The Pharmacy Chick

With apologies to the shoe company with the swoosh logo, I am sending out this challenge to all you pharmacists who CAN vaccinate:  DO.

About 5 years ago,  the state I live in  decided to allow pharmacists to vaccinate.  I was slow to jump on the bandwagon by one year.  I took the wait-and-see stance before I plunged a syringe into somebody’s arm.  One year later found me in a class learning proper technique (which I already knew from my nurse-mother-who-needed-allergy-shots-for-years.  Somehow I knew that this would be a good thing for my business and profession.  I was right.

I started out with flu shots.  I was nervous as a cat at my first clinic.  I was convinced that some yo-yo would faint on me.  Nobody did, and 10,000 shots later, nobody has fainted on me yet, although a few smart alecks ask me if they need to “bend over”  Uh, no thanks.

A surprising thing happened however–customers looked at me different.  I ceased to be the pill-counting machine they thought me to be.  They discovered I had hands that did something different  than just fill prescriptions, ring up sales and hand them the bag.  They touched the patient!   They discovered I had a lap that sat next to them, even if its just for a minute.  They found out they could have my rapt attention when they had an appointment for a shot. No competition for the phone/pill tray/cash register/and every other customer.  One on One for a few precious moments, eye to eye, sitting next to them in a chair.  This was something they had never seen me do: sit.

They also discovered that I could provide a service that had been previously monopolized by the Dr’s office. I was soon vaccinating pneumococcal, TD, Hep A, Hep B, Meningococcal, and others. 

How I was perceived by these people changed.  An interesting observation:  Joe hands me a prescripiton for DrugX and asks how long it will take.  I tell him 15 minutes and he balks “THAT LONG?”    Steve comes in and inquires about a Tetanus shot.  He asks how long it will take: 20 mintues “THATS ALL?”  It seems that all it takes to increase the respect quotient, is a sharp needle.

Vaccinations are also a cash cow, if you pardon the expression.  For the most part, vaccinations are a cash transaction.  For the few insurances that pay for the vaccine, we charge an administration fee.  “Unless you’d like it to be self serve” I jokingly ask..So far no takers. Its one of those rare instances where we get paid for the service aspect of this profession.  As you all know we give out our advice for free, something no other profession does.  When was the last time you walked in to Dewey Cheatham and Howe Law firm and asked them for free advice?  Or,  walked into Cutter and Stitch Health clinic and got free advice about that rash on your leg.  They’d just hand you their rate sheet (or worse yet, laugh at you and tell you to come back when you have an appointment).  We dont get that luxury.

I do some walk up vaccinations.  Treated like a prescription, they are qued like every other.  However, when fall arrives, all vaccinations are done on a purely appointment basis since I am doing flu shots all day as well.  I can schedule 2 shots every 1/2 hour around my regular work in the pharmacy.  The advantage to this is many-fold.  First off, you know your work load. Secondly, the patient knows exactly when he/she is gonna get their shot.  Thirdly, the patient learns a new habit (scheduling an appointment with the pharmacist).  Yea, we do our walk up clinic twice a year, but over the years, I have seen more and more people eschew the clinic for the appointment basis because they no longer have to stand in line. 

If you are a young pharmacist,  Pharmacy Care is your future. If you are an older pharmacist Pharmacy Care is your chance to do something different.  Your techs can do everything but actually stick the needle in, so they learn something new also.  It would seem that mine actually argue over who gets to fill the syringes in the morning.  note to self: apparently there is a cool-factor in syringe filling…

Actual Story repeated over and over:  Pharmacy chick is used to interruptions.  Most come from people with blinders on “Can I ask you a question?” they ask as I am clearly helping somebody else and many get indignant if I tell them I will be with THEM when I done HERE.  Take the same situation, but with a tray with a needle in it.  “Can I ask you a question?” “I will be with you as soon as I am done here–I am about to give an injection”.   “Whoa, Sure, no problem, take your time”.

Its good to be the holder of the needle.

But in all seriousness,  vaccinations help your patients, and help your business.  They also improve your visibility and your credibility as a health care provider. Lastly they are actually fun. And we need a serious “injection” of fun into our profession don’t we? (ok, bad pun).

|

Mr and Mrs Chick took a few days off recently to get some needed home maintenance done.  Actually we are doing a kitchen gut and redo and we decided to be our own paint contractor.  (note to self: painting a ceiling is harder than it looks).  ANYWAY,  this required spending some quality time at home with the radio on.  Normally I don’t listen much to the radio.  I catch the news and traffic in the morning, and listen to all of about 10 minutes of Christian music on my way to the store each day. 

