Advice on working Walgreens Overnight shift for new pharmacist.

[21PharmD]

Hey guys, i really love reading the advice that pharmacists have on this board. I have been reading threads about overnight retail shifts, but i was hoping i could get some specific advice for my specific company Walgreens. Let me just preface my questions by stating that i am a new graduate pharmacist working for walgreens and i am on schedule to work overnight. The overnight shifts seem at this point to be no problem, my only concern is that as a new overnight pharmacist we dont have a senior tech (or any tech for that matter). I really want to do well at this, and was hoping someone could help answer some of the questions i have about the overnight shifts. First for walgreens is there someone i can call if i run into any problems or if I am unsure of how to do something? What are the typical activities that are done on overnight shifts, and what are some of the things that i can do in advance to help out the day shaft if i have any downtime. what are some general things that as a daytime pharmacist you would expect or would like an overnight pharmacist to take care of. Please spare no details as I am really committed to doing well at this, thanks in advance and i look forward to your posts!

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[Momus]

First for walgreens is there someone i can call if i run into any problems or if I am unsure of how to do something? What are the typical activities that are done on overnight shifts, and what are some of the things that i can do in advance to help out the day shaft if i have any downtime. what are some general things that as a daytime pharmacist you would expect or would like an overnight pharmacist to take care of. Please spare no details as I am really committed to doing well at this, thanks in advance and i look forward to your posts!

In general, you call your other 24h WAGs... and all your other questions they can answer too. I think PharmDstudent works graveyard for WAG. She can shed some light ;o

 

[joetrisman]

In general, you call your other 24h WAGs... and all your other questions they can answer too. I think PharmDstudent works graveyard for WAG. She can shed some light ;o

yup yup. Its like a buddy system. I know 3rd shifters that just throw another rph on speaker and chit chat the whole night

 

[BrightLight]

Do not lay out your mattress until everyone else in the pharmacy is gone. Usually the spot where the pharmacy cameras do not catch is the corner by the back wall and the medication bins shelves. Do not expect to fall asleep before 2am because people from ER will still be coming. Do not sleep too tight because some managers can be anal and check on you by calling your name from outside the pharmacy. Work up the night-shift store manager of he store you float to well so that she or he will turn a blind eye on you. There are plenty of DPI boxes in the pharmacy that you can open to form a easy bed on the floor. Pillow can be "borrowed" from the store where they sell dog beds or handicap stuffs. Put them back by 7am so that you do not forget and end up having Loss Prevention visiting you. Do not ignore phone calls or get pissed off at the drunkards who call at 4am to ask stupid questions because they may be hired by the corporate to see if you are sleeping.

If Loss Prevention comes to you and say they have evidence of you sleeping on job, NEVER ever confess! Once you do, it's all over. Never listen to their bullchit that you would be forgiven if u are honest with them. Most of the time, they do not have strong evidence and just want to trick the words out of you and use that to fire you. If you are still uncomfortable sleeping in the pharmacy and if there is one available, sleep in the pharmacy restroom instead. If anyone raises suspicion, you can always claim that you are having a bad episode of diarrhea.

If you want to cook dinner in the pharmacy, only use a broiler. Do not use a grill! The smoke can activate the fire alarm and cause the ceiling sprinklers to ruin your night. That will be the end of your career.

 

[Tinkerbell22]

Do not lay out your mattress until everyone else in the pharmacy is gone. Usually the spot where the pharmacy cameras do not catch is the corner by the back wall and the medication bins shelves. Do not expect to fall asleep before 2am because people from ER will still be coming. Do not sleep too tight because some managers can be anal and check on you by calling your name from outside the pharmacy. Work up the night-shift store manager of he store you float to well so that she or he will turn a blind eye on you. There are plenty of DPI boxes in the pharmacy that you can open to form a easy bed on the floor. Pillow can be "borrowed" from the store where they sell dog beds or handicap stuffs. Put them back by 7am so that you do not forget and end up having Loss Prevention visiting you. Do not ignore phone calls or get pissed off at the drunkards who call at 4am to ask stupid questions because they may be hired by the corporate to see if you are sleeping.

If Loss Prevention comes to you and say they have evidence of you sleeping on job, NEVER ever confess! Once you do, it's all over. Never listen to their bullchit that you would be forgiven if u are honest with them. Most of the time, they do not have strong evidence and just want to trick the words out of you and use that to fire you.

I have heard that the folding lawn chairs they sell in the beach/pool section during the summer work well too... maybe you can scoop one up and hide it before they go out of season. Unless you live in Florida, then you can have a fresh bed all year round.

(true story)

 

[BrightLight]

I have heard that the folding lawn chairs they sell in the beach/pool section during the summer work well too... maybe you can scoop one up and hide it before they go out of season. Unless you live in Florida, then you can have a fresh bed all year round.

(true story)

NO! Don't use their folding chair. It's cheap (quality-wise) and can easily break and cause you serious back injury. I would not count on worker's comp nowadays, especially for an easily replaceable new grad.

