Turning down CII prescriptions when you are too busy

[2012PharmDgrad]

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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.

 

[MindOverMatter]

Correct me if I'm wrong, but if you deny a CII in FL don't you have to document that as well, and then they can't get it filled at any Wags?

Everything you're asking about is scenario-specific. For instance, I wouldn't turn down #20 Percocet 5/325s because I was busy, ever. Behind that script is a patient in pain, and you turning them down because you don't feel like dealing with it is selfish. Roxy's on the other hand I'll turn down all day.

 

[2012PharmDgrad]

Correct me if I'm wrong, but if you deny a CII in FL don't you have to document that as well, and then they can't get it filled at any Wags?

Everything you're asking about is scenario-specific. For instance, I wouldn't turn down #20 Percocet 5/325s because I was busy, ever. Behind that script is a patient in pain, and you turning them down because you don't feel like dealing with it is selfish. Roxy's on the other hand I'll turn down all day.

Thanks for responding. According to the law, documentation of a decision to deny a CII is required if you decide to keep the prescription with the intention to fill it and discover something suspicious about it later on (i.e. realized it was forged upon further inspection). However, if you simply tell the patient you don't have it (even if you do) and return the script, there is nothing to document at all.

How do you make the time for yet another CII script when it is ridiculously busy and you are interrupted once again? I know it may be selfish to turn down a script when I have the medication in stock, but how do you get around to it when you simply can't check at that very instant and the patient is waiting in the drive-thru or elsewhere?

Ultimately, I am thinking about my license being on the line and having to protect it. By getting interrupted with a question about the availability of a CII while I am doing something else, I may end up mistakenly providing the wrong information, not having adequate time to verify it (due to the sheer volume of work), etc.

Selfish as it may be, there is only so much I can attend to at any given moment and telling the person I don't have the Percocet or Vyvanse is the easier way out when you're already behind. I agree that a pain patient may be in dire need of his or her medication, but unfortunately, retail is absolute lunacy and precludes you from truly being there for each and every patient. In addition, with all the drug problems in Florida, I start to grow paranoid and feel it is easier to say "I don't have it" rather than be a narcotic police officer, especially when I am already swamped. What advice would you give a new grad like myself?

 

[owlegrad]

We just push out the wait time. If it is too busy we tell them to come back in x hours. Sometimes that time is an hour, other times it is 6 hours. You just do what you have to do. If they don't want to wait we give them back the script.

It will get better as you get more experience. Hang in there! 🙂

 

[grumps]

You're doing the right thing. The Wags environment is crazy. When they started this flu shot crap, I refused b/c of the chaos already embedded in their model. By all means do what you have to in order to protect your license even if it means parting ways with a psychopathic corporation. And just remember, that detailed history with the initials of all the Power pharmacists who performed the data review and dur, it does not make it to the microfiche when the records are purged from the computer. Only the pharmacist-of-record is on the microfiche. I should have quit back in 2008 when this nonsense started, but no they reassured us that we wouldn't be responsible for a Power mistake.

 

[Rockinacoustic]

You don't have a CII inventory log that you can just check at your station?

 

[Estrace]

I also work for walgreens. I usually don't turn down CII as I have come to realize that people don't abuse CII as much around here. I do however turn down Hydrocodone(Norco/Lorcet/Lortab etc) without blinking now. I used to be worried when I first started when they threaten to call cooperate but nobody from cooperate has asked me anything in the 9 months that I have been working for walgreens.I turned down anything above 60 tabs and if they have never been to that store. I look at their profile quickly to get a sense of their habit (different stores, different doctors etc) . I have only used PDMP once.

 

[Digsbe]

We turned down sketchy CII prescriptions and also did not fill for the physicians that worked for certain practices that we knew were sketchy. As far as turning down a legit CII because we were busy? We never did that, we just gave them an accurate wait time based on our workload. (30min, 1 hour, 2 hours, etc.)

