One of my pet peeves in life is when people don't want to take care of themselves. It's always something or someone else's fault. They expect everyone else in society to cater to their needs at their discretion.
And it pisses me off.
Personally one of the greatest strengths a person can display is to admit that they are wrong. Many people would rather drink Hydrochloric Acid than admit they were wrong. Hell I have a post on here that I have received a lot of feedback on and I know that I was wrong in posting it (don't worry a revised post is in the works).
In pharmacy, one encounters this problem on a daily basis. We're supposed to watch over the thousand plus patients that our store serves every single day. My example?
Earlier a woman came to our drive thru to pick up some prescriptions for her dad. One of the drugs is Proscar 5mg which we did not have. We only have two patients on that particular drug, so we generally keep only one bottle on the shelf at a time for cost reasons. We've never had a problem before as they do not get their refills filled in the same window. Until now.
I explain to her that we do not have the drug in stock and that we would have it by 11am tomorrow morning. She then asked 'why the hell we do not keep drugs in stock that our patients take at all times' and that she was going out of town for a week and that 11am wasn't good enough for her.
She also lived in an adjacent town which caused even more 'difficulty' for her as she would have to drive back and leave for her trip an hour later.
Ya know what, it's not my fucking problem. Anyone who gets prescriptions filled on a regular basis knows that usually there is a snag or two along the way. If I'm going out of town, would I call everything in on a Sunday right before I leave?
Fuck no. I would use that mound of material in my head, you know a brain, and plan ahead just in case. I have no qualms when someone comes in a week before they leave with a list of things they'll need. Hell I'll gladly call and get overrides for a person who does that.
Instead I'm supposed to watch over someone else even though they are fifty-some years old. Perhaps next time you should think things through a little better and not blame me when shit goes south.
And no I did not relay these feelings to her at all. I merely smiled, nodded and found a store that had it so she could get it when they opened at 8am.
Yet I can't help what think what I an asshole thought it was that I had. Then again maybe you have to be an asshole to do this job.
Sunday, August 30, 2009
Sunday, August 23, 2009
Pharmacy - Doctor Etiquette
I know I have been ragging on nurses lately, so I decided to shift gears and take a shot at two of the doctors in our town. Again this does not reflect all doctors, just two of the... dimmer ones we have up here.
First if I ask you a question, I expect a clear answer. This is not the type of field where ambiguity is acceptable. For instance, if a patient calls in a five month old Rx for Lisinopril 10mg when she has been on Lisinopril 5mg for that time period and I then kindly ask you if her does has changed, the appropriate answer is NOT "Don't think so."
I realize it's Friday and you're probably itchin' to start your weekend, but seriously? How am I supposed to take that?
Next time you call and ask me if someone has had a particular Rx filled here, maybe I'll reply 'Don't think so."
Second, if I request refills on Isosorbide MN ER 30mg and you send me back an okay on Isosorbide DN 10mg, don't go accusing me of being a 'smart ass' when I call to get an okay on the proper script.
It's not my fault that you were too lazy to pick the correct drug and dosage for the patient even though they had been on this for the last several years. I realize that drop down menu is really hard to scroll down to, but seriously if we have to exercise patience, why can't you?
Finally, if you're going to send me a new prescription, give me all the damned info. If I see another Rx come across that looks like this:
I'm going to freaking scream. Forgetting a quantity? Ok, that happens. Forgetting refills? Well they just won't get refills. Not giving me the goddamn strength of the drug in question nor directions? Well you've just got in line for a dick kicking.
I have been seeing that last one at least once a week for the last several weeks.
I know this new, I emphasize that because it's been new for two years now, is a large change from the methods they may have previously employed. We all make mistakes, myself included, but sometimes one has to recognize their faults and learn how to correct it. But if you're that uncomfortable with using this system have one of your nurses do it.
For the sake of my sanity, please God let your nurses do it. So at least when they screw up, they generally won't talk back to me.
