Getting in trouble for following directions?

[Tenor CS]

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Here's the situation: I'm a pharmacy tech. My Pharmacist-in-charge (PIC) does everything 100% by the book.

The assistant pharmacist (AP) likes to cut corners.

When we print the rx labels, the drug information monographs print out and sometimes carry over to a 2nd page. Also, a 3rd page sometimes prints, like "Important things you need to know about" [drug name] along with warnings and information.

By the book, we're supposed to fold the 2nd and 3rd pages in a letter-style 3-way fold, which are then placed in the bag with the bottles before being stapled closed.

AP hates the extra pages. S/he wants me to throw them out and not include them, since "patients never read them anyway." That may be true, but PIC says that some of those things are federally mandated, and AP is possibly risking his/her license by discarding them.

AP also tells me not to bother with putting auxiliary labels on the bottles, since it slows down production.

As a tech, is AP putting my certification or state registration in danger by his/her actions?

 

[nnguyenc]

i was careless on one shift and forgot to insert those important
papers...i'm not sure what happened to the patient (hopefully they
didn't die)

 

[pearljam5a1]

OBRA '90 -- pharmacist must counsel on every new script and a piece of paper in the bag isn't counseling. Don't sweat it. The majority of retail pharmacists don't counsel and the majority of patients don't want it. What OBRA '90 instituted mainly was a thing that patients sign saying they refused counseling -- clearly not what was intended.

TL;DR -- you are fine.

 

[Sparda29]

Every pharmacist I have worked with has thrown out the 2nd and 3rd pages. Only extra papers we gave out were the ones with the Medication Guides for specific medications (NSAIDs, antidepressants, etc).

Auxiliary labels, the only one we ever used was the Controlled Substance label.

 

[owlegrad]

Every pharmacist I have worked with has thrown out the 2nd and 3rd pages. Only extra papers we gave out were the ones with the Medication Guides for specific medications (NSAIDs, antidepressants, etc).

Auxiliary labels, the only one we ever used was the Controlled Substance label.

Same here. I have worked with one floater who was fanatical about making sure all pages went with the prescription, but he is the one exception. Everyone else I know throws them out. Labels are hit and miss in my experence, I haven't met anyone who considers them big deal.

 

[Old Timer]

The Med Guides are a legal requirement. OBRA90 did not mandate counseling, it mandated the offer to counsel. State rules may be stricter. You need to get out of the middle and have the PIC speak to the AP and tell the AP to stop being an a-hole.

 

[rxlea]

So what thread was it where someone was laughing that a patient swallowed a suppository? I wonder if that patient would have swallowed the suppository had the script went out with a "for rectal use" label or if the pharmacist counseled the patient. IMO, auxiliary labels are essential because some patients really don't know how to take/use/apply something. They might also not know to shake a suspension or their inhaler. How many seconds does it take to put on a label or two? IMHO (and I am sure I'll get flamed for this or whatever) but it is our responsibility to tell a patient how to take their medication, isn't it?

 

[owlegrad]

So what thread was it where someone was laughing that a patient swallowed a suppository? I wonder if that patient would have swallowed the suppository had the script went out with a "for rectal use" label or if the pharmacist counseled the patient. IMO, auxiliary labels are essential because some patients really don't know how to take/use/apply something. They might also not know to shake a suspension or their inhaler. How many seconds does it take to put on a label or two? IMHO (and I am sure I'll get flamed for this or whatever) but it is our responsibility to tell a patient how to take their medication, isn't it?

I like how you think, but I am not sure I agree with you about the label. I am sure the directions did not call for swallowing the suppository. If patients won't follow the directions on the label why will they bother reading labels? As for counseling, yes that should work. But do plan on counselling every patient that you dispense a suppository to how to use it?

 

[Tenor CS]

There are some patients where you could put 100 labels on the package, and it wouldn't help. In my experience, the vast majority of patients have no idea what their medications are called, what conditions they are for, and how often they take them.

I have no less than 5 people who don't even know when their refills are due. They just stop into the pharmacy every 3-4 days to see if we have anything for them.

I even get people who "run out" of medicine way too early. And I'm not even talking about things where you'd expect it, like narcotic painkillers. I'm talking like drugs for BP and Diabetes. They get a 90 day supply and then show up 2 weeks later needing more. I think they're sharing the pills with other people. I had one mother with 3 kids, all of which were on a crapload of allergy meds. She'd refill all of them and then take it upon herself to split and share the meds among the pills to make them stretch out longer.

 

[Tenor CS]

From my days as a teacher, I remember a valuable piece of advice one of my mentor teachers gave me. He told me to avoid asking "any questions" in class.

When students hear "Do you have any questions?" what they really hear is, "I'm about to move on to the next thing."

I assume when most patients hear "Do you have any questions?" it just prompts a reflex to say "No" instead of actually thinking of any concerns or questions they might really have.

 

[rxlea]

So, to save 2 seconds of your time, you would skip the label?

 

[owlegrad]

So, to save 2 seconds of your time, you would skip the label?

