Need advice..too many mistakes

[pyxisdust]

So I'm somewhat of a new grad. I have been suffering from depression and anxiety for a very long time. Started working as a retail pharmacist recently and I have been having a hard HARD time. The workload is not so much as a problem as my loss of concentration. I love being busy, but lately business has turned to chaos every time I work.

Every time I get distracted because of an insurance issue, phone call or customer question (mostly complaints at this point about stuff not being ready) my mind wanders and I make stupid mistakes. When I started out, I made the stupidest errors of my life by not checking completely the contents of the vial. I trusted my technicians way too much, which ended up in some really stupid avoidable errors. Now I am suffering mentally because I have endangered the public and I am beating myself up every day and every night.

I had about a year of retail experience as a tech before starting this job. Other experience was in hospital. Insurance issues are my number one issue. I have left upwards of 100 scripts in the que for the pharmacist the next day due to being on the phone with insurance companies for 10-20 mins at a time. As I am on the phone, I continue q.a'ing and this I loose my concentration. When I get behind, I get flustered and anxious..more concentration lost. Then I start feeling feel my entire body shut down due to frustration and start getting very fatigued. I feel as if I dont get the insurance issues down, all hope is lost for keeping my job. I really need help and advice.

I have a new checking strategy that I have been trying out for the past week. It has helped somewhat but I am still taking a lot of time with insurance.
I need advice for generally dealing with fatigue, anxiety, frustration. I tried meditation. Doesn't work or I am doing it wrong. I have tried online brain games. I know I am not stupid, but my mental issues have made me "slower".
Also does anyone have advice with fixing insurance issues (specifically Medicaid/care)? Please PM me. I am desperate at this point.

Please be gentle with me as I have really spilled out my heart on this post.

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[Sine Cura]

I have left upwards of 100 scripts in the que for the pharmacist the next day due to being on the phone with insurance companies for 10-20 mins at a time.

Delegate calls to tech if they aren't tied up. And why are you calling? If it's an un-reversed claim issue or "filled-somewhere-else issue and the patient doesn't know anything" issue well that happens but the patient will need to wait if you have a bunch of other scripts to do. Sign them up for call alerts

If you do not understand how to resolve a DUR rejection or there is an SCC issue have you asked the techs or another RPH (if you have overlap)? Most of the time this is a soft reject like with opioid Rx

Another popular reject is ESI claim rejects for opioid agonist fills > 7 day supply but the rejection message doesn't make sense to someone completely ignorant of this fact. You would probably see this at least 20 times a day depending on controlled volume so this does not warrant a call but a fax to the prescriber for them to do a PA or pt can take the 7-day supply through insurance or cash out depending on circumstance.

 

[CetiAlphaFive]

So I'm somewhat of a new grad. I have been suffering from depression and anxiety for a very long time. Started working as a retail pharmacist recently and I have been having a hard HARD time. The workload is not so much as a problem as my loss of concentration. I love being busy, but lately business has turned to chaos every time I work.

Every time I get distracted because of an insurance issue, phone call or customer question (mostly complaints at this point about stuff not being ready) my mind wanders and I make stupid mistakes. When I started out, I made the stupidest errors of my life by not checking completely the contents of the vial. I trusted my technicians way too much, which ended up in some really stupid avoidable errors. Now I am suffering mentally because I have endangered the public and I am beating myself up every day and every night.

I had about a year of retail experience as a tech before starting this job. Other experience was in hospital. Insurance issues are my number one issue. I have left upwards of 100 scripts in the que for the pharmacist the next day due to being on the phone with insurance companies for 10-20 mins at a time. As I am on the phone, I continue q.a'ing and this I loose my concentration. When I get behind, I get flustered and anxious..more concentration lost. Then I start feeling feel my entire body shut down due to frustration and start getting very fatigued. I feel as if I dont get the insurance issues down, all hope is lost for keeping my job. I really need help and advice.

I have a new checking strategy that I have been trying out for the past week. It has helped somewhat but I am still taking a lot of time with insurance.
I need advice for generally dealing with fatigue, anxiety, frustration. I tried meditation. Doesn't work or I am doing it wrong. I have tried online brain games. I know I am not stupid, but my mental issues have made me "slower".
Also does anyone have advice with fixing insurance issues (specifically Medicaid/care)? Please PM me. I am desperate at this point.

Please be gentle with me as I have really spilled out my heart on this post.

You should *not* be on the phone with insurance that much.