When we were painting, the radio was on for hours at a time.  I began to detect a trend in the ads that repeated themselves throughout the day.  I have deduced that the quantity of the ads seem to be inversely proportional to how much I need what they are trying to sell me.  Hang on with me here and you will see what I mean.

There seems to be an abundance of 4 kinds of ads on the radio lately: 3 of which (to me) are virtually worthless.  Here they are in no particular order:  supermarket ads, new car ads, mortgage refinancing ads and mattress ads.  

 Now I can understand supermarket ads–we need to eat food daily, and unless you are a survivalist who grows your own food, you probably visit a grocery store at least weekly, if not more.  Its a competitive market out there and they grasp for every sucker…er customer…they can get.

Its the other three that I don’t understand very well.  I have a car, a mortgage and a bed.  These are not things that I replace weekly, monthly or even yearly!  I have driven the same car for 8 years. Mr chick has had his for 12 years.  They work fine, they are paid for and I am in no hurry to buy something newer EVEN IF I GET 0% financing and free oil changes for life or what ever else they are promising me.  I hate shopping for a car, as most  car salesmen are weasels dressed in a cheap suit. ( Forgive me if there are any honest car salesmen…all 2 of you).

Secondly,  my mortgage rate is fine thank you.  I wasn’t stupid enough to purchase a home I couldn’t afford and I made sure that I always knew what my interest rate would be, and I didn’t lie on my application about my income to get a loan too big for my britches.  I’ll bet I hear a dozen ads every day telling me what a GREAT TIME it is to refinance my home and get money for that great vacation or home improvement. What a crock.

And lastly, I have to wonder,  what is it about mattress companies that requires them to run 100 ads every single day on the radio?  Are they trying to convice Americans that mattresses need to be changed with the sheets? It would seem so.   “Replace your old mattress with a NEW SleepComfortTempurPostureNumber Bed! You’ll sleep so well, an atomic blast will nary stir you!”   When we moved a dozen years ago, we decided to “invest” in a quality bed.  To date it has served us well and by all accounts I still sleep comfortably in it without any pain or discomfort. 

 The only thing I would change?  Get a double KING so the dogs would leave ME a place to sleep.

Tags: a whine a day keeps what away?, non pharmacy life, whats up with that? | |

The coming of fall always makes Pharmacy Chick wax nostalgic to her college days. Already I am seeing Back-To-School ads and kids in the store haggling with their parents over backpacks (why do they need a new one every year?)  I have to be honest, it took me a good 5 years after graduating before I got over the feeling that I should be GETTING READY for fall classes. 

I remember my early days in pre-pharm:  agonizing over whether or not I would get the classes I needed (back then we had something called Arena Scheduling:  we were let loose in the gym like a stampede based on our last names into a giant arena with tables that corresponded with departments.  If you were smart you would rush to the classes you wanted/needed the MOST to sign up–first-come-first-served.)   If I was lucky enough to get the classes I needed, I would then hike it over to the bookstore to load up on the books. It was important to get there early for two reasons: 1) the used books sold first and 2) sometimes they ran out of the books.  If I had to buy new, it cost me more, if I didn’t get the book at all, I had a major problem.  Then at the end of the quarter I’d rush back to sell it back to the bookstore, for if they had enough they’d quit buying them back.  What a racket–they’d pay us squat then sell them for a lot more.

However once I got into Pharmacy school, 2 things changed: 1)  my books cost a hell of a lot more and 2) I couldn’t sell them back!  I had to keep them “for reference”.    This stunk on a whole bunch of levels.  Selling my books back helped me pay for the next quarter of books, and not doing so hurt my budget big-time.  In addition, there were seldom used texts I could buy, and it seemed every professor would pick some new edition  that would require the purchase of a NEW book. 

What pharmacy student didn’t have Goodman and Gilmans- The Pharmacological Basis of Theraputics?  I even had to buy a NEW Remingtons because I was “lucky” enough to be a student when they had a new edition.  By the time I graduated I had hundreds of pounds of books, from Chemistry (medicinal, general, bio, and organic), Theraputics, Pharmacology, Anatomy and Physiology, Law, kinetics, the Merck Manual, Grey’s Anatomy, Microbiology, pathology, and whatever -ology else I had to take.  I even had to buy The Principles and Practice of Medicine (as if you could condense it all in one book).

