Turning down CII prescriptions when you are too busy

[vistaril]

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The others who agree with you have an opinion rooted in experience, and pharmacy education. I don't really know how you got to your opinion other than the fact you may patronize Walgreens occasionally.
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The concept of DOING YOUR JOB isn't unique to pharmacy. That is a fairly universal thing.

 

[owlegrad]

Alright guys chill out please and let's focus on how we can help the OP, not argue with each other.

 

[vistaril]

Alright guys chill out please and let's focus on how we can help the OP, not argue with each other.

??? what is there to 'help' him with? he didn't really have a question. It was more like he wanted validation for what he was doing(and seemed to know it was wrong though....he said as much)

there is only one solution to correct what he is doing, and that instead of lying to customers he could stop lying to them and deal with their prescription.

 

[Wheresmyaricept]

The CVS in my town (does about 600-800 a day but the staff there is garbage) tells people a day and a half wait for c-II's so they usually just end up coming to my store anyway. We check PMP on all controls but we generally don't have an abuse or forgery issue in my area like Florida.

Just give them a realistic wait time of an hour to an hour and a half. If they don't like that answer they can take it somewhere else. If they ask why so long, tell them there are extra steps that need to be taken to verify and fill the prescription and it needs to be done for all c-II's, not just their prescription so they don't think you're singling them out.

Recently Walgreens has dropped the "every script counts" mentality in favor for "we like to keep our DEA licenses so don't screw up". There's been a big push in the northern districts to report shady doctors to the DEA and it is mandatory that every pharmacist has to be enrolled in the state PMP. We have our local DEA agent on speed dial and to date my store has personally had one doctor's DEA revoked already in the month we have been doing this.

We have also been told that any customer communications put in regarding refusal to fill any controlled substance will not make it to the store and will be dealt with at the corporate level so we won't get in trouble.

In the end, don't lie about not having 20 Percocet in stock. Use your professional judgement to refuse other prescriptions. If they get pissed, oh well. You won't get in trouble. Just make sure to scan it in and make a copy and fax it to the DEA later documenting why you refused to fill it 🙂

 

[Carboxide]

well several others agreed with me as well, but whatever. If you feel it is appropriate for a pharmacist to lie to patients that they don't have medications because they are behind, it's really not worth having a discussion.

You're missing what is disagreed with. No one cares the OP is lying; they care that he's lying without a reason. It's usual for a pharmacist to tell a drug seeker that they don't have the drug if they do not want to fill a controlled, and this is done for many reasons.

 

[vistaril]

You're missing what is disagreed with. No one cares the OP is lying; they care that he's lying without a reason. It's usual for a pharmacist to tell a drug seeker that they don't have the drug if they do not want to fill a controlled, and this is done for many reasons.

I think lying to someone that you know to be a drug dealer is ok to some extent...but as you say the op wasn't doing that. A better option would be to identify him as a drug dealer or scammer, block him from the system(not just your pharmacy but all the cvs/walgreens in system) if possible, and actually be proactive about fighting drug diversion.....ie do something.

 

[BidingMyTime]

Well, ultimately its each individual pharmacists license on the line, and so a pharmacist has the right to refuse to fill any prescription, including the reason of they don't feel they have the time to do is correctly. (of course, their employer may not agree with this, but that's between them & their employer)

I've never worked in Florida, and I am aware its a whole different ballgame, so I don't know that my thoughts will be in any way applicable to the OP situation. But my thoughts are, don't refuse a legitimate & properly written prescription. Push out the wait times as far as necessary, then work the RX into your workflow. If there is a legitimate reason why you shouldn't feel the prescription, be honest with the pt. I have no problem telling a patient that I won't fill their prescription because they are 2 weeks early, the RX couldn't be verified with the Dr, etc. Teach the technicians how to look up the inventory, so they don't have to bother you, asking you to check the inventory. Honesty is almost always the best policy.

 

[BenJammin]

The theme of this topic: I'm too lazy to do my job. Unbelievably pathetic.

 

[rickyroxy]

I am fresh out of school and have been working at Walgreens for almost two months in Florida. I never interned with the company while in school and have had to pick up on everything and learn the ropes step by step. I am currently a floater.

So far, retail has not been terrible, but it is absolute insanity at times. I am constantly interrupted every five seconds by either a technician or a patient requesting a consultation. I have no problem filling prescriptions for CIIs as long as I have been allotted enough time to properly verify them in our state PDMP (prescription drug monitoring program) and patient profile.

The problem I have is that I can get so busy and overwhelmed with the million things going on at the same time that I begin to turn down new prescriptions for CIIs.

If I already have enough on my plate and have several CII scripts to verify in addition to other stuff I have to do (and dealing with the interruptions), I find that suddenly my techs will show me another script that has just come in for a CII and ask me if I have it. At this point, I just tell them I don't have it simply because I am already burdened with the work I have at hand and do not want to bother with another controlled substance prescription.

I would rather turn away the script rather than having to bother looking in the cabinets again and pausing what I was doing for the millionth time. Plus, I don't feel like taking the time to go through yet another CII.

What do you guys think? Do you turn down new CII scripts at random whenever you are busy and starting to get stressed? I feel it's the path of least resistance for me, but you have to consider I am inexperienced. How do you, more experienced pharmacists, deal with this situation?

Example: I am busy talking to a patient about a problem he/she has had with insurance, there is a line of cars waiting at drive-thru, the phones are ringing all day, and I get interrupted by a tech showing me a script asking me if we have Percocet 5/325. I am already stressed out and have enough going on that I say "No" just to get that person out of there. I consider it one less person/burden for me in an already hectic environment. I do not have time to check anything when I am speaking to that patient and would rather have that person get out of the drive-thru and leave.

The theme of this topic: I'm too lazy to do my job. Unbelievably pathetic.

Looks like you are too lazy to read the post...

 

[BenJammin]

Looks like you are too lazy to read the post...

No, I read them and I stand uncorrected. Refusing legitimate scripts because you're too busy is being lazy. Give them a long wait time, tell them to wait until tomorrow, but never refuse.