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Keeping up at work

Discussion in 'Pharmacy' started by NewRPh, Aug 5, 2011.

  1. NewRPh

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    Hopefully you experienced pharmacists can give me some tips on keeping up with the pace of work. I'm in my second week as a pharmacist at Kroger, where I was thrown in on my own the day after I was licensed. It's usually me and one tech at a time, with two to four hours of overlap between the 1st shift and 2nd shift techs, and we usually fill anywhere from 150-200 scripts/day.

    I find myself falling VERY behind at times, and once my queues start piling up on me, it's nearly impossible to get caught back up. I may not be giving myself enough credit, as I'm just starting out, but my stress as well as that of my techs tell me I need to change something drastically, asap.

    If you have a significant drug interaction which requires you to call the doctor or do more research, do you do it right away or put it off until the pace lets up a little bit? What about answering phones? Do you let it ring until a tech picks it up every time (given that they're not helping a customer or already on the phone, and you're both busy at your stations)?

    In my transition from intern to pharmacist, I'm finding it difficult not to drop what I'm doing and help someone at the counter/walk-up window or answering the phone right away. I often still do this on top of trying to get acclimated to verifying prescriptions (which interns don't get nearly enough practice doing) and other daily tasks.

    How long did it take you before you really felt comfortable or that you could keep up with the pace of things? Thanks for any help.
     
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  3. MountainPharmD

    MountainPharmD custodiunt illud simplex
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    Welcome to the party my friend! I sent you a PM so we can talk in private.
     
  4. MountainPharmD

    MountainPharmD custodiunt illud simplex
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    Lets talk about significant drug interactions. How many of them are there and how many of them require a call to the Doctor? Honestly this should be a very small part of your day and shouldn't have much of an impact. If you find yourself flagging 10 to 15 prescriptions a day you need to step back and really think about what you are calling about. The computer flags almost everything. You could spend all day calling Doctors about the stuff the computer flags. When you break it down there are only a handful of things that require a call to the Doctor.

    I am some what jaded on this subject because you can never get hold of a Doctor to discuss a potential interaction or anything for that matter. How many times have you called a Doctors office to get some idiot MA on the phone that listen to what you have to say and immediately says oh that fine you can dispense the medication? I have had it happen many times. On drug interactions use all of that knowledge you learned in pharmacy school to evaluate the interaction. Most things can be dismissed or handled with counseling and warning the patient.


    Your techs are you most valuable resource. The quality of your techs will make or break your pharmacy. With that said the techs are there to assist you in the practice of pharmacy by doing non-judgmental tasks. Ringing the register, answering the phone, and showing customers where products are in the store are all good examples of non-judgmental tasks they should be handling. However, your techs are just as stressed as you are. If you stand at the verification station all day and do nothing but check prescriptions you will not be very popular with your techs. You have to strike a balance where you are getting your work done and you are assisting them when they need help. I have found if you always answer the phone or always go to the register first your techs will let you do it even if they are not busy.
     
  5. kvl1027

    kvl1027 Member
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    The hardest thing for me, at first, was delegating responsibility to the technicians. There are a lot of things they can do, that you dont need to do.
    You may need to come up with a more efficient way to check scripts, like a check list so that all scripts are checked the same way.
    My best advice would be to "STAY OFF THE PHONE" as much as possible. You should be the last one to answer the phone. I agree with the earlier poster that you may be spending too much time calling Dr's offices to verify scripts or make interventions. I know when you are right out of the gate every intervention seems important and you feel like you need to call the Dr to make changes. I'll give you an example: There is a cough syrup that all the peds write for, that is not covered by medicaid, the alternative that is covered by medicaid is almost exactly the same minus one ingredient. I know that everytime I call that Dr. they OK the substitution. So I always sub them now without calling and then document on the script that the Dr OK'd it. Most docs would rather have you do this then bother them with what seems to them to be a trivial question.
    I have had so many docs say "just give them what their insurance covers". Sometimes you just have to rely on your knowledge and experience to make some of those decisions. Do you really need to call the Dr. to make sure you can give your patient two 300mg gabapentins instead of one 600mg gabapentin? Or that you want to give fluoxetine 10mg capsules instead of the 10mg tablets? You can save a lot of time making these decisions on your own and you know in your brain that therapeutically, it doesnt make a damn difference.
    Good Luck! I know your pain, you will get there, it just takes some time.
     
  6. xiphoid2010

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    I work in a hospital, but did intern in retail before. Wherever you go, time management is big.

    What I learned is that multi-tasking is a waste of time. All that shifting around and refocusing decreases accuracy and efficiency. Instead, set up blocks of time to focus on one task at a time, verifying scripts, Dr. calls, transfers, 3rd party rejects, orders. Do not deviate from that task during the blocks to only things that the tech and intern absolutely can't handle. Techs/interns should also follow the same principle. Assigned a primary and a secondary duty station. Keep them there, minimize any shuffling.

    Don't be afraid to upset the customer. If it's a non-urgent med, and you need to call the Dr. or insurance, tell them to come back tomorrow. They are welcome to take it else where if they need their cholesterol med in the next 15 minutes. :smuggrin: Try to limit the MD and insurance calls to only the beginning or at the end of the day. Put calls on speaker phone, so you can do other things while waiting 45 minutes to talk to someone.
     
  7. ifillrxs

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    One tactic I use when I have multiple things to do at once is ask myself which task am I the ONLY one qualified to do. This works to a point unless the workload is extremely unbalanced. Once the tasks that only I can perform are done, I move onto tech tasks. If there are multiple scripts to count/fill, I will sometimes cherrypick the easy ones. I do this in case I need to be free to get a doctor call or question at the counter. I don't want to be stuck double counting 180 Percs when a line forms because someone needs me.
     
  8. PharmB10

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  9. NewRPh

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    Thanks, everyone. I tried incorporating a little of what everyone said today, and I was able to keep up pretty well. Granted that we were pretty slow today since it was Sunday, I felt like a had a better handle of what I needed to be doing and asked for help from the tech more when needed. Hopefully in the next few weeks I'll become a workflow pro.
     
  10. RxMTM

    RxMTM Class of 2013

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  11. NewRPh

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    I was thinking more along the lines of:

    [​IMG]
     
  12. owlegrad

    owlegrad Uncontrollable Sarcasm Machine
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  13. xiphoid2010

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    Xanax will just make you fall further behind (or asleep). :smuggrin:
     
  14. Swishers

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    Or vomit all over the floor before passing out. *looks over at roommate*
     

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