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!
Two months worth of reader email
Sorry, I've been....deficient the last two months. I'm not going to promise any more, but I can tell you this. I will have a response for Mr. Plagakis pretty soon. Don't expect anything revolutionary. Don't expect anything mindblowing. Just expect a clear, concise response. Naught but the truth. I also want to look back at some older posts in which he referenced me about releasing steam (in a hilarious masturbation simile) and how/why the post titled, "Jay Pee catches Wal-Mart peeping through the window" relates directly to all of it...
Below, I'm going to post several different things that came to me via email or the CONTACT link. I'll lead with the user's name, and if you wish to reply to one, just reference that name....or don't...I don't care...
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Liz writes: In the past few weeks, our pharmacy has started checking ID for controlled drugs, scanning in new Rx and scanning in hard copies. All of a sudden, our workload has tripled, but our company is cutting tech help. Is anyone else finding this hard to manage?
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Rodney writes: I work as a reimbursement specialist at an LTC Pharmacy, and I'm writing to share an interesting exchange I've had with representatives at Prescription Solutions over the past few days.
I've had a few basic rejections which, were the representatives at Prescription Solutions even modestly intelligent by today's decidedly low standards, should have been able to resolve with much rapidity. Instead, I got stuck with slack-jawed yokels and embittered, defensive inner-city youth. They turned requests for overrides to simple rejections into drawn out, unintelligible arguments, and once they'd been cornered or otherwise became bored with the exchange, they hung up on me mid-sentence.
I may not be the bubbliest person in the world. On the contrary, I'm frank and to the point, but never did I become enraged, and never did I insult or otherwise disrespect the reps in any way. Prescription Solutions - hell, the insurance industry as a whole - has no shortage of stupid, rude, and disinterested people, but I've never had any with the gall to abruptly hang up on a service call. Now, over the past two days, it has happened to me four times.
Though I feel somewhat vindicated by the fact that return calls yielded exchanges with intelligent reps who applied the necessarily overrides with absolutely no hassle, I am perturbed by this sudden shoddy treatment. I know PS has seen extraordinarily long hold times as of late, what are the odds the reps have been granted free reign to terminate calls from "problem callers" (that is, of course, callers who question the rep's ill-informed initial judgment)?
Any thoughts? Similar experiences?
[TAestP's thoughts: I believe the reasoning behind this is, as always, money. When the question is, "Why?" most of the time, the answer is money. In this case, I'd bet if you timed your calls, you got hung up on at specific intervals....something like 3 minutes, 59 seconds. If the agents keep their calls (or a certain percentage) less than 4 minutes, they probably get higher ratings or a bonus at the end of the day. They may also have rewards/cut offs at 10 minutes or 15 minutes. Of course, the person could have just been an asshole, accidentally hung up, or hung up on you because they are lazy and/or didn't know the answer.]
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Lillian writes: I found your blog a few days ago and I love it so far. From your posts, you seem to know a lot about retail pharmacy so I was wondering if you could answer a question for me: Is it true that the field is getting very saturated, very quickly?
A few of my professors warn us that it will be much harder to find a job in retail by the time we graduate (2016). And I've been hearing a lot of people saying that retail is going downhill.
I know there will be more competition for the jobs in several years because of there are more students going into pharmacy now. And I get the feeling that maybe one of my professors is exaggerating the situation to encourage us to go into other pharmacy fields. But do you think this saturation is something to be seriously be worried about?
For the record, I would try to go into retail no matter what the situation is...I just don't want to be completely caught off guard after graduation.
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Kristin Writes:
Dear TAestP,
I know someone who filled a Rx at a CVS. The pharmacist later called and texted her saying "Remember me from CVS? Would love to get coffee with you some time?--Weirdasspharmacist [sic] " She responded that she wasn't interested. She didn't get any more fills there, but she was afraid of contacting his manager or pharmacy baord because CVS had her information on file and the pharmacist could look it up and perhaps do something scary like stalking.
TAestP, what would you recommend doing?
[TAestP's thoughts: If this is true, it is creepy as hell. You are right that CVS would have the info, and he would have access to it. But, he's already pretty much risked his license by doing this -- taking it from creepy to full on stalking would definitely result in a meeting with his state's Board of Pharmacy. If he is not the pharmacy manager at that location, I would call and speak with the pharmacy manager about the incident. Tell her it made you (or her) uncomfortable and that you would like the manager to give your information to their district manager so he/she can call you at their earliest convenience. Then discuss the matter with the DM. I'd be almost anything this would squash absolutely any issue -- cause that DM does NOT want you making a formal complaint with the board. If he is the manager at that store, call a nearby store's pharmacy manager and do the exact same thing. If this does not get you to an ends that you are happy with -- or you get blown off at any level -- google the state's board of pharmacy. One call to them with an accusation like this would definitely result in an investigation and something would be done. Tell your friend I'm sorry my text creeped her out -- she's not gonna like the photos I'm sending tonight....just kidding of course.....:-D]
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Mike writes: so...i witnessed a patient ingest 90mg of methadone...the patient's prescribed dose was 40mg...i gave him the wrong bottle
i'm getting kicked out of pharmacy school 4 months before graduation...what do i do now? should i submit my resume to the nearest McDonald's?
