Free sitter

During the flu season (especially in the midst of handing out Tamiflu like candies), WHYYYYYYYYYY would you not control your kids when you come through to the pharmacy? They cough over our merchandise, knock our things down, play with the gifts and goodness knows where they wipe their hands after wiping the snot off their noses!

Grrrr!!!

If things ever break, they play the innocent card.
WELL!
If you kid breaks something, YOU are responsible – don’t give us the, “Uhh…they are just kids.”

That’s why we’ve been dispensing that many Tamiflu’s to children under 12 – touch touch touch touch! Have they not heard about keeping to good hygiene to prevent the spread of flu? It’s all over the media…since LAST year.

Miss Community

Writing in advance

I am writing this post in advance as I predict how my day tommorrow is going to turn out. I have just been told this morning that I have to cover a fellow pharmacist’s ward while he is away for a working day trip. Tommorrow I will have to juggle my 2 wards, my manager’s ward as she is away and ICU for Chris. On top of all these wards, I also have an Insulin Group Meeting and a 2-hour dispensary slot. I can only be thankful that the Pharmacists’ meeting will be cancelled (at least that’s what I hope). I think I desperately need a lesson on time management. 8 hours work/day – 2 hours in dispensary, 1-1.5 hours for meeting, 0.5 hour for tea break/toilet break/running all over the hospital as the wards are spread out over a few floors and different wings and I will be left with 4-4.5hours for 4 wards. Will it be mean/selfish of me if I just allocate the bare minimum 30 minutes to the wards that are not mine?
Either that or I turn my charms on another pharmacist and presuade him to take a ward off me.
Think the end result will be me being very grumpy and short-tempered. I pity the rest of my staffs tommorow. Should I apologise to them in advance?

Miss Hospital

It printed from the computer!

First photo post.

Well, you can now see that it’s Buscopan written on the script (that was by yours truly) but did the doctor think I could see his screen when he printed that Rx out? What kind of “excuse” was that when I rang up to confirm about what he wanted to prescribe – it wasn’t even the answer I was looking for. I didn’t think I had an accusatory tone when I rang to clarify his Rx.
😛

This is my first experience having a Rx with no drug name – the more common are the ones with drug names but no instructions/quantity. I did guess it was Buscopan because the patient said it was for stomach cramps when I asked her if she knew what the medication was for. If I couldn’t get the doctor on the phone, I thought I could just sell her some instead of sending her away with nothing. No big deal.

The little things that make your day interesting at the pharmacy…

Miss Community

Nurses here frustrates me more than the patients

Well, to be fair, only certain nurses in a certain ward. I like my nurses in the other ward. How am I suppsoed to do my job when I was told off for going into the patient’s room to ask him about his medications in the process of reconciling them. Nurse A, “You shouldn’t go in there to disturb the patients as he needs his rest. That’s why we have visiting hours from such and such time.” Or Nurse B, “Patient just got transferred in from ED. You shouldn’t go in to disturb him.” And they are always hassling me for taking the medication charts or notes away from the designated place. Nurse C , “The doctors will be here for their round soon. You shouldn’t take those notes and charts away.” I really feel like cursing at them. I can’t talk to the patients to reconcile their medications and I can’t look at the notes and charts to check through the perscriptions. Why do I even bother going in there.
Addit:
I wrote the above more than a week ago and then last Friday something happened in the ward that involves medication. A patient just admitted into the hospital had digoxin toxicity. The Nurse Manager came and talked to me about the issue and she asked if I had done a medication reconcilliation for the patient. I was shocked speechless. First, she approached me and second she asked me about medication reconcilliation which I thought she didn’t know it existed. I explained to her that the patient was admitted into another ward before being transferred to mine and the reconcilliation was done by another pharmacist. To cut the long story short, the whole issue involved health professionals from doctors to pharmacists to nurses over the span of 2 hospital admissions in 2 different hospitals. It’s scary how nobody thought to question the dose of digoxin prescribed for the elderly patient, although it’s the maximum dose and hence not wrong, her age would be an alarm bell. The manager and I both agree that more education sessions need to be organised.
To be fair, only a few nurses are that snotty towards me and some are quite nice. And it feels good that my presence and work as a pharmacist in that ward is recognized by the Nurse Manager even if it is only for that small moment.

Miss Hospital

Squiggles on paper – hey a prescription!

If I have made a mistake, I don’t mind apologising. I own up to it and would take responsibility towards it.

