Removing a technician from the pharmacy.

[MindOverMatter]

Advertisement - Members don't see this ad

Yesterday I was alerted that one of my techs had committed a bag error, her third one within a year. She simply did not ask for the address of the patient, and mistakenly sold the wrong patient the wrong med. The patient came back to the pharmacy the next day and let us know what happened.

Upon hearing about this, the tech became very upset and asked to be sent home for the day, a request which I obliged. However, now I am faced with the task of informing her that she will be removed from the pharmacy permanently, since this is the third occurrence within a year. I have never had to do this before, and it's weighing very heavily on me. This is a person who has been a technician for longer than I have been alive, and she is a very sweet person who genuinely cares about others.

I'm sure she already knows what's going to happen, since after her second error she was suspended for a week and told about the consequences of another mistake, but it still makes me feel horrible telling someone that she will no longer be able to do the work she has done for 30+ years.

I don't know what I'm looking for in this post, but if anyone has been in this situation before, please let me know how you dealt with it.

 

[xiphoid2010]

Yesterday I was alerted that one of my techs had committed a bag error, her third one within a year. She simply did not ask for the address of the patient, and mistakenly sold the wrong patient the wrong med. The patient came back to the pharmacy the next day and let us know what happened.

Upon hearing about this, the tech became very upset and asked to be sent home for the day, a request which I obliged. However, now I am faced with the task of informing her that she will be removed from the pharmacy permanently, since this is the third occurrence within a year. I have never had to do this before, and it's weighing very heavily on me. This is a person who has been a technician for longer than I have been alive, and she is a very sweet person who genuinely cares about others.

I'm sure she already knows what's going to happen, since after her second error she was suspended for a week and told about the consequences of another mistake, but it still makes me feel horrible telling someone that she will no longer be able to do the work she has done for 30+ years.

I don't know what I'm looking for in this post, but if anyone has been in this situation before, please let me know how you dealt with it.

Your company should have clearly laid out disciplinary policy and procedures. Follow it and document each step of the process.

Don't take things personally. Everyone must stand based on their ability to perform at work. I haven't had to fire anyone yet, but I have had to give several verbal, and couple written warnings.

I try to look at it this way, people fire themselves, I'm just here to put in the paperwork for them.

 

[rph3664]

If she's suddenly started doing things like this when she never did before, she may be in the early stages of Alzheimer's or some other degenerative disease. 🙁

I did some relief work at a pharmacy that had recently had to discharge a much-loved pharmacist because he started making really strange mistakes, and in the meantime, the pharmacy was being sued because he had been diagnosed with Alzheimer's.

 

[WhiteSnows]

It is tough decision for you and perhaps for everyone else who is in charge. However, patient's safety is the priority. I would lay down the consequences of her action and help her to understand why the company has to let her go. I think it is the most fair thing you can do to her.

 

[rph3664]

It is tough decision for you and perhaps for everyone else who is in charge. However, patient's safety is the priority. I would lay down the consequences of her action and help her to understand why the company has to let her go. I think it is the most fair thing you can do to her.

Very true.

My BFF's mother, who died 2 weeks ago from something else, was asked to retire early from her secretarial job, one she'd had for about 30 years, because she was suddenly unable to perform her duties. She definitely didn't have Alzheimer's, because she got better for a while, but we think she may have had a stroke. It's not an uncommon thing with the older population.

 

[opinionfree]

First, let me compliment your compassion. I can only imagine a tech with that much time, working in a pharmacy, has been called upon countless times to make the lives of the pharmacists working there, easier. Everything from: can you come in early, stay late, cover a sick/vacation call, diffuse angry customers, run my errands, handle hostile phone calls, loss prevention, dress professionally, fulfill constant inane corporate tasks, train new techs, be a friend to even the most arrogant and insincere pharmacists, run interference from all the crap we pharmacists avoid, catch pharmacists mistakes at the register,... This list goes on and on.
Being a licensed and working pharmacist for 23 years (less my recent 8 year vacation), I have had the task of guiding and releasing many pharmacy personnel.
Most often it has been for easy things like stealing. (I don't steal, you don't steal, we don't steal). You get fired.
A few people, that couldn't contain their carnal desires from occurring in the restrooms. (I gave them the old stern warning and high five). Don't do it again or else.
I have had some very old people working in the pharmacy, as well. I would reassign them to positions, within the pharmacy, that were more in line with their abilities. (For me, that is being respectful, NOT preferential.)
For the last 2 months I have had the privilege to work as an 'undercover' tech while preparing to get a California license. While ringing pick ups, at the register, I have caught 5 filling errors (2 were serious). That's a lot of booboos. Not 1 of the 4 pharmacists, said thank you or even thought about filing an error report. Just a simple dismissal and why the errors weren't their faults. Don't play it's not an error till it's rung up game with me: I was ringing them up and caught them.

