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Tuesday, July 30, 2013

More Grammar Lessons...

I hate grammatical errors. I believe if you cannot properly type or write your thoughts then your message is not worth my time. Similarly, if you are a professional entity or business, you should be expected to take the time to proofread. If you do not have that time, then what kind of service can I expect from you as a client/patron?
My own store posted a message on the front door about something being out of service. The handwritten sign said "Sorry for the (sic) inconvience". Often misspelled. I brought it to the attention of Fearless Leader (aka Front End Manager) and he laughed and said "no one will notice".

I was at a winery recently and noticed a misuse of "its/it's". This one drives me nuts. I can no longer take you seriously if your description says "it's aroma has hints of black cherries and..." Sorry, after that you lost my concentration. I don't care. If you don't care that this is wrong, then I don't care to buy it. Apparently no one paid attention to their Saturday Morning cartoons during SchoolHouse Rock".

It's not that difficult, but a prescription needs its own label.

Anyway, my points are these: First, I wonder about doctors who do not take the time to proofread their prescriptions before they are sent to us. If he/she cannot take the time to make sure your prescription is correct, what else are they speeding through? Do I want that constant rush to be part of my healthcare?

Second, if you are a professional company selling professional products to a profession, why can't you take the time to ensure accuracy? Notice in the picture the errors on the label. This is from an apothecary products catalogue selling.
(I will leave it up to everyone else to point them out for the non-pharmacy readers.)

Thank you, and Good Day.

Thursday, July 25, 2013

Help Me Understand

"People are people so why should it be, you and I should get along so awfully?"
People think I complain about my job. I don't. They complain I whine a lot. Wah. They say I should get out of retail. They say I hate my customers. I won't and I don't. It's like having favourite family members. You always smile at the reunions, shake hands and give hugs and kisses, but secretly you're whispering behind their backs about Aunt Flo and her surprise visits, the overprotective Uncle Owen, and Miss Havisham with her wedding issues.
Every day we walk in to work with a smile as bright as the sun. Every day, customers work to erode that. As dawn turns to the noonday sun, bright and high, then lowers in the Western sky, so too, our smiles set as a once hopeful day dies in a sky of clouded pitch. We are not the staff who entered our stores some 10-14 hours earlier. We are officially walking dead as we exit into the night.
How does this happen? The majority of our customers we love. Rather, we like them. Okay it's like a Bell Curve: 5% Love, 20% Like, 50% Accept, 20% Tolerate, 5% Loathe. Give or take on any given day. Who are the ones that ruin it?

"It's obvious you hate me though I've done nothing wrong. I've never even met you so what could I have done?"
Seriously. I'm new to this store. Already you're bitching and screaming at me as if I have personally ruined your life. Calmly and quietly take a step back, take a breath, then come back when you're ready to act like an adult and I will try to help you. If I understand the problem, I can explain it and attempt to fix it. Muttering under your breath that I'm trying to kill you, that you don't know why you come here, that there's a problem at every pharmacy you go to, that your doctor wrote it so you have to have it only indicate to me the problem is seriously YOU. If you do not attempt to understand the problem, if you do not listen to the explanation of the problem, if you are too stubborn to be wrong, we are going to remain at an impasse. Your blood pressure, along with mine, will only continue to rise. Therefore, in order to save us both a lot of health issues, I rescind your invitation to use my pharmacy. You have officially been uninvited. Like the life-sucking vampire you wish to be, you must leave now. It is the official rule of the undead. Please pack your knives and go.

Monday, July 22, 2013

Somebody That I Used to Know

"I swear I recognize your face. Haunting, familiar yet, I can't seem to place it."

