Nov

The Worker’s Plea

Posted by The *Angriest* Pharmacist as Education, Management, Technicians, True Story

1. Tell me clearly what you expect of me.
2. Give me the opportunity and resources to perform.
3. Let me know how I am doing.
4. Provide me with guidance, support, and training when I need it.
5. Reward me according to the contribution I make to the business.

I happened upon this little piece of paper one day while returning from the Cough and Cold aisle. I picked it up as I do all little pieces of trash I walk past each day. I unfolded it to reveal, “The Worker’s Plea” as the title and the items above listed.

I found these statements quite intriguing. Since that day, I have done the best I can to implement these ideals into my pharmacy and treat my fellow pharmacists and technicians according to this doctrine. Not long after I found it, I held a pharmacy staff meeting after closing hours (even required those no scheduled to come in — don’t worry, they punched in!). I went through every item on this piece of paper — along with some notes that jotted in a little notebook in which I taped this sliver of paper.

I told my pharmacists my expectations of them — allowing the technicians to hear this. I told my technicians my expectations of them — allowing my pharmacists to hear this. This, I feel was pivotal. I often think that things change after I leave — that the technicians “get away with more,” or that the other staffers don’t hold them to the same level of expectation as I do. Now that everyone is clear on their role in the pharmacy, we began to hold each other accountable.

A month or so after this meeting, I spent about 15 minutes talking with each technician and 30 minutes talking to each pharmacist about how I felt they were doing since their expectations were set — an evaluation of sorts. These meetings were all held during time I was scheduled off — so my commitment to excellence was displayed. Some were doing exceptional. My pharmacists had become more authoritative over the technician staff and held them accountable for their errors. My technicians took their role more seriously — as an adjunct to a pharmacist — a necessary cog in the machine! It was going well. Of course, some technicians still did not take their positions seriously — they called in sick, wasted time doing various non-imperative tasks to avoid certain difficult or trying duties, or did not try to improve their performance after pharmacist correction (like inputting a script incorrectly). These points were made in the meetings, and change was expected.

Yet, we continued on with the same problems — Technicians calling in sick, making the same error over and over on similar prescriptions, or wasting time away from the pharmacy. After expectations were set, staff pharmacists being made aware of expectations, and a meeting with me, I was perplexed as to why this stuff was continuing.

I had laid out my expectations of my pharmacists and my technicians. Technicians were given plenty of opportunity to perform their tasks, learn from their mistakes, and better their performance. I had a meeting with every member of the staff to let them know my evaluation of their performance in their job duties — which I felt were constructive, to the point, pertinent, and not demeaning or intimidating in any way. They had all been properly trained in ever facet of pharmacy from start to finish — they knew how to do the job right. They knew the seriousness of mistakes — that lives could sway in the balance. We had retrained and added supplemental help when mistakes continued whether it be knowledge of sig codes (like a list of common ones next to keyboards), or miscounting (by requiring fillers to circle the quantity on the page that prints out), or selecting the wrong drug (by requiring fillers to WRITE the middle four numbers of the NDC on each page as a double check). Still — the mistakes were happening, and we had been lucky in that I and my fellow pharmacists caught them. What was I doing wrong?

I’m sure by now you all see what was going wrong. Once I looked at the big picture, I saw it. I knew what it was. I couldn’t believe that I missed it — time and time again. I felt bad that I let it get to that point — I felt like a huge dick.

I was so focused on correcting the mistake with negative feedback, I neglected to reward the correctly filled prescription with positive feedback. To me, it’s much simpler. Knowing that the right medicine got to the right person is the reward. Educating people on their prescriptions is the reward. Hearing the positive feedback from the patient is the reward. Yet, the technicians may not get this feedback firsthand. It may not even be the type of positive feedback they are looking for. This was the problem. The technicians were so worried about the negative feedback (which was far from a ‘bitch out’), they were allowing themselves to make silly mistakes over and over again.

You have got to tell your technicians when they do it right — that you appreciate their accuracy, promptness, positive attitude — everything. Less mistakes made by technicians means fewer mistakes get by pharmacists. We’ve got to thank them for being an imperative part of our pharmacy. Now, I let my technicians know they are appreciated by both kind words and actions. I applaud their efforts when they think out a particularly difficult prescription or really use their noggin’ to solve a pharmaceutical ‘puzzle.’

I’ve also implemented a few other things. On Friday, lunch is paid for by the pharmacists. Period. It took some coercion to get the other pharmacists on board, but we all split it evenly — even if we are not working that day. Whatever the technicians decide is what we eat…and we don’t skimp. Appetizers, deserts, several courses. Whatever! In the past, technicians called in sick on Friday for a 3-day weekend. Not anymore! Now, I have to keep track of who works Fridays to ensure that each technician gets an equal amount of “Free Food Friday.”

