Not My Best Day

So, as I stated in my last post, I love giving flu shots (or any immunization for that matter). However, on Thursday I definitely had THE worst experience of my career. I had an eleven-year-old try to bite me! I have never seen a child so out of control. At one point he was hissing at me!  I actually have shoe scuff marks on the wall of my immunization room that are about four feet off the ground. Now this child is not mentally challenged. He is being treated for ADD but this was something else all together. I refused to help restrain him so his mom and sister did while I took a dive between them and got him in the thigh. It really bothered me! Not because he was being forced to get this shot, because children often have to be forced to get what is best for them. It bothered me because now he will never trust me or another pharmacist again. His mother had to be so "forceful" that I'm sure he had some bruises the next day. That's all I need is for his school teacher to ask how he got those bruises and have him tell her "the pharmacist did this to me". We just aren't trained in how to handle these situations. I personally don't have children and have very little patients for this kind of thing but everyone said I handled it really well. The funniest part was that while this was going on in the shot room there was a lobby full of other people waiting to get their flu shot. It wasn't pretty and it wasn't fun. I normally would have given him the Flumist but we have been unable to get any this year. I offered to call other pharmacies to see if anyone else had it but Mom was insistent that I give the vaccine because everyone in the family had come to me and was impressed with how "good" I was. That's nice and I appreciate the loyalty but this was really not pleasant for anyone involved. I have my opinion about why the child acted this way but I will keep that to myself. My whole staff is laughing about it now (as am I) but I really could have done without that experience. It was actually a two day process because he came in on Wednesday and acted this way so Mom took him home. They were back and waiting on me when I got to work the next afternoon. What a way to start a shift!

It's Back!

  Yes, it's back. Flu shot season is upon us. I don't know about the rest of you but I love giving flu shots. I don't know what it is that I love so much but I do. Maybe it's the one-on-one contact with patients. Maybe it's because most of the people receiving them actually want your service (as opposed to that MAJOR inconvenience of our counseling them on a med they've been taking for 20 years). Or maybe it's the satisfaction of knowing that I am helping my community stay healthy thru the flu season. Or maybe I'm just a masochist and like sticking people with a needle, who knows. What ever the reason I love it. I don't love trying to fit it into my work-flow, but I have an awesome staff that makes it run like clockwork so even that isn't too bad. I don't love my company's total, complete concentration on the subject by setting goals and running contests. That kind of thing cheapens the service and takes the professionalism out of it, but what can you do. A corporation is always going to focus on quantity rather than quality. It's up to us as the professionals to put that kind of thing into perspective and coach our staff on proper procedure and not cutting corners just to meet goals or win contests. And, oh yeah, we still have prescriptions to fill so we can't put flu-shot "blinders" on and forget everything else. But taking all of that into consideration, I still love the simple act of sitting down with a patient, talking to them about what they are going to receive then administering the vaccine.

"Whether I like it or not"

   Not too long ago I had two ladies in my store. They were elderly mother and adult daughter.  Earlier in the day the daughter had called asking for advise. Her mother had accidentally inhaled one of her oral meds and it had taken quite some doing to get it out of her trachea. She had a persistent cough and the daughter wanted to know what to do. Of course, I advised going to the emergency department as it was a weekend and her MD could not be reached. So she went to the E.R. and was then in my pharmacy to get some prescriptions filled. While I was filling them I over heard them talking. The daughter said," You know Mom, my insurance company wants me to use mail-order but I just don't want to. I want a pharmacist that I can reach anytime and that I can talk to face-to-face. I come to this pharmacy because that pharmacist filling your medication will tell me what I need to hear whether I like it or not."  I think that was the single most flattering comment I had ever had made about me. This lady trusted me enough to pay higher copays to use a local pharmacy and she trusted me enough to tell her what she needed to hear not just what she wanted to hear. So many times we deal with people who just want us to agree with them; they don't really want our advise. It's good to know that there are people who respect our opinions and advise. It is very humbling to know that there are people making decisions about their healthcare needs based on the experiences and encounters they have had with me personally. That is why I love this job and that is why I go back day after day and put up with the people who don't respect me. Sometimes it feels like no one cares what you have to say and no one respects you as a person let alone a pharmacist, but every now and then God will bring someone your way to let you know that you are valued and respected and that you are impacting people's lives in a positive way. Watch for these opportunities and hold them dear in your heart.

