Make Me

ME and MICE ELF: Tell us a story. 

CP: When I was young warthog!

ME and MICE ELF: When CP was a young warthooooog!

CP: I asked my mom for a toy. 

ME and MICE ELF: Awwww. 

CP: She said "no". 

ME and MICE ELF: Booooo!

CP: Worse, at times, she even ignored me; it was almost as if she'd not heard my pestering requests at all. 

ME and MICE ELF: Oh dear.

CP: I couldn't make her buy me the toy. My charms didn't work. My polite requests failed. My tantrums and whining produced no results.

ME and MICE ELF: What did you do?

CP: I stole it. 

ME and MICE ELF: <collective gasp>

CP: Not really. But now that I have your attention. . . 

ME and MICE ELF: Damn. Another allegory. 

CP: Requesting refills for patients makes me feel like that young warthog again. 

ME and MICE ELF: When CP was a young warthoooooog!

CP: I can request the refills. I can beg, implore, beseech, supplicate to be heard and get their refills. However, as with my mom, I cannot expect to be heard by the office. I cannot expect to be rewarded.  Sometimes, I am ignored. Just as I couldn't make her buy me that toy, I cannot make your provider give me your refills. Maybe you should try it with your own mother. I mean provider, yourself. 

ME: I take it something precipitated this? 

MICE ELF: Of course it did. You know our brain works in mysterious ways. It's how we deal with the retail world and compartmentalize to survive. 

CP: Lady called to yell that her inhaler was out of refills. It was a Friday night. Provider wouldn't call over the weekend, blah blah blah. Told me it was my job to automatically refill her all her medications, even the prn ones and it's my fault her provider didn't respond.

ME and MICE ELF: <laugh maniacally>

ME: You're so phunny, CP.

MICE ELF: <wipes away tears of laughter> Expecting people to get their own refills. 

CP: Turns out, when I finally reached her provider, they said she hadn't been seen in over a year and she needed to come in before they'd authorise more refills. 

ME and MICE ELF: Harsh. 

CP: She said "oh. okay". 

ME: No apology? 

MICE ELF: No "Thank you"? 

CP: <cackles> Now who's making who laugh? Providers are infallible. We are the assholes. 

Breaking Up Is Hard To Do

CP: Will you call my ex for me? 

CPP: Why? 

CP: I think I left something there. 

CPP: What? 

CP: No clue. I keep getting phone calls and texts but I don't answer them. I don't listen to the messages and I certainly don't read the texts. 

CPP: Bad breakup? 

CP: Not really. 

CPP: Then why can't you call?

CP: I don't wanna. You do it. 

CPP: Am I the friend you got in the breakup? 

CP: Yes. 

CPP: Okay. I gotta ask. Where are we going with this? 

CP: We're going to break up if you continue with the attitude is where we're going. 

CPP: Seriously. 

CP: Phine. I had a patient last month. Asked us to transfer her whole profile from one of the Giant Deuce. I did. 

CPP: Okay. And now?

CP: Well, I transferred the whole profile. I'm not only the new partner apparently, but also the remaining friend from the breakup. 

CPP: Always a bridesmaid. . . 

CP: And she came in and asked if I would call her ex-pharmacy because she is still getting phone calls and texts from them. Not only am I supposed to find out WHY she is getting these messages (couldn't be bothered to listen to the voicemail or read the texts), I'm supposed to make them stop. 

CPP: So you get the rest of her profile, anything that may be new, and problem solved, right?

CP: Except they had no new medications. Nothing they hadn't transferred. Their system still attempts to send refill requests and auto-fill things. 

CPP: Even after some patients have died. 

CP: I told her breaking up is hard to do and did my part as her new BFF to cut the cord but I think the Giant Deuce won't let her go that easy. 

CPP: It would be easier to find a new doctor, change phone numbers, and make a new identity than to evade the clutches of the Giant Deuce without a restraining order. 

CP: Just when I thought I was out, they pull me back in. 

CPP: And apparently she's thinking I owe her a favour. 

CP: Someday, and that day may never come, I will call upon you to do a service for me. 

CPP: That's it. I'm breaking up with you.

CP: Can you transfer my meds first?

No Escape

CP: Do offices even read the communications we send them? 

CPP: Is Metformin pleasant to the nose? 

CP: It was rhetorical. 

CPP: I know. 

CP: But based on some of the responses we receive, I'm not sure their faxy lackey reads below the header "Pharmacy Request". 

CPP: What was your most recent? 

CP: Everyone has received the "refill approved x42" on a "prior auth required" fax, right?

CPP: Yes. Most of the comments on posts such as this will reiterate the salience of this. 

CP: Right. Today's example is my other, most-hated reply. 

CPP: Not. Our. Patient?

CP: Close. 

CPP: No longer taking? 

CP: Almost. 

CPP: What, then?
CP: "NOT ON HIS MED LIST". 

CPP: Well that's not so bad. 

CP: He's a diabetic and it was for his syringes. To administer his insulin. The insulin they prescribed him. The insulin that IS on his med list. You need syringes to make the insulin go; like gas for your car. It would be like the car dealer selling you a new car but not giving you gas to get off the lot. 

