while. At least I know I can do that.

I'm A Babysitter

That's all I fucking am is a babysitter. I realized that today. I'm a babysitter to all these crap ass pharmacists I work with. These are people who have had at least six years of schooling, whom are several years older than me, and yet I am the babysitter. This is my life on a daily basis.

• Pharmacist I was working with today asked me how long a C-V prescription is valid for.
• I have to remind the pharmacist to send the order before he/she leaves
• I have to remind the pharmacist to set the alarm before he/she locks up
• We often have to remind the pharmacist to put the DEA222 forms in the log book
• At times I have to remind the pharmacist to fix the mistakes that have been made either by calling the patient or physically going to get the Rx out of the bin in order to rectify the problem
• I have to remind the pharmacist to intial the prescriptions as he/she fills them
• I have to remind the pharmacist to give an actual hardcopy when filling something new, not just assuming they did it right
• I have to remind the pharmacist that it is not ok to give someone their Lortab early because they're 'going on vacation' when the patient is a known abuser
• I have to remind the pharmacist that he cannot leave the pharmacy empty with just the clerk (who has been a drug abuse in the past) in charge
• I have to remind the pharmacist to consul on some meds

These are just some of my daily reminds I make to several of the pharmacists I work with. The youngest of which has been out of pharmacy school for 10-15 years. Seems kind of sad that I am the one that is wise enough to make these decisions. And people wonder why I don't recommend my work to my friends and realitives.

Checking In

I know I know, two weeks and no stories to make you wet yourself at work. Been having some more ethical dilemmas at work which is kind of wearing me down. Add in two of my friends getting married last weekend and you end up with very little blogging. I have much to write, but not the energy to write at the moment. Until then, heres video of the massive explosion in Toronto from earlier in the week.

First Vid


Closer, but with bad language