 

[vistaril]

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.

If you're not filling valid prescriptions simply because you can't keep up(which seems to be the case), you should probably start looking for a different work environment.

If I had adhd and was on vyvance or whatever and I took it to a pharmacy that I *know* had vyvance in stock and they said "nope, don't have it", then I would immediately report that to a district manager in some wayor through some channel. I would also look into how to report the pharmacist in question to their licensing body in some way.

Your job working at a place like walgreens is to.......do your job. If you can't do it, then find another job.

Now, it's reasonable to give a realistic wait time. That's different. I'm sure there are tons of entitled patients out there who expect to pop in a pharmacy with a script and immediately walk out with their prescription. In many cases that's unrealistic, and it's perfectly reasonable to tell them that.

It's also perfectly reasonable to deny filling prescriptions from certain patients who are known doctor shoppers and whose controlled prescription search is an absolute mess. Or to deny filling prescriptions from certain known drug dealing doctors who are one step away from going to jail. Although in the latter case it's probably best for the store to have a uniform policy regarding certain notorious prescribers.

But it's most definately not reasonable to lie and fail to perform the fundamental duties of your job.

 

[All4MyDaughter]

Denying care because you are too busy or too stressed out is not cool. As other have said, push out the wait time, tell the patient it will be a few hours and give them the opportunity to come back later, but don't LIE to patients because you are having trouble managing the demands of your workload.

 

[BenJammin]

What would I do? I would report you to the state board of pharmacy.

 

[Ackj]

Also sounds like this might be a training issue for your staff. Does your tech really not know if you have percocet 5/325 in stock, or are they unable to check for themselves, either physically or looking up the onhands? Untrained staff (notice I didn't say "new") can really screw up your whole day, and that is not limited to CIIs.

 

[Dr Wario]

Wow, no wonder the chains can push us around so much, we cannot even stick up for each other. Pharmacists talking about reporting other pharmacists to the board for what? telling a patient they don't have something in stock because they already are being pulled apart by the company? Maybe that is not something we would do ourselves, but how dare you treat one of our own that way? Maybe you have never worked in a store where you fill 40%+ controls, perhaps you do not need to deny a bad narc script literally every 10 minutes. Perhaps at one point you bought into the "I don't feel comfortable filling this script" line, but after the 50th time being yelled at and cursed that week, you simply gave up and reverted to the common practice of simply telling them you didn't have 240 roxi 30's and 120 xanny bars.

Oh and extend wait times, like that is so easy when the customers are glaring at you and your sup wants to talk to you about the customer complaint called into corporate. Some day you learn how to manage all of this stuff, like you come to work 30 minutes early so that you are not behind from the second you open the gate, you stop taking any breaks and apologize when you need to use the restroom.

You would report him to the board...Jesus Christ.

 

[rickyroxy]

Wow, no wonder the chains can push us around so much, we cannot even stick up for each other. Pharmacists talking about reporting other pharmacists to the board for what? telling a patient they don't have something in stock because they already are being pulled apart by the company? Maybe that is not something we would do ourselves, but how dare you treat one of our own that way? Maybe you have never worked in a store where you fill 40%+ controls, perhaps you do not need to deny a bad narc script literally every 10 minutes. Perhaps at one point you bought into the "I don't feel comfortable filling this script" line, but after the 50th time being yelled at and cursed that week, you simply gave up and reverted to the common practice of simply telling them you didn't have 240 roxi 30's and 120 xanny bars.

Oh and extend wait times, like that is so easy when the customers are glaring at you and your sup wants to talk to you about the customer complaint called into corporate. Some day you learn how to manage all of this stuff, like you come to work 30 minutes early so that you are not behind from the second you open the gate, you stop taking any breaks and apologize when you need to use the restroom.

You would report him to the board...Jesus Christ.

I agree with this. People who are talking about reporting to board of pharmacy do not how how florida or south florida. I will give OP benefit of doubt due to the fact that he is a floater and new. Once you have your own store it would be much easier to decide since you know your regular patients.

