Surviving the 14 hour shifts

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Get help with your application

Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.

Advertisement - Members don't see this ad
I'm not saying it's a competition, all I'm saying is that there are pharmacists out there that do not complain and might possibly not have a problem with working 14 hours shifts. All you guys who claim to be dead after 10 need to watch out, there might be a snake in your boot!
 
I'm not saying it's a competition, all I'm saying is that there are pharmacists out there that do not complain and might possibly not have a problem with working 14 hours shifts. All you guys who claim to be dead after 10 need to watch out, there might be a snake in your boot!

Dude...seriously have you been smoking crack? Crack is whack yo so you need to put the pipe down.

Either that or stop inhaling all the Percoet and Xanax dust at work. Licking the counting tray every time you count Xanax or Hydrocodone is not cool either...
 
Dude...seriously have you been smoking crack? Crack is whack yo so you need to put the pipe down.

Either that or stop inhaling all the Percoet and Xanax dust at work. Licking the counting tray every time you count Xanax or Hydrocodone is not cool either...

:laugh:
 
Advertisement - Members don't see this ad
Quality of life? You make it sound like you're working in the oil fields in 120 degree weather. If you aren't working for CVS and you're getting breaks and lunch then you're getting what you deserve. I could very well be in the minority but I just laugh at pharmacists like you. There's no way you can be more than 5 years removed from school.

And there is no way you are a pharmacist. My guess is a pre-pubescent pimple face 15 year old playing on his new computer mommy and daddy got him.

Or you could be the long lost love child between Old Timer and Tom Ryan. You make as much sense as they do.
 
If it is your job description and/or it is part of your job, then you are getting paid for it.

Every company has various protocols to follow to help increase cash flows, etc they're just usually in different ways.

One of the things I used to do was explain the reasoning behind requiring some of these things. Take the autofills for instance. The main reason we do them is so you have a sort of stable cash flow that you can rely on. It gives you the ability to count on that fact. Sure some people don't pick them up or don't want them on there, but it's good for the company and it's good for your work flow.

We have several people who get 10+ things a month that we have on auto fill. Is it better that when they come up on autofill we can fill them at our leisure during a slow part of the day or have them call it in and get it ready in an hour?

Strongly agree. The patients who don't like readyfill are the patients who are non-compliant. Who enjoys calling in their scripts? lol no one.
Get those people on readyfill and be amazed at how much easier your days become. Fewer phone calls, fewer waiters, fewer PCI calls, more consistent workload. If you do it right, it will be your best friend. Spend half your day trying to get around it and yes you will hate it. Use it right and love it.

/rant
 
And there is no way you are a pharmacist. My guess is a pre-pubescent pimple face 15 year old playing on his new computer mommy and daddy got him.

Or you could be the long lost love child between Old Timer and Tom Ryan. You make as much sense as they do.

How old are you? I have my doubts that you are old enough to complain and cry about losing all mental and physical function with a 10 hour shift. I'm not joking, there are pharmacists out there that can handle with ease what you seem to consider torture. Don't let your employer find these people because you'll be canned.

I'm gonna gamble and say that you are either work in Houston, Dallas, or Phoenix at a non-independent. How much did I win?
 
Working 14 hours is no big deal. At one point I worked for an independent and before there were 24 hour stores, he had the bright idea to stay open until midnight. There were a couple of times I did the 8AM to midnight shift. I was in my 20's at the time and it was doable. Not fun, but doable.

What are the secrets of being able to do this for a long period of time:

Take care of your body. Eat right, get plenty of exercise. If you expect to stand on your feet for a living, you better take care of your feet & knees. Good shoes & socks are critical. A mat to stand one also helps.

Take a break. You can step away for 10 minutes. I take what I call a MHB (Mental Health Break). Remember stress is self imposed. So don't impose it on yourself.

Being a pharmacist is a lot like surfing. You have to know how to read the waves. If you see the wave forming, you don't wait until it's right on top of you to do something about it. If you do, you drown, while the person who saw it coming, rides it into the beach....

Life is lot easier than people make it out to be. I have been a pharmacist for just about 28 years and have worked in pharmacy for 34 years. There is no correlation between hours worked in a day and when errors occur.
 
Working 14 hours is no big deal. At one point I worked for an independent and before there were 24 hour stores, he had the bright idea to stay open until midnight. There were a couple of times I did the 8AM to midnight shift. I was in my 20's at the time and it was doable. Not fun, but doable.