It sounds like you have a team of rookies or just flat out stupid techs.

See a professional and then take FMLA leave

 

[deleted820760]

Are you seeing a mental health professional? The job is stressful and things will only get worse if you don’t take care of yourself first.

 

[6GodPharm]

Work smarter not harder. Retail is a game and you need to learn to play it or you get played. You shouldn’t be fielding any insurance questions. Although I know insurances fairly well when I answer the phone (yes I help my techs with the phones) and its a insurance company or the front desk lady starts asking whats covered I tell them to hold for a tech. If its easy I want re order this or that I take those. Answering insurance question for pharmacists is like a tech answering a drug question over the phone. They don’t do it and refer it to you. So do yourself a favor and answer calls you can do. In your case right now I wouldn’t even touch the phones.

 

[cozypark]

Have drop-off tech handle insurance issue. It is not RPh’s job.
If tech stuck w ins call and he drop-off line gets longer, send production texh to dropoff to help a little bit until call is done.
Ins call shoud not take more than 5 min. Either resolved or not covered.

Work smarter. Focus qa’ing and deligate jobs to techs.

 

[CetiAlphaFive]

Work smarter not harder. Retail is a game and you need to learn to play it or you get played. You shouldn’t be fielding any insurance questions. Although I know insurances fairly well when I answer the phone (yes I help my techs with the phones) and its a insurance company or the front desk lady starts asking whats covered I tell them to hold for a tech. If its easy I want re order this or that I take those. Answering insurance question for pharmacists is like a tech answering a drug question over the phone. They don’t do it and refer it to you. So do yourself a favor and answer calls you can do. In your case right now I wouldn’t even touch the phones.

I never entertain "WELL WHAT'S COVERED" questions from prescribers/offices.

I don't get a check from the insurance company

 

[Chrish]

READ the whole rx: DOB, Pt name, Drug name and strength as well as whole direction. Never skim it. Stay longer after closing if you have to in the beginning but there is NEVER an excuse not to read the whole rx.

Pour as much content into the cap when verifying as you can. Once again, match the NDC/ pill image that shows up on the screen. Never assume.

Tell your techs to hold on to any questions when you are in the middle of verifying. If they don't listen, simply don't answer them until you are done; they will get the memo. If you are interrupted by the customers, tell them I will be right with you and finish what you are doing. Same thing with phone calls.

It's hard to make the consistent error if you follow these basic rules.

 

[lord999]

I'd recommend you WRITE down your verification steps on a prescription and follow it. I used to use the "around the world" rule where I checked:
1. Name
2. Date
3. Date of Birth
4. Prescriber/DEA
5. Drug Name, Dosage, Quantity
6. Sig

But basically, get OCD about defining a process and sticking to it. I also had "mental" Zen earmuffs to focus out noise when I verified.

Also, you're not the ONLY one to have this problem, don't feel like you're alone. I had that phase as an intern but thankfully I had a good preceptor to set me straight. It's not easy getting this job.

 

[RxPreceptor]

Yeah a method like what lord999 suggested is good. I personally like to think of verifying as playing a matching game of all the elements (I.e. actual Rx vs. Data entry side by side matching). Physically inspecting & touching every part of the medication(s) as well (NDC, label, exp. date, sealed mfr packaging, safety cap type,etc.) & staying organized/neat to prevent HIPAA violations.

Resolving insurance issues will take experience & repetition; if you need to, you might want to jot down notes, but overtime you should be able to recognize the rejections easily. Might want to have your overlap take a few minutes to give you pointers from time to time (billing codes, medicaid restrictions, etc.).

At your current state, sounds like you might want to work on figuring out what's best to prioritize & who (tech) you can count on to designate a task to. I.e. verifying off an order for antibiotics vs. trying to resolve an insurance issue/PA with someone on the phone for cialis

 

[quickpic007]

So I'm somewhat of a new grad. I have been suffering from depression and anxiety for a very long time. Started working as a retail pharmacist recently and I have been having a hard HARD time. The workload is not so much as a problem as my loss of concentration. I love being busy, but lately business has turned to chaos every time I work.

I am desperate at this point.

Please be gentle with me as I have really spilled out my heart on this post.

Every morning take a long hard look at yourself in the mirror. Really think about why you go to work every day. Realize how much hard work it took to get there and how easily it can all be taken away (revoke/probation license due to negligence etc). Remind yourself of that when you step in the door...it should help

 

[sosoo]

go to a 24hr store. do nothing but shadow them all day. see how they do insurance rejects. watch and learn.

