Misfill is stressing me out--how do you guys do it?

[HaleyRX]

I don't know what to do and I really need some advice. I am a tech at a super busy CVS. On Friday, we were getting constant faxes/emails about "PCI is not an option. Make your PCI calls"..I was making PCI calls in between drop-off customers, and we were getting slammed.
Somehow--and I NEVER make hardly any mistakes at drop-off, I really am a good tech--I typed a lithium script for the wrong patient, and it went on the profile of a 6 year old Hispanic child. The child also got his antibiotic, but also the lithium that should've been for someone else. The mom of the child spoke hardly any English.
When the lady came to pick up lithium, we couldn't find it, I pulled the hardcopy, and realized what happened. The script had already gone out the door. No valid phone number on file for the child, the dr's office wasn't answering (it was Friday afternoon)..one of our techs offered to drive to the patient's house (he was getting off) so I gave him my GPS and the address..our pharmacist overheard and made me stop the guy from going.
The pharmacist did eventually get in touch with the child's mom and she said the child was taking the medicine and doing fine. The Rph told her it was the wrong script and to bring it back.
The Rph has a severe speech impediment, however, and with the English/Spanish language barrier, I am very worried because...
The patient STILL HAS the lithium and this is SUNDAY NIGHT.
I am panicked..I feel so incredibly horrible for the mistake. I always felt like "oh this job is so stressful, drive thru, phone all the time, people everywhere"..but I never really felt like it caused PROBLEMS..but I haven't slept this whole weekend, I am terrified of what could happen to the child, and the pharmacist only said "Do not take any action. Only a pharmacist can speak to the patient"...so I can't do anything about it.
The pharmacist doesn't seem that concerned..am I over-reacting? I feel like this is a major deal..
I don't know how y'all do it. I decided a while back pharmacy isn't for me, and as soon as I'm out of college, I'm through with pharmacy. Meanwhile, tonight a little boy has a bottle of lithium with his name on it..and I am sitting here worried..

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[MountainPharmD]

I hope you got your PCI calls done because it is not an option!

 

[Old Timer]

I don't know what to do and I really need some advice. I am a tech at a super busy CVS. On Friday, we were getting constant faxes/emails about "PCI is not an option. Make your PCI calls"..I was making PCI calls in between drop-off customers, and we were getting slammed.
Somehow--and I NEVER make hardly any mistakes at drop-off, I really am a good tech--I typed a lithium script for the wrong patient, and it went on the profile of a 6 year old Hispanic child. The child also got his antibiotic, but also the lithium that should've been for someone else. The mom of the child spoke hardly any English.
When the lady came to pick up lithium, we couldn't find it, I pulled the hardcopy, and realized what happened. The script had already gone out the door. No valid phone number on file for the child, the dr's office wasn't answering (it was Friday afternoon)..one of our techs offered to drive to the patient's house (he was getting off) so I gave him my GPS and the address..our pharmacist overheard and made me stop the guy from going.
The pharmacist did eventually get in touch with the child's mom and she said the child was taking the medicine and doing fine. The Rph told her it was the wrong script and to bring it back.
The Rph has a severe speech impediment, however, and with the English/Spanish language barrier, I am very worried because...
The patient STILL HAS the lithium and this is SUNDAY NIGHT.
I am panicked..I feel so incredibly horrible for the mistake. I always felt like "oh this job is so stressful, drive thru, phone all the time, people everywhere"..but I never really felt like it caused PROBLEMS..but I haven't slept this whole weekend, I am terrified of what could happen to the child, and the pharmacist only said "Do not take any action. Only a pharmacist can speak to the patient"...so I can't do anything about it.
The pharmacist doesn't seem that concerned..am I over-reacting? I feel like this is a major deal..
I don't know how y'all do it. I decided a while back pharmacy isn't for me, and as soon as I'm out of college, I'm through with pharmacy. Meanwhile, tonight a little boy has a bottle of lithium with his name on it..and I am sitting here worried..

Let's see what we can do about this.

First, remember this. Techs/Students DO NOT make mistakes. Pharmacists make mistakes. The pharmacist checked the prescription and certified it was the correct drug for the correct patient at the correct dosage.