What are the secrets of being able to do this for a long period of time:

Take care of your body. Eat right, get plenty of exercise. If you expect to stand on your feet for a living, you better take care of your feet & knees. Good shoes & socks are critical. A mat to stand one also helps.

Take a break. You can step away for 10 minutes. I take what I call a MHB (Mental Health Break). Remember stress is self imposed. So don't impose it on yourself.

Being a pharmacist is a lot like surfing. You have to know how to read the waves. If you see the wave forming, you don't wait until it's right on top of you to do something about it. If you do, you drown, while the person who saw it coming, rides it into the beach....

Life is lot easier than people make it out to be. I have been a pharmacist for just about 28 years and have worked in pharmacy for 34 years. There is no correlation between hours worked in a day and when errors occur.

From what source did you get that information? 😱
 
Working 14 hours is no big deal. At one point I worked for an independent and before there were 24 hour stores, he had the bright idea to stay open until midnight. There were a couple of times I did the 8AM to midnight shift. I was in my 20's at the time and it was doable. Not fun, but doable.

What are the secrets of being able to do this for a long period of time:

Take care of your body. Eat right, get plenty of exercise. If you expect to stand on your feet for a living, you better take care of your feet & knees. Good shoes & socks are critical. A mat to stand one also helps.

Take a break. You can step away for 10 minutes. I take what I call a MHB (Mental Health Break). Remember stress is self imposed. So don't impose it on yourself.

Being a pharmacist is a lot like surfing. You have to know how to read the waves. If you see the wave forming, you don't wait until it's right on top of you to do something about it. If you do, you drown, while the person who saw it coming, rides it into the beach....

Life is lot easier than people make it out to be. I have been a pharmacist for just about 28 years and have worked in pharmacy for 34 years. There is no correlation between hours worked in a day and when errors occur.

qft

A few other things to consider:

Your staff goes along way toward making a day easy or hard.

Attitude, Attitude, Attitude. Also a stool.
 
Advertisement - Members don't see this ad
Life is lot easier than people make it out to be. I have been a pharmacist for just about 28 years and have worked in pharmacy for 34 years. There is no correlation between hours worked in a day and when errors occur.

You are an old fool. You have said alot of dumb stuff but this takes the cake. There is an absolute correlation between hours worked and the amount of errors that occur. You are smoking crack if you think a pharmacist who works an 8 hour shift with adequate staffing and breaks has the same chance of making an error as a pharmacist at your ****ty company who works 14 hours with no breaks and inadequate staffing.

This article is one of my favorites because it comes from your beloved CVS/Caremark. The irony is just dripping off of it!

https://www.caremark.com/wps/portal/HEALTH_RESOURCES?topic=rxtrouble

Selected quotes from the above article "Ills & Conditions Special Report: Avoiding Pharmacy Errors"

When pharmacists are asked to work long hours under grueling pressure, mistakes happen. And although many errors are minor, some of them can be extremely grave.

"There's a real crisis in pharmacies," says Fred Mayer, president of Pharmacists Planning Service, Inc., a lobbying organization in northern California. "And at the heart of it is overworked pharmacists. The system we have has pushed them beyond the breaking point."

If the white-coated pharmacist who fills your prescription looks harried, it's no wonder. The conditions at many pharmacies are akin to sweat shops, analysts say. "In some retail locations, pharmacists are being asked to work 12-hour shifts, sometimes back to back," says Phillip Grauss, a senior pharmacist at Kaiser Permanente in Petaluma, California. "Pharmacists are being asked to handle 30 prescriptions an hour. That's two minutes to fill a prescription, counsel the patient, and check for potential drug interactions. Pharmacists are under incredible pressure to crank out prescriptions. It's no wonder mistakes are being made."

A 1999 study at Auburn University's Department of Pharmacy Care Systems found that distractions and interruptions can double the number of mistakes made in filling prescriptions.
 
From what source did you get that information? 😱

From personal experience. You may make more errors when you are tired, but nobody should be exhausted after working 12.75 hours of a 14 hour shift. Personally I am more tired after working multiple days in a row. There is no study to back up the contention that working more than X hours causes errors to increase.
 
