gradintern

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I'm going to be scheduled as a pharmacist soon and sometimes feel terrified of being responsible as a pharmacist on a shift at a very busy Walgreens. I've never done any reviewing of prescriptions/patient profiles (but have done the final check on the product) and am worried about being slow, about not knowing everything needed to counsel patients, not knowing which interactions to overide and which to call the doctor on and so on. Does anyone have any advice/similar experience?
 

Old Timer

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I'm going to be scheduled as a pharmacist soon and sometimes feel terrified of being responsible as a pharmacist on a shift at a very busy Walgreens. I've never done any reviewing of prescriptions/patient profiles (but have done the final check on the product) and am worried about being slow, about not knowing everything needed to counsel patients, not knowing which interactions to overide and which to call the doctor on and so on. Does anyone have any advice/similar experience?
This is where the rubber meets the road. What you need to do is:


  • Concentrate.
  • Check the same way each time. DO NOT deviate. Once you have done it a few thousand times, it will be automatic.
  • Go fast enough to get things done but not so fast that your endangering your patients. It's like driving. You need to drive fast enough to not be a hazard, but not so fast that are hazard that way.
  • Don't let one rx get you behind. If you find an interaction or a problem. Put that aside. Contact the patient and let them know what's going on.
You will be fine. This is the part where the know it all students get a taste of reality. You work for Walgreens. There are 7000 locations. You can call a nearby store and ask a colleague for advice.....
 

PharmDstudent

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You will be fine. This is the part where the know it all students get a taste of reality.
You know it! :D What do they say, "the 2.0 and 3.0 students lead the 4.0 students"?
 

atlrph

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As a rookie you are entitled to a few DDIs per day. Go ahead and use them while you can. Just blame it all on your co workers. They'll never know. Don't initial your name on the labels. Don't leave any paper trails.
 

Kirbypuff

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I'm going to be scheduled as a pharmacist soon and sometimes feel terrified of being responsible as a pharmacist on a shift at a very busy Walgreens. I've never done any reviewing of prescriptions/patient profiles (but have done the final check on the product) and am worried about being slow, about not knowing everything needed to counsel patients, not knowing which interactions to overide and which to call the doctor on and so on. Does anyone have any advice/similar experience?
Have you not interned at a very busy Walgreen's store before? I just got off of an 8 hr shift at a very busy store so I apologize for the lack of empathy, but this sounds like whining. All drug interactions are at your fingertips on the Walgreen's computer and busy stores have enough staff to help you out. I'm looking forward to starting my pharmacy education this fall, but the fact that you have such little confidence after your four years of pharmacy studies is scaring me. How many years have you been with Walgreen's? Please don't tell me it's been more than a year, because that's how long I've been with Walgreen's and I'm already confident about becoming a pharmacist. Don't worry so much, it's hard to screw up at Walgreen's. I'm sure you'll be fine with some more experience.
 

WVUPharm2007

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Just say to yourself "**** it, I'm the man, dammit."

Worked for me.
 

Old Timer

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Have you not interned at a very busy Walgreen's store before? I just got off of an 8 hr shift at a very busy store so I apologize for the lack of empathy, but this sounds like whining. All drug interactions are at your fingertips on the Walgreen's computer and busy stores have enough staff to help you out. I'm looking forward to starting my pharmacy education this fall, but the fact that you have such little confidence after your four years of pharmacy studies is scaring me. How many years have you been with Walgreen's? Please don't tell me it's been more than a year, because that's how long I've been with Walgreen's and I'm already confident about becoming a pharmacist. Don't worry so much, it's hard to screw up at Walgreen's. I'm sure you'll be fine with some more experience.
I don't care what you do as tech/intern. When you assume the responsibility it's certainly a challenge. Speak to me when you are a grad intern. So what if the computer says there is an interaction. Do you need to do anything about it. Like I said, this is where the rubber meets the road. Every student I have ever had and there have probably been close to 100 by now have all had trepidations when they first started out. This is a natural fear that you will overcome with experience.
 

Fuzzychickens

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Have you not interned at a very busy Walgreen's store before? I just got off of an 8 hr shift at a very busy store so I apologize for the lack of empathy, but this sounds like whining. All drug interactions are at your fingertips on the Walgreen's computer and busy stores have enough staff to help you out. I'm looking forward to starting my pharmacy education this fall, but the fact that you have such little confidence after your four years of pharmacy studies is scaring me. How many years have you been with Walgreen's? Please don't tell me it's been more than a year, because that's how long I've been with Walgreen's and I'm already confident about becoming a pharmacist. Don't worry so much, it's hard to screw up at Walgreen's. I'm sure you'll be fine with some more experience.
I think you'll better appreciate the responsibility you are charged with after a year or two in pharmer school.

I have 2 years at Walgreens and a summer nuclear internship under my belt now- yea sure, they have tools that assist the pharmacist, but it's very easy actually to screw up at Walgreens or any other pharmacy. Thinking otherwise can be the road to unemployment or a lawsuit - I've heard of two lawsuits involving pharmers in the two Walgreens districts I've worked in. I have also heard of two incidents involving radiopharmaceutical dispensing errors that resulted in immediate termination for the tech and pharmacist involved in a nuclear pharmacy setting.

Your perspective will change when you aren't watching a pharmacist excercise their professional judgement and you ARE the pharmacist excercising professional judgement.