CP: Sorry, just predicting the future. Can I help you?
You-Know Me Customer: Well you can try.
CP: That's why I said "can" and not "may". Let's have it.
YKMC: I'm here to pick up a prescription.
CP: For?
YKMC: Myself.
CP: "Cannot find a candle of thought, to light your name."
YKMC: But I come here all the time.
CP: Oh. In that case, let me just reach into my brain and pull out your profile.
YKMC: You're being facetious, aren't you?
CP: No. Wryly amusing myself. How long are we going to keep going like this?
YKMC: I can keep it up longer than you.
CP: Probably not without medication. And I have a trump card yet to play.
YKMC: Seriously. I could own this store by now with all the prescriptions I purchase here.
CP: Well if you were the owner, I'm sure I'd know your name. Didn't we ask you to leave because you were yelling and screaming at me and the rest of the staff?
YKMC: Yes. But the other pharmacies weren't as nice to me as you.
CP: "My God, it's been so long. Never dreamed you'd return. But now here you are. And here I am."
YKMC: Yes. I'm back. And I expect you to know who I am.
CP: Time to play the trump card.
YKMC: Go for it.
CP: <covering the CP name badge> What's MY name?
YKMC: Um. <Looking around for the license or other evidence> I don't know that.
CP: Of course you don't. You can't even remember the name of the one pharmacist you deal with every time you visit; the one pharmacist with whom you choose to verbally spar.  If you can't remember one single employee's name, how can you expect me to remember the names of all the customers responsible for the 3000 prescriptions I fill each week?
YKMC: I'm such a pain in the ass I just figured you always remember the really nice and the really awful ones.
CP: No. We remember the really nice ones. And we forget the awful ones as soon as the conversation ends. In fact, as soon as you walk away, I'll have no memory of this conversation. Why don't you try to be one of the memorable ones so I don't have to kick you out again?

Hearts and thoughts they fade...fade away....Hearts and thoughts they fade...away...

Friday, July 19, 2013

Foil(ed) Again

Pet Peeve of the day for CP: Foil Seals on the bottles.
I do not hate the seals, I hate the un-sealers. You know the people to whom I refer. The ones that leave the little flap in the bottle. The ones that leave the cotton in the bottle after taking just a single tablet off the top. The ones that pop their finger in and don't rip off the whole seal.

I always taught my techs who did this that tablets get stuck and can get thrown away. I explained that "your finger goes in to pop the foil and it has to come out too. It may as well pull the foil out with it".
Notice how the second picture has a tablet stuck under the foil? It was a control and we thought it was missing. Even pounded it on the counter to loosen.

Tuesday, July 16, 2013

Accidental Error Save

I always like answering the unasked question. It's the time where I know to take that extra second to review something with a patient that will lead to a rewarding conclusion for all. In some cases, it may even keep you out of trouble or out of the running for a Darwin Award.
Today's story is about how a simple oversight could have led to awful consequences.

Test Prepper: Where do I find the Miralax?
CP: Directly behind you. Bottom shelf.
TP: Thanks. Is the store brand just as good?
CP: It is. I recommend nothing else. You're going to be flushing your toilet so much, you really shouldn't be flushing money down with it.
TP: Are you sure?
CP: Of course I am. I'm a pharmacist. It's my job.
TP: So I can take your store brand and it'll do the job?
CP: You have to pay for it. You can't just take it. But when you get it home and mix it with the Gatorade, it'll certainly do the job. It's Liquid Plumr for the Bowels.
TP: Okay. Thanks. <turns to go>
CP: One question. Do you also need some Dulcolax tablets?
TP: Yeah. But I already got them. <turning to leave in quite the hurry>
CP: Hold on.
TP: <Irritated> WHAT?
CP: Those would be the suppositories.
TP: What?
CP: Suppositories. You picked up a box of Dulcolax suppositories. You really want the tablets instead. I'm sure they'd slide down really well, but I can't promise how tasty they'd be or even if they'll produce the desired outcome.
TP: Oh. These?
CP: Yes. And you're welcome. That would have been unfortunate. You can thank me when you get home and realize just how big a mistake I kept you from making. While you're holding on to both walls for dear life as your insides wring out your guts and explode like a 4th of July fireworks finale, you'll be thinking "that CP sure was helpful".

The rule of the day is "Always check with your Pharmacist". Period. Prescriptions or OTC products. Because sometimes, you may just not have your crap together...

Monday, July 15, 2013

I Heard the Message. I Just Didn't Listen to the Message...

...Scene cuts in with a "dunh dunh", like this is an episode of Law and Order.

"Tuesday. Afternoon." dunh dunh

CP: Super-tech, did you call Mr. Limp Bizkit about his Cialis prescription?
Super-Tech: I did. I left a message. I told him to call us back. I left all of the relevant, HIPAA-approved information on his cell phone per his HIPAA-approved release form as is HIPAA policy. 
CP: Way to go, Super-Tech. 
ST: <Blushing> Thanks for the compliment. It's because I am awesome at my job. 
CP: You are. This pharmacy only runs well because of the techs here.  