This script came in, on a generic pad with no doctor’s name and no practice address. There was a registration number, signature and date of prescribing. I think this is not the first time I’ve seen this type of script and I have a strong feeling it was from the same patient as well – he gave me an explanation, “We are friends.”

Look, before anyone launches fire on me, let me explain. I don’t judge you for writing prescriptions for your friends. What I do (legally) require is that you do your part and provide ALL details necessary for a piece of paper to be a legal prescription. You can squiggle bits and pieces on the back of a name card (that’s what I’ve gotten before) but as long as ALL the details we need are there, it is possible for me to dispense off it. When the VITAL information is not on a prescription and we do NOT deal with you that often (or at all!), PLEASE do not pass the blame on me.

I suppose the way DrFren responded to my query didn’t rub me the right way. His first sentence was, “The prescription is from me and it’s genuine, so WHY DIDN’T YOU give it to him?”

The Rx was for Buproprion + BD (yes, not dot slash dot but +) x 3/12 and Codeine linctus 100mL.
It didn’t help that the writing on the Rx was liKe tHis. I kid you not.

DrFren proceeded to tell me that he was trying to get his friend to stop smoking and BECAUSE I refused to dispense of the incomplete Rx, his friend is not going to stop smoking. Uh huh. He has left the country for good apparently. Yup – day before he flies out, he comes in to get a Rx for an item that is non-stat.

I’m quite sure you spent some time in med school being taught how to write a prescription and what needs to be on it. It doesn’t matter that previously you’ve had no problem with your said prescription pads when you did your house visits – maybe the staff at the pharmacy where they got dispensed worked with you before and could recognise your signature but we don’t. Since it was handwritten (the medical centre you work at generates electronic scripts), I couldn’t even ask the nurse to check on the patient’s record/history (best thing? The friend has never been to the medical centre before so they had NO information at all)
We don’t deal with your medical centre and when we rang, the receptionist said you were OFF DUTY! We tried contacting your mobile but it went to voice mail and no one answered the phone at home. ALL measures were done to ensure we COULD dispense it. Even the receptionist didn’t think it sounded right. Of course your friend offered to call you but we were taught to contact the place of practice to obtain numbers.

At the end of it, you said with an irritated tone, “I guess I will stamp all my prescriptions now.”
WHY did you not think of/do it in the first place? It’s a REQUIREMENT. You don’t even have to write it down, just a stamp! How hard can that be? It’s just not right that I’m the blame for your friend not stopping smoking because I “refuse” to give him the medication. C’mon, pick up the slack. If you choose to write from a private pad, at least write it properly.

It’s not enough that we get nonsense from patients, we get them from doctors (okay, maybe just this one in my job so far!), too – and for what? For getting our jobs done.
Ugh!

Miss Community

Should have stayed home

Now, the boss is away for 10 days and my preceptor is also going away for a long break to visit his family in Canada. Thus came the roster nightmare for Keather and I thought I’d help out by volunteering to go to work when it’s my day off.

What a nightmare! I should’ve stayed home. It would’ve been quite nice since the sun was out.

First thing that greeted me was a “complaint” from a patient about her blister pack – apparently she received the pack with several doses punctured out and she was very unhappy about how it looked like (honestly, it did look like crap but NO WAY on earth the pack would’ve gone out that way). I looked at it and remembered that the pack was left out last week, so we delivered it on Monday instead (with Friday, Saturday and Sunday’s dose cut off) – I personally charged it and Jules bagged it. It went out pristine!

You know what the q-tech (qualified tech – that’s another story for another day on how she demanded for a pay rise because she was the only qualified tech) said to me?

“Oh, I thought maybe it was the newish-tech or new-tech who did that instead of cutting the days off.”

WHO DOES THAT?! Even if they are new as in just-started-work-today-new, I am confident NO SANE PERSON would have sent the pack out looking that way. Did she really think that the other two are idiots? The driver (we took the time to ring him to find out if he left the pack in the mailbox or handed the pack over in person) confirmed that he left it in the hands of a lady on Monday (patient claims that she only got the pack yesterday and it arrived in that sad state). I have a feeling it has been tampered with but not by any of us – maybe the kids got into it (the driver said there were two children with her when he delivered the pack) because who would want to dig into a pack for metformin and gliclazide tablets? The note from q-tech wasn’t very clear but I assumed she wanted to find out who did it and for that person to call the patient to explain/apologise. Jules said ignore it and don’t bother ringing. I suspect patient is a little delusional – may need a little more than just anti-hyperglycaemic medication.