I usually check their profile and see if its not too soon. For small qty hospital CII, I would fill it but give correct wait time. I would pull up PDMP if its cash patient without any history at our chain. Oxy 30, Dilaudids, percocet 10/325 more than 100 are all denied if no history at my pharmacy.

Adderall has started to become a problem recently where bunch of school, college kids come late at night bringing 2 month old script. If they have no history at my pharmacy I don't fill them. Reason behind this is if they have another pharmacy where they usually fill it and if they don't have in stock then that pharmacy need to order it in keep in stock. I am not going to empty my inventory for another store's not keeping inventory in check. Also patient has to be from same area as well as the doctor. I too sometime get frustrated when I get C-II script left and right but still I always check profile before I deny or accept script. I usually know what I have in stock at my store. Hope this helps.

Don't pay attention to people trying to report to board of pharmacy or complain to corporate. Those days are gone specially in florida. Corporate has been kept in check by DEA and their own lawyers after their warehouses and pharmacy were shut down due to over dispensing. I have had couple of MD's threatening to report me to board because I denied filling their script, it never happened though.

 

[zelman]

Wow, no wonder the chains can push us around so much, we cannot even stick up for each other. Pharmacists talking about reporting other pharmacists to the board for what? telling a patient they don't have something in stock because they already are being pulled apart by the company? Maybe that is not something we would do ourselves, but how dare you treat one of our own that way? Maybe you have never worked in a store where you fill 40%+ controls, perhaps you do not need to deny a bad narc script literally every 10 minutes. Perhaps at one point you bought into the "I don't feel comfortable filling this script" line, but after the 50th time being yelled at and cursed that week, you simply gave up and reverted to the common practice of simply telling them you didn't have 240 roxi 30's and 120 xanny bars.

Oh and extend wait times, like that is so easy when the customers are glaring at you and your sup wants to talk to you about the customer complaint called into corporate. Some day you learn how to manage all of this stuff, like you come to work 30 minutes early so that you are not behind from the second you open the gate, you stop taking any breaks and apologize when you need to use the restroom.

You would report him to the board...Jesus Christ.

I completely hear what you're saying. At first, I was feeling very opposed to the original poster's view. But, in the end, you are completely right, Wario. I think the only thing that really rubbed me the wrong way was the lack of discrimination in rejecting prescriptions by deceit.

Honestly, sometimes lying that you don't have something is the best way to avoid a questionable situation and protracted debacle. But if you're just too busy, just say "24 hours" or whatever will work. These are dangerous meds and it's not worth rushing and screwing something up. Give patients an option, even if it's a bad one.

 

[jawnly211]

if you ever deny someone their medications again, i will goto your store, report you to the DM, then to corporate, then to the board of pharmacy, then to God.....

then i will make you quit your job because you can not manage your time well

your life will be ruined because you are the worst pharmacist ever

🙁

 

[grumps]

.

 

[2012PharmDgrad]

Thanks to everyone with constructive and helpful responses. Contrary to what 'Vistaril" believes, I fill most of the C-II prescriptions I get and do so willingly as long as they are legitimate and I have been able to verify them. I would say I fill about 70% of CII scripts and turn down the other 30% either because they are too soon, they are suspicious, I don't have it, and, yes, a small percentage I have turned down at random.

Only people who practice here in Florida know and understand the problem we have with Adderall, Percocet, and other controls. It is a huge challenge and burden assessing the authenticity of each and every script and many of these patients do not cooperate as well. Broward county, Florida, is number one in the country for the largest number of prescriptions written for oxycodone (and filled). In fact, several Walgreens' locations have lost their licenses to dispense narcotics and pharmacists as well as certain M.D.s have had their licenses revoked. Some of these other pharmacists and physicians have also been disgraced and sent to prison.

