The importance of lifelong learning
I got this guest post submission from a student and found it pretty funny. I'd be there are a TON of pharmacists that are just as clueless here in the states. If you don't use it, you lose it. I know that I don't remember a lot of the intricate stuff I knew back during and right after school. But, I do read, learn, and occassionally challenge myself. This is one of the reasons I like to have students. Constantly explaining things to them helps me remember it, and at the same time, they will know things that I do not remember. Having them teach me benefits me with knowledge and them with recollection and presentation. If you want to keep up and remember stuff, get some students on rotations -- trust me. CE's are worthless in general. When compared to students, they are a waste of time.
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I understand the Unites States requires every pharmacist to get a doctorate prior to becoming qualified. However, in Australia, it isn’t required. It is still an undergraduate degree, so we come out after only four years of studying, do a year’s internship, pass our registration exams and we’re done. Every year, we have to enough “points” every year to remain registered as a way to encourage our ongoing learning.
As I’m still in my third year of my degree at the wonderful University of Sydney, we are required to undertake externships, where we get sent to pharmacies for “workplace experience”. I undertook my externship at a medical centre in Sydney’s north.
As one would presume, the entire purpose of my presence there was to learn. The medical centre pharmacy was small enough for only one pharmacist and pharmacist assistant to run the store.
I was questioning the pharmacist present at the time of the several of the drugs people came in for. One of them was quetiapine- as one should know- an atypical antipsychotic.
“What class of antipsychotic is quetiapine?” I asked.
The pharmacist replied curtly, “I don’t know.”
At that time, the pharmacist assistant, who is also qualified, hospital nurse, commented that he should know coz he just passed his registration exams a few months ago.
So I continued to ask: “Why do antipsychotics cause suicidal thoughts at times?”
“I don’t know.”
Do you fucking know anything?
Let’s try something else then. “Why do topical corticosteroids thin out the skin?”
“I don’t know.”
How much did you bribe the examiner to let you pass your registration exams?!
Ok, so I dropped that topic. So I asked about shingles. “I heard shingles is called herpes zoster, but it’s caused by the varicella virus. So does that mean herpes and varicella virus are the same?”
Again, “I don’t know.”
The pharmacist did not look at me the entire time, so I looked at the computer screen he was typing away at. He was on Wikipedia searching up shingles.
WIKIPEDIA.
SURELY, THERE ARE MORE RESPECTABLE & TRUSTWORTHY REFERENCES TO TURN TO? ALL OF THEM HAVE AN ELECTRONIC VERSION AVAILABLE. MEDSCAPE. AUSTRALIAN MEDICINES HANDBOOK. MIMS ONLINE. THERAPEUTIC GUIDELINES.
“I don’t know anything. Stop asking me questions.”
That’s exactly what I did. So for the rest of my externship that day, I didn’t ask any questions. This incompetent pharmacist went on to report me with an “attitude, and is not willing to learn”.
Oh wait, what? So did not see that one coming.
I have seen a variety of pharmacists in the professional field over the three years I’ve been studying and working in pharmacies. I’ve seen the best pharmacists who are able to treat palmoplantar psoriasis and various skin conditions better than doctors can. I’ve also seen the negligent; one pharmacist gave out Nurofen Plus to a patient with an active peptic ulcer just because they requested it by brand. Even with my incomplete education, I know that I should have offered an alternative, perhaps paracetamol [acetaminophen] for your headache?
The pharmacist I worked with during my externship rivals the worst pharmacists simply due to his knowledge gap. I don’t think customers realise it because all he does is assume the doctor has given all the instructions to the patient, so he doesn’t have to do it, and most customers are regulars so they’ve been on the medications for many years.
Being a young pharmacist isn’t an excuse for being ignorant. Pharmacists are the second most respected profession [second only to emergency workers] so don’t tarnish our reputation!
Random Musings Concerning The Last Week’s Pharmacy Meanderings
1. Monday, I had a lady come up to the counter and ask where I carried the "Lacklend, Lacklyn, or Lacklin -- something like that." [I asked her for some possible spellings] After searching, I was pretty sure she was looking for Lac-Hydrin...possibly Lansinoh which is Lanolin. I presented these findings to her along with a product list of the various sizes of Lac-Hydrins. At this point, she became adamant that it was "LackLend" and that I wasn't looking right. At this point, I told her I thought I remembered them having the product on sale at a specialty pharmacy that is about 45 minutes away. Since she didn't bother to call me, I can only hope she drives all the way there to get the product. Either listen to reason or get told complete bullshit.