 

[6GodPharm]

go to a 24hr store. do nothing but shadow them all day. see how they do insurance rejects. watch and learn.

How the hell is this supposed to help?

 

[sosoo]

How the hell is this supposed to help?

he did say insurance issues is his number one failure, or didn't u read? so what better ways than to wAtch and learn how the pros do things? and 24hr store is where he can learn the most.

 

[6GodPharm]

he did say insurance issues is his number one failure, or didn't u read? so what better ways than to wAtch and learn how the pros do things? and 24hr store is where he can learn the most.

I’m really confused why it needs to be a 24 hour store?

 

[mnoble]

I’m really confused why it needs to be a 24 hour store?

Maybe 24hr store working overnight was what they meant? More time to focus on things when patient volume is low at night.

 

[sosoo]

I’m really confused why it needs to be a 24 hour store?

u can go to a low volume store, watch how ppl fix 2-3 rejects per hour, and think it's amazing how good they are spending an hour of your time and only see 2-3 rejects getting resolved. or u can go to a 24hr store and see how 2-3 pages of rejects are resolved per hour. which one do u think you have more learning experience? higher or lower volume?

 

[RxRetailRx]

What made you have to deal with insurance issues every day ? That's tech's job, unless they are DUR's... then you need to write down all the possible override code, ...focus on your "must do" guide your tech if you need help...

 

[DrVader]

So I'm somewhat of a new grad. I have been suffering from depression and anxiety for a very long time. Started working as a retail pharmacist recently and I have been having a hard HARD time. The workload is not so much as a problem as my loss of concentration. I love being busy, but lately business has turned to chaos every time I work.

Every time I get distracted because of an insurance issue, phone call or customer question (mostly complaints at this point about stuff not being ready) my mind wanders and I make stupid mistakes. When I started out, I made the stupidest errors of my life by not checking completely the contents of the vial. I trusted my technicians way too much, which ended up in some really stupid avoidable errors. Now I am suffering mentally because I have endangered the public and I am beating myself up every day and every night.

I had about a year of retail experience as a tech before starting this job. Other experience was in hospital. Insurance issues are my number one issue. I have left upwards of 100 scripts in the que for the pharmacist the next day due to being on the phone with insurance companies for 10-20 mins at a time. As I am on the phone, I continue q.a'ing and this I loose my concentration. When I get behind, I get flustered and anxious..more concentration lost. Then I start feeling feel my entire body shut down due to frustration and start getting very fatigued. I feel as if I dont get the insurance issues down, all hope is lost for keeping my job. I really need help and advice.

I have a new checking strategy that I have been trying out for the past week. It has helped somewhat but I am still taking a lot of time with insurance.
I need advice for generally dealing with fatigue, anxiety, frustration. I tried meditation. Doesn't work or I am doing it wrong. I have tried online brain games. I know I am not stupid, but my mental issues have made me "slower".
Also does anyone have advice with fixing insurance issues (specifically Medicaid/care)? Please PM me. I am desperate at this point.

Please be gentle with me as I have really spilled out my heart on this post.

I honestly don't think you are cut out for retail pharmacy. You have to have thick skin to work in retail. It took me a solid 6 months before I was completely comfortable with insurance. My advice is that you go work for a LTC or hospital as a staff pharmacist. LTC are a very controlled environment. You don't deal with insurance or customers. But I don't think you are cut out for retail.

 

[CetiAlphaFive]

How to deal with insurance problems:

1.)Spam every DUR and possible code.
2.)If that doesn't work, tell the patient it's not covered.

Why is this hard?

Why would it tire shadowing anyone?

 

[Rouelle]

Do you read the reject notes? Most will tell you what is wrong.

-First thing in the morning, most rejections are either: a) refill too soon (put script on hold or delete current fill) or b) insurance was down last night when auto fills dropped into system (reprocess them)

-Middle of the day, most rejections are: a) refill too soon (pt went to dr and got a year of refills on everything, just put new crap on hold), b) PA required (send off PA), c) med not covered (print screen, fax to dr), d) random dose limitations (ie insurance will only pay for 75 ambien in 90 days, tell patient and ask if they want to pay cash), e) drug interaction DURs (override as appropriate)

Actually having to call insurance isn’t necessary that often (B vs D inquiry, etc). As others have said, the QA pharmacist shouldn’t be doing this stuff the majority of the time. Being the boss and directing flow isn’t particularly fun, but having proper workflow is key in retail.