During my 2 month torture, I mean training, at a large pharmacy chain: I have been taught to tolerate and suck up all customer BS - no matter how hostile or violent it is, never and I mean never let any bad info get to the upper management people, do anything and everything a pharmacist commands of you, fulfill the never ending parade of paperwork and inane tasks corporate creates to keep you spinning like a whirling dervish, and always be full of smiles and kindness towards EVERYONE BUT YOUR COWORKERS..
No where in all the mess, we call pharmacy, are we told to be kind or gentle to the PEOPLE we are working with. It has created an atmosphere of passive anger and self-righteousness, that we vent against the very people that are in the trenches with us.
Do what you must, but please remember that hit 70's song: There but for the grace of God go I.
Good Luck.

PS
Insurance covers pharmacists and techs.

 

[owlegrad]

Am I the only one who thinks that policy sounds harsh? Maybe I am being too carefree here but somehow that policy sounds harsh to me.

But like the others have said, don't make it personal. You said the person was already told what the policy is so she knows what to expect. Do the kind thing and get it over quickly so it is not hanging over her head.

 

[ancienbon]

Am I the only one who thinks that policy sounds harsh? Maybe I am being to carefree here but somehow that policy sounds harsh to me.

But like the others have said, don't make it personal. You said the person was already told what the policy is so she knows what to expect. Do the kind thing and get it over quickly so it is not hanging over her head.

I agree with you. This policy is harsh, and having worked for walgreens before I can tell you it is a mistake that is very possible.. Now that I am working for cvs, I can tell you it is very difficult to sell an incorrect package to patient as they make sure that address and dob have to be verified at pos. If a medication is not listed, it wont ring up. That is great. But at walgreens, you just take the medication , you verify the address and sell it. That is why at wags at pos you have to very careful, and always double check address. I know many pharmacy techs and pharmacists at walgreens who have a list one incident on their file. If you have 3 on your file in your career , you are out. Yes, it is a harsh but it is the procedure.
I would hate to be on your shoes, but just do what you got to do. Good luck.

 

[MindOverMatter]

Thanks for the kind words everyone. For full disclosure, I did "get it over quickly" today. I felt that was the best for everyone's interest. But I'm still kind of in shock at the whole process. I've been a pharmacist for just 2 years, a manager for a mere 8 months, but I know that when all is said and done I will always distinctly remember the first employee I had to let go.

For those that have said things like "these people fire themselves": while I agree with the notion because it appeals to the logical side of me, it's a completely different ball game when you have to look in someone's weeping eyes and tell them that their livelihood has been stripped away from them in an instant. This wasn't just a tech who plans on working for you for 2-3 years while she finishes up school. This was what you call a "lifer". She dedicated decades of her existence to this cause, probably more than you or I will devote ourselves. These kinds of technicians are the fabric of our business, and if you just brush it off as "well, she eff'd up too many times" then you're not seeing it the right way. These types of people bust their asses day in and day out and put up with just as much BS as we do for a fraction of the pay. Yes, she made too many mistakes, and yes there are consequences of these actions, but it doesn't mean that I have to behave like a corporate robot and feel nothing while imposing the sentence.

I'll let this thread fade off into obscurity now. I just wanted to vent my frustration while going through one of the tougher parts of the job.

 

[PharmDstudent]

I feel bad for you, because I've seen plenty of technicians not get fired over that rule. How? They just don't get written up in the first place.

 

[xiphoid2010]

Am I the only one who thinks that policy sounds harsh? Maybe I am being too carefree here but somehow that policy sounds harsh to me.

Making same kind of mistake 3 times within a year seems like a reasonable amount of leeway to me. You would have to get one a verbal, a written, a suspension within a year and somehow still not learned from all that. We are all human, but in that case, someone probably just didn't care or incapable of learning. And when that goes against the basic mission of patient safety of our profession, the appropriate outcome should be pretty clear.

