"Mo' money, mo' tacos"
Right.....
So yeah. A month ago it seemed like a really good idea to do this shift. As the day drew closer I started looking forward to it less and less. First off, my Sunday night hockey started up a week earlier than I had planned, so I had to miss my first ice time. Also I had to work at the hospital the next day at 7am and that's really craptastic after working till midnight (or midnite) in retail hell.
Also making me dread the shift before even stepping through the door was a call that I'd got a couple days prior from my old coworkers warning me that I might not have a tech for my shift. A year or so ago, when I was regularly working at SDM I could have handled that. But I haven't "counted pills" in basically a year. And that is the one skill valued above all others in retail pharmacy. I've worked a few shifts here and there, but always with a tech, and never at a store as routinely busy as my old haunt. I think I was right to be worried.
So, I got there, and as it turned out, they had found me a tech. That was good. What was less good was the identity of that tech. When I still worked there, she and I had a run-in or 3. I even made her cry once (or twice). Those of you who know me probably can't imagine me actually making someone cry. But it's happened a couple times, to a couple different techs. The names have changed, but the situation has generally been the same.
New tech starts.
New tech doesn't receive enough training
New tech is made to function on their own despite lack of training
Tech does stupid things.
Ren gets mad.
Tech does more stupid things.
Ren gets madder.
Tech says and does a whole bunch of stupid things in a flurry of insanity, ignorance, and incompetence.
Ren (with trade-mark pink face and head) calmly tells them that they have done and said way too many insane, ignorant and incompetant things in way too short a period of time and that he finds their performance unacceptable and that they need to improve in a hurry.
Tech crys and hides in the staff room until Ren's face/head no longer looks like a balding giant pink gum-ball.
Of course there was also one time that a tech placed a basket of drugs to check on top of a different patient's order that I was working on, and I threw her basket on the floor in a bit of a rage. Isn't it just my luck that I was working with that tech. Fortunately though, at the time of the basket-throwing incident, I realized I was wrong, and I had apologized. I think because of this, I had zero tech-related problems during my shift.
Of course this would be a pretty boring blog-post if I didn't have any good stories for you. That's where the customers come in. I hate customers. I like patients. This is why I left retail for the hospital. It is possible to have some patients in community pharmacy practice, however they are definitely the minority. Especially at a SDM on a sunday night. You are not an "integral member of the health-care team". You are the 7/11 of medication. You are open when the place the customer would rather go is closed. The people coming in aren't there because they respect YOU for your knowledge, and expertise and empathy, they're there because they left their shit until the last minute and you just happen to be open. (Wow - I just used all three of there/their/they're in one sentence....correctly no less). That's not a patient. That's a customer.
The first customers that I noticed were a nice couple with the most amazing german accents ever. I'm talking 1950's WWII movie accents. I'm still not sure what they were looking for, but they were at least nice. After all my years working in the NE, I can understand Indian-accented english no problem. But european accents just kill me.
Next customer of note was there to pick up some heart medication for his 5(ish) year old daughter. That would have been all kinds of wonderful if he had thought to call ahead. Problem is, 5 year olds don't get the same dose of heart medication as 50 year olds. Oh yeah, problem 2 is that 5 year olds don't make up a very large percentage of the heart medication market so there are no pre-made pills or syrups for them. So while Dad waited, my tech had to compound up some liquid atenolol for his little girl. When I went to check her work, I noticed that the drug file for the liquid was set up wrong and she was going to get the wrong dose.
Whoever had made the drug file had accidentally check-marked one extra box on the recipe. Just one little box. What could that possibly do? Well, this little box "locks" the quantity of an ingredient for a mixture so that no matter what volume you dispense, you use the same amount of that ingredient. For something like concentrated flavourings this is useful because 2-3 drops of flavour works just as well in a 50ml bottle as it does in a 500ml bottle. However it's not appropriate for the active ingredient. While 2x50mg tablets of atenolol in 50mls makes a nice 2mg/ml liquid, it is no longer a 2mg/ml liquid when you increase the volume to 100ml but still only use 2 tablets. In fact the patient would be getting 1/2 the proper dose. This might be ok for most things....but for a drug that's supposed to keep a 5 year old's heart from exploding....it's pretty unacceptable.
So now I've got Dad waiting, and I'm scrambling like a madman to fix this, and to decide if they'd been given the right stuff in the first place. It turns out that they had.....it was only with increasing the volume for the refill that the error in the drug file showed up. But it's a pretty big error, and I hate to say it, it's one that a lot pharmacists might have missed. Way to go me. Of course Dad was just pissed off that it took so long.
I didn't even see my next customer of note. She was calling in because she had brought in a prescription the night before and the pharmacist on duty got a message that her coverage was terminated. Generally drug insurance issues don't clear themselves up on weekends so I asked how I could help her. She said we must have the wrong numbers on file because her regular pharmacy has no problem with insurance (see how wonderful late-night drug-peddling is), and that I should call them and get her coverage numbers and bill things for her, or I should transfer the script there. Thinking that if we've already taken the time to get her prescription on file we might as well get paid for filling it, I called her pharmacy and asked if they'd share her info. Really they're under no obligation to do this. It's her insurance, and she should have provided us with the up-to-date card so we could bill it in the first place, but I asked nicely and they said they would help out. Well I give her name, and they can't find her on file. I thank them and assume that she told me the wrong store.