 

[21PharmD]

These responses are great! LOL. No but seriously im so new to the Company and i dont really know what to expect during the overnight shift. I mean arent most normal people asleep during those hours, oh and most Doctors offices are closed as well, so i guess taking the voicemail wont be a big part of my job during these hours. Any advice, as I am super new to the company. I think they are going to put me with the normal overnight pharmacist on duty the first day and then i will be covering for the overnight pharmacist during their vacation for the rest of next week all by my lonesome. Also if you are a pharmacist that works normal hours what are some of the things that you expect to be done by the overnight pharmacist before you come into work? I love reading your responses as this is all very new to me.

 

[anhedonia]

Working overnight is fun. For the most part. I used to do it for a year. But there was no significant downtime that I could use to sleep or anything. 10-midnight = ED/ urgent care patients, busy busy busy. Midnight to 3: Checking scripts from the day. 3-6 : cleaning up workload. 6-8: people start to come.
Otherwise when it's slow there is always stuff to do: compounds, putting away the orders, running the refill to soon, autofills, cleaning the Yuyama machine, pulling out expired drugs, C2 inventory, emptying trash, vacuuming. The nice thing about overnight is that you're the only one working, you get to make quick decision about stuff. And its a cycle, if you do all the stuff so that day people can come in and hit the ground running, you'd come in that night at 10 PM and (usually) have a clean queues. It's like a courtesy thing, if you leave without doing all the dirty work, they'll for sure leave you all kinds of mess to clean up when you come in at 10 PM.
You quickly get to know all other overnight pharmacist in the surrounding area (I still talk to my old overnight colleague who had the same schedule as I did, three years after I quit working overnight).
Addendum: You call each other for copy, send patients to each other's store for meds you do not stock. Warn each other about *******s who try to fill forged CII. Watchout for those, especially at 4AM during the weekends.

 

[txpharmguy]

Hey guys, i really love reading the advice that pharmacists have on this board. I have been reading threads about overnight retail shifts, but i was hoping i could get some specific advice for my specific company Walgreens. Let me just preface my questions by stating that i am a new graduate pharmacist working for walgreens and i am on schedule to work overnight. The overnight shifts seem at this point to be no problem, my only concern is that as a new overnight pharmacist we dont have a senior tech (or any tech for that matter). I really want to do well at this, and was hoping someone could help answer some of the questions i have about the overnight shifts. First for walgreens is there someone i can call if i run into any problems or if I am unsure of how to do something? What are the typical activities that are done on overnight shifts, and what are some of the things that i can do in advance to help out the day shaft if i have any downtime. what are some general things that as a daytime pharmacist you would expect or would like an overnight pharmacist to take care of. Please spare no details as I am really committed to doing well at this, thanks in advance and i look forward to your posts!

Handle all incoming ER, rx visits etc until it slows down...time depending on store. Then start tackling the queue. Work on all for that day (time after midnight) first. Do housekeeping: filing hardcopies, put away order, filling automation, smart counts, etc, or any specific task RXM asks you to do. (Hopefully, you can get last tech to take out trash, DPI boxes before their shift ends.) After that, clean up any TPRs. Time permitting, you can start filling rxs that are in there for several days out. Don't dump entire queue, perhaps 5-10 at a time. Again, depending on store, customers can start trickling in at 6 or 7, so priority would be to take care of them. Networking with other 24 hour stores is a must. If opening pharmacist walks into a clean counter with queue cleared out for that day, you've done the minimum necessary to help out. With time, you'll get more efficient and can get more done, but I'd just would try to have a clear queue for that day and have a clean, neat, organinzed pharmacy when day shift arrives. When filing automation, fill any critically low/fast moving cells first. Time permitting (ie, weekend shift when it's slower), you can fill all other cells.

 

[21PharmD]

Hey guys I cant tell you how appreciative I am for the responses as they really put working the overnight shift into perspective. In terms of cleaning out the queue should i expect to clean out both the exception queue as well as the work queue? Also if i encounter DURs that, in my judgement, can be overridden do i need to document why i had overridden them? Also if I encounter a DUR that is of legitimate concern, what should i do to clear it from the queue if i cant get in contact with the Dr. Also I am expecting to take care of some TPRs as well, so if I am able to find the reason for the rejection such as refill too soon is there a way i can change the status of the TPR, or should i just cash them out? Again i cant reiterate how helpful your responses are, thanks!

 

[txpharmguy]

Hey guys I cant tell you how appreciative I am for the responses as they really put working the overnight shift into perspective. In terms of cleaning out the queue should i expect to clean out both the exception queue as well as the work queue? Also if i encounter DURs that, in my judgement, can be overridden do i need to document why i had overridden them? Also if I encounter a DUR that is of legitimate concern, what should i do to clear it from the queue if i cant get in contact with the Dr. Also I am expecting to take care of some TPRs as well, so if I am able to find the reason for the rejection such as refill too soon is there a way i can change the status of the TPR, or should i just cash them out? Again i cant reiterate how helpful your responses are, thanks!

Do NOT cash out RTS. You'll only make it harder for everybody else. Several years ago, there was an IC+ enhancement that was supposed to automatically put the refill too soon date into the "fill date" field. It works about 90% fo the time, so a big time saver. Just go through them to make sure resubmit date (ie, fill date) is correct. If RTS is > 7days, rx needs to be stored...go to fill screen and save...will go to stored after you data review. Sometimes there are RTS hidden in the TPR queue as a DUR reject (not to be confused with the DUR queue). Look at the DUR detail and sometimes they put the resubmit date in there. With experience, you'll know what I'm talking about. As far as actual DURs, you're the licensed pharmacist, so it's your call on how you want to handle it. If it's a new rx from the ER for tramadol and you get an interaction for the sertraline they're on. Look at the profile. If it's the first time, I'd flag it for consulation (ie, CAP) and discuss with pt when they pick up. If they've had it a million times, override DUR with "viewed pt profile." Again, you're the RPh on duty, so your discretion is what counts. I would say to keep retrying all TPRs. Perhaps there was a prior auth that was approved, but the pharmacy wasn't notified. If it rejects, just put an exception comment that claim still rejected on mm/dd/yy. You should be able to crank thru those pretty fast, especially is you see the same ones for several nights in a row. Likewise, if a prior auth request has been sitting in there > 7 days and still not going thru. Create exception. Go back and annotate that rx was stored on mm/dd/yy bc prior auth was not approved and store rx as previoulsy mentioned.
To me, cleaning out the work queue is clearing everything for that day when you get off at 8 am (granted there may be some refills entered in from 7-8 that you didn't get to bc people were coming in). If you can clear further ahead, it's a bonus and will make your next shift a little easier, especially if you know there is an order coming and you have to help get those put away as well. Coming in on a Monday night is always going to be the heaviest volume day, so just get by on that day if you have to and the rest should be a little easier. Get honest feedback from the RXM when your paths cross. Ask what you more you can do to help, what could you have done better. Every RXM runs things just a little differently, but communication goes a long way too. FWIW, I've been an RXM for a high volume 24 hour store for many years, so speaking from experience here.
If you have an insurance issue because it's Blue Cross of the Little Sisters of the Poor and you have trouble adjudicating, you many want to loan a day's worth of medicine (exercising good fiscal reasoning) and give to Sr Tech in the AM. Chances are he or she can fix it in a jiffy or will call help desk. Just explain to the customer that you're not too familiar with insurance but you don't want them to leave there empty handed. You really don't have the time or personnel on duty to deal with insurance problems.

 

[21PharmD]

Do NOT cash out RTS. You'll only make it harder for everybody else. Several years ago, there was an IC+ enhancement that was supposed to automatically put the refill too soon date into the "fill date" field. It works about 90% fo the time, so a big time saver. Just go through them to make sure resubmit date (ie, fill date) is correct. If RTS is > 7days, rx needs to be stored...go to fill screen and save...will go to stored after you data review. Sometimes there are RTS hidden in the TPR queue as a DUR reject (not to be confused with the DUR queue). Look at the DUR detail and sometimes they put the resubmit date in there. With experience, you'll know what I'm talking about. As far as actual DURs, you're the licensed pharmacist, so it's your call on how you want to handle it. If it's a new rx from the ER for tramadol and you get an interaction for the sertraline they're on. Look at the profile. If it's the first time, I'd flag it for consulation (ie, CAP) and discuss with pt when they pick up. If they've had it a million times, override DUR with "viewed pt profile." Again, you're the RPh on duty, so your discretion is what counts. I would say to keep retrying all TPRs. Perhaps there was a prior auth that was approved, but the pharmacy wasn't notified. If it rejects, just put an exception comment that claim still rejected on mm/dd/yy. You should be able to crank thru those pretty fast, especially is you see the same ones for several nights in a row. Likewise, if a prior auth request has been sitting in there > 7 days and still not going thru. Create exception. Go back and annotate that rx was stored on mm/dd/yy bc prior auth was not approved and store rx as previoulsy mentioned.
To me, cleaning out the work queue is clearing everything for that day when you get off at 8 am (granted there may be some refills entered in from 7-8 that you didn't get to bc people were coming in). If you can clear further ahead, it's a bonus and will make your next shift a little easier, especially if you know there is an order coming and you have to help get those put away as well. Coming in on a Monday night is always going to be the heaviest volume day, so just get by on that day if you have to and the rest should be a little easier. Get honest feedback from the RXM when your paths cross. Ask what you more you can do to help, what could you have done better. Every RXM runs things just a little differently, but communication goes a long way too. FWIW, I've been an RXM for a high volume 24 hour store for many years, so speaking from experience here.
If you have an insurance issue because it's Blue Cross of the Little Sisters of the Poor and you have trouble adjudicating, you many want to loan a day's worth of medicine (exercising good fiscal reasoning) and give to Sr Tech in the AM. Chances are he or she can fix it in a jiffy or will call help desk. Just explain to the customer that you're not too familiar with insurance but you don't want them to leave there empty handed. You really don't have the time or personnel on duty to deal with insurance problems.

Txpharmguy, I honestly cant tell you how much i appreciate your insight. As a new pharmacist getting ready to work the overnight shift for a new company, your posts go a long way in helping to calm my fears. If ever i run into problems is my only bet calling another 24 hour pharmacy in the area, or is there some company contact line that may help me resolve some issues? Once again I really appreciate the time and effort you have put into your posts, thanks.

 

[Fade to Black]

From my experience what the day pharmacists absolutely love is if you are able to clear or get serious progress done on the TPR queue. What I love about WAG's computer system over other companies' is the ability to leave electronic comments on each rx in the queue. You'll be calling insurance throughout the night and there will be prescriptions which you will be unable to solve, yet adding a comment about what you've tried so far and what else needs to be done will help the day folks in completing solving the reject.

Most of your scripts will be emergency type, if a DUR pops up, the hospital is open 24 hrs and ready for your call. If its from a regular PCP I usually fax the prescriber, leave a comment that I faxed them, and then alert the morning Rph when they come in.

If it's a computer issue dial 1800intercom. For any issue you encounter on your own dial your other 24 hr colleagues like others suggested. Might not be a bad idea to just call everyone in your vicinity introducing yourself. To find 24 hr stores go to pharmacy management, store inquiry, type in a surrounding city and look for a "Y" under the 24 hour column. You probably know this already but you can rapid dial other wags: lift the phone and dial 78, followed by the 5 digit store number, followed by a phone location. 260 is the general rx phone location. If the store number is less than 5 digits add an appropriate amount of 0s. Example: you want to dial store 666: 7800666260. You will remember your local 24 hr store number quick enough.

Welcome to nights . Nights are fun, I think you will like it. My tech usually leaves at 10 pm, sometimes I can get destroyed flying solo. You will learn pretty quick how to prioritize your time.

 

[crossurfingers]

People pretty much covered everything. I don't usually start the queue until around midnight. One of the best times to verify for other stores (if your area has a quota) is around 11pm-12am or after 5am. It's mostly refills and goes a lot faster than verifying new rx's for other stores.

Around 4am is when you can check the TPR's to run through the RTS rejects for the new day and have them go through. The smart count is out at 5am and I also try to put away the delete list.

 

[21PharmD]

People pretty much covered everything. I don't usually start the queue until around midnight. One of the best times to verify for other stores (if your area has a quota) is around 11pm-12am or after 5am. It's mostly refills and goes a lot faster than verifying new rx's for other stores.

Around 4am is when you can check the TPR's to run through the RTS rejects for the new day and have them go through. The smart count is out at 5am and I also try to put away the delete list.

Ok great, thanks for the reply. when trying to get the TPRs marked RTS to go through do i just update rx and see if it goes through, and if it doesnt go through do i document somewhere that I ran it again. Also with the Smart counts what happens if i am off (sometimes by a lot), i think i did it the other night and i ended up with more syringes than were listed on the telzon, and i was wondering if i had done it correctly. Also if we have a customer who comes in wanting to pick up a prescription that is marked TPR to be payable after a certain date, is it ok to tell them they can pay cash now and once the insurance lets it through we can reimburse them for the medication? Also, since I am new to the company and pharmacy in general I am a little concerned that just working overnights wont give me the experience doing things that normally occur during the day, what do you think that i can do to try to keep myself up to par so that if i get put into a normal shift I would be able to adjust? Again I love reading these posts they are super helpful. Thanks!

 

[21PharmD]

From my experience what the day pharmacists absolutely love is if you are able to clear or get serious progress done on the TPR queue. What I love about WAG's computer system over other companies' is the ability to leave electronic comments on each rx in the queue. You'll be calling insurance throughout the night and there will be prescriptions which you will be unable to solve, yet adding a comment about what you've tried so far and what else needs to be done will help the day folks in completing solving the reject.

Most of your scripts will be emergency type, if a DUR pops up, the hospital is open 24 hrs and ready for your call. If its from a regular PCP I usually fax the prescriber, leave a comment that I faxed them, and then alert the morning Rph when they come in.

If it's a computer issue dial 1800intercom. For any issue you encounter on your own dial your other 24 hr colleagues like others suggested. Might not be a bad idea to just call everyone in your vicinity introducing yourself. To find 24 hr stores go to pharmacy management, store inquiry, type in a surrounding city and look for a "Y" under the 24 hour column. You probably know this already but you can rapid dial other wags: lift the phone and dial 78, followed by the 5 digit store number, followed by a phone location. 260 is the general rx phone location. If the store number is less than 5 digits add an appropriate amount of 0s. Example: you want to dial store 666: 7800666260. You will remember your local 24 hr store number quick enough.

Welcome to nights . Nights are fun, I think you will like it. My tech usually leaves at 10 pm, sometimes I can get destroyed flying solo. You will learn pretty quick how to prioritize your time.

Great info,

I am a little confused about the TPR queue, i know a lot of them in there have notes already in them such as WCB, RTS etc. How should i approach these other than try to run the RTS through again to see if it takes? Also who leaves these comments I see on the TPR, is it something i should be doing, and if so how would i go about doing that? If you could just elaborate a little on how to specifically approach this queue it would be greatly appreciated.

Also for the DURs, are they classified based on severity if so how can i find that information. If i do need to call the ER for a DUR where do i document the people i spoke to as well as the relevant information they have given me? To fax a PCP on a DUR, do we just hit the fax button on the top of the screen, and do we have to manually type anything in the fax? also do we add a comment or something to let the other pharmacists know that we faxed the PCP.

Also this may be a stupid question but what do we do with the WCB rejections? and how do we change the fill date on TPRs marked RTS.

Your input is absolutely priceless!

 

[genesis09]

You can put in a new refill date on the TPR rejection screen. The RTS ones will automatically input the date. If you sell a RTS rx for cash, the person cannot come back and get an adjustment. Most will put the refill date in the comment section.
If there is a fax number in the system, just click the fax button and you can fax the person.
The comments are entered by the one who was last working on the issue. Read the comment to see if you can do anything.
For drug/drug interactions, they will rate them according to severity. You can also use facts or clinical pharm for more information.
Learning how to use Sims/texlon is hard to describe. You can change inventory by using the inventory adjustment option.
With WCBs, you don't do anything with them unless the prescriber calls in a refill.

 

[Ackj]

Also if we have a customer who comes in wanting to pick up a prescription that is marked TPR to be payable after a certain date, is it ok to tell them they can pay cash now and once the insurance lets it through we can reimburse them for the medication?

Probably would not be able to reimburse them when insurance covers it, but you might consider selling a small quantity for cash. Like if it's 5 days away from a refill, sell them #5 as cash, then get the refill when it's due. If it's a VERY well known patient that you'd trust, and you have a good enough memory/documentation system, you might advance them and then fill for #25 so that you're even at the end, but I don't recommend doing this often. Most of the time, RTS is a change in therapy or somebody filling out a Mediset who still has over a week's worth of medication, so it's not really an issue. The therapy change you need a new rx with updated quantity/directions, though.

 

[pezdispenser]

Also if we have a customer who comes in wanting to pick up a prescription that is marked TPR to be payable after a certain date, is it ok to tell them they can pay cash now and once the insurance lets it through we can reimburse them for the medication?

They can pay cash for it now as long as it is not a controlled drug, but don't reimburse them later. That is insurance fraud because you are putting in a later date of service. It doesn't fix the underlying problem of why it was RTS either.

 

[Fade to Black]

Great info,

I am a little confused about the TPR queue, i know a lot of them in there have notes already in them such as WCB, RTS etc. How should i approach these other than try to run the RTS through again to see if it takes? Also who leaves these comments I see on the TPR, is it something i should be doing, and if so how would i go about doing that? If you could just elaborate a little on how to specifically approach this queue it would be greatly appreciated.

Also for the DURs, are they classified based on severity if so how can i find that information. If i do need to call the ER for a DUR where do i document the people i spoke to as well as the relevant information they have given me? To fax a PCP on a DUR, do we just hit the fax button on the top of the screen, and do we have to manually type anything in the fax? also do we add a comment or something to let the other pharmacists know that we faxed the PCP.

Also this may be a stupid question but what do we do with the WCB rejections? and how do we change the fill date on TPRs marked RTS.

Your input is absolutely priceless!

Most RTS rejections will tell you when it should go through. If it's way ahead into the future, store the script to get it out of the queue. Don't waste time re-running it to see "if it takes". Open up their history and see when the last fill was sold, this will tell you exactly when they're due for their next fill. What state are you in? Here in AZ, Wag has a central location which handles TPRs, and they will leave comments. Perhaps this is the case for you as well. Open up the exception queue, and you can further filter the list with the drop-down menu by type (wcb, misc, etc.) You don't need to leave a comment on each TPR, do so only if the actual reject is vague. Most rejects are self explanatory (ex: prior authorization required) and do not need comments.

DURs are classified by severity. The major ones will say major and will be in red font. Document on the hard copy or you can add an annotation to the scanned image. Hit "update rx" from the queue and from there you can create annotations with those yellow fill background, have you seen these? Ask someone to show you how to create annotations if not. An rx must have an exception status of some sort to use that fax button. Example: sig looks off on something on a non-emergency med that the patient does not need that night. Here is what I would do: 1) create a msc exception. 2) from the exception queue select this rx then hit that fax button. From there you have a drop down menu with cookie cutter questions for the prescriber (not covered, PA, other, etc) I usually use the "other" type as it allows me to type any message I want to the doc. I type my inquiry to the doc, in this case I would simply type "please verify the sig". There will be a yes/no type checkbox on that screen also asking if you want to include an image of the script in the fax. Default is no, and I always change that to a Y. 3) go back to the exception queue and add a comment "unclear sig, faxed md for clarification, date, time, your initials)

Wcb are simple. I look at when the original exception was created and if it's been ~72 hrs I refax again.

 

[Pojman]

Do not lay out your mattress until everyone else in the pharmacy is gone. Usually the spot where the pharmacy cameras do not catch is the corner by the back wall and the medication bins shelves. Do not expect to fall asleep before 2am because people from ER will still be coming. Do not sleep too tight because some managers can be anal and check on you by calling your name from outside the pharmacy. Work up the night-shift store manager of he store you float to well so that she or he will turn a blind eye on you. There are plenty of DPI boxes in the pharmacy that you can open to form a easy bed on the floor. Pillow can be "borrowed" from the store where they sell dog beds or handicap stuffs. Put them back by 7am so that you do not forget and end up having Loss Prevention visiting you. Do not ignore phone calls or get pissed off at the drunkards who call at 4am to ask stupid questions because they may be hired by the corporate to see if you are sleeping.

If Loss Prevention comes to you and say they have evidence of you sleeping on job, NEVER ever confess! Once you do, it's all over. Never listen to their bullchit that you would be forgiven if u are honest with them. Most of the time, they do not have strong evidence and just want to trick the words out of you and use that to fire you. If you are still uncomfortable sleeping in the pharmacy and if there is one available, sleep in the pharmacy restroom instead. If anyone raises suspicion, you can always claim that you are having a bad episode of diarrhea.

If you want to cook dinner in the pharmacy, only use a broiler. Do not use a grill! The smoke can activate the fire alarm and cause the ceiling sprinklers to ruin your night. That will be the end of your career.

I was a Loss Prevention Manager for multiple stores for about 10 years for a large retail chain.

This post made me LOL. There is some solid wisdom here.

 

[21PharmD]

Hey guys, i am really enjoying your posts. I have worked 2 days as an overnight pharmacists and I already feel like Im not pulling my weight. It doesnt help that the morning pharmacists that come in to take over are super nice and i dont believe they will give me criticism even if warranted. There are also some things I am having trouble understanding. I have no idea how to resolve TPRs, especially the ones that when i open them have no comments. When it comes to cleaning the queue, does that basically mean just going through the work queue and printing and filling all the reviewed prescriptions and taking care of the F4s? The reason why i ask is because the other day it seemed like i was checking the work queue every minute for reviewed prescriptions to print and fill, but there were really very few. When the morning pharmacist came in however they printed out a lot of rx labels that needed to be filled, and i am wondering why those scripts didnt show up all night or if i am not checking them correctly. Is it normal for the queue to accumulate more rapidly early in the morning (8:00 am) then during overnight? Also when we do a partial fill does the quantity matter at all, or can we theoretically give as many as we have on hand. Does anyone know how i go about creating an emergency supply. I spoke with the pharmacy manager the other day, and if i understood correctly they discourage doing partial supply in favor of having CPO fill the prescription the following day, yet when i put the prescriptions in for the following day CPO just seems to spit them back at me, does anyone know why CPO generally sends them back to me? does it have something to do with the drug and maybe it is not a drug they stock? Also how to I create a OOS exception? Also, if there is anyone else out there that can give me some more insight on the what are expected as common courtesy for the overnight shift to take care of, i would feel horrible knowing that i left the morning pharmacist with the work i should have taken care of during the overnight shift. Once again i love hearing your comments and look forward to your responses thanks!

 

[Ackj]

when we do a partial fill does the quantity matter at all, or can we theoretically give as many as we have on hand.

Depending on your company or store, there may be a policy in place for the amount. It's generally 3-5 days worth. So if they take it TID, then they get 9-15, but QD would only be 3-5 tablets. The reason you don't give more is in case somebody else needs a partial fill too. If you needed 30 but dispensed 24 out of your 24, now you can't partial anyone else. If you give 3 as a partial, you can partial up to 8 different people.

I would say it also depends on your store's policy to have them pay now, or after the balance comes in. If they don't pay until they receive it all, the more loss could result if they decide to not return. Also consider if it is an expensive med, rare, brand, etc. In these cases, you may not want to open the sealed stock bottle up and potentially have the entire bottle go to waste.

 

[Momus]

When it comes to cleaning the queue, does that basically mean just going through the work queue and printing and filling all the reviewed prescriptions and taking care of the F4s? The reason why i ask is because the other day it seemed like i was checking the work queue every minute for reviewed prescriptions to print and fill, but there were really very few. When the morning pharmacist came in however they printed out a lot of rx labels that needed to be filled, and i am wondering why those scripts didnt show up all night or if i am not checking them correctly. Is it normal for the queue to accumulate more rapidly early in the morning (8:00 am) then during overnight?

I think your morning pharmacist takes care of auto fill. Most retails have an auto fill program. Graveyard pharmacist are expected to finish those before daytime crew come in. You have to do your refill too soon queue also.

 

[21PharmD]

I think your morning pharmacist takes care of auto fill. Most retails have an auto fill program. Graveyard pharmacist are expected to finish those before daytime crew come in. You have to do your refill too soon queue also.

How do i work on auto fill? I dont even know what that means? I wish someone could offer some detailed information on this subject, so i can feel better about my performance. Does auto fill come at a certain time in the morning, or is there something i can do to help out with them at night. I was literally checking the queue every 10 minutes and could find nothing, is it a possibility i am working the wrong queue? I am just wondering what could be causing the disparity between the few rxs that i get at night vs the many the morning pharmacist gets when she takes over? Are the many that she gets something that i can work on overnights, if so where do i find them? I honestly feel horrible about having the morning pharmacist work on something i should be doing overnight, i seriously lose sleep over it

 

[owlegrad]

Can you ask the morning folks for feedback?

 

[21PharmD]

Can you ask the morning folks for feedback?

I can definitely try. My only concern is that the pharmacists are super nice and i think they shy away from giving me criticism. Other then that i kind of feel like it is the blind leading the blind. Does autofill usually come in at a certain time of day, and should it typically be in the normal work queue where all the other prescriptions are in?

 

[genesis09]

At Walgreens, the auto-fills show up at about 1am.

 

[21PharmD]

At Walgreens, the auto-fills show up at about 1am.

So do these show up in the work queue as regular prescriptions? I am just wondering why so many come up when the pharmacist comes in at 8:00 AM. Is there a place i go specifically to take care of these autofills? I would really like to help with these overnight, as i know how hectic the day shift can be.

 

[awval999]

So do these show up in the work queue as regular prescriptions? I am just wondering why so many come up when the pharmacist comes in at 8:00 AM. Is there a place i go specifically to take care of these autofills? I would really like to help with these overnight, as i know how hectic the day shift can be.