First if I ask you a question, I expect a clear answer. This is not the type of field where ambiguity is acceptable. For instance, if a patient calls in a five month old Rx for Lisinopril 10mg when she has been on Lisinopril 5mg for that time period and I then kindly ask you if her does has changed, the appropriate answer is NOT "Don't think so."
I realize it's Friday and you're probably itchin' to start your weekend, but seriously? How am I supposed to take that?
Next time you call and ask me if someone has had a particular Rx filled here, maybe I'll reply 'Don't think so."
Second, if I request refills on Isosorbide MN ER 30mg and you send me back an okay on Isosorbide DN 10mg, don't go accusing me of being a 'smart ass' when I call to get an okay on the proper script.
It's not my fault that you were too lazy to pick the correct drug and dosage for the patient even though they had been on this for the last several years. I realize that drop down menu is really hard to scroll down to, but seriously if we have to exercise patience, why can't you?
Finally, if you're going to send me a new prescription, give me all the damned info. If I see another Rx come across that looks like this:
Date: 8/14/2009
Patient Name: Jane Doe
Drug: Zemplar
Directions:
Qty:
Refills:
Refills Until: 8/14/2010
Prescriber: Dr. John Jackass
I'm going to freaking scream. Forgetting a quantity? Ok, that happens. Forgetting refills? Well they just won't get refills. Not giving me the goddamn strength of the drug in question nor directions? Well you've just got in line for a dick kicking.
I have been seeing that last one at least once a week for the last several weeks.
I know this new, I emphasize that because it's been new for two years now, is a large change from the methods they may have previously employed. We all make mistakes, myself included, but sometimes one has to recognize their faults and learn how to correct it. But if you're that uncomfortable with using this system have one of your nurses do it.
For the sake of my sanity, please God let your nurses do it. So at least when they screw up, they generally won't talk back to me.
Friday, August 21, 2009
Make Up Your Damned Mind
I have been, since about May, emailing the pharmacy schools I'm interested regarding my situation and seeing if I will encounter any problems. Basically I don't want to apply to a school if I don't meet the requirements or stand any chance. Seemed like the prudent thing to do in my case.
After a bunch of emailing, I had my four schools picked out.
Last week I emailed one of these schools asking for clarification on a portion of their supplemental application. I received my answer and then the advisor mentioned that I was no longer eligible to apply. They had 'tightened' up their requirements and I would be forced to apply next year. It had to do with ACPE standards.
Huh?
Couldn't they have told this to me when we were emailing each other a few weeks ago? Obviously someone would have known that this change was occurring. I had already sent out my PharmCAS application, so there goes a chunk of change there.
Then a few hours later I got another e-mail from this university, from the same guy, thanking me for applying and stating what else I needed to do. How cute.
So naturally I went into a bit of hysteria trying to find a school to replace it. I e-mailed another school in the general area with the same statements as before. Their reply?
"Well it appears that you may need to take a year of Post-Bac biology or chemistry to show that you are really determined to become a pharmacist because that appears to be lacking at the moment?
Huh?
I'm lacking the determination to become a pharmacist? I shoulda just sent them a damned link to this blog. Seeing as it was late at night, and I was at my wits end, I fired back a length e-mail questioning this person's statement.
By the next morning I received a reply from the dean of the school apologizing for the advisers statement and saying that "... given what you have stated in your e-mails you would be an excellent candidate for admission into our program."
Yeah... maybe not.
I have since added two schools to replace that one, but neither one were my first choices. At this point I can't afford to be too picky.
Oh well, it's Friday and you know what that means... it's Amber Bock time!
After a bunch of emailing, I had my four schools picked out.
Last week I emailed one of these schools asking for clarification on a portion of their supplemental application. I received my answer and then the advisor mentioned that I was no longer eligible to apply. They had 'tightened' up their requirements and I would be forced to apply next year. It had to do with ACPE standards.
Huh?
Couldn't they have told this to me when we were emailing each other a few weeks ago? Obviously someone would have known that this change was occurring. I had already sent out my PharmCAS application, so there goes a chunk of change there.