CPP: After the car lot closed. 

CP: On a Friday night. 

CPP: Of a holiday weekend. 

CP: Seriously though. How do you not have "Insulin Syringes" on a patient's med list? Maybe if this were a hospital intake form, I could excuse it. This was a refill request from the primary care provider who wrote the prescriptions for insulin AND syringes. 

CPP: Well it is a "MED" list. 

CP: Don't you start. They go hand-in-hand like peas and carrots, Forrest and Jenny, Jack and Coke.

CPP: At least you could sell the syringes without a prescription. 

CP: Not to a Medicaid or Medicare patient who doesn't ever pay for their supplies. 

CPP: So basically it's a waste of time. 

CP: Maybe if the Giant Deuce hadn't ruined it for all of us by inundating offices with multiple, unnecessary refill requests, the offices may respond a little better; maybe by even reading the fax first. 

CPP: I doubt it. 

CP: I guess we just fax it back, call the patient, tell them their provider thinks they don't need it, and the issue settle itself. 

CPP: Except the posts for the next two days show how lazy and helpless patients are. 

CP: Just let me have this one.

Training Tips

What is your favourite training tip?

Whether it is for interns, students, or technicians, what tips do you use most often?

Think sigs: How do you get them to remember the difference between S and D?

or between A and P?

or SL and ODT?

I have found these sig codes appear most often.

1. AC vs PC (before meals vs after meals) I like to remind everyone of AM (morning) and PM (evening). Think of them as BEFORE Midday and AFTER Midday.

I also throw out to try "AFORE vs POST".

2. AS vs AD (Or OS vs OD). S=sinister. Evil. LEFT Side vs. your DOMINANT Hand (for all but 10%).

 

Make the OK symbol with your left hand. Hold it up to your eye. Now you know "O" is for eye. Also, you can trace an "S" from your middle finger to your pointer finger through the circle to your thumb. OS=Left EYE. 

Make the same OK symbol with your right hand. Straighten your fingers. It makes a lower case "D". OD=Right EYE. 

3. SL vs ODT - SUB=Under which means this is literally Under The Tongue whereas ODT should be remembered as ON DA TONGUE.

What other training tips do you use in the pharmacy?

Moody Blues

CP: Why do I have to be in a good mood all the time? 

CPP: Who told you you did? 

CP: Them asses. 

CPP: pssst. it's "The Masses", not "Them Asses". 

CP: Enunciation is key to wit. But it works in this case. Why do people believe they get to dictate how I feel? 

CPP: How do you mean?

CP: Patients complaining about us not smiling or being in a good mood. Sorry but, are you always in a good mood while you're at work? Work is a stressful environment. I can't think of anyone who complains they'd rather be at work because it's less exhausting than being on vacation. 

CPP: Especially now with no one wanting to work at all. 

CP: Why do I always have to be the one in a good mood though? Why can't you, the patient or diner or patron, be forced to be in a good mood? 

CPP: It would make our jobs a lot more tolerable if we could force that.

CP: Right? Smile! You're out in public. You're not working but I am. I'd rather be running errands or enjoying life but I'm here trying not to kill people and your glum presence is bringing me down, man. I'm going to need you to smile or crack a joke or at least elevate your mood so I can focus. 

CPP: But we work in healthcare where people often need medications to feel better. 

CP: As I said, high stress, high focus. When people focus on a task, they usually make weird, screwed up faces. Think of sticking your tongue out while threading a needle, or a golfer lining up his putt. Or  defeating constipation! Concentration. Focus. 

CPP: Did someone tell you "it takes more muscles to frown than to smile"?

CP: It takes no effort of any muscles to activate resting neutral face. We are expected to concentrate, quickly fill prescriptions, deal with the stress our employers place on us, then force a smile because a patient believes she deserves it? Nah. I'm not buying it. 

CPP: As we've mentioned many a time, perhaps you get bad customer service because you're a bad customer. 

CP: Right. If patients don't smile at us, or diners don't smile throughout dinner, I believe we should be allowed to dismiss them. Maybe we could add a "didn't smile through our interactions" to their profile or a charge on their bill. 

CPP: We will put it right next to allergies. Personality? "Lacking". 

CP: But don't complain my staff didn't smile. You don't get to tell me how I get to look or feel at work. You don't know what's going on behind the scenes. It's like the photograph I tell everyone to take of the pharmacy. You only see that second of your interaction, not what led to it. Yes, we are in the retail sector. But we are also in the not killing people, hurry up and answer my phone call/just a quick question, dealing with impatient patient field of healthcare as well.

Poor Bob

ME: Are we supposed to put out our trash tonight? Or is it delayed?

MICE ELF: I don't know. How do I know? 

CP: If you're like me, you have a Bob. 

ME & MICE ELF: <confused looks> Huh?

CP: Bob is our local neighbourhood friend. A number of years ago, Bob started posting in our community Facebook page the trash delivery schedule around holidays. 

ME: How nice of him. 

CP: Well, I thought it was nice in a saccharine way. Sweet, yes. Unnecessary, definitely. Have we really gotten to the point that we don't know when to take out the trash without someone posting it to our community page? We are adults. We've lived our entire lives without someone reminding us it's trash night. 