So, Pharmacy chick graduated, and along with her diploma, hauled all these books to her first apartment, then to her first house…then to her second house.  Once a year or so, I would visit the library upstairs and dust off the books. I didn’t however ever open them.  There was no reason to.  Every piece of information I would ever need in practice was accessible from reference texts at work.  But for some reason I couldn’t ever get rid of them.

Until one day.  Mr Chick and I decided to paint the Library.  It involved clearing the shelves and for the first time in many years, I had to handle every single book I had ever placed on the shelf.  At that time I decided to “thin the herd”.  Not only did I pitch some old books, but I cleared out a bunch of other stuff as well.  Goodbye went all the chemistry books,  the micro and path books, Grey’s anatomy, dosage forms (I think I got that one pretty well covered).  I have no idea what Goodwill will do with these books, but I thought donation was better than garbage. 

I have to admit however, I still have some.  I still haven’t opened them, but for some reason I still cannot say goodby to the select few.   Its kinda pathetic–how is it I cannot part with these few?  I wonder–does Ole Apothecary have some if his books molding in his bookcase?   Does TAP and TAestP have a secret stash of text books from their college days? Does Mike ever reference his old texts?

Well if they don’t, and they ever need to read up on Theraputics, I have Goodman and  Gilman’s….still.

Tags: cleaning house, non pharmacy stuff, olden days | |

Pharmacy chick logged in today to see that blogpharm as changed its format. Because I am a major techno-phobe, I dont appreciate having changes made to my computer stuff or my internet experience.  I mean, its taken me months just to figure out how to put a picture on my blog and now everything behind the scenes has moved.   Did anybody ask me?  They should have since I am one of only about 5 bloggers that use Blogpharm.  Harrrumph!  I cannot find squat on the composition pages.

I am the same way at the pharmacy.  Change some policy, some procedure, or move some of my stuff and expect some fall out.  Occasionally I won’t comply at all but don’t tell anybody about that.  Every evaluation I get has some comment about my “resistance to change”.  You’d think after 16 years they would give up.

Its been really bad lately in PC’s Pharmacy–We are being micromanaged to death.  Somebody at corporate is trying to justify his job. Every little movement is tracked, monitored, evaluated, then “improved”.  I suspect I couldn’t even pass gas without somebody offering a better way to do it. No longer is the end product the important issue, its all about the PROCESS–and uniformness.  After I unloaded a particular diatribe on the boss,  he exasperatedly asked “Why do you do this?”  I said.  ” I find it much more satisfying to complain than to comply without question. WHY do YOU keep doing this to ME? ”  ( it IS all about ME you know..heh heh) Lets put it this way: The sun rises in the east, sets in the west and the Chick hates change.   Except one.

Give me the winning lottery numbers and I’d be happy to CHANGE my employment status,  CHANGE my residence,  and make some major lifestyle CHANGES!

Til then, don’t mess with my stuff!

PC is checking out for a few days- time for some R&R with Mr Chick in the mountains, hence no computer, no posting, no email!

Tags: pharmacy life, ranting and feeling the squeeze | |

What is it about summertime that turns people’s brain to chowder when it comes to fashion sense? Since Pharmacy Chick sees a bazillion people every day, I’d thought I’d share some of my own observations of shoppers who passed by in recent days. I swear some people get dressed in the dark…

1. Fat chick in Tube Top: Unless you are 6 years old or disappear when you turn sideways, leave the tube top at home. In fact, why not turn that thing into the rag that it is? I cannot believe anybody ever thought that taking an elastic cylinder of fabric, wrapping around a woman’s midsection and calling it fashion was a good idea. One rogue brat with an attitude and we’ll have the mother of all wardrobe malfunctions! PS Nice rose tattoo by the way

2. Same Woman, bottom half: Form fitting skin tight spandex looks really good on models in fitness magazines…and prepubescent teens . It looks especially scary when I can see the polka dotted underpants underneath.

3. Bra’s serve a useful function. Use one during all four seasons. They come in all sorts of fancy colors and fabrics now. They are practically artwork. Nobody wants to see your flabby breasts. This lady came in and to say that she is big-boned would be an insult to big bones everywhere. She was F.A.T. She heaved her flabbiness on my counter (too tired to stand up?) to ask a question. She had on a stretchy tank top (see previous observation) and nothing else underneath. I have no recollection of the conversation, but I’ll never get over the view.