Here is more:

http://www.sciencedaily.com/releases/2007/04/070424130317.htm

ScienceDaily (Apr. 25, 2007) — High workloads for pharmacists increase the potential for medication errors, says a new study by University of Arizona College of Pharmacy researchers published in the May issue of the journal Medical Care.

The pharmacies employed an average of 1.2 pharmacists for each hour the store was open, and each pharmacist filled an average of 14.1 prescriptions per hour. The risk of dispensing potentially harmful combinations of medications that could result in a drug interaction increased by 3 percent for each additional prescription filled per hour.

“It appears that prescription volume is exceeding capacity and that automation and other pharmacy staffing may not sufficiently compensate for the increased pharmacist workload,”

http://findarticles.com/p/articles/mi_m0NUZ/is_9_11/ai_n6355077/

A study published on-line by the journal Health Affairs (1) indicates that hospital nurses working shifts of 12.5 hours or more are three times more likely to make an error than nurses working shorter shifts.

"Our analysis showed that work duration, overtime, and number of hours worked per week had significant effects on errors," (1) the authors wrote. In fact, they noted, the likelihood of making an error increased with longer work hours and was three times higher when nurses worked shifts lasting 12.5 hours or more.

There are thousands of articles and studies out there showing the longer the shift the more errors are made. The majority of the studies are done with nurses and medical residents because they have been working long shifts for ever. Pharmacy is new to this game in the last 10 years. The data out there for nuses can easily be applied to pharmacist. It clearly shows working long hours contributes to errors.
 
I hope you are joking. If not, you sound very foolish, and like someone that I would not give much credibility to.

Show me a single study. One, just one that correlates hours worked in a day to errors. What is the magic x factor. How many errors have you corrected? Do you note what time they happened? They always occur late at night? You have data as well as personal observation to back this up? This is an evidence based profession and you don't have any to back up the claim that working more than X hours per day increases errors.
 
There is not a single study and I want study that says hours worked per day increases error rate for pharmacists. You don't have it. You also don't have personal anecdotal evidence either. The point is, it's workload and distractions that cause errors. You really think if you work 14 hours and check 10 RXs per hour hour average, you will make more errors at the end of the shift. If you do, well you are just wrong. It's volume and workload (tasks not associated with dispensing) that cause distractions that increase errors. It really has nothing to do with hours worked per day. I'm still waiting for the magic bullet. What is the X hour.
 
Damn, dude, you really do hate your job.

I swear the newbies who have been here for 5 minutes have no clue. How does that statement lead you to believe I hate my job? The comment was made in reference to working 14 hour shifts for CVS. I do not work for CVS and never will even if it means being unemployed. I despise CVS and all that they have done and are doing to destroy the profession. Why you may ask do I care what CVS does if I do not work for them? Its called the trickle down effect. What one chain does all the rest will eventually do. For example Walgreens and the pharmacy drive through and Wal-mart and $4 generics. CVS leads the way in all that is wrong and terrible in retail pharmacy today. Therefore, I feel the CVS effect at my job. Now in all fairness it is not just CVS. Walgreens POWER program is equally troubling as well as Wal-Mart and thier $4 generics. CVS seems to lead the way in making things as bad as possible.
 
There is not a single study and I want study that says hours worked per day increases error rate for pharmacists. You don't have it. You also don't have personal anecdotal evidence either. The point is, it's workload and distractions that cause errors. You really think if you work 14 hours and check 10 RXs per hour hour average, you will make more errors at the end of the shift. If you do, well you are just wrong. It's volume and workload (tasks not associated with dispensing) that cause distractions that increase errors. It really has nothing to do with hours worked per day. I'm still waiting for the magic bullet. What is the X hour.

I guess you have me on "ignore" so you did not see my post from above. Pharmacists working 12 and 14 hour shifts on a mass scale is new in the last few years. The CVS 14 hour shift started a couple of years ago so there will be no magic study linking it to increased errors just yet.

Look at the links I posted above. There have been huindreds on studies done with nurses. I think it is an excellent correlation to pharmacy. What has been found is increased worked load and incresed hours working significanly increses errors. In the study I posted above by the journal Health Affairs indicates that hospital nurses working shifts of 12.5 hours or more are three times more likely to make an error than nurses working shorter shifts.