What are the directions for? I am not against labels, just pointing out that if the labels are redundant to the directions than the patient who skips reading the directions is not likely to bother with even more directions stickered to the bottle. Just to be perfectly clear I am not against extra labels at all but if they are redundant to the directions I doubt they do much good. It doesn't help to slap a "Use As Directed" label on a bottle.

 

[Tenor CS]

Examples of warnings you might see on auxiliary labels:

• Call your doctor if you experience changes in mood, depression, or suicidal thoughts.
• Do not take antacids within 2 hours of taking this medication.
• Take this medication with plenty of water.
• Herbal medications may reduce the effectiveness of this medication.
• Consult your doctor before taking certain OTC products with this medication, as they may cause an adverse reaction.
• May cause dizziness (or drowsiness)
• Do not take this product with aspirin.

On my Celebrex, there was one that said "Do not lie down for at least 20 minutes after taking this medication." They did not put that one on the bottle. I was kind of pissed off about that, and called the RPh to let her know. I know I'm probably not going to die of a blood clot, but I would have liked to be informed about the risk. I try to be an informed patient, but from my experience, most patients aren't.

 

[Trankuil]

From my days as a teacher, I remember a valuable piece of advice one of my mentor teachers gave me. He told me to avoid asking "any questions" in class.

When students hear "Do you have any questions?" what they really hear is, "I'm about to move on to the next thing."

I assume when most patients hear "Do you have any questions?" it just prompts a reflex to say "No" instead of actually thinking of any concerns or questions they might really have.

This is why you ask, "What questions do you have?" rather than "Do you have any questions?" because it makes them think and not automatically say no. It really works, try it 🙂

 

[rxlea]

Always ask open ended questions 🙂 owlegrad, I get what you're saying and in the instance of "use as directed" obviously an additional label isn't necessary. However, I think it is important to give the patients as much information as possible. This is why big boxes like CVS and Wags suck. They pressure their pharmacists to fill X number of scripts an hour and they don't give a **** if a patient receives good care or not. To corporate, if something happens, then it is the pharmacist's fault for "being careless". Why not just cover as many bases as possible? Throw the damn stickers on there. The extra few seconds could save a patient from swallowing a suppository or something worse and save you the drama of getting in trouble.

 

[Old Timer]

Always ask open ended questions 🙂 owlegrad, I get what you're saying and in the instance of "use as directed" obviously an additional label isn't necessary. However, I think it is important to give the patients as much information as possible. This is why big boxes like CVS and Wags suck. They pressure their pharmacists to fill X number of scripts an hour and they don't give a **** if a patient receives good care or not. To corporate, if something happens, then it is the pharmacist's fault for "being careless". Why not just cover as many bases as possible? Throw the damn stickers on there. The extra few seconds could save a patient from swallowing a suppository or something worse and save you the drama of getting in trouble.

You base this on your vast years of experience in all types of retail pharmacy?😕

 

[rxlea]

You base this on your vast years of experience in all types of retail pharmacy?😕

No- I only worked at one retail pharmacy and other pharmacists have shared their experiences with me. Obviously I don't know as much as you Old Timer, but it just seems to me that it is common sense to throw the most important labels on there. Hey, if I am wrong, tell me.

Then again, I work at an institution where we have to put all the important labels on the meds so the NURSES don't do something silly...like leave an inhaler at the bedside so grandson can play with it.

Label: "Do Not Store At Patient Bedside"

 

[Rockinacoustic]

I put 'Same medication, different look' on new generic substitutions, 'shake well' on nasal inhalers and if you're really sketchy, two kinds of control aux labels on your bottle. Better safe than sorry.

 

[Old Timer]

No- I only worked at one retail pharmacy and other pharmacists have shared their experiences with me. Obviously I don't know as much as you Old Timer, but it just seems to me that it is common sense to throw the most important labels on there. Hey, if I am wrong, tell me.

Then again, I work at an institution where we have to put all the important labels on the meds so the NURSES don't do something silly...like leave an inhaler at the bedside so grandson can play with it.

Label: "Do Not Store At Patient Bedside"

I personally place ALL the auxiliary labels on that I can fit, sometimes going up the next size in vial. I also give out the med guides and 99% of what the tree slaying computer prints out. I was commenting on the statement:

This is why big boxes like CVS and Wags suck. They pressure their pharmacists to fill X number of scripts an hour and they don't give a **** if a patient receives good care or not. To corporate, if something happens, then it is the pharmacist's fault for "being careless".

I got more pressure from my bosses when I was an independent than the 10 years I have been with the devil. I have never been told don't do that, it slows you down. There is no hourly quota. Yes they judge how fast you work, but there are people who are glacial and they need to be weeded out. Mom can't take a bus to the clinic and a bus to CVS and then be told come back in 2 hours for the 100cc Amxoil 400/5.

I just had my review and during the hour I spent with boss, speed did not come up.

 

[Tenor CS]

Thank you for posting in this thread, Old Timer. As a newbie here, I enjoy seeing the experienced pros who contribute to so many threads.

My Pharmacist-In-Charge is awesome, and during slow times I can really pick his brain, which he seems to like. I think he would make a great college professor one day. He seems to have a great personality for it.

My assistant pharmacist is newly licensed and I don't enjoy working with her. She really doesn't have the whole multi-tasking thing down yet.