4. Short-shorts. Lets add just a few more inches please. I’d rather not see your cheeks under your home made cut-offs. AND, Mr Mid-life Crisis, those running shorts from the 80’s looked great 20 years ago when you actually ran. Now that you are flabby and 50, you just look goofy. Buy some bermudas or cargos.

5. Muscle shirts: Unless you have been recently selected for the cover of a fitness magazine, chances are you aren’t the hottie you think you are. You are all sweaty and stinky and I am grossed out by all that shoulder and back hair sticking out. Jane Goodall would hand you a banana. Put a T shirt on.

6. Bikinis in the pharmacy? Wear your beach wear at the beach. Pharmacy Mike might not agree with me on this one (heh heh) , but then again he might especially since all that pizza you ate during the winter resides comfortably on your hips right now.

7. Nylon hose under shorts? WHAT?….and WHY?

8. Socks OR Sandals, not both…unless you live in Montana where I understand socks are usually worn with Birkies.

9. Miscellaneous faux pas: Dark dress socks with tennis shoes. Shorts with dress socks and loafers. Boxers or briefs? I dont care, just keep them INSIDE your shorts please. And if your stomach protrudes more than 3 inches over your belt, kindly have a shirt long enough to cover it up. AND, speaking of shirts, wear one when you come inside the store.

10 Bare Feet. I am sorry, perhaps I come from another era where ” no shirt, no shoes, no service” was on the door of most places, but it seems that I see an awfully lot of bare feet running around. Not only is it unsanitary but its unsafe. There’s a lot of nasty (sharp) stuff that ends up on the floor of a store and in a parking lot. If you cannot stand the idea of shoes, flip flops will do. Once I heard a shriek down the aisle. For some odd reason a lady shopper gave her toddler daughter a big can of tomatoes to hold. She didn’t hold them for long and dropped them directly on the foot of her mother (wearing only a flip flop) Cut clean thru the big toenail. I bandaged her up as best as possible and sent her to urgent care. 2 hours later she came back with rx’s to fill and said “The dr said you did a good job with the bandages”…yea me.

Any other visual offenses YOU’d like to share this summer?

Tags: non pharmacy stuff, nothing else to do, scary fashion | |

Pharmacy Chick is not the techno geek that some people are. I do however have a failsafe security measure on my laptop that makes it impossible for the un-informed to boot it. Because its old, there is some short in it someplace. I have to perform some kind of squeezing/massage exercise on certain places of the unit in order for it to “connect” and boot. Otherwise, the darn thing blinks at me for a few seconds and remains dead. Therefore, If I disappear for a few weeks, you can bet that the massage no longer works and PC had to buy a new PC! haha…

However, the Chick did indeed had to buy a new cell phone, and in doing so, learned 2 valuable lessons: 1) cell phones do not float and 2) they do not like to get wet.

I rarely have to carry the thing, and when I do, its usually because I have one specific call I am waiting for or My Man Friday is on vacation so I make myself available for the relief pharmacists in case of an emergency. This particular day was such an occurrence. I had to visit the bathroom and against all conventional wisdom I put the phone on the back of the toilet. As I flushed I picked up the phone, and bumped the toilet lid. Bad move. It dislodged my phone from my hand and unceremoniously dropped into the flushing receptacle. As fast as you can say “expensive plumber visit” I had my hand in the bowl retrieving the phone. There are worse things than having to pick a phone out of pee-water, one of which was telling Mr Chick what I did. “Does it work?” he asked. I tried to make a call on it but nothing happened. Once I succeeded in turning it off, it never came on again.

Thankfully I had owned the phone for the prescribed contract so I was able to upgrade for free. My new phone has a camera on it (I never use) and can text (I dont know how). If I pay a lot of money I can read my email on its teeny tiny screen also. I did not opt for the fancy I Phone style. Remember, PC thinks cameras should take pictures and phones should make calls.

When I upgraded my phone the cute sales clerk asked if I wanted to donate my old phone for the women’s shelter…uh, no…not this time thanks.

Tags: cell phones, mistakes, non pharmacy stuff, personal life | |

Every now and then we have a day that causes us to check the calendar to see if its a full moon. This day was one of them. She was in her 30’s, a yuppie type lady with high heels under a smart suit. She handed me a prescription from a clinic very nearby. She was not in my computer so I collected the basic bio-data from her and told her it would be ready in 20 minutes or so. “Oh no”, she said “I dont want to fill this here. I want it at the 99th and Standish store next week” (insert blank look here) I told her that if she drops it off HERE, it wont be THERE next week, it will be HERE at the 12th and main location (where she is NOW). She exhudes a look that says “can you be THIS stupid?” and said “Can’t you call this to them?” Just being a tad pissy that day I responded with “Cant you TAKE this to them, since you want to pick it up there anyway?” She huffily responded “I don’t have time”.

