How to deal with overbearing pharm techs?

[Moxxie]

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So I've been floating this summer as an intern. Which means that I've had a chance to work at a number of different stores w/in my chain - some very busy, others that barely do 100/day. I've worked with some wonderful pharmacists and some kick-ass techs. But I've also worked with several techs that I have simply wanted to smack upside the head.

For example, today I worked with a tech my age (27). She kept bragging about how awesome of a tech she is and how she's been nationally certified for 10 years. Several times she mentioned that she makes more money than me per hour. When someone came up to the counter to ask for OTC recommendations she would say, "Well, I can't give any recommendations, but the intern over there can." And then she'd kind of glare at me. I was very nice to her, but I couldn't help feeling that she resented me for being in pharmacy school, even though her choices have been her own. She's nice to the other techs but she seems to have something against interns (and some pharmacists).

Or I've also worked with techs that blatantly won't follow proper procedure. We're supposed to counsel on all new scripts, especially antibiotics. Sometimes people shrug the counseling off, but on one day I caught several errors/miscommunications just by asking the patients a couple of questions. Because of this, I have mentioned to a couple of techs that I saw letting scripts go through (that later we got phone calls about) that I wanted a chance to at least look at new scripts before I would verify them for dispensing (I can do this step as an intern, but not the QA before it). It was like I was asking her to strip naked or something, I got such a hostile response from one girl (most of the other techs have been cool).

I'm not saying that I'm the perfect intern, that I always do things the right way, or even that I'm the queen of tact. But I'm generally pretty competent and very easy to get along with. I've worked very well with people at almost all of the stores I've been with this summer. It's just a few techs that seem to resist any kind of directions or requests coming from me, a lowly intern.

What's the best way to handle this? Things like my first example I'm willing to shrug off, but I'm not really willing to sit idly by when possible med errors are made because of a lazy or resentful tech. But at the same time, I don't really have the seniority or authority to call them on it. SDN1977, how do you handle techs with a mind of their own? MountainPharmD, have you ever had to call anyone out for their actions? What about you other interns/rphs?

Thanks 🙂

 

[twester]

The responsibility is ultimately on the pharmacist of record for the shift you work. If she/he doesn't have a problem with how counseling is or isn't being conducted, then you don't either (as an intern).

A couple of times, I've been irritated by techs, but I've also been irritated with pharmacists. As an intern, it's not worth getting het up about. Sure, there've been one or two techs I wanted to smack around. But that wouldn't accomplish anything - and I'd probably lose the smack-down.

My experience as an intern has been largely positive. I've had techs, pharmacists and interns bend over backwards to help me. I try to step into each store (I float too) as the newcomer who aims to prove what contribution I can make to the staff. I step back when someone gets territorial, even if that means I end up trapped in one awful station or other.

 

[MountainPharmD]

Excellent question. Working as an intern is going to put you far ahead of your peers who are not working. This is a situation we all have to deal with. Doesn't matter if you're an intern, new Pharmacist or been around for a few years. Every company I have worked with seems to have a technician or two that has been with the company forever and thinks they know more than the Pharmacist. It's a tough situation especially if you are a floater. As an intern floater, unfortunately, there is not much you can do. You are working under the Pharmacists license same as the technician. You can certainly bring up issues and problems to the Pharmacy Manager. If the Pharmacy Manager and or Staff Pharmacist do not do anything about it, you are stuck. Now if there are violations of state and/or federal laws or company policies and procedures you would of course go higher once you talked to the Pharmacy Manager, if they did nothing. That does not sound like what is happening in this situation. Sounds like you have a no-it-all tech that slightly resents you because you are an intern. Your best bet is to do what you can to fit in. Work hard and hopefully over time things will smooth out and you will be able to work together.

How would you handle this type of situation if you were a Pharmacist floating to this store? I think that is the most important question and lesson to learn here. I guarantee you will encounter this same type of situation once you graduate. As a Pharmacist, even a floater, you are in charge and would have to do something. I have had to deal with this several times. The company I work for has many employees who have been with the comapny 30+ years.

So think about what you would do in this exact same situation as a Pharmacist. Coming up with a plan to deal with it now will save a headache in the future.

 

[no-see-um]

Sometimes people shrug the counseling off, but on one day I caught several errors/miscommunications just by asking the patients a couple of questions. Because of this, I have mentioned to a couple of techs that I saw letting scripts go through (that later we got phone calls about) that I wanted a chance to at least look at new scripts before I would verify them for dispensing (I can do this step as an intern, but not the QA before it).