"Sunday. Evening. 4:55p.m." dunh dunh

LB: I am here about my prescription. 
CP: Okay. And why are you here? 
LB: You people left me a message on my phone some time this week. 
CP: Uh-huh. I see. Okay. And what did the message say exactly?
LB: "I don't know. I didn't play the whole thing or listen to it all completely or really pay attention to it at all. I just figured I'd come in here and you might be able to tell me what it's all about". 
CP: Good. Good. That makes perfect sense. See, we leave messages for you, the patient, so we, the pharmacy, don't have to remember everything about every one of the 3,0000 prescriptions we are filling this week. More importantly, we leave them on the day the issue arises in the hopes that you may find it important enough to call us back within a normal timeframe; not 5 days later at 5 minutes until closing. 
LB: So what am I supposed to do now? I need them. 
CP: Hardly. Let me research this for you. Do you happen to still have the message?
LB: No. I deleted it and left my phone at home. 
CP: Convenient. Usually when we call on quicker-dicker-picker-upper pills, it is for one or all of the following reasons:
a. insurance does not cover it at all
b. insurance requires prior authorization and may pay for it
c. refill too soon
d. they will only cover so many tablets every 30 days
Do any of these sound familiar?
LB: I think it said something about some day it may go something or other. Make sense?
CP: Of course. I am fluent in over 6 million forms of communication. Idiot happens to be like a second language-I learned it through osmosis and the immersion technique. But I digress...
LB: So can I get my Phallus Philler or not?
CP: Already done sir. And tonight, may the blood flow ever in your favour....

Friday, July 12, 2013

Kids These Days

I grew up respecting professionals. I grew up respecting adults. It was the way I was taught. It was the way I was raised. Somewhere along the way, as I grew up from child to professional, the way our society treats people seems to have gone wickedly astray. I am, forever the optimist, hopeful that I can still find good being taught today. Decades of retail tell me otherwise, but I still attempt to instill this in the people I meet. Until this all-too-real story happened...

Not-Getting-It-Lady: "But I needs my medications."
CP: And you need a prior auth. 
NGIL: What's I'm s'posed to do now?
CP: Go back to your doctor. We called him. He knows. 
NGIL: But he wrote me these. I has to have it!
CP: And that is why we called your doctor and told him to get the prior auth started. We also called you and left a message at the house so you needn't've come down here without first calling. It would have saved us all the following scenario...
NGIL: But I needs it.
CP: This we know. And with this we are trying to help. Please try to listen and comprehend the words coming out of my mouth. 
12-yo brat child of NGIL: My mom's going to kill you if you don't give it to her!
CP: Sorry. What? So who's going to punch your kid in the throat, you or me? Because if I ever spoke like that to an adult, let alone a pharmacist, my parents would have shoved my head through the counter, dragged me out by my hair, then strapped me to the roof of the car and taken me home where I would have been whooped with every belt in my father's closet. If I ever sat again, I would have been marched back to the store where I would have been forced to issue the appropriate apology. Should you choose to do nothing, I have 3 witnesses behind you who can verify the threat and would have no problem testifying to the police who are about to be called. 

Strange Messages

I love when office staff leave voicemails and end their calls with "If you have any further questions about this, please call our office back at..."
Funny. I didn't have ANY questions in the first place. YOU called ME. Shouldn't your message say "If you have ANY questions about this, please call..."?

I also like the phone prompts at the pharmacies I call, including my own. After listening to all prompts, the final option is usually: "If you have any other issues, please remain on the line." This usually means you are transferred directly to the pharmacy, whether you wanted to be or not. This does not mean, when we answer "CP PHARMACY" you can ask about making a tee time, making dinner reservations, picking up pictures, or asking if we have baby chicks for sale.

Wednesday, July 10, 2013

Sudafed Shoppers and IDs

I never knew driver's licenses cracked. Or came apart. Always in the same place. Until I had to start taking ID's for Sudafed. Perhaps I had just never ID'd enough people to witness the unfortunate hell people's licenses are put through.
Until I saw the magnetic strips were being swapped from stolen licenses onto their own and then taped back together. (Although some people just handed me the parts with the strips to swipe...)
Best story I had about a "Legitimate" Sudafed Purchaser:
A girl in her 20's (because she appeared to be 45) approached the counter and handed over her ID. My eagle-eyed, honest technician brought it to me and asked what to do with an expired license.
CP: Well let's see. Since it's expired and the BMV is right next door, direct her to their office. Also, does she have another form of ID? Something else is wrong with this one.
Sudafed Shopper: Sure. I have this other license here.
<Tech brings it to me>
CP: Can you sit tight while we verify this one?
SS: What seems to be the problem? I've used both of those before.
CP: I'm sure. Well the first one says your name is FW, you are 39 and are 5'6" weigh 217 lbs. and happen to be a red-haired Irish woman.
The second tells me your name is SH, you are 24 and are 5'2", weigh 119 lbs and appear to be a dark-haired Latino. Never mind that the first ID expired 3 years ago and the second one expired 5 years ago. The simple facts that you are 5'10" and appear to be a blonde, former Swedish ski instructor, seem to tell me that neither of these ID's belong to you. Care to try again?
SS: Yeah. I have another one in the car. Can I go get it?
CP: Since I'm not about to go for you and have no idea how many friends you have piled in there, I'll wait for you. And I'll just hold on to these others until you return. Hopefully you did not park too far away. The police are on their way. Too bad the pharmacy is all the way in the back of the store...