 

[Old Timer]

Thank you for posting in this thread, Old Timer. As a newbie here, I enjoy seeing the experienced pros who contribute to so many threads.

My Pharmacist-In-Charge is awesome, and during slow times I can really pick his brain, which he seems to like. I think he would make a great college professor one day. He seems to have a great personality for it.

My assistant pharmacist is newly licensed and I don't enjoy working with her. She really doesn't have the whole multi-tasking thing down yet.

Do what your PIC wants all of the time and if the other pharmacist complains, tell her to take it up with the PIC.

 

[owlegrad]

No- I only worked at one retail pharmacy and other pharmacists have shared their experiences with me. Obviously I don't know as much as you Old Timer, but it just seems to me that it is common sense to throw the most important labels on there. Hey, if I am wrong, tell me.

Then again, I work at an institution where we have to put all the important labels on the meds so the NURSES don't do something silly...like leave an inhaler at the bedside so grandson can play with it.

Label: "Do Not Store At Patient Bedside"

Same here. My favorites:

Shake Well

Keep Refrigerated

 

[Tenor CS]

Apparently, I'm not the only one who has noticed that AP is kind of dropping the ball. When I came in to work today, she was there on what was supposed to be her day off for some "re-training" by the PIC.

 

[rxlea]

Same here. My favorites:

Shake Well

Keep Refrigerated

🤣

"For The Eye"
"For Inhalation Only"
"Contains more than one dose"
"Do Not Shake"
"For The Ear"
"External Use Only"

...

lol

All those are for the nurses, not the patients.

 

[Caverject]

Thank you for posting in this thread, Old Timer. As a newbie here, I enjoy seeing the experienced pros who contribute to so many threads.

My Pharmacist-In-Charge is awesome, and during slow times I can really pick his brain, which he seems to like. I think he would make a great college professor one day. He seems to have a great personality for it.

My assistant pharmacist is newly licensed and I don't enjoy working with her. She really doesn't have the whole multi-tasking thing down yet.

You need to remember these lessons if you ever become a pharmacist. Many new pharmacists that never were a technician before pharmacy school don't transition very well to retail. That's why whenever I work at Wags, I always buy my techs lunch or a coffee from Starbucks. I remember when I got paid $9 per hour...

 

[Tenor CS]

You need to remember these lessons if you ever become a pharmacist. Many new pharmacists that never were a technician before pharmacy school don't transition very well to retail. That's why whenever I work at Wags, I always buy my techs lunch or a coffee from Starbucks. I remember when I got paid $9 per hour...

Maybe that's part of it. When I interviewed, I was upfront with PIC that I considered this job part of a larger picture, and that I intended to pursue a career in Pharmacy. He's been with the company for 14 years, first as a tech, then took a little break when he was in Pharm school, and now as a pharmacist. I kind of hero-worship him a little, since he's so efficient and so good at what he does.

I gotta tell you, though, working with the medicines every day is a much more effective study tool for learning my brands/generics than flashcards!

 

[Ackj]

I personally place ALL the auxiliary labels on that I can fit, sometimes going up the next size in vial. I also give out the med guides and 99% of what the tree slaying computer prints out. I was commenting on the statement:

I do most of the med guides and other odd advertisements that print out. It seems that it's faster to fold the whole stack than go through the pages deciding which to keep, then fold them. Additionally, all our pages have pt name, address, and drug, so either give it to them, or put it in the box for shredding, and that box only gets emptied every 2-3 weeks.

I just had my review and during the hour I spent with boss, speed did not come up.

Out of curiosity, what kind of script volume does your store do? I guess we're considered a "slow" store, only doing around 150/day, so we don't really have the pressure to save every second possible.

 

[StevePerry]

Do what your PIC wants all of the time and if the other pharmacist complains, tell her to take it up with the PIC.

That is absolutely ridiculous advice... if the pharmacist on duty doesn't want the effing worthless papers (not including med guides) stapled to the real label, then you listen to the pharmacist on duty... otherwise that is just plain disrespectful. The PIC can do whatever he/she wants when they are there, but to tell the other pharmacist what to do when it comes to the other pharmacist filling prescriptions??? Seriously? You retail lifers are unreal.

My advice would be to tell the ---hole PIC to talk to the other pharmacist who, if it were me, would tell him/her to shove the extra papers up his/her ---.

 

[Old Timer]

That is absolutely ridiculous advice... if the pharmacist on duty doesn't want the effing worthless papers (not including med guides) stapled to the real label, then you listen to the pharmacist on duty... otherwise that is just plain disrespectful. The PIC can do whatever he/she wants when they are there, but to tell the other pharmacist what to do when it comes to the other pharmacist filling prescriptions??? Seriously? You retail lifers are unreal.

My advice would be to tell the ---hole PIC to talk to the other pharmacist who, if it were me, would tell him/her to shove the extra papers up his/her ---.

The PIC is IN CHARGE. He/she set's the policy and or enforces the policy of the employer. This is a tech who is told by his boss to give out the papers and use the labels. The employer decides what the policy is and the employees follow it. This is exactly how it was when I worked at an independent and it is exactly how it is at a Fortune 20 company. The other pharmacist is also supposed to follow the rules of the company and the lead of the PIC.