Then a few hours later I got another e-mail from this university, from the same guy, thanking me for applying and stating what else I needed to do. How cute.
So naturally I went into a bit of hysteria trying to find a school to replace it. I e-mailed another school in the general area with the same statements as before. Their reply?
"Well it appears that you may need to take a year of Post-Bac biology or chemistry to show that you are really determined to become a pharmacist because that appears to be lacking at the moment?
Huh?
I'm lacking the determination to become a pharmacist? I shoulda just sent them a damned link to this blog. Seeing as it was late at night, and I was at my wits end, I fired back a length e-mail questioning this person's statement.
By the next morning I received a reply from the dean of the school apologizing for the advisers statement and saying that "... given what you have stated in your e-mails you would be an excellent candidate for admission into our program."
Yeah... maybe not.
I have since added two schools to replace that one, but neither one were my first choices. At this point I can't afford to be too picky.
Oh well, it's Friday and you know what that means... it's Amber Bock time!
Monday, August 17, 2009
I Helped Redesign the Vytorin Bottles
Seems like a ludicrous statement does it not? That is a true statement yet I misplaced the actual proof I have from Merck stating I had a hand in it. I misplaced that proof until today when I stumbled upon it while moving.
I usually don't mention it because it sounds outlandish. The sort of thing someone would make up to make themselves sound more impressive and I did not want to give that impression.
Now I don't know if any of you remember specifically, but when Vytorin first came out it was in very similarly colored labels. They consisted of mainly red, white and silver accents with the type on the bottle being fairly hard to see. We especially were having numerous problems with Vytorin 10/40mg and 10/80mg being mixed up due to similarities in the bottle design.
Yes I know we should being paying more attention and blah blah blah, but this was becoming a serious problem to the tune of one error per day. There simply was not enough difference in the bottles or tablets to discern an error if, for whatever reason, there was a lapse in judgment.
So I hopped on the phone one day, after being frustrated, and got ahold of someone in the marketing department. I relayed my concerns, hung up the phone and thought nothing off it... until I received a call four days later from the VP of Marketing for Merck.
He explained that I had brought up a point that no one else had noticed and I was now in a conference call with another Merck exec, the head of the QA department and two other product designers. They asked me what I thought would be helpful to people 'in the field' to identify bottles properly.
I replied that first they needed to emphasize the milligram dosing as it was too small to eyeball quickly with all the other lettering on the bottle. I then suggested that since they had 4 differing bottles (for the 4 strengths) that they needed to move beyond their simple 3 color scheme and employ a fourth or fifth color. I suggested one of the colors be something that would stand out against the red/silver coloring of the current bottles and it should be used with the most common strength for ease of identification. I then suggested a blue would do just fine.
After another twenty minutes of discussion we were done. And I forgot about the incident for several months... until unpacking an order one day. I noticed a massive change in the packaging design... the Vytorin 10/40mg bottles were now blue with my design elements.
I was floored. I didn't say anything because, again, I thought it would sound completely improbable. About a week later I received this letter from Merck in the mail thanking me for my assistance in this matter.
Now I'm sure others hand an input into the design of the new bottles, but I always thought that I had some part in it.
The bigger question is, should I use this for my pharmacy school applications and/or interviews? I know have proof, to a certain extent, that I am not fabricating what I did, but I feel I would be walking a very thin line between what they could misconstrue as the fact and fiction.
So, any thoughts?
I usually don't mention it because it sounds outlandish. The sort of thing someone would make up to make themselves sound more impressive and I did not want to give that impression.
Now I don't know if any of you remember specifically, but when Vytorin first came out it was in very similarly colored labels. They consisted of mainly red, white and silver accents with the type on the bottle being fairly hard to see. We especially were having numerous problems with Vytorin 10/40mg and 10/80mg being mixed up due to similarities in the bottle design.