[TAestP's Thoughts: Either this is untrue and you're trying to waste my time, you're just a general dumb ass, or you have done a ton of other stupid bullshit. Regardless of what anyone may think, there is only one person responsible for what pill goes out the door and into the hands of a patient -- the pharmacist on duty. I don't care if the technician accidentally typed in Oxycodone instead of Omnicef for an infant, I still believe the ultimate responsibility should lay on the pharmacist that verified the prescription. (intentional bullshit and other types of lying and deceit aside -- I'm talking about true accidents by ancillary staff not caught by the pharmacist) However, it does sound like you are in some other kind of facility or setting. Since you witnessed the patient do it -- not sure what that means as a patient should never be handed a pill by pharmacy staff to take -- that changes the role from dispensing to administering which we cannot do (in terms of pills).
If the school threw you out, and this is a true story, you're probably fucked. Sorry dude. I guess you could appeal and plead to the school, but that's the thing with private universities, they can do whatever the hell they want whenever the hell they want. Other than that, see if another school will take you or get a lawyer....or get a job and good luck paying back all those loans....]
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That'll do for now....check back for the next post coming soon....
Should pharmacists get a lunch break by law?
I got the following email from a reader asking my thoughts on lunches for pharmacists. I'm not going to post his name or the store he works for, but you'll get the jist of what is going on:
I've been working for [this pharmacy] in [the Southeastern USA] for many years (5+ let's say). Before that, I spent 12 years at Walgreens. Is there any legal issue in a company not allowing their pharmacists a legitimate, leave the pharmacy, timed, lunch break? Well, legally, it must not be, or they would not be so easily getting away with it. As far as I know, it is the ONLY corporately run pharmacy not giving a lunch break in the state in which I live. All the usual suspects, when it comes to these human rights issues, Walgreeens, CVS, Wal-mart, Sam's Club, provide lunches -- sometimes even within a CLOSED PHARMACY. Do you have any comments? How can I post such a question on your site to ask other professionals?
Well, you did it in the right way. Send your questions, comments or guest articles via the CONTACT Page and I'll see what I can do.
Anyway, readers, tell him what you know. Here's what I know. Pharmacists are sometimes listed as salaried management and therefore fall under different guidelines than your every day cashier, technician, or stocker. I'd bet my bottom dollar that is the case where you work. That's the exact story where I live. Fortunately, I'm able to go sit down, even if just for a few minutes to eat some lunch every day. Even if it's a scattered 15 minutes. I shoot for noon when I know the phone will slow down as the nurses are all out to lunch, and patient's slow a bit too -- at least the ones that have jobs. So, I woof down my lunch. If you can't do that, I'm sorry. Move to another store/chain or transfer to a slower store that would allow you more time in general for afternoon tea...:-)
Anything else for the good of the order?
Helping a young pharmacist establish authority when faced with strong technician personalities
Note: Please visit this lady's website. The Wicked Chemist! She "affectionately" called me a troll, but she likes my posts!
This is a submitted question/dilemma from a young pharmacist known as "M" -- s/he is requesting that the community help her with some professional advice and recommendations from our little blogosphere community.
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As a new pharmacist, I have a dilemna concerning my role/authority in the pharmacy. Since I'm new to the store, I have a lot to learn from the senior techs as far as managing the pharmacy is concerned. In essence, they are actually training me to run the pharmacy. For this reason, I sometimes feel like they take advantage of that, and they do whatever they want. They often come in late and call off last minute. One technician doesn't like to 'fill' so I end up filling most of the scripts, verifying, and then ringing it out as well. She claims she has other stuff to do, which she sometimes does. I can't complain much because she will do certain tasks and help free my ear from the telephone. However, I'm just not comfortable with her not listening when I ask for her to help in filling. I'm trying hard to learn much so I don't find myself solely dependent on them (technicians). So far, I've been nothing but nice to them, and they've yet to call in on my shift. But I know that day will eventually come... Regardless, this has got to stop. We must be able to depend on them as our patients depend on us.
Please help me by providing me some ideas on how I can approach the situation with both my pharmacy manager, other staff pharmacists, and most importantly, address my concerns gingerly with the technicians without alienating them and subsequently finding myself on the wrong end of a string of sick days! I've also got to consider various friendships (or grudges) between techs and pharmacists, or even techs and techs.
Any advice would be most appreciated! Thanks!
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Do you want to submit a guest post or discussion topic [since I don't post nearly enough]? Type it up and email it to me via the 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.
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