 

[Rouelle]

On a side note, are you floating or are you a staff pharmacist?

 

[MV777]

Do you read the reject notes? Most will tell you what is wrong.

-First thing in the morning, most rejections are either: a) refill too soon (put script on hold or delete current fill) or b) insurance was down last night when auto fills dropped into system (reprocess them)

-Middle of the day, most rejections are: a) refill too soon (pt went to dr and got a year of refills on everything, just put new crap on hold), b) PA required (send off PA), c) med not covered (print screen, fax to dr), d) random dose limitations (ie insurance will only pay for 75 ambien in 90 days, tell patient and ask if they want to pay cash), e) drug interaction DURs (override as appropriate)

Actually having to call insurance isn’t necessary that often (B vs D inquiry, etc). As others have said, the QA pharmacist shouldn’t be doing this stuff the majority of the time. Being the boss and directing flow isn’t particularly fun, but having proper workflow is key in retail.

Sounds about right for insurance issues. I rarely call. I usually tell the patient they need to call for a vacation override/copay questions/deductible questions. Tell them it is their plan and they will only discuss it with them. It sounds like you are giving yourself extra work that isn't necessary. I have been a pharmacist almost 2 years and my biggest struggle is delegating tasks and that may be the problem here too. Slowly coming around to it (as my patience gets thinner with each day in the pharmacy). Side question: How much do y'all help technicians pull/fill/QT/check out? I help a fairly good amount and its not that I don't want to help but QA is after all my responsibility that I can't ask for back up with...

 

[cozypark]

go to a 24hr store. do nothing but shadow them all day. see how they do insurance rejects. watch and learn.

Please tell me that you didn’t really mean it.

I work at 24hrs and we dont have time for that.
We do this ins rejection all the time like robot, and it will make us crazy if someone stands next to me and ask “wait, wait, can u go back to previous screen and show me what you type to overide dur?”

We don’t really welcome any delaying during the day. We all give death look when drug rep come by and wait for RPh to give his presentation and coupon.

To OP
Unless you work by yourself, insurance thing is really for tech. If your store has good lead tech, ask him/her how he handles it.
There are only less than 10 kinds of insurance rejection. That’s all repetitve job. You will learn soon.

 

[RxPreceptor]

Yes, way too easy to fall ass backwards in metrics trying to train someone @ a 24 hour store. Yeah, one time a CONZIP drug rep passed by for like 30 seconds & all I could think about was arguing with him how unnecessarily & overpriced it was, and shooting him down with alternatives (enough with the PAs and non formularies God damnit)

 

[6GodPharm]

How to deal with insurance problems:

1.)Spam every DUR and possible code.
2.)If that doesn't work, tell the patient it's not covered.

Why is this hard?

Why would it tire shadowing anyone?

Exactly, my conversation with the patient and front desk lady always goes “patient or you need to contact insurance see whats on the formulary. Doesn’t tell me here, anything else I can help you with? No? Ok take care”.

 

[ranger99rx]

Most 3rd party rejects tell you the reasons: ndc not covered, prior authorization required, alternative, too soon, non payment of premium, pt not covered. You don't need to call insurance for any of these, techs handle them and they can fax MD for alternative or PA. You handle DUR only...input the codes (get a small notebook that fit in your pocket and write them down for now until you remember which codes to use.) Stop doing tech job! I would hate to come in to see 30 scripts from previous day let alone 100. Relax, check 6 points as lord999 mentioned including supervising MD name for PA writing control scripts (not sure if other states require that) and days supply. We hardly call insurance now. If patients ask you why their copay are too high or used to be lower, after verifying that you had billed the same insurance as before tell them to call their insurance to find out why and that you have no control over the pricing, insurances tell you how much to charge.

 

[Modest_anteater]

So I'm somewhat of a new grad. I have been suffering from depression and anxiety for a very long time. Started working as a retail pharmacist recently and I have been having a hard HARD time. The workload is not so much as a problem as my loss of concentration. I love being busy, but lately business has turned to chaos every time I work.

Every time I get distracted because of an insurance issue, phone call or customer question (mostly complaints at this point about stuff not being ready) my mind wanders and I make stupid mistakes. When I started out, I made the stupidest errors of my life by not checking completely the contents of the vial. I trusted my technicians way too much, which ended up in some really stupid avoidable errors. Now I am suffering mentally because I have endangered the public and I am beating myself up every day and every night.