Unless you are the PIC or you own your own store, you follow the policies of the owner as enforced by the manager. This tech was hired by the PIC and unless the PIC's directives are against company policy, he should do what his boss told him. It's sound advice. You should take it sometime.

 

[Tenor CS]

Thanks, Old Timer. I fully intend on following PIC's lead. He has almost 10 years of experience, and all he does is follow federal and state laws, and corporate policies to the letter.

AP is the one who likes to cut corners.

Like someone else said, it's easier to just fold everything than it is to read every piece of paper and decide, "Is this one of the federally mandated ones?"

 

[Old Timer]

Out of curiosity, what kind of script volume does your store do? I guess we're considered a "slow" store, only doing around 150/day, so we don't really have the pressure to save every second possible.

I have a glorified title so I move from store to store. I just finished a year at a store that did between 4500 and 5000 scripts per week...

The slowest stores in the district are all over 1200(except for newly opened) many over 2000 and several are over 3000 and the monster store is at 4500-5000.

 

[StevePerry]

The PIC is IN CHARGE. He/she set's the policy and or enforces the policy of the employer. This is a tech who is told by his boss to give out the papers and use the labels. The employer decides what the policy is and the employees follow it. This is exactly how it was when I worked at an independent and it is exactly how it is at a Fortune 20 company. The other pharmacist is also supposed to follow the rules of the company and the lead of the PIC.

Unless you are the PIC or you own your own store, you follow the policies of the owner as enforced by the manager. This tech was hired by the PIC and unless the PIC's directives are against company policy, he should do what his boss told him. It's sound advice. You should take it sometime.

Unreal, seriously. The pharmacist ON DUTY is in charge of the prescriptions he/she fills as it is the pharmacist ON DUTY's liability not the ----head PIC's liability. For a PIC to think they have some sort of power over a fellow pharmacist's "clinical" decisions is asinine.

As per your "sound advice", I could care less what a PIC thinks when floating through a retail store. Now, a supervisor, yes, they are your superior and I can tell you with all they have to worry about I have never known or heard of one that gives a s--- if extra papers are stapled to a bag (I've actually seen HIPPA violations where techs staple wrong papers to the labels -- one more stupid thing to check).

Bottom line to the OP is your PIC is a jackass pharmacist caricature on some level with apparently too much free time on his hands at work.

 

[Got Em]

Even though Old Timer often gives great advice, I would have to agree with StevePerry over Old Timer on this one. The on duty pharmacist, or whoever is on record at the time, is the one responsible for technicians. I would follow whatever the PIC wants you to do, unless the pharmacist on duty has something else in mind. If the PIC has a problem with this, then he needs to go talk to the other pharmacist, not you, since your job is to work under whoever is on duty.

 

[Old Timer]

It is not the Pharmacists on Duty responsibility to decide which company policy he/she is to follow.

It is a regal requirement to dispense the Medguide with the prescription. This is not a clinical decision, it's a legal decision. In fact failure to dispense a Med-guide is considered misbranding. This would be a federal violation, by the way. Also, your boss corporate or otherwise does not want to be part of the next 20/20 expose on how pharmacists are not dispensing critical information as required by law. Hidden camera shots of reporter getting rx, no med-guide and a copy of the missing information. All of this followed by the reporter shoving a microphone in the face of the pharmacist at the end of the day asking "Mr. Pharmacist, why are you not dispensing this critical information as required by the FDA?" Followed by the statement from corporate that it is the policy of XYZ corporation to dispense this information in compliance with federal law.

It's the company policy to dispense the drug information sheet that appears with the medication. If it doesn't fit on the back of the label, it may need an extra piece of paper It's not a clinical decision at all.

It is not a clinical decision to dispense any advertising/supplemental information the company may procure in order to help pay the salary of the pharmacist and tech.

The only ground you have to stand on is with the auxiliary labels. This is a clinical decision and if the POD wants to put them or not that is totally up to them.

The first three are legal requirements or company directives and there is no clinical decision at all. You do what you are paid to do. Also, the POD is not making a clinical decision at all. She is making a decision based solely on speed of dispensing. I don't give a crap about giving this information to the patient because:

"patients never read them anyway."

AP also tells me not to bother with putting auxiliary labels on the bottles, since it slows down production.

So no, counselor, motion denied. You argument holds less water than a leaky bag. There is no clinical decision here at all. It's policy, plain and simple. You do what your boss wants.

 

[Old Timer]

Even though Old Timer often gives great advice, I would have to agree with StevePerry over Old Timer on this one. The on duty pharmacist, or whoever is on record at the time, is the one responsible for technicians. I would follow whatever the PIC wants you to do, unless the pharmacist on duty has something else in mind. If the PIC has a problem with this, then he needs to go talk to the other pharmacist, not you, since your job is to work under whoever is on duty.

In general you are correct, except when it comes to disregarding legal requirements or company policy. Clinical decisions are solely the pervue of the POD, but a careful reading of the thread finds that NONE of these decisions are driven by clinical considerations.

Once the government decides to require something, you do it.