I extend my sympathies for your situation, but with regards to this part of your post,
I've never heard of this step. Sounds like an extra step for an Intern. Once the pharmacist checks it, it's checked. Maybe I'm missing something??

 

[sdn1977]

I agree with Mountain - great question (& great answer btw...!).

You could add to the drama by "staking your territory" & developing a reputation yourself & demanding each rx gets counseling - which gets around to others in the business.

Or, you can use this as a learning situation, which you're doing here, but really needs to be done "there".

Its been a long time since I was an intern, so my memory might be too shady to rely on for this particular circumstance, but I've worked in situations where techs overstepped their bounds & I've been the pharmacist & perhaps that will help. When I've observed the situation occuring between a tech & an intern, I take the tech aside & remind him/her of their job & their job limitations & how an attitude can go a long way toward making a day be better or worse than it otherwise might be. Then, I take the intern aside & go over the situation, explaining what occured, ways to limit or change the situation when the intern is the actual pharmacist & help with ways to be assertive without being aggressive.

Both these "asides" are away from & apart from other people. I absolutely believe in privacy when work related issues arise. It is humiliating to be reprimanded in public & sets up an "I'm right..she was wrong" situation which often can't be undone.

But, Moxxie, your pharmacist did not do that. So - what can you do with a non-assertive pharmacist in this situation? I'd recommend, at the end of the day, take a moment privately (or quietly) and ask how the pharmacist recommend dealing with this situation so you can learn to become a better pharmacist. This allows you to point out the pharmacist is not doing what he/she should be doing in a way that saves "face" & gives that person an opportunity to redeem him/herself & actually teach you something. You might not get anything valuable out of the interaction, but you've tried to bring a difficult situation to the attention of the supervising person (& given that person something to think about) without adding to the drama.

There are 2 things which are important here - first & foremost is the patient .The second is your learning, which addressing the pharmacist is a way to do it. But, keep in mind - lowering yourself to snide comments, backhanded verbal slaps & other passive-aggressive behaviors which you experienced from the tech are non-productive & cloud the actual issue at hand. You really don't want to go there. You want to be able to learn how to maintain a professional demeanor in all circumstances.

Now - when I come in as a float pharmacist & I experience this...I just clearly & plainly state that no new prescription goes out without counseling by me or my intern. I assume my direction will be followed - give them the benefit of the doubt. If it doesn't happen, I take the individual aside & ask what did he/she not understand. Normally I get "well so & so lets us ....". I clearly & without emotion say so & so is not here & we'll dispense rxs my way during the day I'm here.

I've also been known to get out my "mommy-isms" & when snarling begins I'll say "if you don't have anything nice to say, keep it to yourself". They HATE that, but they don't have to like me - they just have to do what the law requires & I enforce.

I did have a tech once tell me (I was a new hospital pharmacist at the time) "you have to work faster". I stopped everything I was doing, put down everything I was holding, looked at her & told her the ONLY thing I HAD to do was fill each & every order correctly. I suggested she take a break so she could get herself a bit more relaxed & I'd handle things in her absence. We never again had a disagreement.....altho you will always have techs (particularly in hospitals) who just don't understand why you have to look at that order for so long - or god forbid, get a book out. They think you should read on your day off (I'm good, but I don't know each & every interaction & their significance off the top of my head!) & they think we read Facts & Comparisons or Manual of Medical Therapeutics for fun!

So...my advice - think about what you want to accomplish. Its human nature to want to "put that girl in her place". But, actually, as an intern, your interaction with her in that manner will only cause more tension. You may not change the environment that is occuring at that site. There is more than one retail location, corporation & hospital I won't work at because of the underlying politics which don't coincide with my own beliefs. But, as an intern, this is your time to learn what will become important to you, where you'll set your limits & how, and learn how to intervene so the primary purpose (the safety of the patient) is maintained.

Good luck & feel free to come back to ask anything, anytime. You'll graduate with all the knowledge you're capable of at the time, but learning interpersonal issues is often a longer process - particularly when you suddenly become supervisor of someone much older & who has been in the business much longer.

(ps - Caverject - don't read this - I know its long....I had a lot to say😀)

 

[alwaystired]

I've actually dealt with this off and on....the resentment that I get paid more, or techs "counseling", or techs that just ring the drugs up without calling me over to counsel. To me, there's no excuse if I am at work to not have counseling offered. First of all, it's the law. Second of all, I am basically there as extra help for the pharmacist so why not call me over?

As far as the making more money than them, I think it was a lot harder for the techs at my store in the beginning when I didn't know a whole lot. They would make comments and be snide to me. But today, they would be very hardpressed to justify any argument about why I don't deserve what I make, since I can do a whole ton of things they can't do now and I know a lot more than I did when I first started.

As far as them passing off the counseling or answering questions they shouldn't be. I just let it go. Really, it's up to the pharmacist on duty to protect their license and it's not my place or duty. It definitely bothers me, but I'd rather not make a war over it and when I'm the pharmacist, I hope that the techs I am working with understand that I 100% want to be called for new counsels and I will reprimand them if they don't and that will be my place to do so.

Right now I am on rotations and I am finding some of the hospital techs to be kind of overbearing, pushy, and rude and I have very little I can do about it because 1. they know way more than me in that environment and 2. the pharmacists are doing their own thing and I'm left to "entertain" myself which means I follow the techs around and try to learn the work flow of the place.

I think it's going to be difficult to be a younger pharmacist when I'm done because I feel like the techs give me a harder time. Ahhh, the woes of intern, good luck Moxxie.

 

[Caverject]

For example, today I worked with a tech my age (27). She kept bragging about how awesome of a tech she is and how she's been nationally certified for 10 years. Several times she mentioned that she makes more money than me per hour. When someone came up to the counter to ask for OTC recommendations she would say, "Well, I can't give any recommendations, but the intern over there can." And then she'd kind of glare at me. I was very nice to her, but I couldn't help feeling that she resented me for being in pharmacy school, even though her choices have been her own. She's nice to the other techs but she seems to have something against interns (and some pharmacists).

I strongly believe this is just a simple communication issue. The way you described the technician in this case is exactly how I used to be when I was a certified tech. Fact was, I was trying to be funny, personable, and prove my self worth, but what I was really doing was alienating everybody that worked in the pharmacy with me. Until someone had the stones to invite me out for coffee on the clock (meaning pulling me aside to talk to me about the issue), I had no earthly clue how bad I was pissing people off. Did the conversation hurt me? yes, it was a blow to my ego and self-esteem. It also made me much more humble of a person and changed my life in regards to how I handle myself and much more aware of what people say. When the tech says, "I can't offer you advice but the intern can..." it's really a compliment to you more than anything else but doesn't come off that way.

Or I've also worked with techs that blatantly won't follow proper procedure. We're supposed to counsel on all new scripts, especially antibiotics. Sometimes people shrug the counseling off, but on one day I caught several errors/miscommunications just by asking the patients a couple of questions. Because of this, I have mentioned to a couple of techs that I saw letting scripts go through (that later we got phone calls about) that I wanted a chance to at least look at new scripts before I would verify them for dispensing (I can do this step as an intern, but not the QA before it). It was like I was asking her to strip naked or something, I got such a hostile response from one girl (most of the other techs have been cool).

This is where you have the right to become a hard ass. If there is any lip/feedback/hostility when you ask your techs to do something simple, all it takes is a little reminder of where the hierarchy stands. Its also a good idea to have a scenario thought out and you can explain it when you dress down the tech. Some techs really need this if they blatantly refuse to do what you ask them to do. Good luck!

 

[tussionex]

i simply take them to the basement and beat them.

 

[acetyl]

i simply take them to the basement and beat them.

...Or force them to read sdn77's comments?

 

[Moxxie]

Thanks everybody for your replies. Like I said before, I've mostly worked with awesome techs and pharmacists and I've only encountered these problems a few times. I'll have to come up with some strategies but in the meantime, I'll just take things in stride and try to make sure that there are no med errors being made while keeping the peace. 🙂

But I don't think that I have the nerve to tell a pharmacist that they are not doing what they need to be doing or are not keeping track of their techs very well. It just seems like too big of a risk, especially when I'm floating and could be blacklisted. I'm sure that if I saw a major error being made I would speak up, but pointing out errors in management just seems chancy.

As to no-see-um's question, the final step that I mentioned is part of our company's policy: any new prescription requires a pharmacist's or intern's check at the register (verified via fingerprint) before it can be dispensed. Some pharmacists just run over and push their finger on the little scanner, but I like to actually take a glance at the rx and say hi to the person picking it up. The person that checks the rx is kept on record, so if there is an error or misunderstanding that could have been easily caught by counseling the patient, I don't want to be the one on record that let the rx slip through.