Can I ask why you weren't trained to do these tasks? Does WAG really just throw pharmacists into the fire without even training? You didn't shadow an overnight pharmacist for a month? I mean really? I'm sorry about your situtation I think it is completely unacceptable for a company to do this to an employee.

 

[21PharmD]

Can I ask why you weren't trained to do these tasks? Does WAG really just throw pharmacists into the fire without even training? You didn't shadow an overnight pharmacist for a month? I mean really? I'm sorry about your situtation I think it is completely unacceptable for a company to do this to an employee.

Well I was trained overnight for a weekend. Then started the following day. To be honest I think i did get adequate training, and am grateful for the training i was given. When i was training they basically said so long as you clear the queue, do deletes, smart counts, clean the pharmacy, we should be fine. But im wondering if there is anything else that needs to be done, or could be done to help with the day shift. Now do so called autofills show up in the same queue as regular prescriptions? I think it would make sense but for whatever reason I am unable to pull them up in that queue when i am working, and I feel really bad about making the morning pharmacist pick up for my slack, so any detailed information as to how i can help day shift is greatly appreciated. I am also concerned about being stigmatized as the lazy, sloppy pharmacist that no one wants to work with

 

[Estrace]

Can I ask why you weren't trained to do these tasks? Does WAG really just throw pharmacists into the fire without even training? You didn't shadow an overnight pharmacist for a month? I mean really? I'm sorry about your situtation I think it is completely unacceptable for a company to do this to an employee.

All you get is 80 hrs of training which includes PPL. I spent the first week doing nothing but PPL so my hands-on training was basically 40 hrs.
There is just so much to know and I have decided that the best thing to do is just to take it one day at a time. As a floater, I have come to accept the fact that I'm going to work with some techs who will think that I'm not competent enough because I can't resolve certain insurance issues or that I can't think of an OTC medication for some strange ailment. I have epocrate on my cell phone for some OTC recommendations.
.

 

[pezdispenser]

It has been several years since I worked overnight so I could be wrong, but I seem to remember the RTS went through at 2am and the autofill gets put in the work queue at 6am, BUT the promise time for autofills is for the next day or the day after maybe. They are refills so they are already reviewed, but I don't think you or the day staff should print them ahead because they are not due until the next day, so they can be left for you to do overnight. However, the day staff might see that they print out anyway during the day, because the system prints the next hour plus some of the next 24 hours, so they may think it is better to get them done before it gets busy to prevent labels from piling up, especially if you have some sort of robotic dispensing system because it fills at the same time as the label prints and you can't have it clogged up with filled vials.

 

[vardenafil]

dont get shot

 

[txpharmguy]

It's seems like you didn't get enough training, as many of your questions would be answered with 80 hours of training. I'm assuming you work in a POWER since you mention the CPO. If the CPO is filling many next day, there may not be a whole lot to fill overnight. I don't know since I'm in a nonPOWER state. Autofills usually pop in at 3 am with a promised time of 1 am two days out. RTS that are due for that day generally print at 545 am. The autofill scripts popup at the bottom of the work queue. If some yayhoo goes to a non 24 hour store and he says his insurance will pay for it tomorrow (likely a narcotic or other controlled substance), and shows after just shortly midnight. Tell him it won't be ready unti after 8 am. Again, most insurances don't reset the day at midnight. If you work in a POWER store, the TPRs should be handled by the CPO. When the RXM opens next time, ask if you can stay for an hour or so to ask and learn (this would be uncompensated time, but invaluable for you to learn some things specific to his or her store). If the same RPh that came in printed a bunch of labels, ask her why she did that and how you could have helped that person the night before. They may have assumed you've been with the company awhile and know more than you really do. You can always hit "control W" and it will print the next batch of labels due. Depending on the time of day, it may say there are no more labels wth those promised times to fill. In that situation, you know you're probably ahead of the game. To create an OOS, control K (out of stocK), an MSC (control C), change manufacturer (control m). All these are creatable thru the options menu, but I just hightlighted a few to save some keystrokes. If it's a refill and you don't want to partial, can you delete and reenter for next day so Central Fill can send? (Worse case scenario, pt comes in same day and you end up partial filling anyway). Again, as you previously stated, it could be a drug Central Fill doesn't stock. I only do emergency fills on WCB if the pt is directly in front of me. (It has to be in reviewed status>options>create emergency supply..don't dispense more than 3 days or whatever is stricter with your state law). If they say the need loaners and you prepare it ahead of time, they don't show up for 12 hours, MD approves it, and then the only get the balance of the rx, not the whole thing.

 

[crossurfingers]

Can I ask why you weren't trained to do these tasks? Does WAG really just throw pharmacists into the fire without even training? You didn't shadow an overnight pharmacist for a month? I mean really? I'm sorry about your situtation I think it is completely unacceptable for a company to do this to an employee.

I was also thrown into the fire and it sucked big time. People can really shadow an overnight pharmacist for a month?! I got 4 hours of "training" where I took the place of a pharmacist while being supervised. It was totally not the same as being on your own. That's typical WAG for you.

 

[rph3664]

Never worked at Walgreens, EVER, but when the Wags in my old town went to 24 hours, the overnighters were rarely idle - and this was a city of 40,000 in a rural area.

 

[owlegrad]

It's cool how you know how busy they were though.