I’ve also started a Blue Jeans Fridays. Not much to brag about here as it’s not that innovative, but my technician’s can wear blue jeans on Friday at a cost of one dollar. All of this money goes into a coffee can and once it gets up to a sufficient amount, we do something with it. One time we donated $150 to a local baseball team trying to get money to go to a tournament. Another time we had milkshakes from Sonic on a slow Wednesday.

Thank your technicians. Thank your pharmacists. Ensure your pharmacy is a positive work environment. You’ll see it increase your level of customer service. You’ll hear more positive feedback from your patients. And, best of all, you’ll have less mistakes get out the door.

I’m not quite sure if I was meant to find it, just got lucky, or perhaps someone left it just for me — But I can honestly say I’m very happy to have discovered The Worker’s Plea. It has helped me help a few that help thousands.

Or Print it...

M. Augustine says November 6th, 2008 at 9:04 pm

And, now, it’ll probably help hundreds of thousands, and get printed in a pharmacy textbook, or someone will make a movie out of it. Do you still have the note? Has it been published on the web someplace? (Like they said the Desiderata was found in an old Boston church, but greater investigatoin revealed that it came from somewhere in Indiana in the earlier part of the 20th century.) Can you get someone to analyze the handwriting? Sorry, trivia. But, sounds like the spirit of organized cooperation made it a happier place to work despite the incorrigible patients. Anecdotes sort of like what stories we’re hearing when there’s a little less anciety in the world (USA) tonight.

I just Googled it for the first time — never thought to before. It’s all over the freaking internet. I thought I had something special. Someone just copied it off the internet and dropped it in my store. Nonetheless, the story is poignant…right?

PrePharmNC says November 6th, 2008 at 9:12 pm

Hmmpph, this was a pretty positive post. I am quite surprised you would post something like this. I might as well go ahead and ask this before you get back to your angrier self. ; )

How about doing a post on ALL the good things that came out of your work in Pharmacy. When you felt like a superhero (saved a life), seen a scrooge customer turn nice (without any threats from you ;) ), or whatever.

I applaud your recognition of your staff. It’s like the Scrubs effect. If you are anything like your blog persona in real life, they probably see you as a Doctor Cox. A whole bunch of J.D.’s waiting for you to hug them. :)

LOL, have a great night.

Heh. I’ll post positive things as they come about…I promise. I’ve started carrying a voice recorder with me so I can remember shit when I get home…That’s always been my problem in the past — I forget!

PharmGamerKid says November 6th, 2008 at 9:32 pm

Wow, what awesome thing happened just from a piece of trash you picked up.

Now, how would things have turned out if you just tossed the paper without looking at it o_O

monster says November 6th, 2008 at 9:48 pm

OMG I WISH YOU WERE MY BOSS. This is an awesome awesome awesome post!!!! I actually had a lot of difficulties in dealing with my boss because, unlike your staff, when we made errors, we were never taught how to fix them. We were just yelled at. In the middle of doing something, we’d have a “pop quiz.” Anytime someone looked like they were struggling, they got yelled at for not asking for help. If they asked for help, they got yelled at for not knowing. Everyone cowered in the corner.

Luckily for me, I got certified on top of being a pharmacy student, so I had a clue, and I was driven to prove myself to my.. erm.. “authoritative” boss.

Now I’m one of the 1/5 of the staff that actually has a clue. Sad right?

Seriously, if you get sick of the midwest, let me know. I’m sure we could overthrow our boss and get you in with the district manager!

monster says November 6th, 2008 at 9:52 pm

PS I’m so jealous.. we don’t have Sonic here. I probably shouldn’t admit that if I’m going to convince you to replace my boss..

Pharmacy Meanie says November 6th, 2008 at 10:32 pm

I once managed a unionized pharmacy. Pretty much all of your incentives, free lunch, blue jeans days were prohibited by the union. In addition, the staff felt that they could do whatever they wanted. Which turned out to be pretty much the truth. I tried talking to them about errors, I complimented them when they got it right. I had to resort to writing them up by union rules jsut to get them to show up to work. One employee would go on ’stress leave’ for 6 months at a go. She would come back part time and gradually increase her hours-as per the rehab rules. Then, when she started approaching full time hours, she would get ’stressed’ again and take time off. Why? Because the company insurance paid for the difference between what she made on sick leave or part time work and what she would have made full time. Basically she found a way to work less than part time and get full time pay. The others saw this and suddenly they started getting sick. It was hell. I couldn’t fire them for getting ’sick’. Icouldn’t hire anyone becasue these slackers were on the payroll.

So, the moral is that some workplaces are just toxic. NO amount of proper managment will work.