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Pharmacists know all the pills in this world.

As the title says it all, I was asked to identify a pill during my on-call last weekend. When the phone rang at 11:44pm, I was jolted awake and answered in my best professional voice. It was an ED consultant “I have got a patient who came in with an overdose on what she claimed to be sleeping pills. Should I get the nurse to bring the capsules to you for identification?” And I went “Ermm, I am sorry but I am not based in the pharmacy after hours. We have to do this over the phone.” To which there was a pause of dissatisfaction and a reluctant description was given in the line of “It’s a red/brown capsule”. No numbers or letters or words on it. Now, if anyone can identify that I salute them. But at least I can tell the doctor that I do not think any sleeping pills in this country is in capsule form (I was quite positive at that time….if anyone wants to contradict me, please do not as it is too late now). And I am very sorry that I can’t help her. She grunted and put down the phone. Excuse me!!
This is not the first time of me being asked to identify a pill in the middle of the night during my on-call. The last time was to identfiy an orange, round tablet. Again, no numbers, letters or words on it. My first immediate thought was Vitamin C. But somehow I do not think the ICU Registrar will appreciate that. So, again, I have to tell her no, I do not know what it was. But at least we laughed about the impossibility of the task.
Anyway, I felt bad as if I have let the ED consultant down. I proceeded to open up my formulary and start going through the sleeping pills and antidepressants to see if I could find something. Lo and behold, I did manage to find a TCA that bears the description red/brown capsule!! Rang the consultant to tell her of my find and suggested she asked the patient if she takes any anitidepressant. But of course I emphasised that it’s just a guess. Well, this time the call ended abit friendlier.
Now, I welcome any suggestion on good references for pills identification. But I guess the difficulty is different country will have different generic medications.
1 more day of being on-call, I can’t wait for it to end.

Miss Hospital

There’s always a first time

I think I was phone-sex-ed today. It’s really annoying that it is so painfully obvious now but not so when I was on the phone earlier. I suppose you could say I was too polite and idiotically “naive” to think that it was a genuine phone call asking about Viagra.

Even when I think of the conversation now (which REALLY annoys me as my idiocy is glaringly obvious at this point of time!), my skin crawls! UGH!

The phone call came when I was in the midst of trying to complete our daily stock order and it was right smack before my home time. It started innocently enough (although looking back, he sounded like he was whispering or was very breathless – I took it as a sign of pain/discomfort at that time somehow) when he asked if he could speak to a pharmacist. When I replied in the positive that I was one, he proceeded to ask, “Is it okay for me to talk to you about the medicine Viagra?”

Being in our profession, you wouldn’t think too much about such questions because hey! It’s about a drug. It’s what we do – provide advice about patients’ medications.

Let me emphasize again on how STUPID I feel now because even as I try to recall the conversation, I don’t know why I hung on for THAT long – so don’t judge me when you read the rest of my story. I know that I should have been more aware of the conversation’s direction but I was honestly confused/torn between wanting to provide good sound advice (this also through listening to the patient’s problem) and slamming the phone down (I should have trusted my instincts to do that!).

He continued with another question, “I wanted to know, how long does this medicine work?”

It should be effective for about 4 hours – is that what you wanted to know?

So out came the whole jumble. As in the WHOLE JUMBLE.
From time of taking a 50mg tablet (1 hour 45 minutes ago) to “it came up after a few minutes of taking it” to unnecessary information about how he and his partner indulged in foreplay to how his penis did not turn flaccid until 10 minutes after ejaculation.

Yes.
I don’t know what came over me but I just thought he was being painstakingly thorough in explaining his problem.

Then my instincts kicked in when he started going on about how “it is now up again although my partner did not stimulate me and I’m not aroused” to how his partner said she wasn’t satisfied so he had to go down on her (WHAT ON EARTH? DO I NEED TO KNOW????) and too much explicit information about how it was done. Then more information about how she was on top and did I think that having another ejaculation would help his “pennies” come down.

When this was happening, I was trying to cut in to ask, “Sir, so what exactly is your question or your problem now? It’s advised that if you have an erection for 4 hours or more, you must go get help. Call your doctor or go to the hospital – perhaps the dose is too strong for you but you have to talk to your doctor.”

Then there was the “my family physician (yes, not doctor but physician) is also a lady…are you from India?”

