First Overnight Shift... on Friday the 13th

[thisoneorthat]

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Any tips for a new overnight RPh?

I went ahead and searched for a previous SDN thread, and it seems that my overall goal will be to clean up 2nd shift's craziness and prepare 1st shift's workday on a clean slate. I've been told to clean up the work queue & TPR and do general restocking of drugs & materials. I'm expecting a lot of ER scripts early on and then PSE & CII-Vs later on the night. Only thing that worries me is that I don't have much experience w/fake control scripts being a relatively new RPh.... Guess I'll have to go w/my gut instinct.

Not toooo terribly superstitious but since it's Friday the 13th, I hope nothing freaky happens. Also, feels weird to drink coffee 9pm at night, haha.

 

[naseuy]

My first few nights were horrible. I didn't the system too well, and BAM insurance problems, and then the queues would get backed up.

After the night rush ends, it really depends on your area. I've been to a store that's completely dead from 12am onwards until 5 am, but my home store is right next to a hospital center, so we would get a lot of walk ins.

For controls, I wouldn't have a problem filling them if there's a history, or if the quantity/directions are not suspicious (or if they are not acting suspicious in anyway). If you're unsure, you can always just tell them that you have to confirm the scripts during normal office hours.

Also do not put people in as waiters when you're by yourself. That's setting yourself up to fail!

 

[thisoneorthat]

Cool, thanks for the heads-up about not putting them in as waiters. I guess this is the first time I'll have to be self-sufficient, not used to not having a tech.

Besides getting sketchy control scripts, insurance issues is what I'm dreading the most, because even on a "normal" work day, I can't seem to override some w/out one of my super-techs fixing it themselves. Don't suppose calling the number on the back of the insurance card works during the graveyard shift? Guess I'll just have to tell the patient I can't fix it and look stupid, heh.

 

[owlegrad]

Know the phone number of someone you can call.

 

[naseuy]

Cool, thanks for the heads-up about not putting them in as waiters. I guess this is the first time I'll have to be self-sufficient, not used to not having a tech.

Besides getting sketchy control scripts, insurance issues is what I'm dreading the most, because even on a "normal" work day, I can't seem to override some w/out one of my super-techs fixing it themselves. Don't suppose calling the number on the back of the insurance card works during the graveyard shift? Guess I'll just have to tell the patient I can't fix it and look stupid, heh.

A lot of insurance companies are open 24/7, but some are not, so you can try your luck. You should also try to contact other 24 hour stores in your chain. Introduce yourself, ask them for help if you need to, etc.

 

[thisoneorthat]

Interestingly, the other 24-hr store called me around midnight, wondering if Medicaid claims were rejecting for me on my end as well. Nice guy, and I ended up chatting it up w/him for a bit while putting up stock.

I could see why some RPhs would prefer this type of work environment, but this isn't for me. Was slammed from 2200-0300, and for the rest of time, I was still rushing around doing the assigned/usual overnight duties. Not sure if I would have considered this a "busy" night or just that I'm not that efficient. Being a newb, I know I'm not the most quick, but I'm most definitely not the slowest. It really annoyed me that I had hustle around so much during the majority of the stay and was exhausted by 0830.

My other buddy had told me whenever he did overnights, he would bring magazines to read & listen to his iPod. Definitely didn't have time for either of those, ha.

 

[Jell0]

what are night shift hours like at WAG? When I was an intern I worked w/ 2 rphs w/ no retail experience and they survived. You will find yourself calling other 24 hr stores a lot but in the end you'll do fine 🙂

 

[thisoneorthat]

what are night shift hours like at WAG? When I was an intern I worked w/ 2 rphs w/ no retail experience and they survived. You will find yourself calling other 24 hr stores a lot but in the end you'll do fine 🙂

Typical overnight hours are from 2200-0815. The second night, I ended up playing phone tag w/the other WAG & CVS stores. I disliked being alone and chatting w/the other RPhs made the time bearable.

I was originally trained at a busy store, and so I felt the night shift was too quiet (after the ER rush died down). Also, seeing the sunrise and hearing birds chirping at 0700 was depressing. It reminded me of all those all-nighters during my pharm school😛 Overall, good experience though.

 

[297point1]

I'm certain Mike will have no shortage of tips to share...just give him a chance to wake up first.

Good luck!!

 

[WVUPharm2007]

Its like prison with the drug seekers. The first night you will be tested. I swear to God, its like they have a Twitter feed they all subscribe to or something. A new pharmacist is like a new store opening. When they see a new car in the parking lot that isn't usually there...oh, they come in. And when they see its you, some new, fresh face...yeah, they'll see what you will allow. And you have to show that you don't take any nonsense.

No, you will not fill that script for Oxycodone 30mg until you can talk to the MD in the AM. And make sure they know that. Firmly. Otherwise, you might as well take a bullhorn and stand out front announcing, "Come one, come all, narcs, narcs, narcs!"

If they claim that they are getting on a plane in 3 hours at 5AM...they are lying. If it involves any reason why they need narcotics that badly at 3AM, just assume its a lie. It usually is. Sometimes it isn't, but too bad. The drug seekers ruined it for the occasional legit person. Who should be going to the ED, anyway.