Being confident is good, but the attitude that it is "very hard to screw up" isn't going to help.
 
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Glycerin

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I don't care what you do as tech/intern. When you assume the responsibility it's certainly a challenge. Speak to me when you are a grad intern. So what if the computer says there is an interaction. Do you need to do anything about it. Like I said, this is where the rubber meets the road. Every student I have ever had and there have probably been close to 100 by now have all had trepidations when they first started out. This is a natural fear that you will overcome with experience.
:thumbup:

I'd been a tech for 8 years with experience in retail, mail order, and hospital, and I worked as intern in a hospital, so I pretty much know the ropes. However, I agree completely with OT here. Once that safety net of NOT YET being a pharmacist is removed, it is certainly scary at first. You have to start using clinical judgement, and even the simplest issues you encountered as a intern get, at the very least, a second thought before dispensing.

To the OP, the biggest things you have to maintain and protect are your license and the safety of your patients.
 

crossurfingers

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I'm going to be scheduled as a pharmacist soon and sometimes feel terrified of being responsible as a pharmacist on a shift at a very busy Walgreens. I've never done any reviewing of prescriptions/patient profiles (but have done the final check on the product) and am worried about being slow, about not knowing everything needed to counsel patients, not knowing which interactions to overide and which to call the doctor on and so on. Does anyone have any advice/similar experience?
Ah, welcome to Walgreens! :laugh: Are they just going to throw you in there your first day or are you lucky enough to be able to get some real practice with another pharmacist supervising? Definitely ask for the latter. If they don't have enough in the budget to cover that (which I'm suspecting they will say) I would even volunteer to do it without pay.

Make sure you have another pharmacist that you can call to ask any questions you have. Don't worry about being slow. You're just starting so you're allowed. Just make sure you and the tech are both on the same page re: wait time. Also to avoid getting yelled at make sure you call the patient any time there is a problem (drug interaction, out of stock, partial fill, etc.) Also, like someone else said, do final verification the same way each time. You need to establish a routine for yourself. This is how I do it- verify quantity and color, verify markings or NDC, make sure same name is on bottle and label that you are bagging. I personally always double check warfarin and control prescriptions against the hardcopy to make sure everything matches up.

Also keep an eye out for brand/generic (based on rx and patient profile history) for warfarin and levothyroxine as well as any C2's. Good luck! It might be a rocky first few weeks but you'll get through it. We've all been there.
 

Kirbypuff

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Your perspective will change when you aren't watching a pharmacist excercise their professional judgement and you ARE the pharmacist excercising professional judgement.

Being confident is good, but the attitude that it is "very hard to screw up" isn't going to help.
I was just telling the OP to grow some balls. Given the education, if it's any good at all, I would assume that the pharmacist would have sound professional judgment when it comes to pharmacotherapeutics. Pharmacy education plus one year of workflow at Walgreen's is practically idiot proof. Treat patients like they're dumb as **** when it comes to medicine, but smart as hell when it comes to law and suing your white coat off. If you can't do that, you're probably too dumb to be a pharmacist. If you think you're stupid, you shouldn't even try to become a pharmacist; this is people's healths we're dealing with. And what I'm trying to say is that if the OP believes he/she is smart enough to be a pharmacist, these qualms should be easy to overcome.

As a tech, I care about screwing up. License or no license, I give a damn about every patient, even down to insurance issues and finding cheapest alternatives even if I have to do extra labor for little or no gain. If you think that a tech shouldn't care as much as a pharmacist, then you've misjudged my intentions for wanting to become a pharmacist and I can't help but question your intentions of your service to pharmacy.
 

Old Timer

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I was just telling the OP to grow some balls. Given the education, if it's any good at all, I would assume that the pharmacist would have sound professional judgment when it comes to pharmacotherapeutics. Pharmacy education plus one year of workflow at Walgreen's is practically idiot proof. Treat patients like they're dumb as **** when it comes to medicine, but smart as hell when it comes to law and suing your white coat off. If you can't do that, you're probably too dumb to be a pharmacist. If you think you're stupid, you shouldn't even try to become a pharmacist; this is people's healths we're dealing with. And what I'm trying to say is that if the OP believes he/she is smart enough to be a pharmacist, these qualms should be easy to overcome.

As a tech, I care about screwing up. License or no license, I give a damn about every patient, even down to insurance issues and finding cheapest alternatives even if I have to do extra labor for little or no gain. If you think that a tech shouldn't care as much as a pharmacist, then you've misjudged my intentions for wanting to become a pharmacist and I can't help but question your intentions of your service to pharmacy.
This response shows you are truly clueless. You equate being a pharmacist with being a tech. They are NOT the same. Also since you have checked exactly ZERO prescriptions and you have observed exactly ZERO grad interns make the transition from student to pharmacist it's remarkable you say the OP should grow some balls.

The OP expressed the concerns of just about every single pharmacist the first time out. He was not paralyzed with fear. He wanted some advice on what to expect since he had not rally held the responsibility in his own hands. You need something to, understanding. The understanding that you KNOW NOTHING about what it's like to be a pharmacist.
 
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JackBeanstalk

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I was just telling the OP to grow some balls. Given the education, if it's any good at all, I would assume that the pharmacist would have sound professional judgment when it comes to pharmacotherapeutics. Pharmacy education plus one year of workflow at Walgreen's is practically idiot proof. Treat patients like they're dumb as **** when it comes to medicine, but smart as hell when it comes to law and suing your white coat off. If you can't do that, you're probably too dumb to be a pharmacist. If you think you're stupid, you shouldn't even try to become a pharmacist; this is people's healths we're dealing with. And what I'm trying to say is that if the OP believes he/she is smart enough to be a pharmacist, these qualms should be easy to overcome.