Yes I know we should being paying more attention and blah blah blah, but this was becoming a serious problem to the tune of one error per day. There simply was not enough difference in the bottles or tablets to discern an error if, for whatever reason, there was a lapse in judgment.
So I hopped on the phone one day, after being frustrated, and got ahold of someone in the marketing department. I relayed my concerns, hung up the phone and thought nothing off it... until I received a call four days later from the VP of Marketing for Merck.
He explained that I had brought up a point that no one else had noticed and I was now in a conference call with another Merck exec, the head of the QA department and two other product designers. They asked me what I thought would be helpful to people 'in the field' to identify bottles properly.
I replied that first they needed to emphasize the milligram dosing as it was too small to eyeball quickly with all the other lettering on the bottle. I then suggested that since they had 4 differing bottles (for the 4 strengths) that they needed to move beyond their simple 3 color scheme and employ a fourth or fifth color. I suggested one of the colors be something that would stand out against the red/silver coloring of the current bottles and it should be used with the most common strength for ease of identification. I then suggested a blue would do just fine.
After another twenty minutes of discussion we were done. And I forgot about the incident for several months... until unpacking an order one day. I noticed a massive change in the packaging design... the Vytorin 10/40mg bottles were now blue with my design elements.
I was floored. I didn't say anything because, again, I thought it would sound completely improbable. About a week later I received this letter from Merck in the mail thanking me for my assistance in this matter.
Now I'm sure others hand an input into the design of the new bottles, but I always thought that I had some part in it.
The bigger question is, should I use this for my pharmacy school applications and/or interviews? I know have proof, to a certain extent, that I am not fabricating what I did, but I feel I would be walking a very thin line between what they could misconstrue as the fact and fiction.
So, any thoughts?
Saturday, August 8, 2009
Some Tunes for the Weekend
Been a while since I've tossed up some music and since I'm jammin' out today while I thought I'd toss up the newest video from my favorite band.
I am big into the Italian rock band Lacuna Coil. They don't really see a lot of mainstream success over here, which I am perfectly ok with, but they are well known in Europe. I had this particular song stuck in my head for about a week after I bought the album.
Now I realize most people aren't into this type of music, but I'm in a jolly mood and feel like spreading some damn fine music this afternoon.
I am big into the Italian rock band Lacuna Coil. They don't really see a lot of mainstream success over here, which I am perfectly ok with, but they are well known in Europe. I had this particular song stuck in my head for about a week after I bought the album.
Now I realize most people aren't into this type of music, but I'm in a jolly mood and feel like spreading some damn fine music this afternoon.
Thursday, August 6, 2009
My Pharmacy School Admissions Stats
I know when I was judging what was needed to get into pharmacy school, and once I was behind what I needed to do, I had a hard time gaining a complete picture of other applicants. Thus I have decided to share with you all my pertinent data that I am using in my application process.
First here are my PharmCAS calculated GPAs
As I have mentioned previously, I screwed up a ton my first two years in college, but have been trying to make up for it ever since. My science and math GPAs are low due to the fact that I took the majority of those course those first two years. Kind of shitty, no?
PCAT scores can be found here
PCAT 1
PCAT 2
I volunteered at an inpatient hospital pharmacy for 3 hours a week for about five months.
Over the past 8 years I have worked 15,000 hours in a pharmacy. I had to actually figure that out for one application and found it rather amusing. This includes 17 different pharmacies across three states. During that period i also completely redesigned a pharmacy from the ground up. For about two years I was the manager of the out front section of a pharmacy.
I have been certified by the PTCB for four years now and two years ago went through a 20 hour advanced diabetes training course. I've also recieved additional training in orthopedics, compression aids, respiratory aids and mobility aids.
Over this past school year I also worked on an undergrad research project with another student and my microbiology professor. It had to do with isolating and identifying a particular insertion sequence in the E. Coli genome. I have given a presentation at a microbiology conference and the work will be published.
I also have about a twenty year plan in my head to start up my own chain of pharmacies which focuses more on patient care than dispensing since this is the ultimate future of retail pharmacy.