2. Had a very rotund person (never seen her before -- so not a regular) came in and ask me about getting a shingles vaccine as she did not want to catch it from any of her friends. I told her that it was in no way contagious. She goes on to say that 2 or 3 of her friends have it or have had it and that her doctor told her that "IT. WAS. CONTAGIOUS!" I told her that "I will back off my previous statement a very small bit -- If a person comes into contact with a shingles rash, for instance if they are covering the wounds and come into contact with the actual seeping wound, they could potentially catch CHICKENPOX if they had not previously had CHICKENPOX or the CHICKENPOX Vaccination. Shingles, meaning the form of chickenpox that comes back up later in life and causes serious pain, cannot be transmitted from on person to another." [Source: http://www.immunize.org/askexperts/experts_zos.asp] Her response was a steadfast, "Well, my doctor doesn't agree. He says you can get it from anyone that has shingles on their skin or has ever had it."
At this point, I once again took the position of not giving a fuck. Either listen to reason or go away. I told her, "If your doctor is telling you this, and he is serious, I think you need to get a new doctor. As I can print out several different papers and references in just a few minutes that would disprove that notion."
Her response was, nothing less than I expected, "Maybe I should get a new pharmacist..." I just sad, in a trailing voice but loud enough for her to full figure out what I PROBABLY said, "I think you should do that you stupid fat bitch..." Believe me...she was being a standoffish, stupid, fat bitch.
3. Had a lady come to pick up a refill for, of course, Xanax. It was later in the night -- slowed down immensely. I was completely caught up and actually listening to the radio a bit. She came to the pickup window, I looked up her name and immediately saw that we had requested refills, and we had not heard back. She looks me right in the eye and says, "Is it in you box? I mean...can you check your box?...Is it in your box?" I really wanted to say, "Why no, have you checked YOUR BOX? I'm sure we could hide a set of car keys in there!" Instead, she goes into a long diatribe about how a 3 months ago she came to pick up her refill and we told her it wasn't called it...only to find out that after she drove "all the way to the doctor's office," [a gas-chugging 4-5 minutes away] "it was sitting on the counter as there was a problem with it." [The doctor faxed it back sans signature] So, I stand by the statement that the doctor hadn't really done his job! At that juncture, we had faxed them back for ANOTHER Auth. Today, I told her that our inBOX didn't receive prescriptions (just email). She asked me to check our voicemail BOX, and I told her I didn't need to as our number of VMs is displayed on screen [I had ZERO]. No other BOXes to check...cept yours, biggun'!
Your refill? Yeah, it’s too soon
This is a guest post from a technician known for now as J.S. -- s/he will be responding to all comments as necessary. Should you want to send a private email, please use the CONTACT Page and I will forward it on to him/her.
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"REFILL TOO SOON," GUYS. That means, in pharmacy lingo, your insurance will not pay for your prescription until the resubmit date. One late night at the pharmacy, which by the way is in the ghetto, a woman comes in to refill her son’s prescription. As I processed the prescription I explained to her that it is a REFILL TOO SOON and the insurance wouldn’t pay for the refill until tomorrow morning. She obviously wouldn’t accept that answer and went into a rant against me (a technician), the pharmacist working with me, and our drug store. As I recall it went something like this:
“My baby needs his medication! He is sick! He needs it NOW!!!!! You stupid white bitch you had better fill my prescription or im going to kick your ass! Her's too. That other bitch pharmacist! What you think yous better than me? I want it now! Ima get me suma that shit now and my momma gon' pay for it! Make it now! Get it ready, Bitch!”
I looked at her, looked at the pharmacist, and explained to the woman that if she would WAIT ONE MORE DAY [less than 18 hours, actually], the prescription wouldn’t have copay because this woman was on state assisted insurance.
I told her that the medication would be $45 and if she wanted it, she could pay for it, but that amount wouldn’t be refunded the next day. Her response, although not responsive to the information, went something like this:
“What you think I’m broke, bitch? I can’t pay for my babay's medicine? Fuck you ima just buy it ima just buy it you can’t tell me what to do, this my babay, THIS MY BABY AND HE NEEDS HIS MEDICINE NOW GET IT READY DUMB BITCH.”
You're not broke? Oh, okay. Then I guess you’re just one of those lazy folks who doesn’t work and just expects the government to pay for your prescriptions. I can safely assume you are probably on food stamps too? Welfare? You're yelling at me, and I am partially paying for your prescription by paying taxes? I have no choice but to have my tax dollars used to pay for “your babay's medicine,” and I have no choice but to abide by your every wish and want because 'the customer is always right,' right? So, I swallowed my insults, and I bottled my anger, and filled the prescription.
By this time, her mom (the "babay's" grandma) came to the counter and apologized profusely with the accurate explanation that woman was mentally retarded. MENTALLY RETARDED. And she has children? What the fuck. You can draw your own conclusions on that one. And by the way, after all that, she didn’t, or better yet, her mom didn’t buy the medication because she, having some sense about her, WANTED TO WAIT UNTIL THE NEXT DAY. By the way, the drug was for SEASONAL ALLERGIES. Not seizures, not juvenile diabetes, not horrible psoriasis, not dangerous asthma, not epi or glucagon. SEASONAL ALLERGIES. Couldn't wait 18 hours, and *I'm* the dumb bitch.