As a tech, I care about screwing up. License or no license, I give a damn about every patient, even down to insurance issues and finding cheapest alternatives even if I have to do extra labor for little or no gain. If you think that a tech shouldn't care as much as a pharmacist, then you've misjudged my intentions for wanting to become a pharmacist and I can't help but question your intentions of your service to pharmacy.

you really think what you are providing is sound advice? your 1-year tech experience provides you with that much insight of being a pharmacist. If you think what you said is anything other than arrogrant, inexperienced, or demeaning, then you're not as compassionate or intelletually competent as you think. If that's the case, then I can't help but question your suitability to the profession of pharmacy.
 
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gradintern

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Thank you very much to all of you who posted constructive replies. Though I've achieved high scores on the NAPLEX and CPJE, and am confident about my knowledge base, the application of this knowledge as well as the ability to do it in a retail setting is a new challenge. I have had 6 months experience at Walgreens, and though I was allowed to verify prescriptions using another pharmacist's sign on (noting the times I did so on the logbook so that I could be held accountable for what I checked off), and though I made countless calls to doctors' offices based on obvious problems with prescriptions I had typed up or that pharmacists had pointed out to me, I have had zero experience formally reviewing prescriptions.

It may be possible to have another pharmacist on duty at the same time; but is it possible to volunteeer? I heard our pharmacy manager once telling a tech applicant that volunteering wasn't allowed at Walgreens. I imagine that if I were reviewing prescriptions I would have to have a sign-on so that I am held accountable for what I do...or can they just assign me a sign-on and not pay me?
 

Old Timer

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Thank you very much to all of you who posted constructive replies. Though I've achieved high scores on the NAPLEX and CPJE, and am confident about my knowledge base, the application of this knowledge as well as the ability to do it in a retail setting is a new challenge. I have had 6 months experience at Walgreens, and though I was allowed to verify prescriptions using another pharmacist's sign on (noting the times I did so on the logbook so that I could be held accountable for what I checked off), and though I made countless calls to doctors' offices based on obvious problems with prescriptions I had typed up or that pharmacists had pointed out to me, I have had zero experience formally reviewing prescriptions.

It may be possible to have another pharmacist on duty at the same time; but is it possible to volunteeer? I heard our pharmacy manager once telling a tech applicant that volunteering wasn't allowed at Walgreens. I imagine that if I were reviewing prescriptions I would have to have a sign-on so that I am held accountable for what I do...or can they just assign me a sign-on and not pay me?
Now you are over-thinking this. Just follow my rules and life will be fine....
 

Kirbypuff

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This response shows you are truly clueless. You equate being a pharmacist with being a tech. They are NOT the same. Also since you have checked exactly ZERO prescriptions and you have observed exactly ZERO grad interns make the transition from student to pharmacist it's remarkable you say the OP should grow some balls.

The OP expressed the concerns of just about every single pharmacist the first time out. He was not paralyzed with fear. He wanted some advice on what to expect since he had not rally held the responsibility in his own hands. You need something to, understanding. The understanding that you KNOW NOTHING about what it's like to be a pharmacist.
Understanding? I'm understanding that he said
I'm going to be scheduled as a pharmacist soon and sometimes feel terrified of being responsible as a pharmacist on a shift at a very busy Walgreens.
OP's concerned were particularly about Walgreen's, a place where I've worked with at least twenty different pharmacists, in several different stores, with several managers, several interns, several new hires, and two pharmacists who have been fired. I think I know what it takes to get hired, fired, promoted, demoted, and transferred around at Walgreen's. If the OP said she/he is nervous about starting at a hospital, I wouldn't say anything, because I am totally clueless about hospital pharmacy---even CVS, I have no clue. You're focusing too much on the fact that I'm just a tech and not a Walgreen's employee. You see at Walgreen's, when I'm doing my part as a tech, I am relying on the pharmacist's pharmacy education to achieve a shared goal of giving the patient their medication just as much as the pharmacists themselves are also relying on their educations. And at Walgreen's, when in doubt, there is the computer and there is the phone call to the doctor to clarify and ascertain that we are giving the patient the proper medication. Which is why I wanted to tell the OP to relax because granted his/her education is sound, it's very very hard to mess up. Medicinal knowledge is something you either know or you don't. If you know it, how can you mess that up? If you're not sure, you can look it up. Depending on the layout of the store and the number of pharmacists and techs present at a certain time, Walgreen's has a specific workflow plan which will guide you on what you should focus your time on and in what order. You can't negotiate your wage as a pharmacist at Walgreen's because it really is idiot proof.
 

Vitamin K

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Medicinal knowledge is something you either know or you don't. If you know it, how can you mess that up? If you're not sure, you can look it up.

Actually, if you understood medicine at all, you'd know that nothing in pharmacy is black-and-white. Things are constantly changing, we're constantly learning more, and every patient is very individual in their response and reaction to treatment. Not everything can be looked up. A LOT of what we do is "a judgement call" and that's the scary part. Just because the computer system makes sure the prescription is filled on time doesn't mean it makes sure it's filled correctly. Not everything about a patient is even IN the system. I worked for Walgreens for 3 years and saw EVERY pharmacist in there (including the best and brightest) make mistakes. It happens. But when it happens and it's YOUR license and concience on the line, it's a bit different than when you're auxillary staff (i.e. tech/intern) watching it go down.
 

