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Tuesday, January 25, 2011

A day in the life...

Work has been insane. Have I mentioned this? Here's a sample of crazy just from today:

- I call the pediatrician on a child's iron supplement dose. The baby is under 2 years and the dose is roughly four times an adult dose. The NON-MEDICAL PERSONNEL receptionist who answers the phone authorizes the dose. I ask her to let me speak to a nurse or doctor and she refuses, telling me that she's allowed to speak for the doctor, and that's the dose, period.
- A customer asks me if there is anything over the counter for scabies. I tell him no; he tells me he doesn't have insurance so I recommend an inexpensive clinic nearby. He returns in an hour and literally shakes his fist in my face, hissing that he is furious with me. I ask him what's wrong and he replies that he spent $300 on a clinic visit (yeah, didn't follow my advice on the clinic) and that the doctor told him the drug was over the counter so he wasted his money. I look at his prescriptions; he has two prescription-only drugs. I cheerfully fill his prescriptions, despite the fact that he actually really shook his fist in my face. I am not sure who said permethrine 5% and Vistaril were over the counter but um, they aren't.
- I call a doctor's office to get the strength on a prescription.His nurse tells me they are too busy to take my call and will call me later. I tell her the patient had oral surgery and needs this pain medication now. She tells me she'll call when she has a chance. She calls me 6 hours later. For 4 of those hours the patient sat in my waiting room, whimpering softly and bleeding on the floor.
- I am filling a prescription for Bactrim, an oral antibiotic, when I see that the patient has a sulfa allergy. Bactrim is a sulfa drug. I call her doctor about the allergy, and I'm told that the rx (which is typed) should be for Bactroban, a topical antibacterial ointment. I have no idea how this happened (the directions were to take twice a day by mouth - clearly this was not for a cream) but if it hadn't been for the allergy I would never have caught the mistake.
- A customer calls in his own prescription over the phone - ie, a forgery for a controlled substance. Then he's stupid enough to call me right back, this time as the patient, not pretending to be the doctor, and uses the same voice. "Is my prescription ready? My doctor just called it in." DUMB.
- A nineteen year old is discharged after a kidney transplant and brings in his prescriptions. Because he's a transplant patient, he has Medicare. His prescription insurance (medicare part D) says to bill part B because he's a transplant patient and part B covers transplant drugs. Only his drugs aren't all on the covered drugs list by medicare B. So neither medicare is paying and there is no substitute for his drugs and this poor kid is weak and ill and broke.
- A man throws up in the waiting room. In the ensuing drama, a woman grabs her rx from the counter where we are ringing her up and runs out without paying. Her copay was $3.
- Eleven of our top twenty drugs are on manufacture back-order. ELEVEN. No one can get their drugs and they don't understand that it isn't my fault and I'm trying to help. Try explaining this scenario 180 times a day.

Where is my alcoholic beverage???


  1. Oh. My. God. It's kind of scary to read of the prevalence of prescription errors... yikes. What a hellacious day!

  2. UGH! I feel for you. I am a pharmacist too. Retail is a hard environment to work in which is why I switched to long term care. Your post gave me flashbacks....

  3. Speaking of scabies- I have a really funny story about that.
    The back story you have to understand, of course, is that my family is completely crazy.
    My dad was working in Tennessee last summer and staying in really cheapo hotel rooms and developed a random rash. First he thought it was bed bugs (from the cheapo hotel), then he somehow convinced himself that he had scabies. Instead of going to a Dr. like a normal person,he decided to go to the farm store, by cattle dewormer (Ivermectin) and dose himself like a medium sized cow for several weeks. In addition to this, he took several hot showers a day and sprayed himself with flea spray (b/c it contained pyrethrin). When he finally went to the Dr. because none of that worked, the Dr. told him he'd given himself an immune reaction from all the flea spray and hot showers and scratching and that's why he was itching.
    I shudder to think what dad's done to his internal organs.

  4. Medical/insurance industry must be tough to work in. Thanks for your comment on my Blog. You started a whole new trend of giving "real" advice. I appreciate it. Hey, at least you can drink, I'm on the wagon until after my race.

  5. Shelly. Seriously. Your dad is hilarious. Ivermectin? Couldn't he at least have Googled the dose for an adult human??? It's a wonder he didn't kill himself.

  6. I always question my doctor by telling him I read something different on WebMD, hehehe. Think I'll try that with pharmacists next, should be fun.

  7. Oh man, that sounds like a rough WEEK let alone a day.

  8. man! i didn't realize all that pharmacists do. i would feel so bad for the ones like the transplant guy and the oral surgery person. yiiiikes four hours. i would have been calling the doc every 5 minutes.

    as someone w/ allergies - thank you for being attentive about them!

  9. As far as I'm concerned you're a hero!

  10. So I left you that last comment and went to Walgreens to pick up a couple TOTM essentials, and a lady collapsed in the front entry. Guess what? Pharmacist to the rescue. She was on seizure meds and, while she didn't know what it was called, she got them from there so they were able to help her.

    It was scary at first because no one knew what was wrong with her (she was asking for CPR which seemed odd), but I think she'll be ok thanks to a couple good samaritans and a hero pharmacist.

  11. !!! Wow, awesome! In case you missed it, I had a guy have a heart attack in my parking lot a few weeks ago. I was so glad I was BLS certified.

  12. I definitely thought of you and that incident! I think you were a bit more reactive than this pharmacist was though.

  13. So did you fill the iron prescription? Yikes! I do NOT envy your job.

    Hopefully you'll have a great weekend! :)

  14. what a mad day at the office well i think thats how the saying goes is it naghty to get prescribed drugs in america over here is you forge a doctors prescription over here you goto jail