Next, no matter how busy you are, and this is especially true when you are very busy. If you don't have time to do it right, when will you have time to do it again? No matter if it's PCI calls, ABC calls, drive through, line out the door for 3 miles. The busier you are the more you have to be perfect. That means DON'T speed up to 110%. When you are typing an order, concentrate on that order. Also, when you are at drop off, make sure you have a contact number on each RX. It's critical information. Before you scan your credentials, look over the script and review it for correctness.

In between orders, do whatever other tasks are required of you. Just because your colleagues left all of the calls for you on Friday night, DOES NOT mean you are obligated to pick up their slack at the expense of accurately performing your job.

This is not a problem in pharmacy alone. It is a problem throughout the health care field and throughout the entire economy. People are being asked to do more for the same salary and in the case of some people do more for less money, see public employees in Wisconsin.
I appreciate your concern and I think this type of attitude will stand in you in good stead when you are a pharmacist.

 

[DAW2]

and why didnt the pharmacist want to retrieve the lithium?

 

[stevephhs016]

The pharmacist should be more worried than you are. You made a mistake, he should have found it. End of story.

Hopefully, the pharmacist managed to fill out the incident report....

 

[strawberry2011]

Don't feel bad! Everybody makes mistakes. And, as mentioned before, the pharmacist should have caught the mistake. And, yes, only the pharmacist can talk to the patient about the incident, so it is really out of your hands now. You are still as good a tech as before.

I am responding because I am a tech now and my store is exactly the same way. You are not alone!!!

For me, there use to be two of us techs working, but now they cut us down to one! And, yet, the same amount of work is suppose to be done. I tried to be "superwoman" and get it all done... but in the end, I realize I am human and sometimes it is just not possible.. so everyday, I tell myself to do what I can and everything will work out in the end! It doesn't always though and that's when I buy myself some M&Ms and call it a day.. LOL.

 

[PharMed2016]

I don't know what to do and I really need some advice. I am a tech at a super busy CVS. On Friday, we were getting constant faxes/emails about "PCI is not an option. Make your PCI calls"..I was making PCI calls in between drop-off customers, and we were getting slammed.
Somehow--and I NEVER make hardly any mistakes at drop-off, I really am a good tech--I typed a lithium script for the wrong patient, and it went on the profile of a 6 year old Hispanic child. The child also got his antibiotic, but also the lithium that should've been for someone else. The mom of the child spoke hardly any English.
When the lady came to pick up lithium, we couldn't find it, I pulled the hardcopy, and realized what happened. The script had already gone out the door. No valid phone number on file for the child, the dr's office wasn't answering (it was Friday afternoon)..one of our techs offered to drive to the patient's house (he was getting off) so I gave him my GPS and the address..our pharmacist overheard and made me stop the guy from going.
The pharmacist did eventually get in touch with the child's mom and she said the child was taking the medicine and doing fine. The Rph told her it was the wrong script and to bring it back.
The Rph has a severe speech impediment, however, and with the English/Spanish language barrier, I am very worried because...
The patient STILL HAS the lithium and this is SUNDAY NIGHT.
I am panicked..I feel so incredibly horrible for the mistake. I always felt like "oh this job is so stressful, drive thru, phone all the time, people everywhere"..but I never really felt like it caused PROBLEMS..but I haven't slept this whole weekend, I am terrified of what could happen to the child, and the pharmacist only said "Do not take any action. Only a pharmacist can speak to the patient"...so I can't do anything about it.
The pharmacist doesn't seem that concerned..am I over-reacting? I feel like this is a major deal..
I don't know how y'all do it. I decided a while back pharmacy isn't for me, and as soon as I'm out of college, I'm through with pharmacy. Meanwhile, tonight a little boy has a bottle of lithium with his name on it..and I am sitting here worried..

It's the pharmacist responsibility to make sure the prescription is right although I've been in a similar situation before. It didn't involve the wrong medication but the strength. I gave what he had been taking previously since we usually generate off of older scripts to prevent errors and didn't update to include the increase in strength. Luckily the parent caught it and we got it ready but for about an hour I was a wreck because I couldn't believe I had done that. Granted it was very busy with just the pharmacist and I. However, that is no excuse since it could have been easily a bigger error.

 

[PharMed2016]

I don't know what to do and I really need some advice. I am a tech at a super busy CVS. On Friday, we were getting constant faxes/emails about "PCI is not an option. Make your PCI calls"..I was making PCI calls in between drop-off customers, and we were getting slammed.
Somehow--and I NEVER make hardly any mistakes at drop-off, I really am a good tech--I typed a lithium script for the wrong patient, and it went on the profile of a 6 year old Hispanic child. The child also got his antibiotic, but also the lithium that should've been for someone else. The mom of the child spoke hardly any English.
When the lady came to pick up lithium, we couldn't find it, I pulled the hardcopy, and realized what happened. The script had already gone out the door. No valid phone number on file for the child, the dr's office wasn't answering (it was Friday afternoon)..one of our techs offered to drive to the patient's house (he was getting off) so I gave him my GPS and the address..our pharmacist overheard and made me stop the guy from going.
The pharmacist did eventually get in touch with the child's mom and she said the child was taking the medicine and doing fine. The Rph told her it was the wrong script and to bring it back.
The Rph has a severe speech impediment, however, and with the English/Spanish language barrier, I am very worried because...
The patient STILL HAS the lithium and this is SUNDAY NIGHT.
I am panicked..I feel so incredibly horrible for the mistake. I always felt like "oh this job is so stressful, drive thru, phone all the time, people everywhere"..but I never really felt like it caused PROBLEMS..but I haven't slept this whole weekend, I am terrified of what could happen to the child, and the pharmacist only said "Do not take any action. Only a pharmacist can speak to the patient"...so I can't do anything about it.
The pharmacist doesn't seem that concerned..am I over-reacting? I feel like this is a major deal..
I don't know how y'all do it. I decided a while back pharmacy isn't for me, and as soon as I'm out of college, I'm through with pharmacy. Meanwhile, tonight a little boy has a bottle of lithium with his name on it..and I am sitting here worried..

If I was the pharmacist, I would've wanted the lithium retrieved ASAP for safety reasons however small they maybe (Pediatric Patient).

 

[Rxnupe]

yes everyone has given great sound advice. I too work for a very busy CVS, but I put my customers safety first. However, as many has pointed out the PHARMACIST should be more concerned than you are because he's the last person to check the medicine. I don't know why he didn't want to retrieve the medicine. Hopefully and incident report gets out to your Pharmacy Sup and hopefully he/she will realize that a patients health is far more important than the PCI calls.
I simply do the best I can with the hours that are given to me. In the future I recommend you do the same- safety is always first.

 

[iFarm]

Errors, shmerrors... what's most important here is that CVS continues to make lots of money!

Seriously though, don't worry, it's the pharmacist's responsibility to deal with it now. Try to learn from it. Don't let ANYONE rush you.

And any time you feel the need, just be firm and say "I think we're compromising safety." In my experience, that will usually get a pharmacist/manager/DM off your back. If it doesn't, just ignore any PCI (or similar) demands until the busy period is over.

 

[Rxnupe]

Errors, shmerrors... what's most important here is that CVS continues to make lots of money!

Seriously though, don't worry, it's the pharmacist's responsibility to deal with it now. Try to learn from it. Don't let ANYONE rush you.

And any time you feel the need, just be firm and say "I think we're compromising safety." In my experience, that will usually get a pharmacist/manager/DM off your back. If it doesn't, just ignore any PCI (or similar) demands until the busy period is over.

Don't make this a CVS issue- errors happen in every Retail setting and it happens in both busy and slow stores. Didn't last month Safewa Pharmacy had a major error where a pregnant woman took a precription for Methotrexate that belonged to another woman with a similar name? You mention CVS makes a lot of money- so would the error be ok if CVS wasn't profitable???? This has nothing to do with money or CVS a human error was made point blank.

 

[npage148]

Don't make this a CVS issue- errors happen in every Retail setting and it happens in both busy and slow stores. Didn't last month Safewa Pharmacy had a major error where a pregnant woman took a precription for Methotrexate that belonged to another woman with a similar name? You mention CVS makes a lot of money- so would the error be ok if CVS wasn't profitable???? This has nothing to do with money or CVS a human error was made point blank.