Passion4Sci

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I am going to weigh in here only based on leadership vs. subordinate responsibility levels, leapfrogging off Vitamin K.

When I was a heady E4 in the Army I was a 249 gunner in garrison (not deployed) when we ran MOUnT, or Military Operations on Urban Terrain, exercises with my squad and the rest of the unit.

I would watch the senior E4s, E5s and sometimes E6s (Non-commissioned officers; these are are de facto supervisors) lead platoons and squads through "dangerous" mock streets where insurgents, played by rival platoons or companies, would be staked, and it all very closely resembled what we would end up facing in Iraq or Afghanistan. While I could appreciate the difficulty in making sure one's squad/element is all accounted for, directing them during direct or indirect fire or when receiving contact of any sort, it was until I was slapped on the bird and sent overseas and told that I would be leading a real squad, in real combat operations, that the gravity of my training really hit me like a ton of bricks.

In a sense, my "license", that is, my life and the structural integrity of my element, was actually at stake, and a mistake on my part could and would almost assuredly lead to death or injury. Not heeding the warning signs during a presence patrol in Tikrit, Baqubah or Ramadi and you just endangered a lot of lives.

It's not a perfect example by any means, but the take-home message is just like Vitamin K alluded to - When you're "auxiliary" personnel, or in my case, just another cog in the machine during training, you are there and absorbing, but it's not your responsibility if you lose an asset from your element. However, when the health and sustainability of your unit is up to you, and your decisions, and your decisions alone will be accounted for on record, the whole scenery changes... Suddenly, situations which seemed simple for me to handle as just a member of the squad were like a sucker punch when I was a team or squad leader in theater with live ammunition and people who wanted me/us dead in the street.

Perhaps this can be applied quite nicely to Pharmacy after all. When you're a technician, you're observing, but it isn't your ass on the line when something goes boom and someone loses an arm or pays the ultimate price. It's the Pharmacist who is left when the smoke clears. The brass will be gunning for the Pharmacist's license, not your CPhT cert.
 

Kirbypuff

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Actually, if you understood medicine at all, you'd know that nothing in pharmacy is black-and-white. Things are constantly changing, we're constantly learning more, and every patient is very individual in their response and reaction to treatment. Not everything can be looked up. A LOT of what we do is "a judgement call" and that's the scary part. Just because the computer system makes sure the prescription is filled on time doesn't mean it makes sure it's filled correctly. Not everything about a patient is even IN the system. I worked for Walgreens for 3 years and saw EVERY pharmacist in there (including the best and brightest) make mistakes. It happens. But when it happens and it's YOUR license and concience on the line, it's a bit different than when you're auxillary staff (i.e. tech/intern) watching it go down.
Either you're assuming I'm dumb as a rock, or perhaps I'm not expressing myself clearly. Assuming the latter, I'll explain. What I meant by either knowing or not knowing medicinal knowledge is something like knowing that if you've had allergic reactions to penicillin, there is a chance that you will have allergic reactions to cephalexin, and as I said before, you should treat your patient like they're lawyers and give them a full disclosure about that and tell them to stop taking it immediately if blah blah blah. Of course pharmacists make mistakes, but a professional judgment is what it is and that's why it's very important to protect yourself when you communicate to your patients. "They're very very stupid when it comes to medicine, and they're very very smart when it comes you suing you." Ask the patient questions and explain risks. That's why at Walgreen's we ask every patient if they have any allergies or health conditions. And thank goodness for CAPs! If you're choosing to be a pharmacist you have to suck it up and know that you will probably make a mistake at one point or another, but as long as you're consistent and competent there is no need for terror. If I typed something incorrectly, and no pharmacist was able to DRE my mistake, and the patient was hurt as a result, trust me, I would feel immensely guilty about it. Apart from losing a license, I put the patient's health far above it. And as said before (perhaps a bit unclearly and unfortunately offensively--I do apologize,) if one cares about their license more than the best interest of their patient, then perhaps they are not fit to be a pharmacist. If one consistently serves the interest of the patient, the room for error is very small, and especially at Walgreen's your butt is covered quite well against lawsuits. Ahh, I do love Walgreen's. :)
 

Kirbypuff

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I am going to weigh in here only based on leadership vs. subordinate responsibility levels, leapfrogging off Vitamin K.

When I was a heady E4 in the Army I was a 249 gunner in garrison (not deployed) when we ran MOUnT, or Military Operations on Urban Terrain, exercises with my squad and the rest of the unit.

I would watch the senior E4s, E5s and sometimes E6s (Non-commissioned officers; these are are de facto supervisors) lead platoons and squads through "dangerous" mock streets where insurgents, played by rival platoons or companies, would be staked, and it all very closely resembled what we would end up facing in Iraq or Afghanistan. While I could appreciate the difficulty in making sure one's squad/element is all accounted for, directing them during direct or indirect fire or when receiving contact of any sort, it was until I was slapped on the bird and sent overseas and told that I would be leading a real squad, in real combat operations, that the gravity of my training really hit me like a ton of bricks.