I had about a year of retail experience as a tech before starting this job. Other experience was in hospital. Insurance issues are my number one issue. I have left upwards of 100 scripts in the que for the pharmacist the next day due to being on the phone with insurance companies for 10-20 mins at a time. As I am on the phone, I continue q.a'ing and this I loose my concentration. When I get behind, I get flustered and anxious..more concentration lost. Then I start feeling feel my entire body shut down due to frustration and start getting very fatigued. I feel as if I dont get the insurance issues down, all hope is lost for keeping my job. I really need help and advice.

I have a new checking strategy that I have been trying out for the past week. It has helped somewhat but I am still taking a lot of time with insurance.
I need advice for generally dealing with fatigue, anxiety, frustration. I tried meditation. Doesn't work or I am doing it wrong. I have tried online brain games. I know I am not stupid, but my mental issues have made me "slower".
Also does anyone have advice with fixing insurance issues (specifically Medicaid/care)? Please PM me. I am desperate at this point.

Please be gentle with me as I have really spilled out my heart on this post.

Hello friend,

It sounds like your current work environment is dangerously stressful and negatively effecting your mental health. This is a VERY serious issue and could lead to a premature life completion event if left unchecked. The issue is simple:

Your current pharmacy is too busy and demands too much of you.

You need to relocate to a SLOWER pharmacy even if it means less pay. Consider moving to a more rural location that has lower volume. AFter you master dealing with insurance and dispensing then you can move to a more busy store. If all else fails quit retail and instead become a staff pharmacist where there is a different kind of stress but it is often a lower stress than retail due to it's reduced time sensitivity demands.

 

[hye345]

Hello friend,

It sounds like your current work environment is dangerously stressful and negatively effecting your mental health. This is a VERY serious issue and could lead to a premature life completion event if left unchecked. The issue is simple:

Your current pharmacy is too busy and demands too much of you.

You need to relocate to a SLOWER pharmacy even if it means less pay. Consider moving to a more rural location that has lower volume. AFter you master dealing with insurance and dispensing then you can move to a more busy store. If all else fails quit retail and instead become a staff pharmacist where there is a different kind of stress but it is often a lower stress than retail due to it's reduced time sensitivity demands.

Only one caveat to this, at least when it comes to retail pharmacies: the slower ones have less tech help, so you gotta be REALLY good at multitasking.

 

[ldiot]

You really shouldn't be dealing with insurance issues unless it's a low volume store with only 1-2 techs.

Your number one priority should be pharmacist only tasks.... verifying, phone-ins, and pt questions
If you start getting ahead of your techs, than you can help them out but choose something that you can easily get away from (for example, type a couple of escripts). Don't walk to the register when there is a line of 10 people, and don't get caught on the phone with an insurance company, not because you are lazy/don't want to deal with it but because it's a time sink that you can't get away from. If the techs get behind with something, everybody in the pharmacy can help them catch up... but if you get behind verifying only you can fix it so try not to let it happen.

 

[Abby Atwood]

You really shouldn't be dealing with insurance issues unless it's a low volume store with only 1-2 techs.

Your number one priority should be pharmacist only tasks.... verifying, phone-ins, and pt questions
If you start getting ahead of your techs, than you can help them out but choose something that you can easily get away from (for example, type a couple of escripts). Don't walk to the register when there is a line of 10 people, and don't get caught on the phone with an insurance company, not because you are lazy/don't want to deal with it but because it's a time sink that you can't get away from. If the techs get behind with something, everybody in the pharmacy can help them catch up... but if you get behind verifying only you can fix it so try not to let it happen.

I would avoid typing scripts yourself. A second set of eyes on the script is a safety mechanism. It may not be the best time to play fast and loose with that.

 

[ldiot]

I would avoid typing scripts yourself. A second set of eyes on the script is a safety mechanism. It may not be the best time to play fast and loose with that.

That's true. I was going to say you could also print/pull drugs for the techs to count, but at some places this isn't really possible due to the workflow (for example Walmart where you can only count one script at a time). But pulling drugs for the techs to count and typing are probably the best two things you can do if you get ahead of your techs, in terms of efficiency. Walking over to the drive-thru when there is a line of 5 cars or calling an insurance company, on the other hand, are things that I would try to avoid.

 

[Apotheker2015]

Retail will always be a stressful environment no matter what you do. Being able to control what you are able to control will make a difference in your day to day.