I Am Amazed!

  It amazes me that in this day and age an employer can have policies in place that deprive their employees of basic rights like freedom of speech. I'm not talking about when they are at work, representing the employer. I'm talking about policies that make it a violation to say anything negative about the company or any of its representatives when the employee is NOT on the clock. That's what my employer does. They make it a violation to speak out against any entity of the company on public forums such as Facebook or blogs like this one. Just how is that legal? If what I'm doing is not illegal then how can my job be jeopardized by what I do outside of work? The policy is mute on the point of positive statements, by the way. It's only negative that they want to control. Well, I'm here to tell you that my opinion is MY opinion and does not represent the opinion of any person or entity of my employer. I have a right to freedom of speech in any form. I think there would be a civil suite waiting for them if they tried to deny me the  rights that are given to me by the government of this country. This is not a dictatorship! These so called "media policies" were put in place to protect the company from liable by limiting the statements to the media to those who are better equipped to handle "touchy" subjects, but somehow the policies have morphed into something else entirely. All I can tell my readers is to watch what you post. Most of these policies contain clauses that say if you list your employer, by name, as your employer on your profile (such as Facebook) or have any image that represents your employer (such as pictures taken at work) then you are, in fact, representing that employer with everything that appears on your post. So, I for one, have removed all such images and references from my Facebook page. I refuse to not mention my employer on my blog simply because I post this anonymously and would just like to see them trace this back to me. Plausible deniability anyone?

Ever Want A Re-Do?

  Have you ever thought that you would love to go back to pharmacy school now? Knowing what you do now and not having any of the pressures or worries. I have.
I absolutely love learning and I'll admit I am a bit of a pharmacy nerd. I love reading about pharmacy issues and talking about new things. When I was in school I had alot of pressure and worries both scholastically and financially. I would love to be able to just sit in class and absorb all that I could without the pressure to perform (and compete). It's one of the reasons I am a preceptor because I love having young, ambitious, and somewhat naive students in my pharmacy. It keeps me young I think.
  Anyway, back to the question. If you could would you go back to school just for the enjoyment of it? When I asked myself that question the answer was a resounding "YES!". So I thought about how I could do that without actually, physically being in school. My answer was to buy a book that many graduate pharmacists use to prepare for the NAPLEX and do a comprehensive review. In fact the book I bought is Comprehensive Pharmacy Review which is available through APhA or Amazon.com (the price is the same and with the book you get on-line access as well). I bought the book and the practice test book also. I  started from page one and it is wonderful. I was transported back to pharmacy school, which for me was over 20 years ago. I was actually surprised at the things I remembered that we obviously don't use every day. The book starts out with calculations and has practice problems at the end of the chapter. I am proud to say I received a 92% on my practice test. I have to admit I became nauseated at the sight of the Henderson-Hasselbalch equation. For my non-pharmacist readers, that is an equation that was in our faces from day one of pharmacy school and drilled into our heads like it was the answer to life's ultimate question. How many of us have used it since graduating? Yeah, I thought as much.
 Anyway, I wanted to throw this challenge out to you all. If you seriously love learning about your chosen profession, do this along with me. I know, I know, I am a pharmacy nerd and I probably don't have a social life, or kids or whatever to take up my time if I have enough time to do this, but it's my thing and I'm excited about it. Maybe part of it is nostalgia and seeing that not much has changed when it comes to the education of our next generation of pharmacists. The basics are still the basics. I does beat sitting in front of the television for hours on end.