In a sense, my "license", that is, my life and the structural integrity of my element, was actually at stake, and a mistake on my part could and would almost assuredly lead to death or injury. Not heeding the warning signs during a presence patrol in Tikrit, Baqubah or Ramadi and you just endangered a lot of lives.

It's not a perfect example by any means, but the take-home message is just like Vitamin K alluded to - When you're "auxiliary" personnel, or in my case, just another cog in the machine during training, you are there and absorbing, but it's not your responsibility if you lose an asset from your element. However, when the health and sustainability of your unit is up to you, and your decisions, and your decisions alone will be accounted for on record, the whole scenery changes... Suddenly, situations which seemed simple for me to handle as just a member of the squad were like a sucker punch when I was a team or squad leader in theater with live ammunition and people who wanted me/us dead in the street.

Perhaps this can be applied quite nicely to Pharmacy after all. When you're a technician, you're observing, but it isn't your ass on the line when something goes boom and someone loses an arm or pays the ultimate price. It's the Pharmacist who is left when the smoke clears. The brass will be gunning for the Pharmacist's license, not your CPhT cert.
Nice analogy. First of all, thank you for your service.

Although, I've been saying I'm just a tech, I'm actually an intern, since I do intend to become a pharmacist, and most pharmacists treat me as one. I consider techs, interns, Rph's as a healthcare team. Yes, a pharmacist has more to "lose" in the event of an error, but to me, an error is an error.

I know many pharmacists probably care more about their own asses, but I see the world in big pictures and theories. If I do what is right and I do it consistently, my conscience is clear and I have no fear. To err is human. Shoot, I'm glad pharmacists can lose their licenses. Can you imagine how it would be if healthcare professionals didn't face repercussions for their errors? Scary.
 

Passion4Sci

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Nice analogy. First of all, thank you for your service.

Although, I've been saying I'm just a tech, I'm actually an intern, since I do intend to become a pharmacist, and most pharmacists treat me as one. I consider techs, interns, Rph's as a healthcare team. Yes, a pharmacist has more to "lose" in the event of an error, but to me, an error is an error.

I know many pharmacists probably care more about their own asses, but I see the world in big pictures and theories. If I do what is right and I do it consistently, my conscience is clear and I have no fear. To err is human. Shoot, I'm glad pharmacists can lose their licenses. Can you imagine how it would be if healthcare professionals didn't face repercussions for their errors? Scary.
You're welcome.

Oh, I didn't know you're a tech... Your tag still says pre-pharmacy, and I didn't know you got your intern license yet. My bad! Although you did just call yourself a tech, so I guess it's not entirely my fault.

And while "an error is an error", you still don't feel the same about it. Maybe YOU personally do, obviously I can't tell you how to feel. But, I know that practicing in urban ops and doing the exact same thing, but as a leader, felt COMPLETELY different. If I tell my men to break contact and we run right into an ambush, I just got us killed... That is different, in scope, than if I am ordered to break contact by my squad/team leader and we run into an ambush and I get killed. Indeed, the error is the same... We should have engaged and taken cover until reinforcements arrived, and the effect is the same... Most of our element died. But the responsibility of having made that decision, that weight on my "old brain" that commands fight or flight, is much different as a leader than as a follower.

That is simple biomechanics, and I will be very shocked if you don't look back at this thread in 4 years when you've been a Pharmacist out in the field and post saying "Wow, it really IS different."

See, the beautiful flaw in our psychology is illustrated wonderfully by my attitude when I was a follower. It looked and felt easier, and there was zero responsibility on me besides guilt if we lost an asset. Sure, it sucked, sure I'd feel the pangs of survivor's guilt, but without the pressure of decision-making, that mantle of thorns on your head, you just can't know what it's like.

I am not trying to patronize you Kirby, I think you have an expert grip on what life is like as a Pharmacist in Walgreen's, but you certainly can't get into the psyche of the pharmacist until you've been one. I think that's what the Veterans here are trying to impress upon you most keenly...

Until they'd walked in my boots, the soldiers I trained to stand in my place when I got promoted had no idea what they were getting into either. They thought they knew, but they didn't know.

And yes Kirby, I know exactly what it's like in a health care world where the physicians face no repercussions... it's called military medicine.
 

Praziquantel86

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Either you're assuming I'm dumb as a rock, or perhaps I'm not expressing myself clearly. Assuming the latter, I'll explain. What I meant by either knowing or not knowing medicinal knowledge is something like knowing that if you've had allergic reactions to penicillin, there is a chance that you will have allergic reactions to cephalexin, and as I said before, you should treat your patient like they're lawyers and give them a full disclosure about that and tell them to stop taking it immediately if blah blah blah. Of course pharmacists make mistakes, but a professional judgment is what it is and that's why it's very important to protect yourself when you communicate to your patients. "They're very very stupid when it comes to medicine, and they're very very smart when it comes you suing you." Ask the patient questions and explain risks. That's why at Walgreen's we ask every patient if they have any allergies or health conditions. And thank goodness for CAPs! If you're choosing to be a pharmacist you have to suck it up and know that you will probably make a mistake at one point or another, but as long as you're consistent and competent there is no need for terror. If I typed something incorrectly, and no pharmacist was able to DRE my mistake, and the patient was hurt as a result, trust me, I would feel immensely guilty about it. Apart from losing a license, I put the patient's health far above it. And as said before (perhaps a bit unclearly and unfortunately offensively--I do apologize,) if one cares about their license more than the best interest of their patient, then perhaps they are not fit to be a pharmacist. If one consistently serves the interest of the patient, the room for error is very small, and especially at Walgreen's your butt is covered quite well against lawsuits. Ahh, I do love Walgreen's. :)
You're missing the point here. As a tech, you have an ethical obligation as a tech to do your best for the patient, but little to no professional or legal obligation. You might "feel bad" if a patient is hurt as a result of your error, but there really are no ramifications for you aside from that.