I am a tech at a super busy CVS. On Friday, we were getting constant faxes/emails about "PCI is not an option. Make your PCI calls"..I was making PCI calls in between drop-off customers, and we were getting slammed.

sounds like a CVS issue. To a compassionate person, an error, while unavoidable, is never ok. To the board and shareholders of CVS, an error is ok as long as it's cost-effective. They have repeatedly demonstrated this

 

[iFarm]

Don't make this a CVS issue- errors happen in every Retail setting and it happens in both busy and slow stores. Didn't last month Safewa Pharmacy had a major error where a pregnant woman took a precription for Methotrexate that belonged to another woman with a similar name? You mention CVS makes a lot of money- so would the error be ok if CVS wasn't profitable???? This has nothing to do with money or CVS a human error was made point blank.

Settle down. It was a joke! (I even used an emoticon)

Why do you get so defensive when people say things about CVS anyway? Why not just ignore it? Are you maybe trying to further suppress your own hatred for the company by overcompensating in the other direction?

But to show you that I'm fair, I'll go ahead and say that Walgreens is also playing a large part in destroying our profession. There, you win.

 

[R2pharmD2]

Let's see what we can do about this.

First, remember this. Techs/Students DO NOT make mistakes. Pharmacists make mistakes. The pharmacist checked the prescription and certified it was the correct drug for the correct patient at the correct dosage.

Next, no matter how busy you are, and this is especially true when you are very busy. If you don't have time to do it right, when will you have time to do it again? No matter if it's PCI calls, ABC calls, drive through, line out the door for 3 miles. The busier you are the more you have to be perfect. That means DON'T speed up to 110%. When you are typing an order, concentrate on that order. Also, when you are at drop off, make sure you have a contact number on each RX. It's critical information. Before you scan your credentials, look over the script and review it for correctness.

In between orders, do whatever other tasks are required of you. Just because your colleagues left all of the calls for you on Friday night, DOES NOT mean you are obligated to pick up their slack at the expense of accurately performing your job.

This is not a problem in pharmacy alone. It is a problem throughout the health care field and throughout the entire economy. People are being asked to do more for the same salary and in the case of some people do more for less money, see public employees in Wisconsin.
I appreciate your concern and I think this type of attitude will stand in you in good stead when you are a pharmacist.

Excellent advice all around, but I thought the bolded part was particularly relevant. Just about everybody has the natural tendency to speed up when things get busy. Don't. If anything, make a conscious effort to go slower if that's what you need to do to prevent mistakes.

 

[meister]

How much lithium did the kid get?

Back in the day when my manager would make a mistake like this he'd send one of us out to retrieve the prescription and give them a full refund or a gift card or whatever. I'm a little surprised the pharmacist didn't want one of you to do that.

 

[HaleyRX]

Thank you guys for the advice and encouragement. I really don't know why the pharmacist didn't insist on getting the lithium back right away. That was my main thought: let's get this med back. The only thing the pharmacist said was "if this happens again, no tech can talk to the family. only the pharmacist."
As for whether this is a cvs issue or not, I think that my district has a particular problem. We have a couple of people trying to move up the ladder (I've posted their odd demands/expectations before)..they have a policy where they do not allow pharmacist overlap, even with 8 techs on Mondays. We actually had 2 Walgreens pharmacists come to work our store (permanently) but they both walked out after 4 days when the DM told them that pharmacist overlap was ..and yes I quote.."wishful thinking"..
At the time the mistake happened, we had 6 techs. I was doing drop off, we had 2 in production (15 pages in Q), 1 for drive thru (over 1,000 cars in week in our drive thru) and 1 for pick up, also another drop off tech working on 4 pages of QE..
I do realize that legally the Rph is responsible, but if something happens, it is always going to be in my mind that if I had not made a mistake, this would not have happened.
From now on I am going to take my time and make sure everything is 100% accurate, no matter what is going on.

 

[Dalteparin]

Next, no matter how busy you are, and this is especially true when you are very busy. If you don't have time to do it right, when will you have time to do it again? No matter if it's PCI calls, ABC calls, drive through, line out the door for 3 miles. The busier you are the more you have to be perfect. That means DON'T speed up to 110%. When you are typing an order, concentrate on that order. Also, when you are at drop off, make sure you have a contact number on each RX. It's critical information. Before you scan your credentials, look over the script and review it for correctness.

Quoted for truth (and because I needed to hear it too)!