Monday, July 8, 2013

Take Your Time, Prescriber...

Received an e-script for "Nystatin Domestic Powder" Dispense qty: 1, Directions "Take Apply once a day".
Called the office immediately and had to leave a voicemail; a voicemail which was not returned by the time they closed 4 hours later.

CP: "Hi. This is CP calling to clarify a prescription you e-scribed a few minutes ago. I need to know if the Nystatin powder is supposed to be Oral or Topical. I also need to know what exactly a quantity of 1 means. Should I give them 15g, 30g, or 60g? Also, what is meant by "take apply?" Are they using it topically, externally? Or are they taking it orally and applying it in their mouth? If that is the case then the Rx should quite obviously state "Oral Powder" to erase any confusion. If you could call us back with this clarification we will be able to fill this patient's prescription and get her on her way and feeling right as rain.

Then I turned to my intern who was eavesdropping with an obvious smirk on his face and I asked him "Did that come across as cynical?"
He said "Just a little."

The next day I had less-cynical intern call to inquire about the progress on the prescription. He too had to leave a message. I mentioned he almost veered off into rather-cynical intern. He said "I tried not to."

The following day, now about 48 hours after First Contact, the prescriber herself phoned me.
Lost Prescriber: I got a message about something I may not have written correctly? I was rather confused and couldn't find it in my drop down menu.
CP: First question...Where is she using it?
LP: Topically.
CP: Fine. Then look for Nystop Powder. Very easy to remember and it will take you directly to a correct product.
LP: Hey, I found it. Thanks.
CP: The quantities are 15, 30, and 60 grams.
LP: Well she has no insurance and is just trying this so I'd say 60 grams would work.
CP: Um, ok, you send it that way. I'll just run it through for a 15gm bottle and use a discount card and tell her I fixed it for her.
LP: Sounds good. Hey, thanks for picking up the phone and speaking with me.
CP: Sure. Just doing my job.
<Seriously not sure if she was being patronizing or sincerely thankful I was so helpful.>

Friday, July 5, 2013

Expiration Dates

Why is the most difficult explanation we have the one about expiring refills?
(For ease of explanation, we shall use a conversation from the holiday.)

Typical Patient: I'd like to have this prescription refilled?
CP: That's a question. Do you have the bottle handy with the number on it?
TP: Yes. It's right here in my hand. (Not so typical, but necessary for today's lesson.)
CP: What is it?
TP: 8675309
CP: I'm sorry. It appears these refills have expired.
TP: What? It says on my bottle 6 refills.
CP: I'm sure it does. What's the rest of it say?
TP: Rest of what?
CP: It says "6 refills UNTIL...???"
TP: <softly, under breath> "6 refills until 7/4/2013.
CP: Correct. It means they expired yesterday, on the Holiday.
TP: I thought it meant I could still fill it today?
CP: No. "Until" means up to but not including that date.
TP: I don't get it.
CP: Okay, let's try this. You know how, from November 1st until December 24th, you are bombarded with "XX Shopping Days UNTIL Christmas"? It means you have only so many days UNTIL Christmas. On Christmas Day, you can no longer shop BEFORE the Holiday; it is, in fact, the actual Holiday. Same with the refills. "Until 7/4/13 means up to that date, say 7/3/13. On the Actual 4th of July, it is too late. You with me?
TP: I understand the Christmas thing. I always do my shopping early. But this refill thing escapes me.
CP: How about you do your refill thing early too?
TP: I don't get it. My doctor said I'd be on these forever.
CP: Yes. And Christmas will come around, forever. However, just like you still have to shop if your family is going to receive lovely gifts from you, you still have to "shop", aka "call in your refills", if you are going to get medication. Enjoy the fireworks going off in your skull right now. I was supposed to leave 20 minutes ago. We are closed. Happy 4th!