I felt the additional burden of responsibility when I received my intern permit, but I can only imagine how heavily that onus weighs as a pharmacist. Assuming the role as the final safeguard on a patient's life must be incredibly frightening.
 

Passion4Sci

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As a tech, you have an ethical obligation as a tech to do your best for the patient, but little to no professional or legal obligation. You might "feel bad" if a patient is hurt as a result of your error, but there really are no ramifications for you aside from that.
Quit stealing my moral of the story, dammit! =]
 

WVUPharm2007

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Are you serious? Walgreens is in it for THEIR best interest as a company, not yours as a pharmacist. They would get rid of a pharmacist at the drop of a hat if it meant they wouldn't be sued.
QFT. Buy that malpractice insurance, folks...
 

Kirbypuff

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I am not trying to patronize you Kirby, I think you have an expert grip on what life is like as a Pharmacist in Walgreen's, but you certainly can't get into the psyche of the pharmacist until you've been one. I think that's what the Veterans here are trying to impress upon you most keenly...

Until they'd walked in my boots, the soldiers I trained to stand in my place when I got promoted had no idea what they were getting into either. They thought they knew, but they didn't know.
Keep me accountable in 4 years!!! Ask me then if I'm scared lol. :)


Are you serious? Walgreens is in it for THEIR best interest as a company, not yours as a pharmacist. They would get rid of a pharmacist at the drop of a hat if it meant they wouldn't be sued.
Of course Walgreen's does what is in its best interest. I'm saying Walgreen's has a system set up so that a reasonably competent pharmacist will be protected naturally if they do what they are supposed to do. Privacy disclosure forms, registration procedures, these Walgreen's templates are all in place for a reason if one pays close attention. A pharmacist who was truly interested in their protection would follow suggested guidelines.
 

Old Timer

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Are you serious? Walgreens is in it for THEIR best interest as a company, not yours as a pharmacist. They would get rid of a pharmacist at the drop of a hat if it meant they wouldn't be sued.
Get some friends in law school. They are 100% responsible for the person they employ. They hired him/her they placed him/her and they are resposnible for supervising him/her.

They can't just dump the pharmacist and absolve themselves of liability.

The reason malpractice insurance is so cheap is it is only secondary to your employers coverage. If it was a primary policy, we would be sued way more often.
 
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The main thing is getting the correct drug, in the correct strength, with the correct directions, to the correct patient. You said you already had experience in verifying/final check so you are already ahead of the game. The rest will fall into place as you gain experience. If you want to call the MD on every interaction at first, that is fine (although it will slow you down). You will eventually learn which ones you can let go.

As far as customer questions/counseling, you can download Facts and Comparisons to your smartphone from SkyScape (Nokia N Series, iPhone, or BlackBerry) and can look up anything you do not know right at the window. "Let me look that up for you." or "Let me double check that." seems to work.

Don't worry about looking like an idiot occassionally, it is not the end of the world. You will have fewer incidents where you look stupid to the customers or coworkers as the years roll by.

The advantages of working at a busy store include overlap with other Pharmacists and of course lots of Techs working. If you don't know something you can always ask a coworker.
 

stevephhs016

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Yeah, I love the smartphone idea with Facts and Comparisons. I'm also in the same position as OP but my biggest concern is getting questions you have no ******* idea about. Thus, I need a smartphone with epocrates or whatnot and be able to get back to the patient.

I def think one of the stressors is a busy store. I think this scenario has been presented but with 3 phone calls on hold, 5 waiters, 5 drop offs, a couple of insurance rejections, couple of patient consults waiting for you, while still verifying, along with being understaffed and being a new grad, that can get stressful. I'm sure everyone has experienced this.

I guess the bottom line is really just experience, experience. Everyday for me is a learning experience, no matter how easy-difficult the task is.

Off-track question, how's your smartphone in terms of speed, in opening programs and looking stuff up?

And, what malpractice insurance plan has everyone been getting? Seems like the big one is HSPO's Pharmacist plan with 1,000,000/3,000,000 coverage for $71.
 

Old Timer

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And, what malpractice insurance plan has everyone been getting? Seems like the big one is HSPO's Pharmacist plan with 1,000,000/3,000,000 coverage for $71.
OK, why do you think it's only $71.00 per year?
 