Spring Is In The Air

Ahhhh! Spring! Or if you live in the South, we go directly from winter to summer. It's HOT! Anyway, I haven't posted in quite awhile because I've been so busy. What is it about springtime that makes people move or change jobs? In the last few weeks I've lost half of my technician staff. Luckily, it's all been for good reasons like promotions and college. I had one tech get accepted to pharmacy school. I like to think I was at least a partial influence on that decision. So, I've been busy trying to re-staff. That is so difficult! A good tech is just so hard to replace. We all know how it is; you get so comfortable with a tech that you can anticipate each other's next move. They know what to expect out of the pharmacists and we know what to expect out of them. It's symbiosis at it's best. When in tune we run like a well-oiled machine. Now I have to replace some of that machine's parts. The whole training process starts all over again. Fortunately, word got out that I needed techs and I have had a flood of phone calls from other stores' techs that have had their hours cut, so I have a good pool to pull from. So, that's what I've been up to not to mention some physical ailments that have been taking up my time. I'll try to post again soon, but for all my readers, I just wanted you to know that I'm still here. I spend alot of time reading other blogs as well. So, everyone have a great spring!

Respect Our History

  This is a short post with just some observations I gained while at a C.E. conference this weekend.  It was great, by the way. One of the universities in our state has a twice yearly continueing education seminar that gives us all of our required C.E. for the year. Anyway, as I looked around the room there were approximately 200 people there. They ranged from pharmacists to pharmacy students to technicians and they represented all types of practice areas. I saw people there from their mid-twenties clear up to pharmacists in their nineties and I realised that this was a picture of our profession. We have bright new minds and we have long standing experience. Personally, I have to admire any pharmacist who hasn't practiced in 30 years but still attends continuing education seminars and is still active in the profession in other capacities.
  One thing that bothered me was that, as I sat there waiting for the program to begin, I overheard some young people behind me ridiculing and making fun of an elderly pharmacist who looked to be in her 80's or 90's.  Of course, they weren't doing it to her face, but to me it was pure disrespect. That woman represented at least 60 years of history and experience in our profession. I can't even imagine the hurdles she had to overcome as a woman trying to make it in a  man's world when she was younger. I wish I would have had the time to sit and talk with her; possibly glean some wisdom. I mean can you imagine the changes she has seen in this profession in her lifetime?! I know that in the 23 years that I have practiced there have been enormous changes. Some good, some not so good, but massive none the less.
  I want to say to those young people that time flies when you're in this game. Soon there will be new grads looking at you like you're their grandparents. Respect your elders in this profession because if it weren't for them and their hard work, you wouldn't be making the big bucks right now. Learn what you can from them as long as they are around. If nothing else, grow up!

Loyalty Rant

  Recent events at my pharmacy have had me thinking about loyalty. What it is, what it isn't and how it has changed over the years.
  I can remember my dad talking to me about loyalty to my employer. He said that loyalty is a one way thing. It's something I show toward something or someone else. It's not a two way deal where I'll be loyal but only if you are loyal to me. Or I'll be loyal until you tick me off. That is not loyalty; that is performance based acceptance which is totally different.
  I guess the reason loyalty to employers has declined is that most people these days work for a corporation that has no "face" to it. It's much easier to be loyal to someone you can see, interact with and voice yourself to. Why is it harder to be loyal to corporations? Well, corporations are big and by being big they employ a large number of people who all have to be treated the same. That means we usually aren't treated like individuals or recognized for individual performance. The person who constantly calls off work is treated the same as the person who always shows up, that sort of thing. Corporations have lots of "management" who really are impotent when it comes to addressing your concerns. They may boast an open door policy for voicing concerns but they don't guarantee that any of the concerns will be recognized or taken care of.  But, still, are these good reasons to drop any loyalty toward your employer? What about loyalty to the actual people you work with. No, they don't have any effect on your paycheck but what about loyalty for loyalty's sake.  Why are so many people in the workforce only looking for what the employer can give them rather than just doing their job. I figured out a long time ago that the only thing my employer owes me is  a paycheck at the end of two weeks because I had worked for it. I'm loyal to my employer because I'm grateful to have a job in this economy. I may not always like how individuals in my company do their jobs or I may not agree with decisions that are made, but I remain loyal because I'm not a quitter. I hung my hat here, so to speak, and I'll stay.
  You are probably wondering why I'm going on about this topic. Well, I have recently been stung a few times by lack of loyalty on the part of some of my staff. For example, I needed a Senior tech and I knew of one at another store who was not getting the opportunity that she wanted, so I asked to have her transferred to my store. She did so and I set about augmenting her knowledge of procedures that was lacking in her previous training. I gave her encouragement and opportunity,but how was I repaid? She was stealing me blind on hydrocodone! I felt betrayed. You may say that she had a problem and I agree. She has a bigger problem now because she will never set foot in a pharmacy again. Okay, so we don't count her. Her addiction was overriding her loyalty to me; got it. The next example is a technician who I also gave opportunities to who previously did not have said opportunities. She used our company resources and time to become certified. The company paid for her classes and for her exam. How did she repay that generosity? As soon as she became certified she took a job with an insurance company doing prior authorizations. Oh, she still wanted to work for us but only one day a week. That, my friend, is ingratitude! It made me look bad because I recommended her to the program. So not only did she display a lack of loyalty toward my company but also toward me personally! Don't get me wrong, I can't blame anyone for wanting a) to get out of retail if they can and b) get more money if they can, but decency would tell you to give some time to the company that got you into the position you are in. Without them you wouldn't qualify for the new job in the first place. If it were up to me, I would slap her with a bill for the price of the classes and the exam. If it were a pharmacist who had done this, they sure would be.
  I guess it all comes down to selfishness. It's not all about me. Look around at the people you work with. Even if you don't care for that person they are still your comrade. They are still on the same side of the counter as you are. That big corporation that you may work for is made up of individuals. They are the ones that deserve your loyalty. Be grateful for what you're given. Not just a paycheck but things that are harder to measure like experience, opportunity, and trust. And most of all, don't ever get the attitude that just because you show up your employer owes you anything but a paycheck. Everything else is out of the goodness of their hearts (even if they don't have one).