WHAT?!!!
I’m not being racist but he had an accent and he did indeed ask that question.

He also told me that he thought masturbation (he apparently thought I didn’t know what masturbation was because he started explaining that he uses his hand to touch his “pennies” up and down…WHY WAS I SO TOLERANT?) was a better way to relieve his erection. The funny thing was, he also threw in a, “I hope I’m not making you uncomfortable, I’m not doing phone sex with you but just wanted to ask what to do.”

I think my “too polite” came across as “ooo, tell me more, I am enjoying myself and I think I will participate, too” that’s why he kept going on with all the explicit details (and that in turn probably turn him on or something) – I really hate myself for not thinking faster or asking him to piss off. Honestly. I’m ashamed that I let a bloody pervert drag myself through this whole ordeal.
If he really had a partner with him, piss off to her – why bother calling a pharmacy? I should’ve passed the call to David but hey, I’m a pharmacist. I didn’t know it would turn out this way – I know better now but I’m still peeved!

In the end I said, “Sir, this conversation is going no where and I can’t help you. You should go get some help from your doctor or go to the hospital.”

There was a disgusting, breathless, “Uhhh thank you so much for talking to me.”

Can you say EWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW???

Miss Community

Feeling the loss

It’s only been two days without our supertech and her absence is evident, especially when we get busy. I feel really bad but I had to say what I said to newish-tech and new-tech today because if I don’t, I will boil over.

Supertech earned her title by being above average. One may assume that she probably has 5 years or more experience under her belt but the truth is, she’s not even allowed into casinos yet (turning 21 this week). For her age, she’s AMAZING. Quick to learn, initiative, hardworking, alert, organized and funny to boot.

I don’t need to say, “Would you help me serve?” or “Would you help me take this out?” or “This is a waiter, we need to do it now.”

Even when she’s in her secluded corner making up packs, she is always on the lookout for any customers or patients walking into the shop – I wouldn’t be the sole person at the front, frustrated that no one else sees the patient/customer waiting while I’m serving another and feeling bad that I can’t help both at once. It looked really bad today when I had three patients/customers waiting and while I was serving the 4th, newish-tech and new-tech was in plain sight but not noticing the three.

*sigh*

If you ask me about the state of that packing corner, I could go on for hours (okay, I exaggerate) – supertech never left her corner messy. She completes everything before going off for a break, no leaving messes half way through her tasks. In our line of work, you try to keep everything tidy/clean, so the mess that they leave around really irritates me. Yes, they. New-tech seemed to have pick that up, too.

Oh! The opened boxes of medication – why would you open two boxes of the same medication and not look around for the opened box first?

Now, I know my boss checks email all the time at work but it’s for work. She’s the business manager, support office communicates by electronic mail. I check my email account for work, too, if it’s business hours – not very often because everything else comes through the intranet. Granted, I do use work computer to log on to Facebook but that’s usually when I have run out of things to do (usually in the later part of the evening).
Newish-tech goes on Facebook anytime she wishes, sometimes even when she’s making up a pack. Excuse me, since when was it okay to do so? Your priorities are getting your jobs done and obviously they are not done yet. And even if the packs are done, there are always other things to do. I don’t stand in front of the computer, in the middle of my jobs, checking out what my friends posted/did/commented.

Appropriateness and priorities, people!
I can’t impose what I believe/practice on you but isn’t that just the norm for any job? If one says it’s because she’s still young, why is supertech not like that?

I’m feeling the loss because when supertech was here, she sorts out my beef with newish-tech because she gets things done. Now that she’s left, it’s all there – bare and ugly. I wonder if I should tell her but I’ve already told her a few things of what’s “supposed-to-be” and I really don’t want her to feel I’m picking on her. That’s why when if I work evenings or weekends with her, I try not to set any bad example. If possible, no using the computer apart from work because hey, one has to walk the talk as well.

*sigh*

Miss Community

I’m done

Recently I’ve been pretty quiet.
Mind you, it’s not that I’ve stopped getting loonies and what nots at work but I’ve turned rather…jaded. Maybe I’m battling with some hormonal fluctuations but I feel like I’m done, done with this job that deals with (difficult) people day in and day out.