For starters, why are you making insurance phone calls? Please share. How did you get wrapped up in that pattern? It needs to stop.
As others have told you, most insurance rejections state clearly what the issue is. If it’s a PA, typically it’s because of step-therapy; e.g.,, the prescriber decided to write for a newly marketed brand name medícation without trying first line therapies that are likely generic and covered.

Clinics shouldn’t be calling your pharmacy to ask what’s covered. All that information is available for patients on their formulary. It’s all online and by law, they had to be offered a printed copy of it when they signed up for their insurance. If they tossed it away or declined it, well tough. They should be calling the insurance company to ask what’s covered.

When I catch technicians tying up resources by offering to make such calls for patients, I quickly jump in and nip it in the bud.

I do keep an eye on the status of insurance rejections that are pending in the queue. I know those people will show up at some point expecting those medications and I make sure those people get a phone call. I don’t necessarily handle the rejections unless their straightforward.

When insurance companies call asking for the pharmacist, it’s typically to give you a PA number. You have no reason to take that call. Your tech at drop off Should be handling that. Or they also ask for the pharmacist to have you run the rx again and confirm that it goes through insurance. I tell them I will have my technician help them with that.

Unless you’re working at a 24 hour store, you really shouldn’t be all that involved with insurance. You should be aware of the status of the queue to make sure your techs are not just looking busy, which you can do at places like Walmart; or to make sure your techs are not cluttering your queue with PA requests for drugs that will clearly not be covered like sildenafil - 97% of the time it’s just for erectile dysfunction and you’d be surprised how many technicians miss that and request a PA instead of just running it to cash. Or Propecia with a DAW, when we all know you can get generic finasteride for a fraction of the cost.

If your pharmacy chain has an app, and/or text message alerts, you need to promote that and sell it to people. Pull out your phone and show them how. That will decrease the number of calls you get from people asking if their medications are ready.

Try to sync people’s meds if you can. You won’t get to this point until get really organized. Once you’re there for a while you’ll notice patients that are there 5 times a week. There’s no need for that. Find the date when all meds go through insurance and with the patient’s consent, set them to auto-refill on the same day of the month. Done.

Train your techs to not talk to you while you are verifying prescriptions and products. You shouldn’t be interrupting them, either. It goes both ways. Just like an interruption can cause you to make a mistake, the same goes for them.

Hope this helps. Let us know!

 

[pyxisdust]

all of you have helped so much. I appreciate the advice.. I have a few updates I will type them all soon. Hope you all have a happy holiday season

 

[CetiAlphaFive]

I'd recommend you WRITE down your verification steps on a prescription and follow it. I used to use the "around the world" rule where I checked:
1. Name
2. Date
3. Date of Birth
4. Prescriber/DEA
5. Drug Name, Dosage, Quantity
6. Sig

But basically, get OCD about defining a process and sticking to it. I also had "mental" Zen earmuffs to focus out noise when I verified.

Also, you're not the ONLY one to have this problem, don't feel like you're alone. I had that phase as an intern but thankfully I had a good preceptor to set me straight. It's not easy getting this job.

Also, it's important to recognize your personal style.
I used to try the "around the world" then the "bounce back and forth across the input and script" methods.

I realized that I'm white hot fast if I verify this way: Verify the critical, then the non criticals. I see prescriptions as a solar system.
The planets (patient info is earth, the prescriber info, date, refills, and the notes, DAW etc...) all orbit the Sun (Drug name, strength, # tablets per dose, frequency of doses)

Knowing that I'm going to get the drug, strength, and sig right every single time takes the stress out of it, and I think that's probably the single greatest cause of errors. Stress.

Obviously, the patient info is just as important as the drug, but I feel like that's a lot harder to **** up than the critical info.

 

[eeyore spice]

Your situation sounds a lot like mine about 5 years ago. I never wanted to do retail, so I focused on research while in pharmacy school and had no internship per se; I assumed I would do 2 years of residency and move on from there. I didn't match, which was devastating. The only job I was offered was floating with a chain. I was completely unprepared, but it sounds like I got way more training than you did, and got that training from a better mentor.

If you want to keep your job, admit that you need more training. It will look much better than trying to hide your struggling from your supervisor. Ask about things you don't understand, and write down the answers. Keep a cheat sheet or a folder full of them next to your station. At the very least, it'll show that you know you can do a better job and WANT to do a better job.

You also might want to ask a psychiatrist about your concentration.