One Of My Favorite Things

   I think one of my favorite things about my job is working with young people who are either in pharmacy school or considering pharmacy as a career.  The pharmacy students usually still have that warm fuzzy feeling about "helping people" which is refreshing (although sickening at times). They are young and bright and they keep me on my toes. I love theses people and I love being part of their education and shaping. In our area we have three pharmacy schools so I see alot of students. I'm also not stupid enough to think that I can't learn something from them.
   I also like finding young people to work in my pharmacy who are considering pharmacy as a career. I purposely look for this when interviewing for a technician spot. The one thing that has helped me the most in my career is that I worked in a pharmacy in some capacity since I was 13 years old. I knew what I was getting into when I headed off to university. Once there, my experience in a compounding pharmacy helped with my compounding lab and my calculations classes. I met many, many students who didn't have a clue what pharmacy was all about. They just knew that pharmacists made good money. Or I met the ones who didn't really like to work with people and they thought that pharmacy was a good choice. All they knew was that they could study lots of chemistry. I'm not sure what they were thinking they would be doing when they graduated. There are only so many research jobs available, you know. Anyway, working in a pharmacy is a great way to see if this job is for you. I like to think I'm a good influence on their choice because over 20 years later I'm still enthusiastic about this profession.
   However, I have had a disturbing trend lately. Every one of my "candidates" have decided that they don't want to do what I do every day. I think that's good in a way because it's better to find out now than after 6 years of study and thousands in student loans. Of course, each one has had different reasons for not wanting to pursue the career. I've had ones that just didn't want to make that much of an effort to study. That's great because they would make pharmacists who don't want to work. I get that. I've had ones that decided they would rather be medical doctors. That's great too, although I always point out to them that medical isn't better than pharmacy, it's just different. They still can learn alot by working in a pharmacy; like understanding what pharmacists can contribute to patient care.
    The ones that really bother me are the ones that choose not to go into pharmacy because they hate working retail. That's the one I don't understand. Oh, don't get me wrong, I understand not liking retail, but that's only one aspect of pharmacy. Not to mention that your role as the pharmacist is vastly different than your role as a cashier or technician. I also see a huge difference in my job and my profession. I can use my profession to influence my job and the atmosphere in which I work. That's up to me. So, I guess I just can't figure out where I'm failing these young people or where I may be misrepresenting my profession. Maybe I'm just in a slump right now, I don't know. I just really want to get the message out that pharmacy is a great and noble profession. It is worth the time, money and effort to become one of us. Retail is not the worst thing in the world and it's not the only choice you have. It was my choice, but then I'm a people person and I've grown a pretty thick skin over the years.
   So, please, if you're considering pharmacy, just step back and take an unbiased look at the profession. Try to get a look at other aspects like hospital or consulting. I was fortunate. I worked hospital, retail and nursing home consult before and during pharmacy school. Try to get a well rounded, full aspect view of this wonderful profession before making your decision. If you're already in pharmacy school and you really, really don't like what you see in this profession, then leave now. Don't rack-up those student loans just to work in a job that makes you miserable. Believe me you will take it out on your patients even if you don't mean to.  If you're already in school and you like what you see I welcome you to this profession with open arms. My best advise is to be flexible and open to change. Because this profession changes more rapidly than we realise and being open to change makes you a valuable asset to any company and makes your life a whole lot easier.
   If you're a pharmacist out there that has students or would-be students pass through your stores, do your best to put a good face on what we do. It's easy to get negative in this business. We often feel abused and taken advantage of. When this happens your attitude is what will be the lasting impression for these young people. The patient that yelled at you can be gone for hours, but if you keep ranting about it it makes the experience last a whole lot longer than it needed to. Shake it off and teach your students that this kind of thing can be survived and that how you handle it can influence the rest of your day either for the better of for the worse. We are the face of pharmacy and we can make a difference.

