Don't Be Ridiculous

Sorry I've been gone before I really even got started. I had a traumatic life event that knocked the wind out of me on Monday, but I'm back and ready to write again.

I feel the need for a little levity. Most days there are some nuts, some sane people, and some mean people that walk up to the counter. If you want to make the Crazy Ass Hall of Fame, you really have to be a standout to get our attention. Here are the top 10 of all time :

1. The guy who came in with a piece of metal in the white part of his eyeball (it was large enough to see from  a few feet away), and wanted to know if we had a strong magnet he could use to pull it out.

2. The elderly lady who was bat shit crazy, wore a fake fur coat, and used the cab drivers that transported Medicaid patients as chauffeurs in her personal fleet of limousines , and who tricked me into seeing her boobs because she wanted me to look at her rash.

3. The tranny with long dark hair and red fingernails who pulled up to drivethrough and asked me if I could go get a bottle of water for her.  I told her politely "no"' because I was the only one there. Otherwise I would have, because that would have been an interesting conversation.

4. The little girl who walked up to the counter with a full on pink sparkly unicorn outfit, whose mother said she just got up that day and said she wanted to wear it , so she let her. I actually really admired those two!

5. The old guy who came in missing an eye one day and told me he got in a fight with a guy in Mexico. We usually had to clean up the counter after he left because he would lean against it and his ostomy bag would leak. Didn't seem to bother him at all. And rumour had it he was actually very well off. Must have felt a glass eye or a properly fitted ostomy bag were not necessary!

6. The old man who was waiting in drivethrough and called me on his cell phone wanting to know if something was wrong with the truck in front of him, because he had waited a very long time...... and then proceeded to take up twice as much time himself when it was his turn.

7. The employer who said one of his guys had been hurt and wanted to know if we had steri-strips. Meanwhile I see the guy standing behind him, white as a sheet, holding his hand up with his other hand, which is covered with blood soaked gauze. I'm like "no, you need to get him to the ER before he passes out!(How cheap can you be??)

8. The old grizzled heavy set guy with a 3 day stubble who I finally decided, that yes, he liked to dress in ladies clothes. Mostly double knit in bright colors.

9. The Amish guy who kept talking about his wife "when she goes off"and we finally figured out he was talking about their sex life.

10. The group of stupid people who (allegedly) had a meth lab in their house, blew it up and burnt the house down Friday night,  and by Saturday morning were in the store, with their faces cut all to pieces and third degree burns with a fist full of scripts for pain meds and vouchers from the Red Cross to cover the cost.
Ummmm...last time I checked, it is not a natural disaster when you mix up a bunch of volatile chemicals in a 2 liter soda bottle and blow your own ass up!!

We have a front row seat to the endless human parade, and sometimes it ain't pretty, but it sure makes for some good stories!

Catch you later,

BP

In a Hurry? Don't Come in This Week!!!

First  week of the month is always super busy. Mondays in general are busy, and since some of the doctor's offices were closed for Good Friday, tomorrow is probably going to be brutal.

If you do need to pick up a prescription, it is a really good idea to drop it off or call it in a day ahead of time. It allows us to work your order into our day and try to iron out any issues with insurance or to order the drug if we are out of stock. What doesn't work well is to walk up to the counter with a plastic bag full of bottles, dump them on the counter, and expect to wait on them.

Much as I wish it was Mayberry in 1966 and we could sit down at the drug store counter with Miss Ellie, the lady druggist , and have a soda, that just isn't the way it is anymore. The pressure we are under is intense, and even though the chains are saying they are "bringing the pharmacist out front", what they don't tell you is that when we come out front, there is nobody in the back. Nothing can go out without our okay. Sometimes we are the only one working in the pharmacy for hours at a time.

Some tips to help you help yourself (and us!) :

1.  If you have refills, call them in a day or more ahead of time. The touch tone systems are hard to use, so it is ok to use the voice mail  Please use the patient message option, not the doctor line.

2 . If you must speak to a staff member, please have your prescription numbers ready to read to us. Do not try to pronounce the drug names. We just need the numbers. After you give us your order, please give us a specific day and time you will be picking them up. Sometime today or tomorrow is not helpful.

3. Do not call and ask to speak to the pharmacist , and then proceed to read off a list of refill numbers. The technicians can handle this task. AND PLEASE PLEASE USE THE NUMBERS! A leisurely stroll thru your prescription profile causes us no end of frustration. It's pink and I don't know what it is for, or just fill everything that is due, are 2 other phrases that make us want to bang our head on the counter.

4 . Do not say you will be in at a certain time, and then show up early because you were in town, and expect your order to be ready. And don't add the cherry on top by getting upset with us because it is not ready.

