Letter to my pharmacy profession

[ggpharma]

This letter is addressed to my profession of pharmacy.



I want you (the pharmacy profession) know I am confused and I am grieved. I was sold on the lie; that as a pharmacist I would be one of the most trusted medical professionals. I was told during school I was obtaining something noble and just. I was told that FEW had the honor to pursue this career path. I was told that as a pharmacist WE ARE THE LAST STOP before the drugs hit the patients. I was told IT IS MY LEGAL and ETHICAL DUTY to be that last stop and to always double check to protect my patients. I am confused and grieved because this is just not the case in pharmacy practice today. I have contacted the State Board of Pharmacy, DEA, Medical Board, Health and Human Services, Joint Commission, and State Health Department Services, DPS, and Senators on behalf of my patients for no avail. I have risked everything to do my job and protect theft while my patient fought to live.



I am greatly confused by the practice of pharmacy and the hypocrisy of it. Why is it in retail pharmacy I must anxiously research the patient’s fill history to ensure they are not doctor shopping or pharmacy shopping? Why is it in retail I must meticulously check every detail written down on the script or the pharmacy can be fined? Yet the profession of pharmacy allows hospitals to cook the narcotic books? Why is it that small independent retail pharmacies suffer these fines but major hospitals can loose liters of fentanyl and 600 ml of versed because of nursing with no recourse? I am confused why we have a state prescription-monitoring program yet continue to allow the streets of our nation to be littered with drug addicts. I am so confused by so many things and all of them stem from my chosen profession of pharmacy. Can we be a just profession and profit on death? Why is our medicine in America so much more expensive? Hospitals loose and forget to document narcotics every day while retail pharmacies do monthly narcotic audits? Are we (the pharmacy practice) so foolish to think that the fentanyl on street is entirely foreign supply?

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[Seriously Serious]

I still do not understand how pharmacists continue to play victim. You had four years of school and work experiences to realize the reality of pharmacy practice. If you work as a tech in retail, it only takes a few months to fully understand everything that the pharmacy staff endures.

You played yourself and now you're upset.

The US healthcare system is a whole other topic, that's way more complex... either by accident or by design (or both).

 

[APN-59 rph]

I guess it's OK to blow off steam..but really.....I wandered into pharmacy many moons ago and soon realized that it was just a boring..fast moving job..with potential for disaster...but the MONEY kept jumping up AND I had another job that was challenging and interesting and that made the work life do-able...I don't see how even the studs who are training to take over daddy's store can stand it. Probably no choice. As usual..once you get the car and house and dog and kiddies etc..you stuck....learn to like it..Very very few do like the job...but see stuck above...(Pharmacy school weenies have forked tongues.)

 

[VA77]

If your serious, you can send a letter to ACPE, AACP, and your state BoP. That way when all the cards fall some investigative journalist will have lots of material to say these entities were warned and I love to give them a huge black eye and hurt what shred of credibility they have left.

 

[alpha12]

This letter is addressed to my profession of pharmacy.



I want you (the pharmacy profession) know I am confused and I am grieved. I was sold on the lie; that as a pharmacist I would be one of the most trusted medical professionals. I was told during school I was obtaining something noble and just. I was told that FEW had the honor to pursue this career path. I was told that as a pharmacist WE ARE THE LAST STOP before the drugs hit the patients. I was told IT IS MY LEGAL and ETHICAL DUTY to be that last stop and to always double check to protect my patients. I am confused and grieved because this is just not the case in pharmacy practice today. I have contacted the State Board of Pharmacy, DEA, Medical Board, Health and Human Services, Joint Commission, and State Health Department Services, DPS, and Senators on behalf of my patients for no avail. I have risked everything to do my job and protect theft while my patient fought to live.



I am greatly confused by the practice of pharmacy and the hypocrisy of it. Why is it in retail pharmacy I must anxiously research the patient’s fill history to ensure they are not doctor shopping or pharmacy shopping? Why is it in retail I must meticulously check every detail written down on the script or the pharmacy can be fined? Yet the profession of pharmacy allows hospitals to cook the narcotic books? Why is it that small independent retail pharmacies suffer these fines but major hospitals can loose liters of fentanyl and 600 ml of versed because of nursing with no recourse? I am confused why we have a state prescription-monitoring program yet continue to allow the streets of our nation to be littered with drug addicts. I am so confused by so many things and all of them stem from my chosen profession of pharmacy. Can we be a just profession and profit on death? Why is our medicine in America so much more expensive? Hospitals loose and forget to document narcotics every day while retail pharmacies do monthly narcotic audits? Are we (the pharmacy practice) so foolish to think that the fentanyl on street is entirely foreign supply?

I am guessing you entered pharmacy when saturation was already a thing so you have no excuses.

 

[M0df]

I re-read this a couple times and still not clear.

What did you contact all those agencies about?

How are missing controls in a hospital connected to your particular situation?

It sounds like you feel you were unjustly punished. The rest is all over the place.

 

[RxPreceptor]

So if you feel certain prescribers, employees, and/or patients are contributing to pharmaceutical grade street drugs, report to your state PMP

Let's all make SDN a drama free and passive-aggressive free forum

 

[KidPharmD]

Why is it that small independent retail pharmacies suffer these fines but major hospitals can loose liters of fentanyl and 600 ml of versed because of nursing with no recourse? I am confused why we have a state prescription-monitoring program yet continue to allow the streets of our nation to be littered with drug addicts. I am so confused by so many things and all of them stem from my chosen profession of pharmacy. Can we be a just profession and profit on death? Why is our medicine in America so much more expensive? Hospitals loose and forget to document narcotics every day while retail pharmacies do monthly narcotic audits?

I feel like this needs a citation. We are a larger pediatric center, but are no where near the size of our adult counterparts and we employ 3 separate people who's only job is to keep track of our narcotics.

I don't know what our overall use is, but I am going to guess that our percentage variance is much lower than retail pharmacies. That isn't saying that there isn't diversion in many hospitals, but most of it is really beyond the pharmacy's control (nursing diversion is extremely hard to track).

Do you think we don't do regular audits on our narcotic stores? It is a lot more often than monthly too.

I don't deny that there aren't broken things about our healthcare system, but I think there are plenty of places to lay blame before we ever get to our profession.

 

[ValeRx]

We can't lose track of a single lorazepam without the whole place shutting down.

 

[SELDANE]

We can't lose track of a single lorazepam without the whole place shutting down.

You’re kidding....right?

 

[Sparda29]

This letter is addressed to my profession of pharmacy.



I want you (the pharmacy profession) know I am confused and I am grieved. I was sold on the lie; that as a pharmacist I would be one of the most trusted medical professionals. I was told during school I was obtaining something noble and just. I was told that FEW had the honor to pursue this career path. I was told that as a pharmacist WE ARE THE LAST STOP before the drugs hit the patients. I was told IT IS MY LEGAL and ETHICAL DUTY to be that last stop and to always double check to protect my patients. I am confused and grieved because this is just not the case in pharmacy practice today. I have contacted the State Board of Pharmacy, DEA, Medical Board, Health and Human Services, Joint Commission, and State Health Department Services, DPS, and Senators on behalf of my patients for no avail. I have risked everything to do my job and protect theft while my patient fought to live.



I am greatly confused by the practice of pharmacy and the hypocrisy of it. Why is it in retail pharmacy I must anxiously research the patient’s fill history to ensure they are not doctor shopping or pharmacy shopping? Why is it in retail I must meticulously check every detail written down on the script or the pharmacy can be fined? Yet the profession of pharmacy allows hospitals to cook the narcotic books? Why is it that small independent retail pharmacies suffer these fines but major hospitals can loose liters of fentanyl and 600 ml of versed because of nursing with no recourse? I am confused why we have a state prescription-monitoring program yet continue to allow the streets of our nation to be littered with drug addicts. I am so confused by so many things and all of them stem from my chosen profession of pharmacy. Can we be a just profession and profit on death? Why is our medicine in America so much more expensive? Hospitals loose and forget to document narcotics every day while retail pharmacies do monthly narcotic audits? Are we (the pharmacy practice) so foolish to think that the fentanyl on street is entirely foreign supply?

Our narcotic safes are extremely secured in hospital and there is a big deal when anything goes missing.

Now, what happens once it goes upstairs with wastage is on nursing and not our responsibility. Example, ICU patient passed away and they have a bag of fentanyl and versed with liquid still inside. The nurses are responsible for ensuring the destruction and it's supposed to be signed off by 2 nurses.

Now, something else I noticed was that the fentanyl vials have overfill. When I'm compounding fentanyl drips, let's say 10 bags of Fentanyl 500 mcg in 100 ml NS. I'll take 20 vials of 250 mcg/5 ml from the safe. I'll withdraw 100 mL from the vials and shoot 10 mL into each bag after removing 10 mL of diluent from each bag. I noticed that each vial has about 1 mL of overfill, and I'll have like 10 mL left over at the end, in which case I'll just grab another NS bag and make an extra bag. However, there's nothing stopping someone from just pocketing that overfill.

 

[ValeRx]

You’re kidding....right?

A little exaggeration but no. Things get very serious and they really dig into where that lost tablet went.

 

[Sparda29]

A little exaggeration but no. Things get very serious and they really dig into where that lost tablet went.

Yeah, this morning one of the floors lost a Oxy 5 pill and I told them to call the nursing supervisor. Then the nursing supervisor calls me and asks me to print out a Pyxis report for Oxy 5 for the whole month.

 

[Dred Pirate]

this confuses me, and why would you send this to my DM? I am guessing he did a shotgun approach and sent it to a bunch of people - just odd

 

[GrandTheftAutumn]

How come I didn't get one

 

[BidingMyTime]

Yet the profession of pharmacy allows hospitals to cook the narcotic books? Why is it that small independent retail pharmacies suffer these fines but major hospitals can loose liters of fentanyl and 600 ml of versed because of nursing with no recourse?

maybe back in the 1960's or 1970's this could happen, but this is certainly not happening in hospitals today. There are many mechanisms in place to prevent diversion. There is "cooking" of the narcotic books. All narcotics, even in the pharmacy, come out of Pyxis/Omnicell. Wastage is also done in the Pyxis/Omnicell with a witness log-on. Yes, diversion occurs, but people trying this inevitably get caught. `

 

[mentos]

Don't hate the game hate the player.