 

[xiphoid2010]

I feel bad for you, because I've seen plenty of technicians not get fired over that rule. How? They just don't get written up in the first place.

That's the problem with some in leadership positions. Too kind or too soft, or just want to do the minimum, but that's not right. Others though have their hands tied, like what I saw with the union situation at VA.

Effective leadership is based on communicating clear expectations, holding people accountable using a consistent set of rules, reward and punish fairly. Otherwise staffs have the tendency of learning and trending towards the bottom performer.

P.S you are right, being the DOP of an LTACH is a pretty sweet gig. 🙂

 

[ancienbon]

Making same kind of mistake 3 times within a year seems like a reasonable amount of leeway to me. You would have to get one a verbal, a written, a suspension within a year and somehow still not learned from all that. We are all human, but in that case, someone probably just didn't care or incapable of learning. And when that goes against the basic mission of patient safety of our profession, the appropriate outcome should be pretty clear.

I think the way this policy is if you make 3 during your time , you are fired. I agree 3 during a year is a lot. But getting fired for 3 , say in 5 years is harsh. When i worked at wags, i knew a girl that probably have more than 3 during the year and was never fired. Lol. At the same store, the pharmacy manager sold someone metformin to another patient. When patient came, he acted like nothing happened and did not report it. Lol

 

[genesis09]

Walgreens policy is if you sell 4 incorrect packages to patients within a one year span, then you are fired or forced to go into a non-pharmacy position. If it has been more than one year since the last incident, than it is treated like a first strike.

 

[ancienbon]

Walgreens policy is if you sell 4 incorrect packages to patients within a one year span, then you are fired or forced to go into a non-pharmacy position. If it has been more than one year since the last incident, than it is treated like a first strike.

really, it is a year? I remember having an argument with tech , who said it was 3 or 4 during one year. And I always thought it was 4 during your time at wags.
then, it is not harsh

 

[BidingMyTime]

Making same kind of mistake 3 times within a year seems like a reasonable amount of leeway to me. You would have to get one a verbal, a written, a suspension within a year and somehow still not learned from all that. We are all human, but in that case, someone probably just didn't care or incapable of learning. And when that goes against the basic mission of patient safety of our profession, the appropriate outcome should be pretty clear.

I think it sounds harsh, but it really depends on the volume & the hour a technician works. There is a big difference between a technician working 1 day a week in a 200 RX/day pharmacy making that error 3 times in a year, and a technician working 5 days a week in a 800 RX/day pharmacy. I feel that any policy that doesn't account for the hours per week being worked and the volume being dealt with is completely unfair. Common sense should tell us its the percent error that counts, not the absolute number of errors.

 

[xiphoid2010]

I think it sounds harsh, but it really depends on the volume & the hour a technician works. There is a big difference between a technician working 1 day a week in a 200 RX/day pharmacy making that error 3 times in a year, and a technician working 5 days a week in a 800 RX/day pharmacy. I feel that any policy that doesn't account for the hours per week being worked and the volume being dealt with is completely unfair. Common sense should tell us its the percent error that counts, not the absolute number of errors.

Your argument, while has some logic, forgets the logic of corrective actions. Common sense tells me that if I have got caught twice already, I would be changing the process and double check that item so I wouldn't end up with a 3rd and then a 4th within the 12 months period.

Also one can take a % view, or but also can take a patient harm point of view. Is 4 patients harmed by a full time tech any better off? Logic would dictate that correcting the bigger sources of errors would decrease number of patient harmed more than smaller sources.

 

[genesis09]

really, it is a year? I remember having an argument with tech , who said it was 3 or 4 during one year. And I always thought it was 4 during your time at wags.
then, it is not harsh

It is a year. We've had someone who had a IPP and then another one more than a year apart, and so, was given another verbal. 4 IPPs during one's entire career is harsh but 4 within a one year period is reasonable.

 

[joetrisman]

It is a year. We've had someone who had a IPP and then another one more than a year apart, and so, was given another verbal. 4 IPPs during one's entire career is harsh but 4 within a one year period is reasonable.