Ah! If only I could say all these at the height of a VERY bad day or week (in a parallel universe where we are allowed to be rude to our patients/customers or if I’ve just HAD enough and will quit at that very moment):

“You know what Mr-Do-No-Wrong? I’ve had enough of you! Just because you can’t see very well doesn’t mean it gives you the right to blame everything on us. Someone’s made a mistake you say? Well, try looking around the house for your eye drops first before coming in the store to imply we are lying and did not dispense your one month’s worth of eye drops just one week ago! It was charged to your account, the script was already in the filing boxes – it was GIVEN out! I’m sure if and when you find those SIX bottles of eye drops at home, all wrapped up in our paper bag, you wouldn’t even call or inform us that you’ve made a mistake because you are Mr-Do-No-Wrong!”

“You know what MrsHighMighty? You don’t come in to a dispensary and dismiss everyone in the dispensary that is TRYING to be nice and help you DISPENSE your medication…and then proceed to ask for our retail manager, who is busy on the phone/with another customer/having a tea break JUST so you can hand her your PRESCRIPTIONS to be dispensed. That makes both retail manager and dispensary VERY ANGRY! You’re wasting our time! If it’s to say hello to our retail manager, that’s fine. If it’s once off, that’s fine – but it’s EVERY SINGLE TIME! Not only in person, but on the phone! It’s as if there’s a hierarchy of staff in your mind and you won’t speak or want to deal with us “minions” – well, good luck when our managers go off on a MONTH’s leave and you need your medication RIGHT NOW. The rest of us apparently do not know how to dispense your list of medication.”

“You know what MrHigh? I don’t buy your “I was burgled” excuse RIGHT AFTER your “I lost my medication” excuse RIGHT AFTER your “Someone broke into the house” when you come in for your repeats of Alprazolam after being 90 tablets the week before. Go see your doctor and come back with a new script (if you do get one) if you need more. I AM NOT A THREE YEAR OLD! Besides, who would know of and specifically target your medication – your evil twin, perhaps???”

“You know MrsExplicit? I really DON’T WANT to know about your sex life with your husband or what happens down there. It’s the same thing EVERY SINGLE TIME! You hog our phone lines and you especially LOVE calling on weekends when there is only ONE staff left. You don’t get hints that we want to get OFF the phone and somehow “shame” is not a word you understand. I don’t want to know that you need $57 to pay your last payment for the fridge HP (which was an excuse used for the past 6 weeks with different staff when asking for credit!) or that you need the money to put on the layby of boots at K-mart or that you don’t have money for groceries (this is right after saying that you needed the money for the boots) – where on earth is your priority????? Stop calling us on your mobile and maybe you’d have the money to pay for your medication!”

“You know what MrsTrespassed? Do you know what is the meaning of TRESPASSED FROM OUR PREMISES? You don’t come right in after you’ve been served the notice. We can call the cops. I don’t want to hear your sob story – please bring your scripts somewhere else to be dealt with. To think we’ve all been so accommodating and nice to you, went the extra mile to make sure things are done – and you took advantage of it by stealing our OTC products. Thanks. Now get out! It’s your choice to stay on, my colleague has called the cops.”

“You know what MrCreepy? If you bringing us pieces after pieces of those NRT cards, day after day, week after week – but never getting them filled – we have all the reason to think you’re a creepy man using those “scripts on hold” as an excuse to see one of our staff. That and also the fact that you ALWAYS ask to speak to her even though she’s busy/out for lunch/on the phone/serving another customer – it’s not even about something urgent or related to her. It’s CREEPY! You don’t have to call to tell her that you won’t be coming in next week – I’m sure she’ll survive not seeing you for a week, in fact, I think I hear a breath of relief!”

“You know what MissClueless? Our service fees started from September 2008!!! Don’t come in telling me you DON’T KNOW there were after hours’ fees and that you NEVER get charged extra at the other branch – I’m not DUMB! I was still working in that branch when they started those fees, so don’t tell me THEY DON’T CHARGE because that’s a downright lie! When you go to the doctor’s on a weekend or after hours, why don’t you yell at them asking WHY is there extra charge? You just pay them without any question – why do we have to go through lengths to explain things to you? How would I know why the doctor prescribed something that’s not funded?!”

Ah! The things that I’d like to say!
It’s unfair that we get shouted at but we have to keep smiling and maintain our cool. It’s not about customer’s rights in this matter, it’s more about respecting each other as individuals. Even if I’m not happy with a waiter or a sales person, I don’t YELL at them.

Maybe I should consider joining MissHospital? At least one won’t have to deal with walk-in customers…I think.

Miss Community

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