MICE ELF: But what if you forget? Or it actually got pushed a day? How dreadful!

CP: Seriously. It either sits on the curb an extra day or I miss it and take it out next week at its regularly scheduled broadcast time. 

ME: I have a feeling this is more allegorical than you are letting on. 

CP: Quite right. It's the struggle of the pharmacy and the pharmacist. We used to allow people to call in their own refills. 

ME & MICE ELF: <in horror> GASP!

CP: Right! We used to believe that people, especially adults, were completely capable of recognising their bottles were nearly empty and trusted them, WE TRUSTED THEM!, to call in their own refills. 

MICE ELF: What happened?
ME: Yeah. What happened?

CP: We started to fill them for them. "Courtesy refills" we called them 

ME: Ghastly! 

MICE ELF: The horror. The horror! 

CP: What happened to us is the same thing that befell Poor Bob. For years he reminded our community to place our bins at the curb on the proper night. One night, a night much like this one, he didn't post a reminder. Did he forget? Was he imperiled? None knew. The only echoes on the page that night were of lost souls seeking guidance. Bob? Hey Bob? Do I put out the bins tonight? People became angry with Bob. What was at first an overly sweet, caring gesture had become an expectation. He was the torchbearer for proper trash disposal all around town! If we couldn't rely on him to guide us, what were we going to do? 

ME: Call the local trash company? 

CP: <sniffling> No one knows the number. Bob knew it. That's all we needed to know. 

MICE ELF: Check out the trash company's website? 

CP: <howling in anguish> And trash poor Bob like that? All we know is the Facebook page. Without it we are lost. He is our beacon. Why would we go directly to the source? To the company itself when we have BOB!?

ME: Did people blame Bob? 

CP: They did. Many unfriended Bob. Physically and emotionally, not on actual Facebook. They still needed to be good neighbours on there and find out about the local picnic and parades. But they were distant on the sidewalks, let me tell you. 

MICE ELF: All these poor people made fun of Bob for doing a nice thing out of the goodness of his heart and then they expected it of him and so turned on him the one time he didn't deliver. 

ME: Like refilling patients' refills automatically is somehow our job. Well done. 

MICE ELF: What happened to Bob?

CP: Huh? Oh. No clue. I took my bins out like I always do. Either they get picked up or they sit another night. I'm sure he's okay. I guess we'll find out Labor Day. 

What at first appears as consideration, later devolves into obligation and expectation. 

If Your Hospital Operated Like Your Pharmacy

CP: Hi. Thanks for staying with us this weekend. Did you find everything you were looking for?

PT: Um. Yes. I was here to give birth to my baby. 

CP: Wonderful. Well I see we processed your insurance card. Let's head over to checkout and we will get you out the door with that adorable bundle. 

PT: Thanks. I'm exhausted. 

CP: I bet. Okay. Do you have a loyalty card with us? 

PT: <puzzled> Not really sure. 

CP: I can look it up by your phone number if you really don't have it. 

PT: I'm not really interested. 

CP: You don't want the coupons?

PT: For what? 

CP: $10.00 of your next delivery or BOGO adult diapers!

PT: No. 

CP: Would you like any of the following vaccines today?

PT: Didn't I get them already? 

CP: Maybe. It's almost always flu shot season so we like to get ahead. Or COVID vaccine? HPV is a hot seller this month. I could double tap you and your SO right now if you like? 

PT: I think I'll pass, thank you. 

CP: Ok. We will continue to ask this each time you visit us. You're bound to submit eventually. Would you like to receive texts about our services? 

PT: Not really. I delivered a baby. I don't visit here regularly. 

CP: So that would be a "no" for automated refill reminders, doctor calls, home delivery, and cheese-of-the-month club? 

PT: Yes. No. No! to all of it. I just want to get home with my baby. I've been here for days. 

CP: I understand. But if I don't ask all these questions, they make us dress up in velcro fly suits and shoot us out of a cannon onto a velcro spider wall where the corporate overlords feast upon us overnight. This really should be a simple "sign here, good day" transaction but most people end up hating us about here as we are only halfway done. 

PT: <looks down> Can I, um?

CP: Yep. Nurse away. I feel her pain. And yours. Moving on. Are you interested in donating to the Charity-of-the-Moment fund? It helps corporate get a write-off without doing anything and you can feel good about yourself for a few seconds. 

PT: I give at the office. 

CP: Would you like us to get a delivery room ready for you for this time next year? 

PT: What? 

CP: It's our proactive procreative program. It's good to strike while the iron is hot so we discover many couples return within a year of giving birth to deliver their next one. There's a discount if you book now. We will send you monthly fertility reminders, when to have sex now that you have a newborn pamphlets, ovulation predictors, and you'll get 400 loyalty points just for signing up. 

PT: Sure. Anything to get out of here.

CP: Great! I may make my quota this time and not have to become a fly again. 

PT: Anything else? 

CP: No. Well, now that you mention it, since you are leaving with more people than you entered with, we are going to have to add your baby and repeat the entire process for her. 

PT: <exhaustedly> Just mark "yes" for everything.