You may say that hospital nuses have nothing to do with working 14 hours at a retail pharmacy. I say it is an excellent correlation. Nurses work long shifts where they are on thier feet for the mafority of it with few or no breaks and an ever increseing patient load. Kind of sounds familar doesn't it?
 
I swear the newbies who have been here for 5 minutes have no clue. How does that statement lead you to believe I hate my job? The comment was made in reference to working 14 hour shifts for CVS. I do not work for CVS and never will even if it means being unemployed. I despise CVS and all that they have done and are doing to destroy the profession. Why you may ask do I care what CVS does if I do not work for them? Its called the trickle down effect. What one chain does all the rest will eventually do. For example Walgreens and the pharmacy drive through and Wal-mart and $4 generics. CVS leads the way in all that is wrong and terrible in retail pharmacy today. Therefore, I feel the CVS effect at my job. Now in all fairness it is not just CVS. Walgreens POWER program is equally troubling as well as Wal-Mart and thier $4 generics. CVS seems to lead the way in making things as bad as possible.

Calm down, there. I'm aware you have never worked for CVS. I'm also aware you used to work for Walgreens until you told them to shove it because they delivered nothing they promised you upon your hiring. I'm also aware that you went to Kansas for your PharmD, you're married with at least one child, and you live in Texas. Give me some credit for being aware of the people whom I'm interacting with.

I'm aware that in any field, whenever a "leader" has an "innovation", the other players in the field will follow suit as best they can. Me saying that you hate your job was in a tongue in cheek fashion because you just compared a retail shift to being impaled through the anus and in the past referred to retail pharmacy as a "1000 pound weight crushing your soul".
 
Calm down, there. I'm aware you have never worked for CVS. I'm also aware you used to work for Walgreens until you told them to shove it because they delivered nothing they promised you upon your hiring. I'm also aware that you went to Kansas for your PharmD, you're married with at least one child, and you live in Texas. Give me some credit for being aware of the people whom I'm interacting with.

I'm aware that in any field, whenever a "leader" has an "innovation", the other players in the field will follow suit as best they can. Me saying that you hate your job was in a tongue in cheek fashion because you just compared a retail shift to being impaled through the anus and in the past referred to retail pharmacy as a "1000 pound weight crushing your soul".

Damn dude you do pay attention. My bad on that one. The only thing you missed is I have three kids now. We added two more when we moved to Texas.

My comments were tounge in cheek as well. I was trying to come up with really bad things to compare with a 14 hour shift at CVS. Pretty creative I thought.

I forgot about the 1000 pound weight crushing your soul comment. That was a good one. It still holds true today.
 
Damn dude you do pay attention. My bad on that one. The only thing you missed is I have three kids now. We added two more when we moved to Texas.

I forgot about the 1000 pound weight crushing your soul comment. That was a good one. It still holds true today.

Dude...I was scrolling through some of my old threads and saw where you defended retail practice.. don't make me bump that thread!

:meanie:
 
Dude...I was scrolling through some of my old threads and saw where you defended retail practice.. don't make me bump that thread!

:meanie:

Hold on pal lets not take the gloves off just yet! I still think retail pharmacy is the real practice of pharmacy. My comments of late are directed towards the retail chains who are ruining the porfession and making it impossible to practice good pharmacy in the retail setting.

Things have taking a drastic turn for the worst in the last five years. Retail has been reduce to nothing more than assembly line factory work. Crank out as many prescriptions as possible with as little labor as possible. I would rather sit in the basement of a hospital pharmacy doing order entry rather than the assembly line worker retail has turned us all into.
 
Things have taking a drastic turn for the worst in the last five years. Retail has been reduce to nothing more than assembly line factory work. Crank out as many prescriptions as possible with as little labor as possible. I would rather sit in the basement of a hospital pharmacy doing order entry rather than the assembly line worker retail has turned us all into.

Really? Retail wasn't like this 5 years ago?
 
Damn dude you do pay attention. My bad on that one. The only thing you missed is I have three kids now. We added two more when we moved to Texas.

Meh. I've only been on here for a little over a year, and I go to a new school. Not a far-fetched notion that I might be an idiot. I'm not, but given certain other posters on here who go to newer schools *cough*Sparda*cough*, it's not an entirely unfair assumption to think that.

My comments were tounge in cheek as well. I was trying to come up with really bad things to compare with a 14 hour shift at CVS. Pretty creative I thought.