Once the company decides on something, you do it.

The company trains the tech to do something in a certain , they do it and they should not risk violating company policy to satisfy the whims of the POD.

The POD is the professional and it his duty to work this out with PIC and remove the techs and other ancillary personal from the middle of this issue. Besides, your day and life as a pharmacist is only as good as your help. If they hate you or don't respect you, your life will suck, since you can't do it all....

 

[StevePerry]

It is not the Pharmacists on Duty responsibility to decide which company policy he/she is to follow.

It is a regal requirement to dispense the Medguide with the prescription. This is not a clinical decision, it's a legal decision. In fact failure to dispense a Med-guide is considered misbranding. This would be a federal violation, by the way. Also, your boss corporate or otherwise does not want to be part of the next 20/20 expose on how pharmacists are not dispensing critical information as required by law. Hidden camera shots of reporter getting rx, no med-guide and a copy of the missing information. All of this followed by the reporter shoving a microphone in the face of the pharmacist at the end of the day asking "Mr. Pharmacist, why are you not dispensing this critical information as required by the FDA?" Followed by the statement from corporate that it is the policy of XYZ corporation to dispense this information in compliance with federal law.

It's the company policy to dispense the drug information sheet that appears with the medication. If it doesn't fit on the back of the label, it may need an extra piece of paper It's not a clinical decision at all.

It is not a clinical decision to dispense any advertising/supplemental information the company may procure in order to help pay the salary of the pharmacist and tech.

The only ground you have to stand on is with the auxiliary labels. This is a clinical decision and if the POD wants to put them or not that is totally up to them.

The first three are legal requirements or company directives and there is no clinical decision at all. You do what you are paid to do. Also, the POD is not making a clinical decision at all. She is making a decision based solely on speed of dispensing. I don't give a crap about giving this information to the patient because:





So no, counselor, motion denied. You argument holds less water than a leaky bag. There is no clinical decision here at all. It's policy, plain and simple. You do what your boss wants.

First off, I had defended you in the past regarding your now obvious drinking of the kool aid. Now I'm almost convinced you are a corporate plant by CVS.

Notice my use of " " when referring to "clinical". I specifically ruled out the med guides, if you read my previous post, that are actually mandated by law. I have NEVER heard of any pharmacist being chastised by a DM or above for not adding the extra sheets at ANY company. If this is in fact your company policy, then how come such a small percentage of your pharmacists (what, less than 5% probably?) follow it even though it would be blatantly obvious to any corporate visitor?

Separate from this argument, if the pharmacist on duty wants to break company policy, the liability for this horribly severe infraction of wasting CVS's raping of the rainforests would lie solely on the pharmacist not the tech. For example, if a pharmacist decides to give out a medication without a prescription and hands the bottle to the tech and tells him to give it to the patient, who is going to be in trouble with the law and the company (imagine if he didn't staple the extra sheets too!)? Unless the techs on duty are blatantly insubordinate with subsequent discipline to follow, the pharmacist that is on duty is responsible for what the techs do with the law and the company, period. So regarding your weak argument, OVERRULED.

 

[Old Timer]

First off, I had defended you in the past regarding your now obvious drinking of the kool aid. Now I'm almost convinced you are a corporate plant by CVS.

Notice my use of " " when referring to "clinical". I specifically ruled out the med guides, if you read my previous post, that are actually mandated by law. I have NEVER heard of any pharmacist being chastised by a DM or above for not adding the extra sheets at ANY company. If this is in fact your company policy, then how come such a small percentage of your pharmacists (what, less than 5% probably?) follow it even though it would be blatantly obvious to any corporate visitor?

Separate from this argument, if the pharmacist on duty wants to break company policy, the liability for this horribly severe infraction of wasting CVS's raping of the rainforests would lie solely on the pharmacist not the tech. For example, if a pharmacist decides to give out a medication without a prescription and hands the bottle to the tech and tells him to give it to the patient, who is going to be in trouble with the law and the company (imagine if he didn't staple the extra sheets too!)? Unless the techs on duty are blatantly insubordinate with subsequent discipline to follow, the pharmacist that is on duty is responsible for what the techs do with the law and the company, period. So regarding your weak argument, OVERRULED.

Your only argument is the POD is GOD and can do what he/she wants. That is a fallacy that has been created by the shortage of pharmacists. Pharmacists had the upper hand and could pretty much do what they pleased. Now the shoe is on the other foot. If the pharmacist is a professional and not and ego tripped a-hole, he/she will resolve policy issues with the PIC and not place the techs in a position to resent him/her.

Your arguments change the minute they are defeated. First you say clinical decisions are made the POD, once that fallacy gas been debunked you change your tune.

The actions of the POD are wrong, they are bad for business, bad for the morale of the staff, bad for the POD as the staff will come to despise him/her for being a prick.