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Do you want to submit a guest post [since I don't post nearly enough]? Type it up and email it to me via the same contact page. Also, let me know if you want your name/email address shared publicly, what POLL question you would like to accompany it (if any), and anything else you think is important. Guest Posts will be edited for grammar and spelling. I may also add emphasis, clarification, funny links, or other silly stuff [I might remove inappropriate stuff as well]. I will NOT alter the content/message of your post.
How to comment
I'm tired of randos coming to my website and submitting bullshit comments to various posts. I've got better things to do than delete 3-5 comments per day calling me an asshole, a meany head, or questioning my professionalism/ethics (and then banning the user)...as if you reading a vague story about a drug seeker / drug shopper compromises THEIR privacy. As if ANYONE reading these stories can find out what state I'm even in -- much less a patient's name. That's just not possible. Considering that I'm not a complete idiot, I change facts, details, and other things to keep the backbone of the story without making it so obvious as to the subject and subject matter. The person fingered in the story wouldn't even know they are the subject matter in 9 of 10 posts.
I get talked to like I'm a piece of shit all day. I'll be damned if I'm gonna come home and take e-shit from some nameless fuck over the internet (I do realize the hypocrisy of using the term 'nameless fuck' as I am one). But, what I mean is, people stumble upon this site and give me shit -- non-pharmacists, non-healthcare workers, nobodys. I'm not that bad. I'm not a horrible person. Some of this is a joke. It's an act. It's a persona in some ways.
I do (or envision and reimagine) the things that you want to do but can't. A favorite comment from these nameless fucks is that I would/should be fired in their business for doing X or saying Y. Who are they to judge me or question what I do.
I can't fully express how much this pisses me off. Nor can I adequately express how some of these hatred and anger is misplaced. I'm not a bad guy. I'm not an unethical dick. 'You' just don't like THAT post.
Now, don't get me wrong -- I'm not deleting these comments because they person questions my judgment or doesn't like what I did. I can handle a dissenting opinion. That's not the issue. I would be FINE with that. But, I've yet to have a dissenting opinion posed in a professional manner worthy of being posts. For instance, in response to, "Unfortunately, this is a true story" I got the following comment:
"This was written in a humorous way I’ll give you that.. Guy sure was stupid LOL!! I would fire you ASAP but I suspect you probably own or manage the pharmacy in the story, which is even more repulsive. You sir sicken me, and should be ashamed of your profession."
Now, do you see how that has no point? That serves no purpose other than to push me down (as well as the profession of pharmacy. Now, I can accept that this situation could have been handled a different way. But, unless you present a clear and concise rebuttal without resorting to belittling me or our pharmacy, I don't give a fuck what you have to say. Now, you don't have to be a kissass, but you can bring about a different POV without being a prick. Here's what you could say:
"While I agree that was frustrating, you handled it dead wrong. You're a pharmacist and obviously have some education. Not everyone in the world is a smart as you. Some people need things spelled out to them. Some people have learning disabilities. Did you ever things of that? Did you do what they taught you in school and ask him to show you how he will use the inhaler after you educated him? Oh, I forgot, you barely did educate him. This situation is nothing but a failure of a pharmacist to counsel a patient effectively.
See how that works? With a little cunning, you can tell me I'm wrong, pose your opinion, maybe even take a jab at me, have your comment posted, and not get permanently banned from my site WITHOUT BEING A SNIVELING PRICK. I'm not saying you can't swear. I'm not saying you can't question me or what I did. Just don't be a jerk. Don't attack me -- unless it is REALLY fucking funny and REALLY fucking good.
So, how do I remedy this? I thought about deleting all comments and blocking all future comments/discussion, but I value that input from fellow pharmacists and technicians. Instead, I've decided to require registration. That means that initial registration will require a name, verified email address, and maybe some other information as I see fit (such as an acceptance of terms of service). Then you can post comments on the site. After a certain number of approved comments, you will get the ability to post comments that skip my moderation -- after earning trust so to speak.
http://www.theangriestpharmacist.com/wp-login.php?action=register
We'll see how this goes for a while. Maybe a little bothersome registration will prevent assholes from doing what they do best.
TAestP Twitter
- Does anyone else find it sickening that more than 1300 people give a shit what my thumbs say here? I'm proud and amazed. 8 hrs ago
- Another show that I think is funny: MTVs "I just want my pants back." So, I'm 18. Fuck me. I just like the show. Watch it. Or don't. IDGAF. 9 hrs ago
- Anyone that doesn't love #TheFinder GFY! 1 day ago
- "I'll do anything! I'll get in my bra and you can throw nails at me..." 4 days ago
- I don't know exactly why but I fucking love #FranklinAndBash 5 days ago
- Ok. I'm thoroughly impressed with #TheFinder on Fox Thursdays -- everyone should watch and/or DVR. 1 week ago
- Bitches be triflin'! That bitch said she wanted some. Then what happened? I had a drink and she fell asleep! Bollocks I say!!!! 1 week ago
- It does wonders for my funny bone. 1 week ago
- More updates...
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