Creative would be a good word. Impaled through the anus? If that's what came to mind, I'm not sure I want to know what kind of obscenities were hurled at you while you were in the Army.

I forgot about the 1000 pound weight crushing your soul comment. That was a good one. It still holds true today.

I feel really bad for several of the P-4's at my school. They kissed so much ass when ACPE visited, and were horrified that I had anything bad to say about the school. Retail pharmacy is going to stomp all over them, and they're going to let it happen, and they're going to hate their lives in 5 years.
 
Advertisement - Members don't see this ad
I guess you have me on "ignore" so you did not see my post from above. Pharmacists working 12 and 14 hour shifts on a mass scale is new in the last few years. The CVS 14 hour shift started a couple of years ago so there will be no magic study linking it to increased errors just yet.
I have worked for CVS since 2/01 and there were 14 hour shifts then. I know, I worked some of them. That's plenty of time.

Look at the links I posted above. There have been huindreds on studies done with nurses. I think it is an excellent correlation to pharmacy. What has been found is increased worked load and incresed hours working significanly increses errors. In the study I posted above by the journal Health Affairs indicates that hospital nurses working shifts of 12.5 hours or more are three times more likely to make an error than nurses working shorter shifts.

You may say that hospital nuses have nothing to do with working 14 hours at a retail pharmacy. I say it is an excellent correlation. Nurses work long shifts where they are on thier feet for the mafority of it with few or no breaks and an ever increseing patient load. Kind of sounds familar doesn't it?

You may think, in fact you rarely do, it's so, but I prefer evidence. You would assume that adding Zetia to a statin and lowering LDL more would improve outcomes, but it doesn't. Most mistakes are first and foremost systems mistakes. The work flow or failure to follow the work flow leads to errors. Distractions lead to errors. Volume leads to errors. Hours worked does not lead to errors and there is not one study that backs up your assertion.
 
1009pharmacy-soda-fountain.jpg


If I ever open up a pharmacy, I'm gonna have one of these. Bring back the soda/ice cream floats!
 

I feel really bad for several of the P-4's at my school. They kissed so much ass when ACPE visited, and were horrified that I had anything bad to say about the school. Retail pharmacy is going to stomp all over them, and they're going to let it happen, and they're going to hate their lives in 5 years.

Life is what you make it. I personally enjoy my job most days. I got a Thank you card from a customer on Sunday for just doing my job. I like CVS so mucj more than the last independent job I had. By far less stress than working for the guy I worked for. They pay me a lot o money, I have a great schedule and life is good. If you work for somebody else and hate pharmacy, don't blame CVS.
 
Creative would be a good word. Impaled through the anus? If that's what came to mind, I'm not sure I want to know what kind of obscenities were hurled at you while you were in the Army.

There is actual on SDN reason for that one. There is a thread about vampires which I have not read. The title of the thread got me to think of how Vlad Dracula used to kill people. He would impale them on a greased stake through the anus which somethimes took days for the victim to die. I thought it was a creative example of some thing worse than a 14 hour shift at a bust CVS.
 
I swear the newbies who have been here for 5 minutes have no clue. How does that statement lead you to believe I hate my job? The comment was made in reference to working 14 hour shifts for CVS. I do not work for CVS and never will even if it means being unemployed. I despise CVS and all that they have done and are doing to destroy the profession. Why you may ask do I care what CVS does if I do not work for them? Its called the trickle down effect. What one chain does all the rest will eventually do. For example Walgreens and the pharmacy drive through and Wal-mart and $4 generics. CVS leads the way in all that is wrong and terrible in retail pharmacy today. Therefore, I feel the CVS effect at my job. Now in all fairness it is not just CVS. Walgreens POWER program is equally troubling as well as Wal-Mart and thier $4 generics. CVS seems to lead the way in making things as bad as possible.

Registration date on a message board does not correlate to experience in the real world of pharmacy. At what age did you graduate and how long have you been a registered pharmacist?
 
1009pharmacy-soda-fountain.jpg


If I ever open up a pharmacy, I'm gonna have one of these. Bring back the soda/ice cream floats!

I joke with our RXM about needing to do that to meet our flavoring quotas at Wags (90% of our Rxs our medicare so selling flavor is nearly impossible). If it get hot enough, I might just try to swing buying a bag of ice and seeing how good of icys that the flavors make.
 
