another cvs pharmacist

[rickyroxy]

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Hello all, as I said, I am a cvs pharmacist.... and I have been readin this forum for quite a while, today i thoght of jumpin in .. so as every one bashes about cvs, i would also join in.... reason behind that is, i was just written up cause of C II inventory issue. ... we were short of few pill in different CII's , now when I say this, let me tell u that we are a 24 hr, busy cvs, in broward county, FL..I get every other script of roxy 30 (reason behind my profile name) ... half of them we turn away, still we fill around 7000 roxy 30/week.. but we verify everything along with diagnosis... that leads us to counting that many pills, along with other regular controll meds... we came short few pills consistently withing last 4 months. so our superviser and DM wrote all pharmacits, 2 day time and 2 night time for coaching and counselling....on first instance... with notice that if it happens again we would be terminated... now they want us to count before and after any c-2 we despense and put on hard copy, which is practically impossible compared to our volume in general and volume of c-2's we do... Now because of the coaching and counselling, I am payin more attention to those scripts than regular MD calls, insurance problems, and staffings issue.... I was wondering if ne one in similar situation know how to deal with this,.. or i would just not fill any roxy's ne more even for cancer patients.... sorry for long post, but i was totally exhausted and felt like not doin my job .... which is counting pills by 5.....

 

[KARM12]

So how do you account for the missing meds?

This is part of your job and I don't see how they are being unreasonable by asking you to count narcotics. Appropriate documentation for schedule 2 meds isn't a CVS policy, it is federal law.

 

[All4MyDaughter]

I agree with Karm that accounting for C2s is part of the job. OP - it would be a lot easier to read and digest your posts if they were in standard English. The abbreviations and text-speak are very distracting.

 

[DASicari]

I think the issue may be that all of the pharmacists were written up, even if they were not the ones making the error. Or are you the PIC?

 

[ethyl]

Seems like it should be the PIC ultimately responsible, not the individual pharmacists. Punishing 3 innocent pharmacists in order to get to the single guilty pharmacist is BS.

 

[MountainPharmD]

First off it is each pharmacists responsibility to comply with the policies of the company and the law not just the PIC.

Second, to the OP if you do not have time to do your job correctly the first time do you have time to redo it a second? Being a busy pharmacy is not an excuse. In fact the busier the pharmacy the more vigilant you should be with counting C-IIs.

I work in a busy pharmacy that does a very high percentage of C-II prescriptions. The filling tech double counts the prescription, the pharmacist counts it and the pharmacist counts the back stock to make sure it matches the perpetual inventory. I did this because we were short a 100 count bottle of Methadone and a 100 count bottle of Methylphenidate earlier this year. Talk about chit hitting the fan. Upon investigating I found that everyone had gotten lazy on filling C-IIs. Someone ended up miss filling two prescriptions because they did not double count and count the back stock. Every one complained about how long it was going to take to fill C-IIs. You know what? It doesn't take that much longer and we have had no problems since then.

(If you are wondering how someone could miss fill a 100 tablets it is quite easy if you are not paying attention. We fill many prescriptions for large quantities of Methadone. What I suspect happened is a prescription for 540 Methadone 10 was filled on a busy Saturday. The pharmacist typed, counted and verified the prescription. I am sure the pharmacist was interrupted several times and put 640 in the bottle instead of 540 and did not catch the error because they did not count the back stock.)

 

[rickyroxy]

Alright, I know counting narcotics is a part of my job, and I am not saying that we did not do mistakes. But nothing that alarming like missing 100 count bottles. There was a spill of Morphine sulfate liquid, which happened when amber plastic bottle was sitting in waiting bin. Then one vyvance script was filled for 30 instead of 15 because customer changed his mind, so pharmacist had to change script but did not take out 15 pills. Now all being said, we all were upset because we all were double counting the way CVS wants us to fill narcotics. They could have given suggestions on how we can improve, like back counting etc. But you don't come and write-up every one like we are not doing our job. I have been floating at different stores atleast twice a week, and I can tell that none of the store maintains organized inventory book like we do, none of them fill oxycodone scripts, it feels like we are being honest and report even single missing pill and also taking care of pain, cancer and sickle cell patients and being written up...

Thanks for replying

 

[Its Z]

mmmm... quit and find another job?

 

[Trakker]

another cvs pharmacist bites the dust!

 

[Old Timer]

If you are short one tablet of a C-II medication you and your employer can be fined $25,000.00. That would be per drug. So it behooves you to make sure it is correct. If it comes up short time & time again, it shows you and your colleagues are not doing their jobs.

If the store is that busy, then should have two pharmacists most times. Make sure they both count it. There are lot's of things you can do...

 

[ethyl]

If you are short one tablet of a C-II medication you and your employer can be fined $25,000.00. That would be per drug. So it behooves you to make sure it is correct. If it comes up short time & time again, it shows you and your colleagues are not doing their jobs.

If the store is that busy, then should have two pharmacists most times. Make sure they both count it. There are lot's of things you can do...

Does such a fine count only for significant loss? I've been under the impression that federal law requires the reporting of only "significant loss" for a DEA Form 106. "Significant loss" seems to be undefined by the DEA. 2-3 pills is typically ignored wherever I have worked, so long as it's not consistent loss. Although, the thread author has made it sound like multiple bottles were a few pills short which I can understand is significant.

 

[Old Timer]

Does such a fine count only for significant loss? I've been under the impression that federal law requires the reporting of only "significant loss" for a DEA Form 106. "Significant loss" seems to be undefined by the DEA. 2-3 pills is typically ignored wherever I have worked, so long as it's not consistent loss. Although, the thread author has made it sound like multiple bottles were a few pills short which I can understand is significant.

You only have to report a "significant" loss. Of course, significant is not defined. However, if the DEA audits you, there is strict liability under Federal law to account for each pill with fines up to $25,000.00 per count.

 

[rickyroxy]

I agree with Karm that accounting for C2s is part of the job. OP - it would be a lot easier to read and digest your posts if they were in standard English. The abbreviations and text-speak are very distracting.

Few lines for "pharmacy student", become a retail pharmacist first, then post something that you never did before... If you can not digest english, then stop using your cell phone, I guess u can not digest texting... no offence buddy, if u can not give suggestion then don't go in to english digestion.....

 

[rickyroxy]

So how do you account for the missing meds?

This is part of your job and I don't see how they are being unreasonable by asking you to count narcotics. Appropriate documentation for schedule 2 meds isn't a CVS policy, it is federal law.

They are being unresonable by writing us up, and not those pharmacy which have no proper documentation of c-2 inventary still getting away with it. and as another poster suggested, as long as its not significant loss, you do not have to report it to DEA. and to say the least we are humans, even robot can mis-count...

 

[rickyroxy]

Seems like it should be the PIC ultimately responsible, not the individual pharmacists. Punishing 3 innocent pharmacists in order to get to the single guilty pharmacist is BS.

Well, I would say its responsibility of all 4 pharmacists, even thought night staff is not that great, I would not blame any particular pharmacist.

 

[rickyroxy]

mmmm... quit and find another job?

I would have done it if that was an option...

 

[All4MyDaughter]

Few lines for "pharmacy student", become a retail pharmacist first, then post something that you never did before... If you can not digest english, then stop using your cell phone, I guess u can not digest texting... no offence buddy, if u can not give suggestion then don't go in to english digestion.....

Um, ok "buddy." Typing that way on a forum makes you look silly. And hard to understand. I feel like I need a translator to figure out what you are saying here. Digesting english? What does my cell phone have to do with this? Sorry if I hurt your feelings, but what the heck does "if u can not give suggestion then don't go in to english digestion...." even MEAN? I'm going into pharmacy education/ambulatory care. English digestion is not a career I'm familiar with. Sounds tasty though.

 

[rickyroxy]

First off it is each pharmacists responsibility to comply with the policies of the company and the law not just the PIC.

Second, to the OP if you do not have time to do your job correctly the first time do you have time to redo it a second? Being a busy pharmacy is not an excuse. In fact the busier the pharmacy the more vigilant you should be with counting C-IIs.

I work in a busy pharmacy that does a very high percentage of C-II prescriptions. The filling tech double counts the prescription, the pharmacist counts it and the pharmacist counts the back stock to make sure it matches the perpetual inventory. I did this because we were short a 100 count bottle of Methadone and a 100 count bottle of Methylphenidate earlier this year. Talk about chit hitting the fan. Upon investigating I found that everyone had gotten lazy on filling C-IIs. Someone ended up miss filling two prescriptions because they did not double count and count the back stock. Every one complained about how long it was going to take to fill C-IIs. You know what? It doesn't take that much longer and we have had no problems since then.

(If you are wondering how someone could miss fill a 100 tablets it is quite easy if you are not paying attention. We fill many prescriptions for large quantities of Methadone. What I suspect happened is a prescription for 540 Methadone 10 was filled on a busy Saturday. The pharmacist typed, counted and verified the prescription. I am sure the pharmacist was interrupted several times and put 640 in the bottle instead of 540 and did not catch the error because they did not count the back stock.)

So you are saying that your techs count c-2? In my pharmacy only pharmacist have access to the safe, which is 4 cabinets, and we carry each and every c-2 in market and we never run out of them... We get our bussiness through that. Even near by CVS send their customers to our store cause they do not carry them and what we do... we get that customer along with all other prescriptions.. We have been beating budget for atleast last 6 months by more than 200 scripts per week... We do have overlap, but that is only on monday and tuesday's for 4 hours each. Also we get the c-2 order twice a week so some days I have to put up the order, fill out the DEA 222 form and also dispense at the same time...

 

[rickyroxy]

Um, ok "buddy." Typing that way on a forum makes you look silly. And hard to understand. I feel like I need a translator to figure out what you are saying here. Digesting english? What does my cell phone have to do with this? Sorry if I hurt your feelings, but what the heck does "if u can not give suggestion then don't go in to english digestion...." even MEAN? I'm going into pharmacy education/ambulatory care. English digestion is not a career I'm familiar with. Sounds tasty though.

If it is that hard for you to understand it, then skip it, go to next post.... We do digest quite a few prescriptions from doctors, which are missing vital information. We don't tell them we can not understand your prescription. Just an analogy.... Tell me one thing, do you even understand the post?? If you don't them don't comment on it. Skip it the pharmacy student post...

 

[owlegrad]

Well, I would say its responsibility of all 4 pharmacists, even thought night staff is not that great, I would not blame any particular pharmacist.

If it is the responsibility of all four pharmacists, why is it wrong to write them up when it doesn't get done?

Serious question, trying to understand.

 

[rickyroxy]

If it is the responsibility of all four pharmacists, why is it wrong to write them up when it doesn't get done?

Serious question, trying to understand.

The answer to serious question is that, its first time it happened. and without giving any suggestion, you write them up, with a condition that if it happens again, you would be terminated.. and then come with pre-printed coaching & counselling for all 4 p'cists with just their name changed... and want us to sign on that. Thats what's wrong. That is not how you treat your pharmacists. Nobody got written up on first mis-fill... Just an excuse but valid one....

 

[All4MyDaughter]

If it is that hard for you to understand it, then skip it, go to next post.... We do digest quite a few prescriptions from doctors, which are missing vital information. We don't tell them we can not understand your prescription. Just an analogy.... Tell me one thing, do you even understand the post?? If you don't them don't comment on it. Skip it the pharmacy student post...

LOL. When I see a prescription that's missing information I ask the prescriber for clarification. Especially if the missing information is vital. I'm not seeing how digestion is involved... and I must say I've never seen a prescription written with texting abbreviations. That would be pretty funny.

 

[owlegrad]

The answer to serious question is that, its first time it happened. and without giving any suggestion, you write them up, with a condition that if it happens again, you would be terminated.. and then come with pre-printed coaching & counselling for all 4 p'cists with just their name changed... and want us to sign on that. Thats what's wrong. That is not how you treat your pharmacists. Nobody got written up on first mis-fill... Just an excuse but valid one....

So basically, you want your boss to give you constructive ideas on how to fix the problem and extra time to make it happen? Sounds reasonable to me.

Sometimes bosses just want to make a statement and try and scare people into getting something fixed. And as you know this is an important thing to get fixed. Doesn't make it right, but it is what it is.

On a side note, the way you describe filling CII's terrifies me. I am glad I do not intern at a store that fills every narc script we get. No offense.

 

[owlegrad]

LOL. When I see a prescription that's missing information I ask the prescriber for clarification. Especially if the missing information is vital. I'm not seeing how digestion is involved... and I must say I've never seen a prescription written with texting abbreviations. That would be pretty funny.

Why are you even contributing to this thread? You are a student. A student. You know nothing about nothing. Come back when you are pharmacist and maybe you will have something to contribute. Maybe. Digest on that awhile.

 

[rickyroxy]

LOL. When I see a prescription that's missing information I ask the prescriber for clarification. Especially if the missing information is vital. I'm not seeing how digestion is involved... and I must say I've never seen a prescription written with texting abbreviations. That would be pretty funny.

Have you seen a script mso4 IR, 1T, po, bid, and dont question that if it is a IR or ER? I guess not. You have to call MD, which it self a part of job to reach MD, and ask them did you mean exetended realese or Immediate realease.. you get answer from the nurse, " thats what doctor wrote" and then you turn into interogattor and ask " do you know the difference" and then they say, hold on , let me check with doctor... One suggestion for you, do not go to retail pharmacy, because it takes balls to be in that situation... I know no body likes retail but there are thousands of pharmacists who deal with this everyday, they can leave their job. But if they do and go to hospoital or nuclear or whatever other options we have, you guys would not have a job left... We do retail no only because of money. We care about customers, patients... We know them by their name. and The only reason they come to CVS is not because of "Customer Value Service", they come here because they know their pharmacist.... by name... and trust us that we will take care of them.. Do you even know what is " Share cost"? that is the florida meicaid requirement to fill prescription for medicaid patients... We are the only pharmacy in are who does that.. I can go on and on.. to justify what We do in our pharmacy, but the reason behind this post was injustice done to us for unreasonable reasons...

 

[All4MyDaughter]

Why are you even contributing to this thread? You are a student. A student. You know nothing about nothing. Come back when you are pharmacist and maybe you will have something to contribute. Maybe. Digest on that awhile.

I can't digest on that. I'm busy digesting some wonton soup and sesame chicken. I have been eating all day. It's Derby day and we went to two parties. Delicious food, but the baby consumes all my resources and I was hungry again and had to send the hubby out for takeout.

Seriously. Wouldn't digesting a prescription be hard on the stomach? Or is it just extra fiber in the diet? Maybe if I did this I would be more regular? But how would you fill it after it's digested? So many question about this. And I'm not sure why I'm asking U because U R just a student. NEway, just go on to the next pharmacy student post.

 

[owlegrad]

I can't digest on that. I'm busy digesting some wonton soup and sesame chicken. I have been eating all day. It's Derby day and we went to two parties. Delicious food, but the baby consumes all my resources and I was hungry again and had to send the hubby out for takeout.

Seriously. Wouldn't digesting a prescription be hard on the stomach? Or is it just extra fiber in the diet? Maybe if I did this I would be more regular? But how would you fill it after it's digested? So many question about this. And I'm not sure why I'm asking U because U R just a student. NEway, just go on to the next pharmacy student post.

That sounds like heaven. You can just eat and eat and eat? I know there are drawbacks and all (morning sickness I guess?) but man that sounds great. Please excuse me, I need to digest on this for some time.

Edit: You are right not to ask me. What can I, a lowly student, possibly know? Nothing, that's what. It's my digest to bear.

 

[rickyroxy]

So basically, you want your boss to give you constructive ideas on how to fix the problem and extra time to make it happen? Sounds reasonable to me.

Sometimes bosses just want to make a statement and try and scare people into getting something fixed. And as you know this is an important thing to get fixed. Doesn't make it right, but it is what it is.

On a side note, the way you describe filling CII's terrifies me. I am glad I do not intern at a store that fills every narc script we get. No offense.

I guess you did not read the post carefully, we DO NOT feel every narc script we get, I turn down every other oxy 30 script, along with every other call on hold askin if I have an oxy'30 in stock... which is in it self quite exhausting. I can be a pharmacist not to fill any single oxy scripts, and there are quite a few in my district, I would not be written up. But when you see those patients, listen to them, analyse their situation, how independent pharmacy tring to rob them when they do have insurance still charging them 10 or 15 dollars per pill of oxy 3o, you have to think, what the hell is going on.. You have to think as a pharmacist. Do I want to take adavantage of the patient or do I want to help them with their pain. They are dying.. Its all about palliative care. End of life pain management. Even doctors call us to make sure we have pain meds for their patients... Now I can be one of the pharmacist who do not even take a look at the situation and just turn away even percocet scripts....

 

[All4MyDaughter]

That sounds like heaven. You can just eat and eat and eat? I know there are drawbacks and all (morning sickness I guess?) but man that sounds great. Please excuse me, I need to digest on this for some time.

Edit: You are right not to ask me. What can I, a lowly student, possibly know? Nothing, that's what. It's my digest to bear.

During this pregnancy I have craved meat like crazy. That diet seems to agree with me (or the baby) because I have gained very little weight. But I've also been very careful to limit sweets and sugar. Plus try to get in a lot of healthy stuff too. I don't think I could eat this way when I'm not pregnant. I think my cholesterol levels couldn't take it!

The second party I attended today had five or six different kinds of smoked meat, including duck. Some of it was marinated for days and then smoked over a 24 hour period. It was wonderful. The hostess is also pregnant so she had made sure to have the best food.

Tomorrow will be a big eating day too. We're taking my mother to a Mother's Day brunch after church and then taking my mother-in-law to a Japanese Steakhouse for dinner.

On Monday I'll go back to my regularly scheduled eating plan consisting of five or six small meals per day. Since I finished pharmacy school (which I *think* means I'm not a student anymore 😀) I get up, eat a small breakfast, go back to sleep, get up and eat a healthy lunch, have a small snack in the afternoon, eat a bigger dinner with my husband and usually have a bedtime snack. It seems to work well.

 

[owlegrad]

In my pharmacy only pharmacist have access to the safe, which is 4 cabinets, and we carry each and every c-2 in market and we never run out of them... We get our bussiness through that. Even near by CVS send their customers to our store cause they do not carry them and what we do... we get that customer along with all other prescriptions.. We have been beating budget for atleast last 6 months by more than 200 scripts per week... We do have overlap, but that is only on monday and tuesday's for 4 hours each. Also we get the c-2 order twice a week so some days I have to put up the order, fill out the DEA 222 form and also dispense at the same time...

I guess you did not read the post carefully, we DO NOT feel every narc script we get, I turn down every other oxy 30 script, ....

I think I read it quite carefully. Your post speaks for itself. But don't mind me, it is not my place to tell you how to practice pharmacy.

My comment was that I am glad I don't work at your store, and that comment stands.

 

[owlegrad]

Tomorrow will be a big eating day too. We're taking my mother to a Mother's Day brunch after church and then taking my mother-in-law to a Japanese Steakhouse for dinner.

On Monday I'll go back to my regularly scheduled eating plan consisting of five or six small meals per day. Since I finished pharmacy school (which I *think* means I'm not a student anymore 😀) I get up, eat a small breakfast, go back to sleep, get up and eat a healthy lunch, have a small snack in the afternoon, eat a bigger dinner with my husband and usually have a bedtime snack. It seems to work well.

Just went to a hibachi place the other day to celebrate my awesomeness in not failing second year. It was great.

You will always be a student, you don't fool me for a second. Hey, I wonder if my school would call you a rising pharmacist? 😀

 

[Its Z]

I would have done it if that was an option...

Well, if you can't quit your job, then quit your whining.

 

[rickyroxy]

I think I read it quite carefully. Your post speaks for itself. But don't mind me, it is not my place to tell you how to practice pharmacy.

My comment was that I am glad I don't work at your store, and that comment stands.

I guess I did not mention that we are also a learning store, that means that every new hired technician, goes through the training through our store, before they go and work in their home store. So, they get real time training. If you were training in my store, you would learn how to answer question at drop off, drive thru, and phone call, when are we gettin our shipment of c-2 without asking the pharmacist, who is on hold with md office to get diagnosis for narc script... and also to satisfy loestrin 24 fe script, which did not go through her discount card....

 

[All4MyDaughter]

Just went to a hibachi place the other day to celebrate my awesomeness in not failing second year. It was great.

You will always be a student, you don't fool me for a second. Hey, I wonder if my school would call you a rising pharmacist? 😀

Hibachi is on my list of craves. In the last little bit we've been for: 1) MIL's birthday 2) husband's birthday with his mother her boyfriend 3) husband's birthday with my family 4) friend's baby shower (I picked the place) 5) to celebrate the Match 6) last week because I was hungry and 7) several other times just because.

I like the meat (of course!) but I also like the soup, salad and veggies. Plus the chef is very entertaining. I took my seven year old niece with us one time and she pronounced it FABULOUS! Plus she enjoyed speaking Spanish with our chef. He's been a "Japanese Master Chef" for almost a decade but is from Mexico. I'd hire him to be my personal chef if I could afford it. I like it when he throws the eggs up in the air and catches them in his hat!

 

[rickyroxy]

Well, if you can't quit your job, then quit your whining.

If whining is the only way to discribe problem, then I am whinning... You are retired, that doesn't mean you never whinned about ur situation...

 

[Its Z]

If whining is the only way to discribe problem, then I am whinning... You are retired, that doesn't mean you never whinned about ur situation...

I'm not retired.

I certainly wouldn't whine about getting written up when done rightfully so. It's not like you did good and got written up for it. The store did a lousy job. Instead of trying to find a way to prevent further mistakes, you're here whining about you got written up.

I will whine. But only if the situation calls for it.

Your case doesn't call for it.

 

[Its Z]

You may think missing a few CII pills is no big deal but if my hospital had a missing CII of any sort, there will be a medication variance and incident report along with potential piss test for employees. And it would be investigated. We don't take that chit lightly, yo.

 

[owlegrad]

Hibachi is on my list of craves. In the last little bit we've been for: 1) MIL's birthday 2) husband's birthday with his mother her boyfriend 3) husband's birthday with my family 4) friend's baby shower (I picked the place) 5) to celebrate the Match 6) last week because I was hungry and 7) several other times just because.

I like the meat (of course!) but I also like the soup, salad and veggies. Plus the chef is very entertaining. I took my seven year old niece with us one time and she pronounced it FABULOUS! Plus she enjoyed speaking Spanish with our chef. He's been a "Japanese Master Chef" for almost a decade but is from Mexico. I'd hire him to be my personal chef if I could afford it. I like it when he throws the eggs up in the air and catches them in his hat!

I don't care for the salad, I don't like that orange gunk they put on it. Everything else is great. Even the chicken is almost as good as the beef, which still boggles my mind. And the veges and rice? Killer. Some chefs are better than others, but I have never had a bad time. Man I wish I was digesting on some of that now. It's late and you are making me hungry.

 

[Pharmacy Kid]

I'm not retired.

But, but it says retired under your avatar. 😉

 

[All4MyDaughter]

I don't care for the salad, I don't like that orange gunk they put on it. Everything else is great. Even the chicken is almost as good as the beef, which still boggles my mind. And the veges and rice? Killer. Some chefs are better than others, but I have never had a bad time. Man I wish I was digesting on some of that now. It's late and you are making me hungry.

We always get the same chef. I think it's because we are good tippers. I like how he calls my husband "Meeester David" (with the eeeee all drawn out). It's cute. Plus I admire his work ethic. He works seven days a week! I couldn't do that. He's a good cook and a good conversationalist, which I think is the key to good tips in that environment.

 

[atpsynthase]

If whining is the only way to discribe problem, then I am whinning... You are retired, that doesn't mean you never whinned about ur situation...

What is your native language?

 

[Praziquantel86]

I don't care for the salad, I don't like that orange gunk they put on it. Everything else is great. Even the chicken is almost as good as the beef, which still boggles my mind. And the veges and rice? Killer. Some chefs are better than others, but I have never had a bad time. Man I wish I was digesting on some of that now. It's late and you are making me hungry.

That ginger dressing is incredible. Leads into crunchy spicy tuna wonderfully.

 

[Ackj]

I guess you did not read the post carefully, we DO NOT feel every narc script we get, I turn down every other oxy 30 script

I'm sorry sir, the man in front of you just a script for this, I won't be able to fill this for you. However, the woman behind you can have some.

 

[eagles22]

I guess I did not mention that we are also a learning store, that means that every new hired technician, goes through the training through our store, before they go and work in their home store. So, they get real time training. If you were training in my store, you would learn how to answer question at drop off, drive thru, and phone call, when are we gettin our shipment of c-2 without asking the pharmacist, who is on hold with md office to get diagnosis for narc script... and also to satisfy loestrin 24 fe script, which did not go through her discount card....

Is your period key broken? You seem to be using several of them when one would suffice.

 

[KARM12]

Stop complaining and go count your narcs correctly or some new grad will.

I would write you up too if your store was missing that much medication.

 

[PharmD RPh]

Welcome to SDN RickyRoxy home of pharmacy students that think they know it all.

I can relate to your situation. High volume stores are more likely to have discrepancies because of the volume, and larger number of staff. It's impossible to directly supervise everything that goes on behind the pharmacy counter.

Based on your post, you allegedly are only a few tablets off your count based on filling 7000 dosage units of oxycodone 30 mg per week and over a 4 month time frame. From my direct experience this is not a significant loss by DEA definition or interpretations. And no you would not be fined $25,000 per tablet. This loss only accounts for roughly 0.0027% of what you've dispensed. If it makes you feel better fill out a DEA form 106 and report it.

I doubt most of the other posters in this forum have been in your position and hence probably can't offer sound advice. A number of things can go wrong to make counts appear incorrect. 1. Invoice posting errors. 2. Technician spills and random tablet goes missing. 3. Technician miscount. 4. Broken tablets in the bottle. 5. Someone does inventory counts and accidently enters wrong on hand counts and the list goes on. Finding the root of the error over a few tablets in this time frame is too time consuming, tedious and a waste of time based on your volume. If you were off by a 100 ct. bottle, then we have a different story. From my experience, if this was a loss prevention/theft issue, there would be more than a few tablets missing. Addicts aren't people that take only 3 tablets over 4 months. However, if you feel you have a theft problem, have a drug test requested for your store through your loss prevention department. Make sure only pharmacists have access to C-II narcotics and maybe have the RPh count every C-II. Do this for 4 months and see if you still have an issue.

Personally, I think it's crazy you're being disciplined for such a small discrepancy. I have never heard of this happening in my neck of the woods. Hang in there and develop a strategy to mitigate your situation.

 

[WVUPharm2007]

Wow, the students are haters today. Damn.

----

I'd start counting back every CII to ensure the count is right. At the very least, do you do an end-day narc inventory to ensure its correct?

And, Z, the reason you do piss tests is because keeping inventory in retail is much tougher than in hospital pharmacy. In a hospital, you have the time to count...then recount the inventory...then the tech who loads the pyxis counts...and each time a nurse dispenses, they count. There is a paper trail on every transaction.

In retail, if you accidentally give a patient with a script for #480 oxy 30 a few over...which is very possible in a store with extreme amounts of distraction...there is not paper trail and no double check. You can go see that the tech put 5 extra doses in the pyxis...but you can't see a patient's bottle after dispensing.

It's a different world, my man. Hell, just a month ago, my pharmacy was missing #20 Oxycontin 40mg...the district pharmacy manager was notified...nothing came of it. It's not considered a significant loss, so its reported and forgotten about.

 

[selo]

Welcome to SDN RickyRoxy home of pharmacy students that think they know it all.

I can relate to your situation. High volume stores are more likely to have discrepancies because of the volume, and larger number of staff. It's impossible to directly supervise everything that goes on behind the pharmacy counter.

Based on your post, you allegedly are only a few tablets off your count based on filling 7000 dosage units of oxycodone 30 mg per week and over a 4 month time frame. From my direct experience this is not a significant loss by DEA definition or interpretations. And no you would not be fined $25,000 per tablet. This loss only accounts for roughly 0.0027% of what you've dispensed. If it makes you feel better fill out a DEA form 106 and report it.

I doubt most of the other posters in this forum have been in your position and hence probably can't offer sound advice. A number of things can go wrong to make counts appear incorrect. 1. Invoice posting errors. 2. Technician spills and random tablet goes missing. 3. Technician miscount. 4. Broken tablets in the bottle. 5. Someone does inventory counts and accidently enters wrong on hand counts and the list goes on. Finding the root of the error over a few tablets in this time frame is too time consuming, tedious and a waste of time based on your volume. If you were off by a 100 ct. bottle, then we have a different story. From my experience, if this was a loss prevention/theft issue, there would be more than a few tablets missing. Addicts aren't people that take only 3 tablets over 4 months. However, if you feel you have a theft problem, have a drug test requested for your store through your loss prevention department. Make sure only pharmacists have access to C-II narcotics and maybe have the RPh count every C-II. Do this for 4 months and see if you still have an issue.

Personally, I think it's crazy you're being disciplined for such a small discrepancy. I have never heard of this happening in my neck of the woods. Hang in there and develop a strategy to mitigate your situation.

I must say this is the most insightful post i have read about this topic. It is hard to believe the op was disciplined for such a minor discrepancy.

 

[Its Z]

And, Z, the reason you do piss tests is because keeping inventory in retail is much tougher than in hospital pharmacy. In a hospital, you have the time to count...then recount the inventory...then the tech who loads the pyxis counts...and each time a nurse dispenses, they count. There is a paper trail on every transaction.

It's a different world, my man. Hell, just a month ago, my pharmacy was missing #20 Oxycontin 40mg...the district pharmacy manager was notified...nothing came of it. It's not considered a significant loss, so its reported and forgotten about.

Is that right... so don't y'all keep track of all drug NDC# dispensed in retail? We don't in inpatient. We don't have time. 😎

It aint about time. It's about priorities and what's important. Evidently retail doesn't think much of keeping the CII in check as much. Except for OP's boss.

That being said, we just terminated a retail pharmacy manager who had CII discrepancy in a fairly large volume.

 

[All4MyDaughter]

Is that right... so don't y'all keep track of all drug NDC# dispensed in retail? We don't in inpatient. We don't have time. 😎

It aint about time. It's about priorities and what's important. Evidently retail doesn't think much of keeping the CII in check as much. Except for OP's boss.

That being said, we just terminated a retail pharmacy manager who had CII discrepancy in a fairly large volume.

I know of two retail PICs who were dismissed for similar issues. The discrepancies weren't large volume, but more like persistent small volume discrepanices. One of my friends got a promotion to PIC after hers was fired b/c of CII recordkeeping.