Ads for the Kool-aid, you are so totally of base as to show a complete lack of understanding of business. Your business understanding would -3 on a scale from 1-10. The amount of supervision is dependent on how close the management is to you. So let's compare CVS and Dr.M's independent in Florida. Let's say both hire a pharmacist and set the policy to give out Med Guides and both of the new hires decide not to. CVS will only do something if A the PIC forces a confrontation, or B the media publicizes this fact. The DM is not looking through the trash to see what's in there. But at Dr.M's if he sees you not doing something he told you to do, your probably wouldn't last long there. You might get a warning, but a second time disobeying a directive from your employer will result in termination. In other words, the do what the **** your boss says is much more strictly enforced in a small company where management is closer to you than in a large company. But if CVS gets bad publicity and you are warned to follow a certain policy and you intentionally disobey, they will fire your ass.

The shortage is over and management has he upper hand at least for now.

 

[Its Z]

the shortage is over and management has the upper hand and you'll never get it back in your lifetime.

fify!

 

[Old Timer]

fify!

I assume you meat iffy, and I was just a tad hyperbolic.....

 

[Its Z]

no, not iffy. fify... "fixed it for you"

 

[MountainPharmD]

Not much to say here except...You sir are an idiot. Obviously you have graduated sometime in the last year. Your inexperience and lack of understanding oozes off the page. Follow along kids and lets break down this ridiculous post.

Unreal, seriously. The pharmacist ON DUTY is in charge of the prescriptions he/she fills as it is the pharmacist ON DUTY's liability not the ----head PIC's liability. For a PIC to think they have some sort of power over a fellow pharmacist's "clinical" decisions is asinine.

This statement may have some truth in it but how does it relate to the OP's question? It is not a "clinical" decision to follow the law. You have your head so far up your ass it may never see sunshine if you think the PIC is not responsible for all pharmacy staff members and their compliance with the law. Deciding to put the FDA mandated medication guide in the bag and offering to counsel are not clinical desicions. There are legal requirements that PIC absolutly has a say in. You keep repeating "I have never seen anyone get in trouble, mad ect." to everyone's comments. Well no **** Shirlock in the whole three months you have been a pharmacist I am sure you haven't seen much of anything.

As per your "sound advice", I could care less what a PIC thinks when floating through a retail store. Now, a supervisor, yes, they are your superior and I can tell you with all they have to worry about I have never known or heard of one that gives a s--- if extra papers are stapled to a bag (I've actually seen HIPPA violations where techs staple wrong papers to the labels -- one more stupid thing to check)..

You could care less what a PIC thinks when you float through thier store? Oh dear lord pray to what ever God you worship you never float into my store. I put up with zero **** from anyone when it comes to compliance with the law or company policies and procedures. I have had some real serious come to Jesus talks with a few pharmacists concerning how things will be done while they are working in my pharmacy. I haven't kicked anyone out yet but I have come real close.

Bottom line to the OP is your PIC is a jackass pharmacist caricature on some level with apparently too much free time on his hands at work.

No sir, it is you who is the jackass. You are obviously very new and very inexperienced. Hopefully you will pull you head out soon. You have a lot to learn kid...alot.

 

[MountainPharmD]

That is absolutely ridiculous advice... if the pharmacist on duty doesn't want the effing worthless papers (not including med guides) stapled to the real label, then you listen to the pharmacist on duty... otherwise that is just plain disrespectful. The PIC can do whatever he/she wants when they are there, but to tell the other pharmacist what to do when it comes to the other pharmacist filling prescriptions??? Seriously? You retail lifers are unreal.

My advice would be to tell the ---hole PIC to talk to the other pharmacist who, if it were me, would tell him/her to shove the extra papers up his/her ---.

.........and if it were the PIC I would tell you to pick up all you **** and get the hell out of my pharmacy. The next time we would talk would be with the district supervisor and human resourses as we were writing you up for insubordination and what ever laws and/or company policies and procedures you violated. As big an idiot as you come off on here it would be a very short time before you employment with said company was terminated.

 

[Ackj]

I could care less what a PIC thinks when floating through a retail store. Now, a supervisor, yes, they are your superior

I would say the pharmacist in charge would be ... in charge. That'd probably make them your superior. I have two pharmacists at my store, our supervising puts them in, our other pharmacist doesn't really care. The other pharmacist tells me "I don't care either way, but you may as well put them on so you're in the habit for when you work with (supervising pharmacist)."

If they were just throw-away info, why would they be printed out? The company wants them there, regardless of if whether you think they're important. As I'm sure you're aware, the company is much bigger than you, and your opinion on a such extraordinarily minor matter is insignificant to them. When our DM floats through, he puts them in too. How about that? Somebody higher up in the company following company policy. Do you think he became the DM through insubordination? It's pretty unlikely.

As I've said before, I'm not in a very busy store, so I'm not strapped for time and I don't count every second. But if you're in such a predicament, go ahead, cut whatever corners you want to.

 

[StevePerry]

Not much to say here except...You sir are an idiot. Obviously you have graduated sometime in the last year. Your inexperience and lack of understanding oozes off the page. Follow along kids and lets break down this ridiculous post.



This statement may have some truth in it but how does it relate to the OP's question? It is not a "clinical" decision to follow the law. You have your head so far up your ass it may never see sunshine if you think the PIC is not responsible for all pharmacy staff members and their compliance with the law. Deciding to put the FDA mandated medication guide in the bag and offering to counsel are not clinical desicions. There are legal requirements that PIC absolutly has a say in. You keep repeating "I have never seen anyone get in trouble, mad ect." to everyone's comments. Well no **** Shirlock in the whole three months you have been a pharmacist I am sure you haven't seen much of anything.