I call her back and after a chorus of about 5 people answering the phone one after each other "hello?" "hello!" "hello?" "hello!" "hello?" I got through to the correct person. I told her that "her" pharmacy didn't seem to have her on file and inquired as to whether she gave me the wrong store's info. She then informed me that she has a different last name at the other store and that is probably why they couldn't find her. I told her that it was not "probably" the reason.....it was THE REASON.
I called her pharmacy again and this time they were able to find her file. Funny what using only one name will do for efficiency. They then quoted me the exact same insurance info that I had on file. I'd had enough. I transferred them the prescription. I called and told her that. Since I don't work at her pharmacy I was completely unaware that they close at 6:00pm on sundays and it was already 5:50pm. At least I would claim to be unaware if it ever came up.
My next issue was a problem with a doctor. For the patient he'd ordered a compound of two different creams mixed together. Unfortunately he didn't seem to think it was important to let us in on the secret ratio of the two creams that he had wanted them to get. Since the prescription was dated over a month ago I didn't really go easy on the customer either. "I can't wait till tomorrow, I need it tonight". Gee bud. Maybe you should have brought it in sometime in the last 5 weeks and we could have had this sorted out already. But you instead decided to hold onto it until 8pm on a Sunday night. S.O.L. pal. We'll call in the morning.
My last annoying customer of the night was a woman that I could just tell was in a bad mood as soon as I saw her. She just had that body language that screams "stay out of my way". So of course I hustle up to the counter to help her out. Or maybe I took my time and finished off some filing leaving her to stew for a bit. Negative body language from you results in passive-aggressive retaliation from me. So I finally meander my way up to her and she asks for a prescription for her son. I take a quick look in the new-fills in the drawer and there was nothing there. I look him up on the computer and ask her what is meant to be ready since he hasn't had anything filled in 3 weeks. She says "it's his adderal....we got it a month ago and you didn't have enough". Ah....adderal. For ADD. I'm sure there are dozens of wonderful, patient caring parents whose children suffer from ADD. Unfortunately the stereotypical ADD-kid's mom tends to be a high-strung, multi-tasking, cell-phone-chatting, talking before thinking bitch. So I thanked her for now mentioning that she was picking up an owing and proceeded to quickly find his package.
She then started complaining that her daughter had come in earlier in the day to pick it up along with another prescription but "YOU didn't give it to her". I agreed that I most likely did not give anything to her daughter because I hadn't seen her daughter since my shift started at 4pm, and actually hadn't seen her since I worked there last over a year ago. She corrected herself and shifted the blame from me personally to "you guys". Much better. Psycho! But it didn't matter that much because it was one of us, and her daughter didn't get what she asked for and someone should be punished for that because mommy had to come out at 11pm for no good reason. So then, because I felt like pissing her off as much as possible, and since she is the type to make it really easy for me we had this conversation....
Ren - "So... you're saying that you're upset with us because your daughter came in for two prescriptions earlier, but she only came home with one?"
ADD-Mom - "That's right, it's not the first time that this has happened and this is totally unacceptable."
Ren - "So, you're saying that your daughter came in here expecting two things to be given to her, and she did not notice when she was only given one?"
ADD-Mom - "It's not like she checked the bag, she shouldn't have to"
Ren - "Ma'am, I'm not sure if she forgot to ask, or if we did forget to give it to her, but if your daughter is unable to count to two it would probably be best to not send her in alone for your family's medications in the future."
I thought she was going to spray me with goo after her eyeballs exploded out of her head. Instead she just grabbed the bag from my hand and stomped out.
Seriously....there's one person to blame here. And they're not employed by the store. It's not like we dropped 499 different items on the counter for her instead of 500. And it's not like a fast food drive through where you feel bad checking your bag in front of the window because some psycho ADD-Mom in a minivan is behind you honking because her ritalin-babies are starving. "Move your ass! Ritalin baby hungy! Ritalin baby hungy!"
Nope....this is like going up to the bar and asking for 2 bottles of Pilsner. When they come back to you with your beer, you pull out your fancy counting fingers and hold 2 of them up and compare the number of fingers to the number of bottles. If the number of fingers matches the number of bottles, then you happily pay your money and enjoy your beer. If they only give you one beer then you sulk off with your tail between your legs and tell your mommy that the mean people at the bar wouldn't give you two. Then you cry a bit and say "me hungy!" until mommy makes it all better. Or you grow up a little bit and say, "Excuse me my good man, I asked you for a quantity of beers that match the number of fingers that I am holding up. However I seem to have fewer beers than this and would like you to remedy the situation post-haste." Then you happily drink your beers and go home. Easy.
It's good to work a shift in retail every now and then. It very quickly reminds me why I don't do more.
Posts
