This is me...

... Tweeting while at work:

Except I usually have a shirt on.

Usually.

The Authorities Response...

...when we asked them how they expect us to add MTM counseling and increase script count with decreased technician hours:

Patients Get Specific

If you're a pharmacist or pharmacy technician, this will make perfect sense to you.

People, for whatever reason, feel the need to add extra words to their request or statement. Example:

"Where's the non-drowsy Claritin-D?"

Sometimes they feel the need to stress the "non-drowsy" part of their sentence. And when you try to explain to them that there isn't a drowsy version, they just look at you like you're pulling a fast one on them. I think it might be the power of advertising... a TV ad which tells the views to "Ask for the non-drowsy Zyrtec-D at your pharmacy counter!" so that's exactly what they do. Have we become so dumb-downed in our society that everything must have a clarifying adjective added?

It just sounds stupid on our end. It would be like asking:

"Where's your pain-relieving Tylenol?"

Oh, that's right next to the non-pain-relieving Tylenol.

"Do you have any vitamin-containing supplements?"

Yes, it's on the aisle with the placebo vitamins.

"Where are your sterile band aids?"

We keep them separate from the non-sterile band aids to prevent contamination.

And all this makes perfect sense... until you get this question, which I did yesterday:

"Where's the non-drowsy Benedryl?"

Dear Doctor and/or Prescriber

Here's a refresher course, because a lot of you need it. Here's what WE need YOU to put on EVERY prescription. It doesn't matter how busy you are or how important you think you are. These are legal requirements:

Thank you for your attention.

What would YOU do for Nookie?

I have her figured out now. But it wasn't so much fun before then.

We have a patient named Nookie. Bummer of a name, I'm sure. But anyway when Nookie calls and a new tech talks to her things rapidly deteriorate. Nookie has a habit of calling on the phone and asking "Which of my medications is ready?"

Before we had her figured out, we would look on the computer and see that no, none of her prescriptions are "ready." To us that means they're filled and "ready for pick up." But that's not what it means to Nookie. What she really means to ask is, "Which of my medications may be refilled today?" In essence, she means what's "ready" to fill today. So when someone new tells her we don't have anything "ready" she gets mad and demands to talk to the pharmacist, which is usually me.

This has been an issue with every floater or new technician when she calls. Oh, I've tried to tell Nookie our pharmacy terminology which actually makes perfect logical sense but she's not going to change her language for us. So every month if someone answers the phone that doesn't know her it's the same thing all over again.

Here's the worse part. She always calls from the parking lot. She wants to know what could be filled between the time she leaves her car and walks to the pharmacy in the back of Goofmart Grocery. I'm aware of this too and I've felt like telling her that nothing is ready to be filled in five minutes... but then there's that whole written warning thing with The Authorities hanging over my head. So I just fill the scripts as fast as I can. 

I do it for Nookie.

Trust your Instincts

A few years ago I had a patient and his wife that moved into my Goofmart area. I'll call them the Mathers.

Although I'm in a really snooty part of town, the Mathers had "downgraded" from an even snootier part of town. Economic times had hit this very wealthy couple and they were forced to move to what must have felt like the ghetto to them.

Maybe this is universal everywhere, but I have a number of wealthy patients that must have 20mg of Ambien to sleep every night. Mind you, insurance rarely covers this but they don't care and they'll pay cash. It was no different for Mrs. Mather. She was convinced that she needed 20mg of Ambien every night to fall asleep. After confirming with their doctor the first time, I became used to filling the double quantity every month.

A few months passed when Mr. Mather came to the pharmacy with new prescriptions for BOTH of them... Ambien 10mg, #360, 2 QHS. Damn, that's a lot of Ambien. I told Mr. Mather that I wasn't comfortable filling that much Ambien and I would need to confirm with the doctor. He said sure, no problem. I asked him if they were planning to travel in Europe for several months or something. He said no, he just thought getting a high quantity would give them a better price. Times are tough for the Mathers, he said.

I confirmed the quantity with their doctor, a doctor known in our area for catering to the extremely wealthy. He said he didn't have any problem with the quantity. But I still had an odd feeling about it, so when Mr. Mather returned I told him I just was not comfortable filling two scripts for that much Ambien. He said no problem, and took the prescriptions with him.

A few days later I saw a news report that Mr. and Mrs. Mathers had committed suicide in their home in Snootyville. It was not a drug overdose, however. They used other means. When I mentioned the unfortunate news to my pharmacy partner, Mickey said they had come by the pharmacy (when I wasn't there) and brought in two prescriptions for a lot of Ambien. Mickey said he was going to fill them but that the price was more than Mr. Mather could afford even with a quantity discount.

It didn't feel right filling that much Ambien. It felt wrong. As it ended up, I was not a participant in the Mathers' plan to end their lives. I am sorry they felt the need to end it all for whatever reason, especially if it was about money. I don't want to sound rude or uncaring (because I'm not), but I am grateful I was not a part of their suicide. 

My message to you: Trust your instincts. This situation had a lot of red flags that were obvious, especially in hindsight. But at the moment when you don't know everything, rely on your gut. It will help you.

Silly Funny Sunday on a Lazy May Day