You could care less what a PIC thinks when you float through thier store? Oh dear lord pray to what ever God you worship you never float into my store. I put up with zero **** from anyone when it comes to compliance with the law or company policies and procedures. I have had some real serious come to Jesus talks with a few pharmacists concerning how things will be done while they are working in my pharmacy. I haven't kicked anyone out yet but I have come real close.



No sir, it is you who is the jackass. You are obviously very new and very inexperienced. Hopefully you will pull you head out soon. You have a lot to learn kid...alot.

Come on Mountain I expect you at least to read/interpret my posts better than your reply suggests. I swear, does no one actually read my posts? THE MED GUIDES ARE MANDATORY PER THE LAW. This is the 3rd freaking time I said that. Those need to be included everytime. Yes if counseling is required or at the very least if the offer is required you must do it. I never even addressed that in my posts (I don't know where the hell you pulled that from). My issue is with extra papers being stapled to a bag. THERE IS NO FEDERAL OR STATE LAW ABOUT THAT.

I have no respect for people that nitpick things like stapling extra papers to a label WHEN THEY ARE NOT PRESENT. Do you seriously think if the second pharmacist is good with customers and can handle volume, but doesn't want to listen to some jackass PIC who thinks he's God of the Pharmacy 24/7 about stapling a freaking paper to a label is going to get fired for insubordination... I don't know what kind of fantasy land you live in. Obviously you don't know any DM's on a personal level or yours is a complete douche who is not worrying about the things he should to keep his job for much longer in the future.

The global point of my posts is that the pharmacist that is on duty should be respected by the techs right or wrong and held accountable by his DM and the law right or wrong. If the PIC has a problem with the second Rph, talk to him. If this doesn't resolve it, take it to your DM (who in this case would rofl I'm sure), but regardless don't tell the techs to disrespect the pharmacist on duty.

And why you gotta be a d--- and automatically assume new grad status? I've been out for quite a few years and float retail on the side for extra $... I just get a kick out of some of these megalomaniac PIC's at some of these retail joints you run into/hear about who think they can boss another RPh around like a tech.

I'll give you the benefit of the doubt on your last post, but if you're going to respond please read/understand my entire post this time and try not to be a jackass.

 

[StevePerry]

I would say the pharmacist in charge would be ... in charge. That'd probably make them your superior. I have two pharmacists at my store, our supervising puts them in, our other pharmacist doesn't really care. The other pharmacist tells me "I don't care either way, but you may as well put them on so you're in the habit for when you work with (supervising pharmacist)."

If they were just throw-away info, why would they be printed out? The company wants them there, regardless of if whether you think they're important. As I'm sure you're aware, the company is much bigger than you, and your opinion on a such extraordinarily minor matter is insignificant to them. When our DM floats through, he puts them in too. How about that? Somebody higher up in the company following company policy. Do you think he became the DM through insubordination? It's pretty unlikely.

As I've said before, I'm not in a very busy store, so I'm not strapped for time and I don't count every second. But if you're in such a predicament, go ahead, cut whatever corners you want to.

No doubt, it is an insignificant matter. I just think it is ridiculous to care so much about a prescription that goes out without your initials on it (assuming LEGALLY it is accurate and safe for the patient) to the point of writing a tech up over something so insignificant. That is absolutely ridiculous and shows the PIC in that scenario is an ---hole.

 

[StevePerry]

Your only argument is the POD is GOD and can do what he/she wants. That is a fallacy that has been created by the shortage of pharmacists. Pharmacists had the upper hand and could pretty much do what they pleased. Now the shoe is on the other foot. If the pharmacist is a professional and not and ego tripped a-hole, he/she will resolve policy issues with the PIC and not place the techs in a position to resent him/her.

Your arguments change the minute they are defeated. First you say clinical decisions are made the POD, once that fallacy gas been debunked you change your tune.

The actions of the POD are wrong, they are bad for business, bad for the morale of the staff, bad for the POD as the staff will come to despise him/her for being a prick.

Ads for the Kool-aid, you are so totally of base as to show a complete lack of understanding of business. Your business understanding would -3 on a scale from 1-10. The amount of supervision is dependent on how close the management is to you. So let's compare CVS and Dr.M's independent in Florida. Let's say both hire a pharmacist and set the policy to give out Med Guides and both of the new hires decide not to. CVS will only do something if A the PIC forces a confrontation, or B the media publicizes this fact. The DM is not looking through the trash to see what's in there. But at Dr.M's if he sees you not doing something he told you to do, your probably wouldn't last long there. You might get a warning, but a second time disobeying a directive from your employer will result in termination. In other words, the do what the **** your boss says is much more strictly enforced in a small company where management is closer to you than in a large company. But if CVS gets bad publicity and you are warned to follow a certain policy and you intentionally disobey, they will fire your ass.

The shortage is over and management has he upper hand at least for now.