I think this is a soft rule dependent on your store volume as I've seen more than that

 

[BidingMyTime]

Your argument, while has some logic, forgets the logic of corrective actions. Common sense tells me that if I have got caught twice already, I would be changing the process and double check that item so I wouldn't end up with a 3rd and then a 4th within the 12 months period.

Also one can take a % view, or but also can take a patient harm point of view. Is 4 patients harmed by a full time tech any better off? Logic would dictate that correcting the bigger sources of errors would decrease number of patient harmed more than smaller sources.

Well, yeah, but if both the part time & full time technician have the same error rate, and the full time technician is fired because of that error rate, than the part time technician is promoted to full time....well the absolute number of errors is going to stay the same. I guess I'm thinking from the standpoint that humans aren't perfect and screw up. I don't know what an expected average would be, but I think that in a person who is well-trained & competent, there would be an expected average.....if, for example it was 2%, then one couldn't reasonably expect to hire in any replacements that would have better than a 2% error rate (although there may always be a few outliers), on the other hand, if an employee is having a 3% or higher error rate and doesn't respond to corrective action, than it makes sense to fire the person and hire in someone else who would have the potential to meet the expected 2% error rate. As much as it would be handy if humans could perform perfectly like computers, it doesn't happen. Humans get distracted & think they checked something when they didn't, or the hear or see wrong and think something is right when it isn't, etc. Humans will always make mistakes.

The best thing employers can do is make sure their employees are well-trained in error prevention. Sure, tell the employee to check every pt's address or address/b-date. What does that mean? Employees need to be told specifically what it means, ie it means you ask the patient to recite the address to you, you don't read the address to them and ask if its correct, because half of patients aren't listening and will say yes just because they want to get out of the pharmacy. If you can't understand them because they are mumbling or accent or whatever, ask for an ID to check, don't guess what they are saying. You also tell them to check the address on every prescription leaflet, don't assume they are bagged together correctly, or assume if they grabbed multiple bags out of bin that they correctly grabbed all the bags. One thing I've seen some technicians do is to physically check with a pen each leaflet as they check the address, great for kinesthetic people to make sure they check each leaflet. I doubt training was the case in the OP example, since she was a decades long technician, but I've seen this too often, especially with bag errors, where technicians a written up for making errors, but nobody has every really taught them error prevention techniques.

 

[PharmDstudent]

P.S you are right, being the DOP of an LTACH is a pretty sweet gig. 🙂

I'm soooooooo happy for you! 👍👍

 

[Aznfarmerboi]

Yesterday I was alerted that one of my techs had committed a bag error, her third one within a year. She simply did not ask for the address of the patient, and mistakenly sold the wrong patient the wrong med. The patient came back to the pharmacy the next day and let us know what happened.

Upon hearing about this, the tech became very upset and asked to be sent home for the day, a request which I obliged. However, now I am faced with the task of informing her that she will be removed from the pharmacy permanently, since this is the third occurrence within a year. I have never had to do this before, and it's weighing very heavily on me. This is a person who has been a technician for longer than I have been alive, and she is a very sweet person who genuinely cares about others.

I'm sure she already knows what's going to happen, since after her second error she was suspended for a week and told about the consequences of another mistake, but it still makes me feel horrible telling someone that she will no longer be able to do the work she has done for 30+ years.

I don't know what I'm looking for in this post, but if anyone has been in this situation before, please let me know how you dealt with it.

The biggest problem that I have with senior technicians are that they are unwilling to change. This is a good example of that. There is a reason why every company requires the tech to verify the patient's address. If a tech can not comply with that after three times, she should be terminated. You will be doing yourself and your patients a service by terminating her.

I love the CVS system now because it is almost impossible for a customer to get the wrong prescription since you have to scan the rx out.

 

[owlegrad]

I love the CVS system now because it is almost impossible for a customer to get the wrong prescription since you have to scan the rx out.

Yes I agree. I hated it at first for being so slow, but now that I am on the other side of the bench I love how difficult it makes it to give the wrong patient a script. You have to be almost deliberately negligent or trying to make a mistake for it to happen.

 

[88888888]

Yes I agree. I hated it at first for being so slow, but now that I am on the other side of the bench I love how difficult it makes it to give the wrong patient a script. You have to be almost deliberately negligent or trying to make a mistake for it to happen.

I agree too. Scanning does help.