5. We have made a "contract"with the patients who have called in and asked for their prescriptions later in the day, or later in the week. We work in sick kids, sick adults, and people with bloody gauze stuffed in their mouth or wrapped around an extremity  because these are unplanned events, and because it is the right thing to do,  Please do not be rude to our staff or other patients because you dropped off refill bottles and they are not ready in 15 minutes. If you make an appointment to have your car serviced, and the service department allows people to come in at will and get their car serviced without an appointment, and your car comes out after theirs, are you going to be happy?

Remember, patience is a virtue. If you come to us and we tell you the wait is an hour, do yourself and us a favor and go get a cup of coffee, take a walk, do another errand, or go home and stop by later. Staring a hole in our head with your eyes, tapping your fingernails or keys, sighing, coughing , leaning over the counter and asking if yours is ready yet, is not going to make us work any faster. In fact, it upsets us and makes us nervous. It is distracting and can lead to errors, and actually makes your wait longer because when we are hassled we have to fight to concentrate and keep our emotions under control.

Now I am going to bed early so I can get through tomorrow.

BP

Here, there, and everywhere....

Last night's shift reminded me why it is important to try to stay with one pharmacy so your pharmacist can get to know you and help you keep track of your medications. A very sick patient came to us with a
prescription for oxycodone . This patient had a legitimate need for pain medication. Unfortunately, when
we checked the INSPECT report (a report the state has set up that tracks the use of controlled substances), this patient had visited 7 different doctors and 12 different pharmacies in the last few months. This, and the fact that the patient had filled a prescription for oxycodone 15mg (he was given 2 prescriptions, one for February and one for March), after his doctor wrote a new prescription for 20mg , sent up a red flag.

Fortunately this patient's physician is a very kind and caring doctor, and called to help with this patients predicament. We were able to reach a compromise that allowed the patient to get a partial supply of medication until his doctor could meet with him and they could work on his plan for pain management.

Pharmacy loyalty is often complicated by the large chain pharmacies, who offer incentives to transfer their prescriptions, like gift cards, $4 prescriptions and free antibiotics.  We don't blame the patients for wanting to take advantage of these offers, but it does cause prescriptions to be scattered between several different pharmacies. The other hidden problem is that these transfers are done over the phone from one pharmacist to another. This archaic system is another place for errors to occur, particularly if there is a language barrier (some pharmacists have a very heavy accent), the phone line is fuzzy, the pharmacy is loud, or the transferring pharmacist talks too rapidly or softly to be understood. While I am transferring prescriptions in this manner, I am of course unavailable to check prescriptions and answer patients questions, as is the pharmacist on the other end of the line.

If you need to use different pharmacies for whatever reason, please write out a list of your medications, directions and strength of the drug so we can copy it into your profile for reference purposes.

I don't have to work this weekend, so I am signing off. Happy Easter!

BP

Let Me Introduce Myself

I am a retail pharmacist working for a large chain. I graduated from Purdue University in 1984, which, if you do the math, means I have been doing this for 29 years.  I have worked in hospital pharmacy, a small clinic pharmacy, a small local chain pharmacy, and finally a large chain pharmacy, where I "floated"for the first five years. Since floating means that I worked in lots of different stores, I have experienced many different practice settings, from busy (1000 prescriptions a day), to not so busy (200 prescriptions per day) , from city to rural, from high income to low income.

The reason I started this blog is to help educate patients on how to make things easier on yourself (and me !)

when you use a retail pharmacy. No matter what store I work in, no matter who my patients are, certain problems come up again and again. Most of these problems are avoidable.

Your pharmacist is smart, intellectual, usually an introvert, highly self motivated, hyper-responsible, introspective, caring, giving, humble, friendly, a worrier, a problem solver, meticulous, detailed, 

able to multi-task, organized, picky, and a conflict-avoider. On top of this, most of  us have a keen

sense of humor which we have developed to relieve the stress of the environment in which we practice.

We are often your best advocate when it comes to getting through some of the problems that come up with your medical care. You don't need an appointment to talk to us. We are available 24-7 , and you can call any of us, whether you are a patient of ours or not, and we will try to help you. You can walk up to the

window and talk to us face to face. We don't charge you anything to tap into our expertise. Believe it or not, this is what we most love to do. This is what we signed on for. What we got from our employers is a whole 

different story. 

We see the Big Picture between your primary care doctor, your specialist, your dentist, your eye doctor, and your insurance company. We can often help you weave this web of confusion together by contacting the right person and by interceding on your behalf. 

Believe it or not, we care about you, and we want to help you. We just need your respect, your patience, and some information to go by. Don't make the mistake of assuming that we are what our employers say  we are. We can do a lot to help you, but what we do takes time to do safely and properly.

That's all for today. Time to go in and work the evening shift!

BP