OK, lets recap. Miss I-dont-have-time drove a prescription to a pharmacy she didnt’ want to fill it at to put it on hold so WE could call somebody else next week to fill it elsewhere and she could drive and pick it up there. Perhaps I am missing something but wouldn’t it have been just as easy to have Dr Wonderful pick up the phone, call 99th and Standish, have the rx filled there? Just a thought.

I put the rx on hold and forgot about it. I have no idea if 99th and Standish ever called. I don’t care.

Tags: customers, pharmacy life | |

One of the things Pharmacy Chick thinks is important is the presentation of the prescription given to the patient. I do not like wrinkled tape on the label, the labels crooked on the bottle, and I don’t like to have mispellings. I cannot tell you how many times I have sent a label back to be retyped because pain was spelled “apin” or THE was spelled “hte”. To me, having something spelled wrong tells my customers ” I do not care enough about this process to handle the details and do it right”

Therefore when I got (for the thousandth time) a prescription given to me with the prescribed drug spelled incorrectly, I had to shake my head. Care to guess which two drugs are mis-spelled most of all? Vicodin and Percocet. Give me a break! These two drugs are so common that even the most newly hired medical assistants should be able to spell them correctly.

So why then, do I still see Vicodan and Percoset? What does that say to the patient when the physician’s office gives him/her a drug that they seemingly cannot even spell right? Its not like we are having them spell Afluxihydrodoxyaminodinodab (don’t bother looking it up, you won’t find it). I have seen Vicodin spelled wrong so many times that “vicodan” starts to look normal…

There are times I wish I could just hand the script back to the patient. “There is no such drug”, but for obvious reasons I can’t do that. So I just decided to add it to my gripe list….and blog about it.

Tags: pharmacy life, rambling | |

This morning as I padded sleepy-eyed from the bed to the dresser, I commented to Mr Chick “Today’s going to be a good day!” He asked why and I said “Because its WHITE sock day” We both had a little chuckle because we knew exactly what it meant.

The Chicks do not have a large diversity in the sock drawer. We have a drawer of white socks and a drawer of black socks. When I draw from the black sock drawer, it means I have to go to work. When I draw from the white sock drawer, Its a play day. Today is a WHITE sock day. Poor Mr chick. He put on black socks today

My only exception is this: If I ever make it to Boston, I’ll be RED SOX all over! Boo Yankees.

Peace!

Tags: drivel, letting you in to my life, non pharmacy stuff | |

Going to work on a monday is like beating myself over the head with hammer. It hurts, but for some stupid reason (money??) I keep doing it. You’d think that after a while, I’d get out of the way of the hammer.

Since people who receive faxes from pharmacies probably look at them for 7 nano seconds before passing them off, I have tried to dumb them down to their basic components. I try to use simple terms (first grade) and sharpies to make my point. TWICE today, it was ignored like I was writing sanskrit or something.

Case in point number 1. We asked for a refill for a patient for 90 days supply of Atenolol 50mg She had been on 1/2 tab BID, #90. A couple of hours later a prescription was faxed for same lady for Atenolol 50mg #90 1 po BID. with 11 refills. Because this was inconsistent with what we asked for we sent it back for clarification “Did you intend to change directions from one-half tab twice daily to one tab twice daily?” Please Verify and fax back. … A few hours later we got yet another prescription from the same office–no note, nothing, Atenolol 50mg #180 1 po BID….with 11 refills. First off, do they have any idea that they just ok’ed refills for this woman for 36 months? Secondly, they did not specifically address my question. The other pharmacist said “Fine, it will be filled as written and the patient can talk to the dr if they disagree, just make sure they know whats been changed”

Case in point number 2. Armour Thyroid is on backorder in all strengths. We gave Mrs Jones the last 5 of the 120mg tabs (1qd) we had over the weekend. The patient asked US (not my job) to contact the dr to find out what she should do. We send over a nicely crafted note that said in summary ” ALL Armour thyroid is on back order, is there an alternative you’d like to use in the mean time?” He faxes back (God’s honest truth here…) Use Armour thyroid 60mg 2qd. Brilliant…Hello? is there anybody in there? Can you read? I’m not an ignoramus. If I HAD 60mg Armour, I’d have used it….

It was such a Monday…

Tags: doctors, pharmacy life | |