Desturbing Trend

I wanted to comment on a disturbing trend I've noticed lately. I get alot of "floater" pharmacists through my store due to vacation coverage and whatnot. Many of these are young, newly licensed pharmacists. The trend I'm seeing is young, mostly male pharmacists who are treating their job as if it is just a spring-board to something bigger and better. I see them spending a majority of their time at work on the phone "workin' a deal" of some kind. I've even seen them bring their lap-top to work so they can work their on-line business in their "spare" time. It just amazes me! I spent six years in school to become  a pharmacist. That's what I wanted to be when I was done. Most of these guys are talking about owning or working a business from their computers so that they can do what? Sit around all day on the computer? Uh, we do that anyway (minus the sitting part). They say they want to spend a few years in pharmacy and make enough money to quit and do something else. I don't know what kind of money they think we are making. I mean I know it sounds like alot to a starving college kid, but when you factor in taxes and life in general, we do o.k. but not much past that. I guess it just disturbs me that their focus is not on pharmacy as a profession but as a tool for something else. Where is the pride in that? Obviously these guys had someone else pay for their education, because if they have student loans then that is just one more factor in when they can "quit and do something else". Some could argue that it's no different than the women that only work a few years then quit to have babies, but somehow I see a difference there. It's a sacrifice rather than a selfishness, maybe.
I don't know. I just really had to comment on this trend. For someone who loves being a pharmacist regardless of all the negativity out there, it's just disturbing. I almost feel like I have an enemy in the camp. We spend so much of our time defending what we do as a profession then we have these young people coming right into our midst and under-mining our work. I wouldn't consider someone a professional if, while filling my prescription, they were working a deal on the phone to sell their brand of energy bars (true case). Not only is this a conflict of interest by selling product similar to that of you employer's but it is stealing. Yes, I said stealing. When you are paid to do a job and you spend your paid time doing something else, that is stealing. If you paid a babysitter to watch you kids and she spent the entire time in bed with her boyfriend, would you feel like paying her? It's called Self Interest and it takes the care out of health care.
Maybe this is just a trend in my area, I don't know.

Here We Go Again

Here we go. My store was robbed again on Tuesday. Thankfully no one was hurt. That makes twice in less than four months. I practice in a very small town so if we are having this much trouble I can only imagine what it's like in larger cities. Over the years I have seen this job become more and more dangerous and most people have no idea. I have always said that this job is 90% law enforcement only we don't get to carry weapons or wear body armour. At what point are the corporations going to add more safety precautions to our stores? We have counseling windows that are so low that anyone can jump across them with no difficulty. Why do they have to be so low? When I posed that question to my superior I was told that they have to be handicapped accessible. Uh, if someone is in a wheelchair I can easily leave the pharmacy to counsel them face-to-face, I don't have to do it at the designated window.
  I know I'm rambling but I am very concerned about this. The perpetrator came to the window and handed the technician a note that said, "We can do this the easy way or we can do this the f**ing hard way!" The tech gave the note to the pharmacist who proceeded to give the guy what he wanted. This was a real threat even though a weapon was not produced. The guy left with no further difficulty. Then my company steps in. They didn't close the pharmacy or allow the staff to go home to recoup. So, it's the first of the month, busy as all get out and my staff pharmacist is having to talk to the police in-between counseling and filling prescriptions! At no time was it even offered to my staff to take a break or go home all together. Then the real kicker is that I, as Pharmacist-in-Charge, was not even notified that this had happened. I was off that day and no one bothered to call me. I didn't find out until the next day when I went to work. I'm a little upset about this situation as you can tell. My staff were courageous and handled this situation with poise and professionalism. My company on the other hand left alot to be desired.