Wednesday, July 3, 2013

Just For Fun

People always like to complain that we short them pills. Most often it is on controlled substances. Every once in a while it will be on something innocuous like Lasix.  While I cannot say that counting errors do not happen, it is unlikely to occur with the frequency and in the amounts that are often claimed.
Omeprazole 20mg? We only gave you 30 instead of 60? That I do understand since they come prepackaged in 30-ct bottles.
Lasix 20mg on a count of 30? When we count by 5's? Unlikely.

I had someone complain every month we shorted her on her "month's supply". Turns out she started every new bottle on the first of the month. Months with 31 days she either skipped that day or bullied us into giving her an extra one. In February, I asked for my extra 2 pills back.

Just for fun, I'd like to give someone an extra pill. Not just anyone. Someone who always complains. Someone who takes two(2) tablets as one(1) dose just once a day. Give them a single extra tablet.
Crabby Customer: You idiots shorted me 1 tablet!
CP: How do you know?
CC: Because I only have 1 tablet left and I always take 2 tablets as 1 dose.
CP: Uh-huh. I see. How do you know we SHORTED you a tablet?
CC: Because I only have 1 left.
CP: Could it not be possible, your Holiness, to have actually provided you with an EXTRA tablet? Let's just assume for minute that you also did not ever drop a pill somewhere along the way.
CC: I suppose it is possible. But you people always...
CP: Always do this to you. I know. Which is why I gave you an extra one. Just for fun. Now laugh, take your extra pill, and say thank you.

Tuesday, July 2, 2013

Zombie Apocalypse

Pharmacy would be the worst place to be during the initial outbreak of a Zombie Apocalypse. Think about this...

Where is the first place people will go for advice for their initial symptoms?
Where else do people herd around each other in tight-knit groups to ensure complete lack of privacy?
Ever see Contagion? Rise of the Planet of the Apes? See how that spreads?

In World War Z, people were fighting over bottled water and canned goods. The pharmacist was dispensing...with a gun. No one was asking him for the 512's.

Since I do have the keys however, I could imagine being camped out in there for some time. Coping with it would be so much easier. I'm just not sure I want to be at work when it all starts. While we are quite savvy and resourceful, there is not much of a defense to be mounted with vials and counting trays. I'm not sure my sharpened spatula qualifies as a Katana.

Monday, July 1, 2013

Boggles the Mind

Watch the amazing adventures of the welfare mind.
A seemingly pleasant fellow approaches the pharmacy counter, pictures of his newborn baby in hand. Bragging about the first addition to his family and handing out cigars while smiling at all of the "congratulations" being tossed his way, this man is here to pick up his precious bundle's prescription. Since she is fresh from the oven, like warm rolls in your kitchen, she is not ready for insurance yet. No bother. The pharmacy will gladly call them to see if any override may be provided for her in your benefits. It is an innocent little newborn after all. Father gladly accepts this and says he will hang out in the free library (magazine section) perusing the periodicals until we notify him of our progress.
Hours later (okay, it was 27 minutes of being on hold), and no progress having been made after being transferred to 3 people, it's time to page back Herr Father to update the situation...
HF: Well, any luck?
CP: Alas, no. There are still trying to fix it, but it doesn't look promising. They said coverage is set to begin the first of next month, but today may not happen.
HF: I understand. What are my options?
CP: First, since it's only $9.00, pay that today and get your baby her needed supplements and enjoy every precious second you can with her instead of standing here.
Second, wait around and hope they magically fix it before we close in 7 hours.
Third, and I do not recommend this, leave it here until the First when her benefits are active and come back then.
HF: Well, since it's only like $10, I can probably get it. But I'm reading this great tome at the moment so I can stick around a bit.
CP: Sure. Keep celebrating with the customers and showing off those great pictures.

<An hour later, Herr Father returns to the counter>
HF: I was waiting on a prescription for my bouncing bundle of joy.
Intern: Of course. Let me check on that. It appears CP has not heard back yet. We just tried it and again, it has failed to go through. Are you going to just pay for it?
HF: Well, no. But I really got into this magazine so I want to buy that today instead. I'll come back in a day or two in case they figure it out.
Intern: Um. Ooookay. Well, your total is $9.57 with tax.
HF: Great. Thanks.
Intern: Yeah. Sure. Congratulations on that baby. Remember, your interests no longer come first. Hers do.
HF: I know. She means everything to me. Thanks again.
<HF walks away>

Intern: You know he bought that magazine right?
CP: Instead of the prescription?
Intern: Yes.
CP: Sweet. <To Tech> Told you. That'll be $5!