 

[21PharmD]

Ok guys, a little update. I really do enjoy working nights and i am having a blast with it. Since i am still new to the company there are still a few things that take a little getting used to. The one thing I could really use more help on is the TPR queue. I was working in a place the other night with about 100 TPRs and i was really hoping i could get those numbers down before morning shift comes in. I was able to store a lot of them that had refill dates way out (>7 days), and for those that were just a little early i tried to change the fill date to the appropriate date, but i would get printouts from the printer that looked like doctor faxes and the labels would then just print out cashed out which i thought was strange. Also this may be a little vague but while i am writing i might as well give it a shot, what purpose does the message queue really serve, and are the messages that show up in the queue in red font supposed to indicate anything different than the other conventional black ones.Also, i know this depends on specific circumstances, but do any of you overnight pharmacists fill CIIs overnight? I mean i could understand scripts from the ER for small quantities, but how about other CIIs large quantities, patients or prescribers you are unfamiliar with etc? The reason i ask is because patients come in telling me that they always get their CII scripts at the pharmacy and that there is never a problem filling them at 3AM with the regular pharmacist. Eventually this escalates into them shouting at me and telling me to check their record. Anyone have any ideas as to how to defuse these situations, or any strategies to make things move a little more smoothly. By the way, the input in this thread has really helped my transition go very well, thanks!

 

[txpharmguy]

Ok guys, a little update. I really do enjoy working nights and i am having a blast with it. Since i am still new to the company there are still a few things that take a little getting used to. The one thing I could really use more help on is the TPR queue. I was working in a place the other night with about 100 TPRs and i was really hoping i could get those numbers down before morning shift comes in. I was able to store a lot of them that had refill dates way out (>7 days), and for those that were just a little early i tried to change the fill date to the appropriate date, but i would get printouts from the printer that looked like doctor faxes and the labels would then just print out cashed out which i thought was strange. Also this may be a little vague but while i am writing i might as well give it a shot, what purpose does the message queue really serve, and are the messages that show up in the queue in red font supposed to indicate anything different than the other conventional black ones.Also, i know this depends on specific circumstances, but do any of you overnight pharmacists fill CIIs overnight? I mean i could understand scripts from the ER for small quantities, but how about other CIIs large quantities, patients or prescribers you are unfamiliar with etc? The reason i ask is because patients come in telling me that they always get their CII scripts at the pharmacy and that there is never a problem filling them at 3AM with the regular pharmacist. Eventually this escalates into them shouting at me and telling me to check their record. Anyone have any ideas as to how to defuse these situations, or any strategies to make things move a little more smoothly. By the way, the input in this thread has really helped my transition go very well, thanks!

The purpose of the message queue is to notify of rxs that there are stored, a generic is available, or rx can't be processed thru IC+. Be careful with the stored rxs as they can be drugs in same class, but pt no longer takes or it could be a different dose. I'm not certain about the message queue colors, but red is after promised time and black before promised time in the exception queues. As far as late night CIIs, check when they're verified (product date). If it is typically at night, might not be a problem, especially if it's on time. Does your state have a prescription monitoring website? You might want to utilize that. It's not uncommon to fill CIIs as next day (ie, overnight) for many ADD drugs or chronic meds. I had my RPNs fill many of those. Again, if your suspicious, let them know you have to clarify something on the rx in the morning with the doctor. If it's legit, chances are there won't be any trouble. If pt is anxious, they'll probably ask for the rx back. You're not the police. Your job is to make sure the rx is legit and is being prescribed for a bona fide medical condition. Always, be polite. You don't want trouble. Of course the "out of stock'' option might work too

 

[cgkc]

Wow, to have 7 days off every other week sounds very nice!

How about the negative health effects of night shift work. I remember reading that there are increased risk of cancer, diabetes... associated with night shift.

 

[nextyearrx]

Do not lay out your mattress until everyone else in the pharmacy is gone. Usually the spot where the pharmacy cameras do not catch is the corner by the back wall and the medication bins shelves. Do not expect to fall asleep before 2am because people from ER will still be coming. Do not sleep too tight because some managers can be anal and check on you by calling your name from outside the pharmacy. Work up the night-shift store manager of he store you float to well so that she or he will turn a blind eye on you. There are plenty of DPI boxes in the pharmacy that you can open to form a easy bed on the floor. Pillow can be "borrowed" from the store where they sell dog beds or handicap stuffs. Put them back by 7am so that you do not forget and end up having Loss Prevention visiting you. Do not ignore phone calls or get pissed off at the drunkards who call at 4am to ask stupid questions because they may be hired by the corporate to see if you are sleeping.

If Loss Prevention comes to you and say they have evidence of you sleeping on job, NEVER ever confess! Once you do, it's all over. Never listen to their bullchit that you would be forgiven if u are honest with them. Most of the time, they do not have strong evidence and just want to trick the words out of you and use that to fire you. If you are still uncomfortable sleeping in the pharmacy and if there is one available, sleep in the pharmacy restroom instead. If anyone raises suspicion, you can always claim that you are having a bad episode of diarrhea.

If you want to cook dinner in the pharmacy, only use a broiler. Do not use a grill! The smoke can activate the fire alarm and cause the ceiling sprinklers to ruin your night. That will be the end of your career.

Lol, seriously?