RX CARE

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Have you not interned at a very busy Walgreen's store before? I just got off of an 8 hr shift at a very busy store so I apologize for the lack of empathy, but this sounds like whining. All drug interactions are at your fingertips on the Walgreen's computer and busy stores have enough staff to help you out. I'm looking forward to starting my pharmacy education this fall, but the fact that you have such little confidence after your four years of pharmacy studies is scaring me. How many years have you been with Walgreen's? Please don't tell me it's been more than a year, because that's how long I've been with Walgreen's and I'm already confident about becoming a pharmacist. Don't worry so much, it's hard to screw up at Walgreen's. I'm sure you'll be fine with some more experience.
Oh gawd, you are really one of those know-it-all techs or interns aren't you? You are completely missing the point that the retail milieu is very subjective in terms of training and the acquisition of skills. There are people who are not very ept at integrating different aspects of the job with speed. Confidence does not equal competence. The OP might be a very competent person....even might have graduated at the top of his class, but needs time to develop the confidence of handling his responsibilities, that's just how some people are. You've worked for only one year and you think your confidence mirrrors your professional accountability as a pharmacist? How dare you? You haven't even started pharmacy school yet. Do you know how dynamic the profession is? A drug interaction you get on a computer screen could mean something or nothing at all depending on the situation. Having a litany of drug interactions at your fingertips and applying them in a patient specific circumstance are two different things, which will only come to you as a result of your knowledge base. I do not know who you are, you might be a very bright person, maybe average, maybe not too smart; whatever the case, may the Lord be with you during the integrated therapeutics portion of your pharmacy education, but until you take start studying those, you do not have the credibility to ascertain what it feels like to bear the responsibility of a pharmacist who is the last safeguard in drug therapy. Your one year experience is laughable.....trust me...I worked in retail for 6 years before starting pharmacy school and I felt on top of the world just like you are now. I can even remember thinking how I could totally do a pharmacist's job. But until you have gone to school and fathomed how much knowledge and the complexity of knowledge that is required in making the right therapy decision, you would not know what it entails. Trust me ...it's also gonna dawn on you!
 
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Off-track question, how's your smartphone in terms of speed, in opening programs and looking stuff up?
I have a Nokia N75 with the 2GB memory card and love it. I keep Facts & Comparisons open all the time in the background, just one button to push and it pops up. The speed is good when I move around to the various sections on a particular drug.

I also keep my work schedule on there, syncing with Google Calendar via GooSync so my wife can look it up online if she needs to. I have the unlimited Internet plan and the speed is decent with 3G. If for some reason my Comcast Internet is down at home, I can use my Nokia as an Internet access point for my laptop via Bluetooth. Best phone I have ever owned.
 

KARM12

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Keep me accountable in 4 years!!! Ask me then if I'm scared lol. :)


Of course Walgreen's does what is in its best interest. I'm saying Walgreen's has a system set up so that a reasonably competent pharmacist will be protected naturally if they do what they are supposed to do. Privacy disclosure forms, registration procedures, these Walgreen's templates are all in place for a reason if one pays close attention. A pharmacist who was truly interested in their protection would follow suggested guidelines.
Ugh, almost 700 posts of nonsense.

Please? As a pre-pharm tech, you know all? It is very natural to feel apprehensive and scared about your first time in charge. All of us who have made this transition from student to pharmacist have felt this way. I worked as an intern for my company for 2 1/2 yrs prior to being a pharmacist and I was scared. It is different when it is your license and you are the one responsible. OldTime sums it up and gives great advice. You build confidence and learn a routine that works best for you. No system is fool proof and as a pharmacist, you should always have that in your mind. No one is invincible.
 

Kirbypuff

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Oh gawd, you are really one of those know-it-all techs or interns aren't you? You are completely missing the point that the retail milieu is very subjective in terms of training and the acquisition of skills. There are people who are not very ept at integrating different aspects of the job with speed. Confidence does not equal competence. The OP might be a very competent person....even might have graduated at the top of his class, but needs time to develop the confidence of handling his responsibilities, that's just how some people are. You've worked for only one year and you think your confidence mirrrors your professional accountability as a pharmacist? How dare you? You haven't even started pharmacy school yet. Do you know how dynamic the profession is? A drug interaction you get on a computer screen could mean something or nothing at all depending on the situation. Having a litany of drug interactions at your fingertips and applying them in a patient specific circumstance are two different things, which will only come to you as a result of your knowledge base. I do not know who you are, you might be a very bright person, maybe average, maybe not too smart; whatever the case, may the Lord be with you during the integrated therapeutics portion of your pharmacy education, but until you take start studying those, you do not have the credibility to ascertain what it feels like to bear the responsibility of a pharmacist who is the last safeguard in drug therapy. Your one year experience is laughable.....trust me...I worked in retail for 6 years before starting pharmacy school and I felt on top of the world just like you are now. I can even remember thinking how I could totally do a pharmacist's job. But until you have gone to school and fathomed how much knowledge and the complexity of knowledge that is required in making the right therapy decision, you would not know what it entails. Trust me ...it's also gonna dawn on you!
I never said the OP was incompetent. I was just trying to boost his/her confidence. I assumed correctly that the OP did not work for Walgreen's for more than one year (they worked only 6 months) and that's why my confidence would insinuate that after an additional 6 months of working with Walgreen's, the OP should feel more confident as well. I don't see how your post helps the OP in anyway. You DON'T know me and I've been accepted into pharmacy school after just 6 months of pharmacy experience, but it took you 6 years before you could get into pharmacy school and you're trying to judge me? Where do you think my confidence comes from? It doesn't come from my 1 year of pharmacy experience but practically everything else about myself, my life experiences, etc. You must think I rolled out of bed one morning and thought I wanted to become a pharmacist. Yes, my post wasn't sugary and nice, but at heart I wanted the OP to rely on his/her education and also reflect on why they chose to become a pharmacist to remotivate them all over again. Walgreen's is a great place with lots of safety nets compared to other retail pharmacies so I wanted to the OP take comfort in that. That combined with other posters' advices would perhaps help the OP move on from their fears.
 