The Results Are In!!

  After many responses to my last post, the results are unanimous: Certified Pharmacy Technicians are healthcare professionals. Everyone pretty much has the same opinion that if the job requires specialized training, education and licensing then it qualifies as a profession. I was not surprised by the results. That being said, I have to denounce Walgreens for making their technicians work as cashiers on Thanksgiving and Christmas. They would not have gotten away with asking the pharmacists to do the same. I have also seen a marked change in attitude toward my technicians ever since. The rest of the front-end staff is treating them like "hey, if you can do my job I'm sure that I could do yours just as easily". This practice devalued my staff in the eyes of other employees and store management. I'm not saying that the techs are personally better than the front-end help but I am saying that they are professionally better and should be treated as such. I know it's a mute point because starting this year all Walgreens pharmacies will be open so the techs will have to work the holidays, but at least they will be doing "techy" things instead of selling cigarettes. And at least they will have more than 2 weeks notice that they will have to work..unlike last year.
  I want to extend a huge thank you to all the technicians out there who acted as team players and did their best in the position they were placed in. This in itself proves that you are consummate professionals! You make me proud every day that I work with you. I know that this blog is anonymous but my "thank you" goes out to not only my own staff but all the hard working technicians across the country (and elsewhere). We cannot do our jobs without you nor do we want to try!
  My state is implementing a law this year that will require all technicians to be certified. That tells me that even the state board recognizes that the job requires special training and dedication which is the hallmark of a professional!!

Update and Question For The Masses

  I know I haven't posted much recently. With the onset of colder weather, I am struggling with worsening rheumatoid arthritis. Typing is difficult. Working is difficult. Being patient with my patients is difficult. Being patient with my employer is most difficult. In an industry where speed is valued over anything else, there isn't much room for someone who has difficulty moving quickly or needs help getting lids off bottles. Luckily, I'm a good manager and my store is doing well enough that some of my short-comings are over looked.
  The question I wanted to pose to the masses is this: Are certified pharmacy technicians considered healthcare professionals? I want to state right away that my answer to this is a resounding "YES"! However, I think there are some employers who do not agree. My company made the decision several weeks ago that if a technician worked in a store that had the pharmacy closed on Thanksgiving or Christmas, that the technicians had to work one of the holidays as a front-end cashier. What kind of message did that decision send to these valued employees? It said, "We don't think of you as healthcare providers. We don't care that you already had plans made for your holidays (the decision was passed down a mere 2 weeks prior to Thanksgiving). We don't care that you had to study and pass a certification exam. On these days you are no different than the unskilled, minimum wage cashiers that we employ." Now the next question is: What message did this decision send to the customers of the store? Many of these customers were regulars to the store. They saw their pharmacy technician behind the front counter selling cigarettes. That, in my eyes, was the wrong message to send. The techs had no choice in this but yet their reputation as a caring healthcare professional was tainted by this decision made by some out-of -touch corporate flunky who was probably trying to impress someone. And who didn't have to work the holiday himself.  Not to mention the fact that because it was a holiday everyone that worked was getting paid double-time. I don't know, I'm not a business major, but that math doesn't add up to me. Minimum was vs. CPhT wage? Hmmmm!
  Anyway, I would like to hear some thoughts on this subject.  I actually had one of my best technicians quit over it. She went to work for a PBM where she has a cubical, a desk and an hour lunch break. She evaluates prior authorization requests. It sounds to me like she made the right decision, don't ya think? Let me hear from you on this. I would like to know if any other companies made such a stupid decision to try and alienate some of their most valued professionals.