Do you have a learning disability too? WTF IS WITH THE MED GUIDES! Read posts #28 and #36 by me, I blatantly refer to the med guides being mandatory and something that I believe should be stapled to the bag. Do not even respond to this post without clarifying that fact. I doubt you could string together a meaningful reply without using something I didn't say or something I did say out of context.

You seriously think YOU have a good understanding of business? Unlike others on here I'm not going to be disrespectful and try to pretend like you and Mountain are idiots, but come on. With margins tightening the way they are, do you think stapling things not required by law to hundreds of labels a day is a real high yield activity? As I referred to in a previous post, do you think a DM is going to give two s---- if a pharmacist who is good with customers and can handle volume doesn't staple things (other than med guides) to the labels? And you work for CVS? CVS???? Again you would obviously make a HORRIBLE district manager, especially for your company, and would last about a week trying to create your utopian district focusing on micro over macro.

 

[StevePerry]

Your arguments change the minute they are defeated. First you say clinical decisions are made the POD, once that fallacy gas been debunked you change your tune.

Hey Judge Koch, I'm glad you rendered a verdict in the confines of your own mind, but yeah, nothing was debunked/defeated/conceded in reality.

 

[MountainPharmD]

Come on Mountain I expect you at least to read/interpret my posts better than your reply suggests. I swear, does no one actually read my posts? THE MED GUIDES ARE MANDATORY PER THE LAW. This is the 3rd freaking time I said that. Those need to be included everytime. Yes if counseling is required or at the very least if the offer is required you must do it. I never even addressed that in my posts (I don't know where the hell you pulled that from). My issue is with extra papers being stapled to a bag. THERE IS NO FEDERAL OR STATE LAW ABOUT THAT.

I have no respect for people that nitpick things like stapling extra papers to a label WHEN THEY ARE NOT PRESENT. Do you seriously think if the second pharmacist is good with customers and can handle volume, but doesn't want to listen to some jackass PIC who thinks he's God of the Pharmacy 24/7 about stapling a freaking paper to a label is going to get fired for insubordination... I don't know what kind of fantasy land you live in. Obviously you don't know any DM's on a personal level or yours is a complete douche who is not worrying about the things he should to keep his job for much longer in the future.

The global point of my posts is that the pharmacist that is on duty should be respected by the techs right or wrong and held accountable by his DM and the law right or wrong. If the PIC has a problem with the second Rph, talk to him. If this doesn't resolve it, take it to your DM (who in this case would rofl I'm sure), but regardless don't tell the techs to disrespect the pharmacist on duty.

And why you gotta be a d--- and automatically assume new grad status? I've been out for quite a few years and float retail on the side for extra $... I just get a kick out of some of these megalomaniac PIC's at some of these retail joints you run into/hear about who think they can boss another RPh around like a tech.

I'll give you the benefit of the doubt on your last post, but if you're going to respond please read/understand my entire post this time and try not to be a jackass.

I am pretty sure I interpreted your post correctly. You said you had absolutly no regard for what the PIC wants in the pharmacies you float to. In fact you made it quite clear you do what ever the hell you want and could careless what the PIC says.

No one is harping on the Medguides. You started it by saying you throw them away and a PIC that makes you put them in the bag is a ego maniac, control freak pharmacist trying to alter the clinical decisions you make. I and several others have said following the law is not a "clinical" decision. You then back tracked and startred talking about the patient information sheets that print out.

As for this statement:

The global point of my posts is that the pharmacist that is on duty should be respected by the techs right or wrong and held accountable by his DM and the law right or wrong. If the PIC has a problem with the second Rph, talk to him. If this doesn't resolve it, take it to your DM (who in this case would rofl I'm sure), but regardless don't tell the techs to disrespect the pharmacist on duty..

I get the global point of your posts. You feel it is fine to do whatever the hell you want and could careless what the PIC wants. My point is this, come into my pharmacy with that attitude and I have a big surprise for you. Respect goes both ways. You respect the PIC who is responsible for the operation of the pharmacy.

 

[MountainPharmD]

Steve = voice of reason in this thread


I'm newly licensed and likely naive about some things, but it seems like some of you are blowing things out of proportion in this thread.

That says it all. If you think he is the voice of reason you have a problem.

 

[aboveliquidice]

Do you have a learning disability too? WTF IS WITH THE MED GUIDES! Read posts #28 and #36 by me, I blatantly refer to the med guides being mandatory and something that I believe should be stapled to the bag. Do not even respond to this post without clarifying that fact. I doubt you could string together a meaningful reply without using something I didn't say or something I did say out of context.

You seriously think YOU have a good understanding of business? Unlike others on here I'm not going to be disrespectful and try to pretend like you and Mountain are idiots, but come on. With margins tightening the way they are, do you think stapling things not required by law to hundreds of labels a day is a real high yield activity? As I referred to in a previous post, do you think a DM is going to give two s---- if a pharmacist who is good with customers and can handle volume doesn't staple things (other than med guides) to the labels? And you work for CVS? CVS???? Again you would obviously make a HORRIBLE district manager, especially for your company, and would last about a week trying to create your utopian district focusing on micro over macro.

Just for the record - implying that someone has a learning disability for missing your convoluted point is rude. It also hampers your ability to communicate effectively. Just sayin'...