And on top of that I'm a huge pharmacy nerd.
So there you have it, that's what I'm going to look like to the admissions committees at the four schools I'm applying too. Hopefully they will be able to look past my faults and admit me. Only time will tell now...
First here are my PharmCAS calculated GPAs
As I have mentioned previously, I screwed up a ton my first two years in college, but have been trying to make up for it ever since. My science and math GPAs are low due to the fact that I took the majority of those course those first two years. Kind of shitty, no?PCAT scores can be found here
PCAT 1
PCAT 2
I volunteered at an inpatient hospital pharmacy for 3 hours a week for about five months.
Over the past 8 years I have worked 15,000 hours in a pharmacy. I had to actually figure that out for one application and found it rather amusing. This includes 17 different pharmacies across three states. During that period i also completely redesigned a pharmacy from the ground up. For about two years I was the manager of the out front section of a pharmacy.
I have been certified by the PTCB for four years now and two years ago went through a 20 hour advanced diabetes training course. I've also recieved additional training in orthopedics, compression aids, respiratory aids and mobility aids.
Over this past school year I also worked on an undergrad research project with another student and my microbiology professor. It had to do with isolating and identifying a particular insertion sequence in the E. Coli genome. I have given a presentation at a microbiology conference and the work will be published.
I also have about a twenty year plan in my head to start up my own chain of pharmacies which focuses more on patient care than dispensing since this is the ultimate future of retail pharmacy.
And on top of that I'm a huge pharmacy nerd.
So there you have it, that's what I'm going to look like to the admissions committees at the four schools I'm applying too. Hopefully they will be able to look past my faults and admit me. Only time will tell now...
Saturday, August 1, 2009
This Is How You Fix A Prescription
Just after lunch I was handed a script and notified the patient was waiting. It was for one of our elderly patients who just had hip surgery and received a prescription for pain meds. She is one of those old-school rural hard as nails women so if she needs pain meds she must really be hurtin'.
I scan through it and I see:
Immediately I eyeball the DAW, namely because who the hell stocks name brand Lortab? I confer with the patient, who 'doesn't give a hoot if it's brand or generic as long as it works', and decide it is clearly a mistake. Looking further I see the doc himself entered it in the computer which further hints at a simple mistake.
I hop on the phone to the clinic she just came from. I explain to the person on the other line what has transpired and that I need a new prescription before I can dispense. I then emphasize that it is Friday afternoon and this needs to be resolved this afternoon so she's not screwed for the weekend.
Next I tell the patient what I have to do and that I'll make sure its delivered to her free of charge later this evening. Problem solved.
Or so I thought.
3 o'clock rolls around and I noticed I still haven't gotten a new prescription back from the office. I call again and go through my spiel once again. I, more firmly this time, state that this has to be done before the office closes for the weekend.
The clock now reads 4:30 and I know they will be closing in a half hour and I still have not heard anything back from them.
Now I understand Friday afternoon's are a pain in the ass for them too. There are people showing up to sneak in an appointment so they can 'score' some drugs. I completely respect that. In all honesty though, how hard is it to walk back to the docs office with the situation and have them print out a new prescription? Could take all of what, two minutes?
It had slowed down quite a bit and my co-tech was hinting about leaving a bit early. Displeased about the fact this little old lady would have to suffer this weekend, and realizing I had some free time, I hatched a plan.
I kindly asked my co-tech if she would not mind waiting a bit to leave as I was going to go on a short trip. I took the fubared hard copy, grabbed my keys and headed to my car. The office was only a few blocks away, I was going to pay them a visit.
Walking in, I see the clusterfuck I expected to see. Waiting patiently until one of the receptionists shoos away a seeker, I ask where this doc's office is located. Recognizing my story from earlier, she pointed me to the direction of one of his nurses who was out front.
I strolled over to her, prescription in hand, and explained the story to her.
"Ah yes, I got that a couple hours ago, but haven't had time to get to it," she stated.