Kirbypuff

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Ugh, almost 700 posts of nonsense.

Please? As a pre-pharm tech, you know all? It is very natural to feel apprehensive and scared about your first time in charge. All of us who have made this transition from student to pharmacist have felt this way. I worked as an intern for my company for 2 1/2 yrs prior to being a pharmacist and I was scared. It is different when it is your license and you are the one responsible. OldTime sums it up and gives great advice. You build confidence and learn a routine that works best for you. No system is fool proof and as a pharmacist, you should always have that in your mind. No one is invincible.
Resident? Another non-Walgreen's employee trying to rebut my statement on how it feels to work at Walgreen's. Awesome.
 

MountainPharmD

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Understanding? I'm understanding that he said OP's concerned were particularly about Walgreen's, a place where I've worked with at least twenty different pharmacists, in several different stores, with several managers, several interns, several new hires, and two pharmacists who have been fired. I think I know what it takes to get hired, fired, promoted, demoted, and transferred around at Walgreen's. If the OP said she/he is nervous about starting at a hospital, I wouldn't say anything, because I am totally clueless about hospital pharmacy---even CVS, I have no clue. You're focusing too much on the fact that I'm just a tech and not a Walgreen's employee. You see at Walgreen's, when I'm doing my part as a tech, I am relying on the pharmacist's pharmacy education to achieve a shared goal of giving the patient their medication just as much as the pharmacists themselves are also relying on their educations. And at Walgreen's, when in doubt, there is the computer and there is the phone call to the doctor to clarify and ascertain that we are giving the patient the proper medication. Which is why I wanted to tell the OP to relax because granted his/her education is sound, it's very very hard to mess up. Medicinal knowledge is something you either know or you don't. If you know it, how can you mess that up? If you're not sure, you can look it up. Depending on the layout of the store and the number of pharmacists and techs present at a certain time, Walgreen's has a specific workflow plan which will guide you on what you should focus your time on and in what order. You can't negotiate your wage as a pharmacist at Walgreen's because it really is idiot proof.
A typical miss guided rant by a "super tech"/I am smarter than the pharmacist technician. These are the worst kind of technicians to work with in my opinion. They are not smart enough to know they are not smart enough to do what the pharmacist does.

With statements like
“And at Walgreen's, when in doubt, there is the computer and there is the phone call to the doctor to clarify and ascertain that we are giving the patient the proper medication.”
And
“ You can't negotiate your wage as a pharmacist at Walgreen's because it really is idiot proof.”
You should get promoted to upper management fast. It seems that is what every idiot in charge at Walgreens thinks. You can put anyone behind the verification computer and the “system” will take care of it. What a joke Walgreens has become.
 

StaviZFingerZ

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Resident? Another non-Walgreen's employee trying to rebut my statement on how it feels to work at Walgreen's. Awesome.

Good Lord....

Karm can run circles around you in everything that pertains to pharmacy. Know your place...you're just a little prepharm who rang up a couple of customers at Wags...

Get it straight...Karm is a PGY2 which means she has more experience and knowledge than most posters on this forum.

Know your F*****kin place.


:thumbdown:
 

StaviZFingerZ

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This thread turned nasty real quick. From what I have read, I think you are all trying to give the OP some confidence, but providing them in a different manner.
I think Kirbypuff's intentions just came off wrong, granted her efforts were very poorly worded. I personally would like to be told that time will give me the confidence instead of someone questioning my confidence in my level of education.

I'll be a P1 this upcoming fall and have never worked in retail pharamy, heck, I have never worked as a pharmacist tech, but if life has taught me anything, it's the two things listed below.

1. Things are a lot easier said than done.

2. You can't ignore experience.... there is a reason people with experience are more highly regarded in all aspect of life.

So overall, I think it would be highly presumptuous of me to tell the OP to how to feel better about his situation and be more comfortable, because I have never been a pharmacist at Walgreen, yet even a pharmacist.
 

MountainPharmD

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Get some friends in law school. They are 100% responsible for the person they employ. They hired him/her they placed him/her and they are resposnible for supervising him/her.

They can't just dump the pharmacist and absolve themselves of liability.

The reason malpractice insurance is so cheap is it is only secondary to your employers coverage. If it was a primary policy, we would be sued way more often.
Do a search about what Wal-Mart is doing to some of its pharmacists. In the P&P manual it says if you make an error and have violated any company policies in doing so you are responsible for the liability not the company. I will try and find out where I read about that. I think I read about one example on the TPA forums.

It would be very easy for a company to shift liability to the pharmacist. They may employ the pharmacist and therefore share some liability but Walgreens corporation is not licensed to practice pharmacy the individual pharmacists are.
 

StaviZFingerZ

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And if I remember correctly, Karm did retail prior to beginning residency?

And she graduated early and worked as a clinical coordinator before starting the residency.
 

MountainPharmD

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For the first time in my life, I'll agree with you here...she's too dumb to know how dumb she is...
Second time. The first was agreeing with me that I should get out of retail. Its okay I will let your oversight slide.
 

StaviZFingerZ

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Second time. The first was agreeing with me that I should get out of retail. Its okay I will let your oversight slide.

:eek: dang.... I've been proven wrong..
 

MountainPharmD

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Crap....I have been up since 4:30...I should go to bed. I am sure I will be up at 4:30 again. Yeah, yeah...I am wuss....Thanks Z.:thumbdown: