Inpatient pharmacist errors

[peachesforteaches876]

Hi,
I have been working as an inpatient pharmacist for 2 years now. Recently I have been making more errors than i am comfortable with (maybe averaging from 1 a week?) and i cant really wrap my head around why. I don't think any of my colleagues (hopefully) would call me a bad pharmacist. I work my A** off, and im a good team player and i pretty much have a good relationship with everyone. I have noticed something since i started here though that has pushed me hard enough to consider quitting. Unfortunately we have a few older/senior pharmacists that like to sit around and do nothing, so our younger, fresher people tend to carry the weight when covering in central pharmacy. We have staff that manipulate our management and basically get to be horrible at their job but still work here and have seniority. It also feels like some of these older pharmacists know the less you involve yourself in the less chance there is you will make an error or be in a situation you don't want to be in (which i honestly find horrible for patient care, to punt things off on younger less experienced counterparts). Like all things in inpatient if its a terrible order its probably stat or your our of stock. This is the same for technicians as we are union so we have a few bad eggs we just cant get rid of. Anyways, basically i feel like were entirely understaffed when we are full -3/4 census (which is 95% of the time during covid) and Im constantly juggling 50 things at once, which is unsafe. I am not the only colleague that has felt this way but unfortunately nothing changes. I imagine that is maybe why I'm making stupid mistakes (signing off on wrong meds, being in wrong pt charts, auto subbing incorrectly)? Do i need to slow down and maybe be more like my older counterparts (i have a really hard time doing this. I inherently match the pace that we are required to respond to (ie. orders in the que, phone calls, missing meds).

I also cant help but to think inpatient pharmacy is just not for me in terms of pace and stress level. I keep asking my self consistently (of course more often when i make mistakes), what am i even doing here? And i really really loose sleep over work, i think thats the worst thing.

idk do any inpatient rphs or those that have maybe made a switch had these thoughts these issues and moved to a different facility and felt better? Felt it was better staffed or maybe its just me and im horrible. i don't know. I will say honestly like most of us im absolutely burnt out.. like SOS.

open to any advice

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[Rockinacoustic]

Sounds like you need to slow down and work at a pace that is safe. Whatever merit you find out of verifying the most orders or answering the most phone calls won't matter if you're the root cause of patient harm.

 

[ValeRx]

Yep... slow down, work at the pace you're comfortable with. I know your pain. Some other pharmacists in my pharmacy are basically dead weight and I'm the one processing every single inpatient order while the others are making their tea in the break room.

 

[Idk17]

Working with older, slower pharmacists that avoid doing anything and therefore make no mistakes while they leave you to do 10x the workload isn't a situation you're likely to escape by just leaving inpatient pharmacy.

Personally, I kind of like working shifts where I'm by myself so I don't have to get annoyed by all that. It does mean you're probably busier and need to be able to prioritize well though. When I work a normal shift where there are 3-4 other pharmacists with me, I feel like I'm getting paid to do nothing.

 

[sadface]

When I was working with similar pharmacists I found some success in straight up asking them to do a particular task especially if they were messing around. I would just say something like “hey I’m drowning in stat drips and have three pages I’m waiting on calls for, can you do that vanco consult in the queue?” Or “hey I think x would be our next task to prioritize, since I’m already doing y, could you start on that? Or is something else a bigger priority?” It’s frustrating to micromanage other people but if they are obviously not working, most of them were receptive to it.
Everyone is more likely to make mistakes the faster they go. I would consider going back to a pace you are comfortable with and focus on prioritizing the most urgent tasks. I do shift my mindset with how busy I am but I tend to spend less time on micromanaging slight therapy optimizations compared to rushing through entering or timing orders.
I would also spend a little time reflecting on your “wins” and great interventions you’ve caught. We tend to remember our mistakes and get caught in a perfectionism mindset and forget the times we made a difference many other pharmacists may have missed.

 

[owlegrad]

I would also spend a little time reflecting on your “wins” and great interventions you’ve caught. We tend to remember our mistakes and get caught in a perfectionism mindset and forget the times we made a difference many other pharmacists may have missed.

Great advice. It can really go a long way if you can find a few wins here and there to balance out the rest.

 

[Sparda29]

Slow down and make the older pharmacists pick up the slack.

I noticed around the time I started, I was verifying like 30 orders in 10 minutes meanwhile the older pharmacist would spend 5 minutes on one damn order. When I'm overnight, I have to pick up the pace otherwise there will be 300 orders by 7AM. But I have some overlap with the day shift and that's where I notice that the older day shifters are slow as ****.

 

[Sine Cura]

Seems like the opposite in retail. Newer people not adapting "successfully" to the pace at which you "need" to work

You cannot data-verify 5 scripts an hour in retail and not be backed up unless that location does literally 60 Rx/day.

 

[samven582]

Yep... slow down, work at the pace you're comfortable with. I know your pain. Some other pharmacists in my pharmacy are basically dead weight and I'm the one processing every single inpatient order while the others are making their tea in the break room.

99.9% of pharmacists who work at the VA are dead weight.

 

[WorthlessOxygen]

Seems like the opposite in retail. Newer people not adapting "successfully" to the pace at which you "need" to work

Not in my experience. The new grads that are slow don't tend to last long so it's generally pretty much what OP described here.

 

[mustang sally]

Well, there are errors and then there are errors, if you know what I’m saying. It sounds like these are probably minor mistakes on your part, so I agree with others to just slow down and work at a pace that is comfortable to you (not like a dead weight pharmacist pace, but just slow down a little). The work will still be there. No need to rush things unless something is truly stat.

Also, it does seem like hospitals are getting more stressful these days (at least mine certainly is), but it’s important to remember that a lot of stress is how we react in certain situations.

 

[pinkpharmd]

Slow down and make the older pharmacists pick up the slack.

I noticed around the time I started, I was verifying like 30 orders in 10 minutes meanwhile the older pharmacist would spend 5 minutes on one damn order. When I'm overnight, I have to pick up the pace otherwise there will be 300 orders by 7AM. But I have some overlap with the day shift and that's where I notice that the older day shifters are slow as ****

Please share your tactic on how to get others to work. I work in hospital and working with others kills my soul. Instead of patient care, Amazon, kid’s homework, trip planning are a priorities.

 

[pinkpharmd]

Hi,
I have been working as an inpatient pharmacist for 2 years now. Recently I have been making more errors than i am comfortable with (maybe averaging from 1 a week?) and i cant really wrap my head around why. I don't think any of my colleagues (hopefully) would call me a bad pharmacist. I work my A** off, and im a good team player and i pretty much have a good relationship with everyone. I have noticed something since i started here though that has pushed me hard enough to consider quitting. Unfortunately we have a few older/senior pharmacists that like to sit around and do nothing, so our younger, fresher people tend to carry the weight when covering in central pharmacy. We have staff that manipulate our management and basically get to be horrible at their job but still work here and have seniority. It also feels like some of these older pharmacists know the less you involve yourself in the less chance there is you will make an error or be in a situation you don't want to be in (which i honestly find horrible for patient care, to punt things off on younger less experienced counterparts). Like all things in inpatient if its a terrible order its probably stat or your our of stock. This is the same for technicians as we are union so we have a few bad eggs we just cant get rid of. Anyways, basically i feel like were entirely understaffed when we are full -3/4 census (which is 95% of the time during covid) and Im constantly juggling 50 things at once, which is unsafe. I am not the only colleague that has felt this way but unfortunately nothing changes. I imagine that is maybe why I'm making stupid mistakes (signing off on wrong meds, being in wrong pt charts, auto subbing incorrectly)? Do i need to slow down and maybe be more like my older counterparts (i have a really hard time doing this. I inherently match the pace that we are required to respond to (ie. orders in the que, phone calls, missing meds).

I also cant help but to think inpatient pharmacy is just not for me in terms of pace and stress level. I keep asking my self consistently (of course more often when i make mistakes), what am i even doing here? And i really really loose sleep over work, i think thats the worst thing.

idk do any inpatient rphs or those that have maybe made a switch had these thoughts these issues and moved to a different facility and felt better? Felt it was better staffed or maybe its just me and im horrible. i don't know. I will say honestly like most of us im absolutely burnt out.. like SOS.

open to any advice

I was in a similar situation as you but like my friends say I don’t work at a real hospital. Your workload is much higher than mine. I did everything for inpatient department. I kept that place so neat and handled all problems. I gave report when I left. I sent medication doses. I questioned missing doses. I also believe my clinical skills is far better than most pharmacist I work with. I care about my work. You should ask yourself, why do you work so hard? They have all these other pharmacist that are there to support the service and if anything they are getting paid more than you to do 1/5 your work output. Management needs to correct this. Just remember, you can finish all the orders you want and answer all the calls but you can’t take back a deadly mistake. The receipient of your error is somebody’s mom, father, daughter, grandma, grandfather, uncle, etc.

 

[Sparda29]

Please share your tactic on how to get others to work. I work in hospital and working with others kills my soul. Instead of patient care, Amazon, kid’s homework, trip planning are a priorities.

I work overnights with another Rph, he has gotten better.

But as for dealing with the morning shift crews antics. As soon as they come in at 7AM, what I'll do is go upstairs to deliver some meds and I'll take my sweet ass time at doing it, chat with some doctors, grab a sandwich from the cafeteria.

That way, as soon as they come in, they are forced to log on and start looking at orders instead of bull****ting for 15 minutes, talking, getting situated, eating breakfast, etc.

 

[TheBlaah]

I work overnights with another Rph, he has gotten better.

But as for dealing with the morning shift crews antics. As soon as they come in at 7AM, what I'll do is go upstairs to deliver some meds and I'll take my sweet ass time at doing it, chat with some doctors, grab a sandwich from the cafeteria.

That way, as soon as they come in, they are forced to log on and start looking at orders instead of bull****ting for 15 minutes, talking, getting situated, eating breakfast, etc.

That's funny. At my hospital, the dayshift coverage for the pharmacy would come in and eat breakfast in the breakroom for the 30 minute overlap they have with nightshift.
Then second shift would come in at noon, and dayshift would then go on an hour long lunch break.

I only found this out upon having to work a night shift.

 

[Sparda29]

That's funny. At my hospital, the dayshift coverage for the pharmacy would come in and eat breakfast in the breakroom for the 30 minute overlap they have with nightshift.
Then second shift would come in at noon, and they would they go on an hour long lunch break.

I only found this out upon having to work a night shift.

It's nonsense and management let's them get away with it. I even had to change my workflow because of them. There are some tasks that only the night shift has to do so I used to intentionally wait until 7am to start them so that I would be busy with my own tasks so that they would have to start working immediately. Then management said overnight tasks need to be completed by a certain time so that overnight pharmacists can help out with the morning workflow.

 

[Deja]

if you want things to change then just match the other pharmacists pace and let **** burn lol if you do everything yourself, all management will see is that all the tasks are completed... they don't care how it's done

 

[StockPharmD2020]

That's funny. At my hospital, the dayshift coverage for the pharmacy would come in and eat breakfast in the breakroom for the 30 minute overlap they have with nightshift.
Then second shift would come in at noon, and they would they go on an hour long lunch break.

I only found this out upon having to work a night shift.

Have any openings? I'd love to show up and do nothing for an hour ha

 

[pinkpharmd]

Have any openings? I'd love to show up and do nothing for an hour ha

Some people I work with show up and do nothing for 8.5 hours!

 

[samven582]

if you want things to change then just match the other pharmacists pace and let **** burn lol if you do everything yourself, all management will see is that all the tasks are completed... they don't care how it's done

I'm going to try this lol

 

[BidingMyTime]

Ethically, you should work at the fastest pace you can safely work at, and not worry about what your co-workers/slackers are doing. Realistically, the politics in your hospital may not support that. And realistically, you are unlikely to find any better workplace, and likely to find much worse (especially since you would be starting as the newbie at that place.) So, I don't have no good answers. I wouldn't risk you license over it, which mean only work at the fastest pace you can safely work at. You can certainly try forcing your co-workers to do their share...worse that could happen is you get fired, but that is better than losing your license.

 

[dmd20000]

I was in a similar situation as you but like my friends say I don’t work at a real hospital. Your workload is much higher than mine. I did everything for inpatient department. I kept that place so neat and handled all problems. I gave report when I left. I sent medication doses. I questioned missing doses. I also believe my clinical skills is far better than most pharmacist I work with. I care about my work. You should ask yourself, why do you work so hard? They have all these other pharmacist that are there to support the service and if anything they are getting paid more than you to do 1/5 your work output. Management needs to correct this. Just remember, you can finish all the orders you want and answer all the calls but you can’t take back a deadly mistake. The receipient of your error is somebody’s mom, father, daughter, grandma, grandfather, uncle, etc.

I do the same as you but I see myself risking it more to get more done so more errors can occur. I think about it differently now so when I go to work I will keep myself busy doing everything I can at my own pace so when I am at work I feel like they own me until my shift is over.