The Intern says November 6th, 2008 at 11:58 pm

What great ideas!! I’m definitely going to initiate free lunch Fridays when I graduate, even if I’m the only one willing to pay. Just hoping I get a store where we get TIME to eat lunch.

sickofstupidpeople says November 7th, 2008 at 12:08 am

I’ve tried all of that too - works great for the techs, but I can’t seem to get the same results from pharmacists. One of them just said today that it wasn’t his job to tell a tech what to do because he doesn’t get paid manager salary or bonus. I do get paid those, but am on medical leave - so, until I get back, the place is circling the drain, and my good techs are burning out…

Jesse says November 7th, 2008 at 12:46 am

Before I came to college, I worked for an independent pharmacy in ‘da hood.’ My boss would pay for breakfast and lunch almost every day and drinks from Sonic on random days. It was totally awesome. He would even let us have free drinks and snacks from the pharmacy (which I try not to take advantage of). As clerks, we could wear anything without consequence and pharmacists did not wear lab coats (cleaner). This put us on the same level with the customers and shows that we are as human as they are.

Nursing Student and pharmacy technician says November 7th, 2008 at 7:22 pm

Thank you for this post. I take my job seriously but many of my peers do not, and sometimes it may because 1)unlike me they aren’t moving on from the profession 2) they get paid very little 3) Most importantly—they don’t get rewarded when they do their job well. I used to work in a very stressful environment where there was finger pointing, now we help each other when we make mistakes and pat each other on the back on a regular basis, thats team work and when a boss can encourage that and a reward system of even just compliments it makes going into work worth it

KeaponLaffin says November 7th, 2008 at 7:32 pm

From a completely different industry point of view:
I worked alot of different jobs as a ‘grunt’. Call em what you want, kitchen worker, warehouse worker, technician(both technical(IT) and physical(pretend mechanic of some unspecified kind)), whatever.
Same applies to ‘professional people in the ‘pharmacy technician’ business’. You’d be surprised.

Most of the time, we won’t work harder or better for a raise(We will). Some might, but most will work harder and better for -respect-.
We are the cogs in the machine that make the machine work.

It’s not even really the perks. The perks are fine, the perks are great! However what it really comes down to is….does the boss value me for the good work I actually do? Or does s/he just consider me a Grunt and think s/he can hire any other Grunt to replace me?

You don’t even need something like ‘praise’ just ‘acknowledgment’. Then your own good workers will help you kick out the slackers and weed out the newbies who can’t cut it.

Again, perks are fine, perks are great. But Casual Fridays, free pizza and chocolate won’t get ya better workers.
Respect for the good job they do(to those who do) will.

PS: I do not want this taken as a disrespectful comment to the Angriest Pharmacist in any way. I mostly agree with em.

Doreen says November 8th, 2008 at 4:11 pm

I’m a Tech and I definitely related to this. I dread the days I work with my pharmacy manager, not because I can’t get away with slacking a bit, but because the majority of our interaction is her pointing out my mistakes (a label didn’t go on a prescription exactly how she wanted, I forgot to double count a control, forgot to modify an experiation date, front store item has to be returned at the front store register, ect).

I love working with my other pharmacists, though. There’s more interaction and light-hearted conversation. With mistake, instead of it being “this is how it’s supposed to be,” it’s “hey, can you fix this.” For me, the less authoritative approach to mistakes tends to help me more with remember to do something correctly. As each Tech clocks out of their shifts, they say “thanks for helping out today.” Everytime I work with one of them, he’s also treating the Techs to a drink or a pizza.

I think my pharmacy manager has tried to use positive reinforcement more these days. However, positive reinforcement has to be appropriate for the job and individual. Saying how nice of a job one did with picking the staples out of the pharmacy carpet that the vacuum didn’t pick up isn’t exactly the greatest encouragement, heh.

Kara says November 10th, 2008 at 1:56 pm

Amen! I try and do a running commentary all day long as I work. “THANK YOU for remembering to pull the hardcopy of the scrip on hold- you save me so much time checking, and I so appreciate it!” “THANK YOU for screening calls while I was on hold for an important clarification call- you really know how to prioritize!”
I don’t always buy food on Fridays, but if a day is very stressful, I will spring for pizza or take-out and make techs leave the pharmacy to go sit and eat and have a break. I will also bring in muffins on days I know will be busy (Monday, Friday or the day after a holiday). They still laugh about a horrifically busy day when I came in for a split shift to chaos- I sent the frazzled am tech on a fifteen minute break with instructions to eat chocolate immediately. The rest of the day we laughed as we worked. I think rewards in the moment are most effective (as any SuperNanny or Super Dog Trainer will tell you!).
The Big Box I work in has a reward system of little incentives that I will use (even tho I don’t think they are very effective)- they entitle the recipient to drawings and awards.
Recently, a tech did a catch that highlighted a misfill that resulted in subtherapeutic effect for the patient. I intend to give her a giftcard for her diligence in addition to her reward.
Raises and perks are nice, but constant appreciation for small acts of competency seem to hold a lot more weight in the big picture-because they are day-to-day, not random.