I joke with our RXM about needing to do that to meet our flavoring quotas at Wags (90% of our Rxs our medicare so selling flavor is nearly impossible). If it get hot enough, I might just try to swing buying a bag of ice and seeing how good of icys that the flavors make.

It's not gonna sell well when customers find out that flavoring is free at Target.
 
Damn, how can they afford to give away 0.0000001ml of liquid for free? :meanie:

Oh man, can I use a bucket to collect it? :laugh:

Aren't there chairs or stools for people to sit when they're working on some of the computers? I thought that should rest your legs and feet for a bit.
 
Oh man, can I use a bucket to collect it? :laugh:

Aren't there chairs or stools for people to sit when they're working on some of the computers? I thought that should rest your legs and feet for a bit.

A lot of the retail chains frown upon pharmacy staff sitting down at work. One time at CVS, the district pharmacy supervisor was already at the pharmacy. I came in, clocked in, said hi to the pharmacy supervisor, walked over to the drop off station, grabbed a stool and sat right down there while typing in prescriptions (I only got up to pull medications). My shift was over 3 hours later but the pharmacy supervisor was still there. The next time I came in, I couldn't find the stool anywhere and I was told by the supervising RPh that the district supervisor was pretty pissed about me sitting down and decided to throw away the stool.
 
A lot of the retail chains frown upon pharmacy staff sitting down at work. One time at CVS, the district pharmacy supervisor was already at the pharmacy. I came in, clocked in, said hi to the pharmacy supervisor, walked over to the drop off station, grabbed a stool and sat right down there while typing in prescriptions (I only got up to pull medications). My shift was over 3 hours later but the pharmacy supervisor was still there. The next time I came in, I couldn't find the stool anywhere and I was told by the supervising RPh that the district supervisor was pretty pissed about me sitting down and decided to throw away the stool.

Do you think it would have turned out to be any different if you were a pharmacist instead of an intern?
 
What are the secrets of being able to do this for a long period of time:

Take care of your body. Eat right, get plenty of exercise. If you expect to stand on your feet for a living, you better take care of your feet & knees. Good shoes & socks are critical. A mat to stand one also helps.
The CVS where I did my rotation did NOT have an anti-fatigue mat. The callus that I had from working 9-5 every day for 6 weeks during the spring without a mat finally went a away (2 months later)!
 
I have worked for CVS since 2/01 and there were 14 hour shifts then. I know, I worked some of them. That's plenty of time.



You may think, in fact you rarely do, it's so, but I prefer evidence. You would assume that adding Zetia to a statin and lowering LDL more would improve outcomes, but it doesn't. Most mistakes are first and foremost systems mistakes. The work flow or failure to follow the work flow leads to errors. Distractions lead to errors. Volume leads to errors. Hours worked does not lead to errors and there is not one study that backs up your assertion.
Which can be company based, too. CVS had me answering the phone while *filling* prescriptions. It was really dangerous, because the phone had to be answered in 2 rings and that means that I had to stop what I was doing to pick up the phone, ie a company, systems-based problem.
 
Which can be company based, too. CVS had me answering the phone while *filling* prescriptions. It was really dangerous, because the phone had to be answered in 2 rings and that means that I had to stop what I was doing to pick up the phone, ie a company, systems-based problem.

Yup, over here at Costco, when we get busy we just stop answering the phone.


Do you think it would have turned out to be any different if you were a pharmacist instead of an intern?

Nope. I know a pharmacist who was pregnant. One day that she was scheduled to work, she ended up having a miscarriage in the morning. The pharmacy scheduler told her that she still had to come in to work that day.
 
I have worked for CVS since 2/01 and there were 14 hour shifts then. I know, I worked some of them. That's plenty of time.
By a combination of your posts and username, this surprised me. I thought you'd been with them for 20-30 years.
 
Advertisement - Members don't see this ad
I picked up on the impaled through the anus reference because I watched this show on the Discovery Channel about Vlad and his greased stakes. They did a computer modeling of how exactly they could impale someone through the anus without actually killing them. Apparently it was a skilled task because certain people were trained to do it. The stake would be put in slowly and carefully so the heart and spleen would be missed on its way to/through the esophagus and out the mouth. They would leave the screaming people on the stakes for days to ward off Vlad's enemies, who were so disgusted and traumatized at the gruesome sight that they ran the other way. The people actually die from sepsis.