After a while, you will know your regulars, you will know your scammers, you will know the 12:01-ers. At this point its easy. You're entrenched as the bastard that won't let people get away with things easily. You need that reputation. Some people walk in...see me...turn right back around. They know I don't play. You get your pills when they are due, no sooner, I don't care about your travel plans, period. If I don't know you, you don't get pills, period. The only narcs I fill are for regulars that always come to me every month and people coming from the ED that aren't known drug seekers.

Adapt this policy and it'll be good.

 

[thisoneorthat]

Its like prison with the drug seekers. The first night you will be tested. I swear to God, its like they have a Twitter feed they all subscribe to or something. A new pharmacist is like a new store opening. When they see a new car in the parking lot that isn't usually there...oh, they come in. And when they see its you, some new, fresh face...yeah, they'll see what you will allow. And you have to show that you don't take any nonsense.

No, you will not fill that script for Oxycodone 30mg until you can talk to the MD in the AM. And make sure they know that. Firmly. Otherwise, you might as well take a bullhorn and stand out front announcing, "Come one, come all, narcs, narcs, narcs!"

If they claim that they are getting on a plane in 3 hours at 5AM...they are lying. If it involves any reason why they need narcotics that badly at 3AM, just assume its a lie. It usually is. Sometimes it isn't, but too bad. The drug seekers ruined it for the occasional legit person. Who should be going to the ED, anyway.

After a while, you will know your regulars, you will know your scammers, you will know the 12:01-ers. At this point its easy. You're entrenched as the bastard that won't let people get away with things easily. You need that reputation. Some people walk in...see me...turn right back around. They know I don't play. You get your pills when they are due, no sooner, I don't care about your travel plans, period. If I don't know you, you don't get pills, period. The only narcs I fill are for regulars that always come to me every month and people coming from the ED that aren't known drug seekers.

Adapt this policy and it'll be good.

You've hit the nail on the head.

The second night, around 0200, I had a classic-looking PSE customer come in, feigned surprise that he didn't see the usual night RPh's car outside, then proceeded to yap about why I wasn't married. Noticed his address didn't match, and I denied his sale. His tune quickly changed to cursing at me saying that every other store had let him buy in the past. I asked if I could "share his concerns with my store manager," and he left. He kicked the hell outta the immunization privacy wall on his way out lol

Same night, had a new patient w/Oxy 80mg and while the script looked legit, I told him I would have to call in the morning. He demanded my full name and said he would call corporate on me. Go ahead, bud, I ain't scared.

I'm scheduled to work at least 4 overnight shifts in mid-October so I'm prepared to battle again. My techs have told me the next morning that I'm not as cheerful & compassionate working the night shift vs first or second. Well duh, look at what I have to deal with🙄

 

[owlegrad]

You've hit the nail on the head.

The second night, around 0200, I had a classic-looking PSE customer come in, feigned surprise that he didn't see the usual night RPh's car outside, then proceeded to yap about why I wasn't married. Noticed his address didn't match, and I denied his sale.

His address didn't match what?

 

[thisoneorthat]

His address didn't match what?

The address on his ID didn't match the database system's address when I scanned his license.

I was told by the DM and numerous pharmacy managers that if the addresses didn't match, even if they could recall the old address that was in the system, I need to deny the sale. Something about how in theory, all government issued IDs are supposed to all be linked, but in reality that's not always the case so people end up being able to buy more than the legal limit per month.

 

[owlegrad]

The address on his ID didn't match the database system's address when I scanned his license.

I was told by the DM and numerous pharmacy managers that if the addresses didn't match, even if they could recall the old address that was in the system, I need to deny the sale. Something about how in theory, all government issued IDs are supposed to all be linked, but in reality that's not always the case so people end up being able to buy more than the legal limit per month.

Gotcha, our state system is not that fancy. It just approves or denies, doesn't show us anything like that. Sounds like a good system.

 

[joetrisman]

You've hit the nail on the head.

The second night, around 0200, I had a classic-looking PSE customer come in, feigned surprise that he didn't see the usual night RPh's car outside, then proceeded to yap about why I wasn't married. Noticed his address didn't match, and I denied his sale. His tune quickly changed to cursing at me saying that every other store had let him buy in the past. I asked if I could "share his concerns with my store manager," and he left. He kicked the hell outta the immunization privacy wall on his way out lol

Same night, had a new patient w/Oxy 80mg and while the script looked legit, I told him I would have to call in the morning. He demanded my full name and said he would call corporate on me. Go ahead, bud, I ain't scared.

I'm scheduled to work at least 4 overnight shifts in mid-October so I'm prepared to battle again. My techs have told me the next morning that I'm not as cheerful & compassionate working the night shift vs first or second. Well duh, look at what I have to deal with🙄

I noticed during my time at Wags the meth heads and fake script people tended not to say a single word OR they talked you to no end. Usually the latter. Me thinks they get nervous and thats why they talk so much

 

[owlegrad]

I noticed during my time at Wags the meth heads and fake script people tended not to say a single word OR they talked you to no end. Usually the latter. Me thinks they get nervous and thats why they talk so much

Oh yes. If you are a woman it seems you get no end of compliments on your hair, nails, makeup, etc. If male a steady stream of personal questions, small talk, etc.

 

[WVUPharm2007]

I noticed during my time at Wags the meth heads and fake script people tended not to say a single word OR they talked you to no end. Usually the latter. Me thinks they get nervous and thats why they talk so much

I get the old high school cutie that's now a washed up 27 year old dope fiend that still thinks she's got it. They think flirting with me will work. Hahaha...no.

They'll try to give you a nickname, be all buddy buddy...come up with crazy stories...don't let them fool you. Its a game to them.

 

[Momus]

I did it for 5 years, graveyard shifts are easy. You either like it or you don't. When I did it in MY slow store, I spent at least 5-6 hours every night watching stuff on my laptop: TV series, breaking bad, walking dead, dexter, buffy, niptuck, random videos, movies 1080p I downloaded from Piratebay.org, did little cardio workout around the store LOL...

When I float at a busy store in downtown doing graveyard, I'd get 2-3 hours break at least and did about ~120 rxs give or take, I think max I ever did was a little over 200 rxs with only 1 rph with no help working, this happened when incompetent day time float rph was sent to handle a busy store, I ended up cleaning all the mess. The regular staff rph there normally wouldn't get that much 2-3hr break because he is a bit slower than me.

 

[LucidDream]

While this isn't a question directly related to working overnight shifts, I could not find any specific information related to it and figured I would ask here.

As a new grad/RPh, I've worked at a few 24 hour stores the shift before the night person comes in- 1300-2100- with no overlap and the theme is that I have always gotten slammed the last hour or two with urgent care scripts and am finding it difficult not to leave a lot of stuff in fill for the night shift person. Any advice on how to multitask between phones/drive-through/pickup/processing during that crazy busy hour or two?

 

[crossurfingers]

Call up front to see if anyone will help ring out customers. If not, try to alternate between them all. Have your techs type in prescriptions as they come and not save them for later. Set your wait times to like an hour and a half (or whatever is realistic to your situation). You can tell them you can call them if it is done sooner. Try to make sure to get accurate patient phone numbers on all scripts so you can reach them if there is a problem. They will yell for sure if they have to wait an hour and a half to find out it's still not ready due to a problem.

Also, are you talking about clearing the whole queue for the overnighter? We don't do that over here. We only clear up until midnight or so and the overnighter is expected to do the morning's scripts. If it is super slow then we clear the next morning's but that hardly ever happens. I would just worry about keeping up with the next few hours.

Sometimes no matter how hard you try, it's still not enough and things pile up. Just keep going and count down the hours...

 

[owlegrad]

I would prioritize the phone calls the lowest and just let people know what I am doing. For example I may tell the people at pickup that I will ring them up as soon as I help drive-thru or tell someone at drop off I will be over as soon as I am done checking people out. You can only do one thing at a time and trying to rush will only make it worse. I try to focus on one task at a time, for example I try to type all my scripts together, then fill them, then check them. Trying to do each script one at a time from typing to checking is just not efficient IMO. Once I am filling and checking I just let people at the counter know I will come up as soon as I am done doing what I am doing. If someone leaves because they don't want to wait...less work! 😀

I pity the person who foolishly steps up to consultation during this time. Like the phones they are getting a very low priority. 🙁 I just let them know I will be with them as soon as I am done with everything else. Most often at that point they just ask where something in the store is anyway. 😉

What I find much harder to juggle is flu shots. They should be processed "like waiters" according to company policy, but they are the only "waiters" that require me to be unavailable for several minutes so I don't think that is a realistic expectation.

Like fingers said, make sure you have phone numbers so you can call people to reset expectations. You do NOT want people showing up expecting their scripts to be ready and they are not. I tell people not to come back until they get a text or call that it is ready (assuming I can get them to enroll in text messaging).

 

[knight on horse]

Haha, my first day ( evening, not an overnight ) was fine until the tech left ...

then everyone walked in at the same time, everyone was a new registration, everyone had insurance problems, patients making long demands on the phone. And I hadn't interned with the company and so was new to the system. Remarkable now that I look back on it

It was at a 24 hour pharmacy. I did work the night shift there afterwards. For that I recommend:

A) Prepare caffeine for the before dawn wall. The night manager makes it, or you make it, bring it, or buy it, somehow. I don't normally recommend caffeine, and it's not necessary, but you may become zombie like without it. I find I do wake up with the early morning light though, which means 1] I have a good cortisol wakening response, probably (with testosterone) why I love to stay up and am a light sleeper 2] still adjusted to the day schedule, which is bad for long term night work, not just for being awake but for all health conditions.

B) Be able to find the numbers of other 24 hour pharmacies, your own chain and others.

C) Write yourself a note with bold, clear points to take in at a glance and psych you up out of any potential fugue like state for customer service.

D) Make an impromptu 'Restroom brb' sign for the drive through. No one cares if you're out for a minute or two when it's slow. After all, you could even be helping a customer. Just be aware that the pharmacist is not to sleep, leave the store, or otherwise vacate the pharmacy for lengths of time