Sunday, November 16, 2008

The Holy Grail

Over the past year or two I have noticed a trend with new employees to the company I work for. Before everyone, from tech to clerk, was a bit on the skittish side, always erring on being cautions at first. Honestly, with what we do, that's a good way to start because being a clerk in a pharmacy is not quite like being a clerk in a grocery store, nor is being a tech similar to being a stocker in that same store.

Now our new employees jump into everything all at once, with completely disregard to our system. It doesn't help my company doesn't really train anymore (they don't even go over HIPPA procedures), but you can only put so much blame on that. What should you do when a clerk ignores a large 'SEE ID' note on a drug seeker's bag? What should you do when a clerk doesn't always remember to have people sign for scripts? Sad thing is, we aren't allowed to do anything. Last time I tried to correct a clerk I was bitched at for 'under cutting the store manager'.

Tech's have become even worse. For some reason, these new people come in and think the Holy Grail is to process proscriptions. They'll count for one day and then I'll find them trying to run a refill or fill a new Rx. Even if I tell them not to, they'll still find they're way back there. I tell them, after working barely a month in the pharmacy, you don't have the immedate knowledge to jump into running scripts, but they don't listen.

I believe in scaring them a bit when they first come in to give them a proper understanding of their surroundings. My manager does not agree with such a method, but then again they make no effort to properly train and tutor people. So I took the ambitious tech under my wing for an hour to give him a feel for what things are like.

Script came in for Augmentin 875 tablets for an seven year old girl. He starts to fill it, but I stop him. He asks me why and I tell him there's no way a seven year old girl can swallow those sized tablets and that we should contact the doctor to get another script just in case. How would he know that and why do we need to get another script he asks. Well, for those of you who don't know, Augmentin tablets are rather large and after dispensing them for a while, you just know this. You also get another script handy because it's a seven year old girl, chances are she's going to be in a rather foul mood since she is sick and it is better to get her on her way home.

Prescription comes in for Hydroxyzine 25mg and he starts filling that one. I notice though that he had picked Hydralzine 25mg (this is one of my favorites). I point that out on him and he goes, eh it happens. I tell him, no it does not just happen and you just switched an antihistamine with a vasodilator which can kill the right patient. His eye's start to get a little wider.

Another prescription comes in for Amoxicillin 500mg that he starts filling for a woman in her mid 20s. He cruises through some of the warnings and starts filling it, but I stop him. I ask him if he looked at any of those warnings (I hate this part of our system) and he says no. I then asked if she happened to be on birth control, with her age it's highly likely, and he said he didn't know. I informed him the effects the drug can have on birth control and if he filled it like that it's possible he could have just brought an unplanned baby in the world. His eyes became even wider.

Is it cruel to go through something like this? Perhaps it is a little bit, but I really don't care. These new techs have cost of tons in money (kickin out a Lovenox script because you don't know how to clear the reject is real cool) and have endangered patients. Personally I'd like to go through steps like this with every new tech.

At least I know he won't mosey on over to that computer for a while now...

1 comment:

Shalom said...

Aargh.

I hate it when techs just blow through warnings. Happened all the time in $CHAIN. The only time they ever bring it to my attention is if they get a hard stop, which doesn't happen too often. It's like talking to the wall sometimes. Fortunately in this store my tech is the store's owner, and he's good about this stuff; if he gets a warning he elbows me in the ribs and sez "Hey, is this OK?" and I check it out for him. At least we don't have to worry about losing a huge amount of money on reimbursements, that's the first thing we check.

Re mixing up hydralazine and hydroxyzine: Just in case, I keep the hydralazine stock bottles inside a 40-dram vial with a cap. This way, it takes an extra step to get it out, so it's less likely to be grabbed by mistake. (The label on the vial that says "THIS IS hydrALAzine, DON'T MIX UP WITH hydrOXYzine" probably helps too.)