 

[pharmgirl2011]

Thanks everybody for your replies. Like I said before, I've mostly worked with awesome techs and pharmacists and I've only encountered these problems a few times. I'll have to come up with some strategies but in the meantime, I'll just take things in stride and try to make sure that there are no med errors being made while keeping the peace. 🙂

But I don't think that I have the nerve to tell a pharmacist that they are not doing what they need to be doing or are not keeping track of their techs very well. It just seems like too big of a risk, especially when I'm floating and could be blacklisted. I'm sure that if I saw a major error being made I would speak up, but pointing out errors in management just seems chancy.

As to no-see-um's question, the final step that I mentioned is part of our company's policy: any new prescription requires a pharmacist's or intern's check at the register (verified via fingerprint) before it can be dispensed. Some pharmacists just run over and push their finger on the little scanner, but I like to actually take a glance at the rx and say hi to the person picking it up. The person that checks the rx is kept on record, so if there is an error or misunderstanding that could have been easily caught by counseling the patient, I don't want to be the one on record that let the rx slip through.

Are you referring to your intern hours we do in 4th year? excuse me for being confused...I know we do rotations in our 4th year, so is that when we are a pharmacy intern? or is it anytime we are working at a pharmacy while we are in school? Can you work as a pharm intern after pgy1? Thanks in advance!

 

[twester]

Are you referring to your intern hours we do in 4th year? excuse me for being confused...I know we do rotations in our 4th year, so is that when we are a pharmacy intern? or is it anytime we are working at a pharmacy while we are in school? Can you work as a pharm intern after pgy1? Thanks in advance!

In Colorado, a person only has to be licensed as an intern pharmacist and file hours worked with the state board to get credit for hours work. My school requires an intern pharmacist license as a condition of enrollment, so many people in my class worked in that capacity in their P1 year.

 

[alwaystired]

Are you referring to your intern hours we do in 4th year? excuse me for being confused...I know we do rotations in our 4th year, so is that when we are a pharmacy intern? or is it anytime we are working at a pharmacy while we are in school? Can you work as a pharm intern after pgy1? Thanks in advance!

We have rotations during the first and second year in community. And then we can also work if we want as well.

 

[ZpackSux]

So I've been floating this summer as an intern. Which means that I've had a chance to work at a number of different stores w/in my chain - some very busy, others that barely do 100/day. I've worked with some wonderful pharmacists and some kick-ass techs. But I've also worked with several techs that I have simply wanted to smack upside the head.

For example, today I worked with a tech my age (27). She kept bragging about how awesome of a tech she is and how she's been nationally certified for 10 years. Several times she mentioned that she makes more money than me per hour. When someone came up to the counter to ask for OTC recommendations she would say, "Well, I can't give any recommendations, but the intern over there can." And then she'd kind of glare at me. I was very nice to her, but I couldn't help feeling that she resented me for being in pharmacy school, even though her choices have been her own. She's nice to the other techs but she seems to have something against interns (and some pharmacists).

Or I've also worked with techs that blatantly won't follow proper procedure. We're supposed to counsel on all new scripts, especially antibiotics. Sometimes people shrug the counseling off, but on one day I caught several errors/miscommunications just by asking the patients a couple of questions. Because of this, I have mentioned to a couple of techs that I saw letting scripts go through (that later we got phone calls about) that I wanted a chance to at least look at new scripts before I would verify them for dispensing (I can do this step as an intern, but not the QA before it). It was like I was asking her to strip naked or something, I got such a hostile response from one girl (most of the other techs have been cool).

I'm not saying that I'm the perfect intern, that I always do things the right way, or even that I'm the queen of tact. But I'm generally pretty competent and very easy to get along with. I've worked very well with people at almost all of the stores I've been with this summer. It's just a few techs that seem to resist any kind of directions or requests coming from me, a lowly intern.

What's the best way to handle this? Things like my first example I'm willing to shrug off, but I'm not really willing to sit idly by when possible med errors are made because of a lazy or resentful tech. But at the same time, I don't really have the seniority or authority to call them on it. SDN1977, how do you handle techs with a mind of their own? MountainPharmD, have you ever had to call anyone out for their actions? What about you other interns/rphs?

Thanks 🙂

Treat your technicians with utmost respect...and make them feel important.