I asked if the doc was in his office and she replied yes. I asked if she was dealing with a patient and she replied her shift was almost done.
So I handed her the prescription and asked her to go to the doc now, before he leaves, and get this resolved. She hesitated until I reassured her that it is a very simple fix that will alleviate a very simple mistake.
She disappeared for no more than 60 seconds and came back out with a freshly printed, and correct, prescription for Hydrocodone/APAP.
"The doctor apologizes for the mistake and appreciates you coming here to help his patient." she notified me. And then she scurried off.
The whole experience took place within a three or four minute period. I waited four hours to do what took four minutes.
Everyone was polite and courteous though, so I cannot bitch about them. It was just a crappy situation at a crappy time.
When I walked back into the pharmacy everyone had this confused/stunned face as I handed them the proper prescription. Our little 86 year old patient would go through the weekend pain free and I got to go on a little adventure.
Now that is how you fix a problem with a prescription is it not?
I scan through it and I see:
Lortab 5/500
1T Q 6 Hours PRN Pain
#30
0 Refills
Dispense as Written
Provider: Dr. Michael Jackson
Immediately I eyeball the DAW, namely because who the hell stocks name brand Lortab? I confer with the patient, who 'doesn't give a hoot if it's brand or generic as long as it works', and decide it is clearly a mistake. Looking further I see the doc himself entered it in the computer which further hints at a simple mistake.
I hop on the phone to the clinic she just came from. I explain to the person on the other line what has transpired and that I need a new prescription before I can dispense. I then emphasize that it is Friday afternoon and this needs to be resolved this afternoon so she's not screwed for the weekend.
Next I tell the patient what I have to do and that I'll make sure its delivered to her free of charge later this evening. Problem solved.
Or so I thought.
3 o'clock rolls around and I noticed I still haven't gotten a new prescription back from the office. I call again and go through my spiel once again. I, more firmly this time, state that this has to be done before the office closes for the weekend.
The clock now reads 4:30 and I know they will be closing in a half hour and I still have not heard anything back from them.
Now I understand Friday afternoon's are a pain in the ass for them too. There are people showing up to sneak in an appointment so they can 'score' some drugs. I completely respect that. In all honesty though, how hard is it to walk back to the docs office with the situation and have them print out a new prescription? Could take all of what, two minutes?
It had slowed down quite a bit and my co-tech was hinting about leaving a bit early. Displeased about the fact this little old lady would have to suffer this weekend, and realizing I had some free time, I hatched a plan.
I kindly asked my co-tech if she would not mind waiting a bit to leave as I was going to go on a short trip. I took the fubared hard copy, grabbed my keys and headed to my car. The office was only a few blocks away, I was going to pay them a visit.
Walking in, I see the clusterfuck I expected to see. Waiting patiently until one of the receptionists shoos away a seeker, I ask where this doc's office is located. Recognizing my story from earlier, she pointed me to the direction of one of his nurses who was out front.
I strolled over to her, prescription in hand, and explained the story to her.
"Ah yes, I got that a couple hours ago, but haven't had time to get to it," she stated.
I asked if the doc was in his office and she replied yes. I asked if she was dealing with a patient and she replied her shift was almost done.
So I handed her the prescription and asked her to go to the doc now, before he leaves, and get this resolved. She hesitated until I reassured her that it is a very simple fix that will alleviate a very simple mistake.
She disappeared for no more than 60 seconds and came back out with a freshly printed, and correct, prescription for Hydrocodone/APAP.
"The doctor apologizes for the mistake and appreciates you coming here to help his patient." she notified me. And then she scurried off.
The whole experience took place within a three or four minute period. I waited four hours to do what took four minutes.
Everyone was polite and courteous though, so I cannot bitch about them. It was just a crappy situation at a crappy time.
When I walked back into the pharmacy everyone had this confused/stunned face as I handed them the proper prescription. Our little 86 year old patient would go through the weekend pain free and I got to go on a little adventure.
Now that is how you fix a problem with a prescription is it not?
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