Being cognizant of the issues in my state, I find it a part of the job if I have to turn down these scripts. Ultimately, it is my license on the line and a few posters here don't seem to comprehend what's going on here. Reporting me to the board of pharmacy for what? Because I am not comfortable filling a script and lie to the person about not having it? Especially when I am a FLOATER and don't really know who is a regular customer or not.

Sadly, I think it is safe to say EVERY pharmacist out there, myself included, has turned down prescriptions for legitimate patients at one time or another- it is the nature of the beast and this profession. Unfortunately, a few patients who may truly need these medications pay the consequences for the abuse and diversion by drug seekers. But to suggest I am a horrible person, given the fact that the retail setting is absolute lunacy, especially if you are short-staffed (as I have been at times), is ludicrous.

 

[BenJammin]

Wow, no wonder the chains can push us around so much, we cannot even stick up for each other. Pharmacists talking about reporting other pharmacists to the board for what? telling a patient they don't have something in stock because they already are being pulled apart by the company? Maybe that is not something we would do ourselves, but how dare you treat one of our own that way? Maybe you have never worked in a store where you fill 40%+ controls, perhaps you do not need to deny a bad narc script literally every 10 minutes. Perhaps at one point you bought into the "I don't feel comfortable filling this script" line, but after the 50th time being yelled at and cursed that week, you simply gave up and reverted to the common practice of simply telling them you didn't have 240 roxi 30's and 120 xanny bars.

Oh and extend wait times, like that is so easy when the customers are glaring at you and your sup wants to talk to you about the customer complaint called into corporate. Some day you learn how to manage all of this stuff, like you come to work 30 minutes early so that you are not behind from the second you open the gate, you stop taking any breaks and apologize when you need to use the restroom.

You would report him to the board...Jesus Christ.

This post is exhibit A of why pharmacy gets no respect. Come on and grow some balls. Put yourself in the shoes of an owner...your pharmacist is turning away legitimate C-IIs because he doesn't have time to fill it? What the hell? I'd fire you quicker than lightning.

You'll get no respect from me with an attitude like that. Do your job or get a new one.

 

[zelman]

This post is exhibit A of why pharmacy gets no respect. Come on and grow some balls. Put yourself in the shoes of an owner...your pharmacist is turning away legitimate C-IIs because he doesn't have time to fill it? What the hell? I'd fire you quicker than lightning.

You'll get no respect from me with an attitude like that. Do your job or get a new one.

Seeing as you're playing the owner, I'd like to ask why you've apparently understaffed your store. Shouldn't you be increasing pharmacist and tech hours to appropriately evaluate prescriptions which could potentially result in your controlled substance license revocation?

 

[Lubeckd]

This post is exhibit A of why pharmacy gets no respect. Come on and grow some balls. Put yourself in the shoes of an owner...your pharmacist is turning away legitimate C-IIs because he doesn't have time to fill it? What the hell? I'd fire you quicker than lightning.

You'll get no respect from me with an attitude like that. Do your job or get a new one.

So as a owner, you make a lot of money off controls?

 

[BenJammin]

Seeing as you're playing the owner, I'd like to ask why you've apparently understaffed your store. Shouldn't you be increasing pharmacist and tech hours to appropriately evaluate prescriptions which could potentially result in your controlled substance license revocation?

Get a new job! Quit being such a complainer and take action.

So as a owner, you make a lot of money off controls?

Totally irrelevant. People who get C-IIs may have a legitimate need. Again, you're a perfect example of pharmacy gone bad.

 

[Lubeckd]

Get a new job! Quit being such a complainer and take action.



Totally irrelevant. People who get C-IIs may have a legitimate need. Again, you're a perfect example of pharmacy gone bad.

It depends, we aren't naive, and owners think like businessmen as well. You think pharmacy is all easy, but it's just up to individual professional judgements.

At the end it is your license on the line, DEA will get you rather than the board of pharmacy if you dispense a control to a drug dealer. Only person who can take your license is board of regents

 

[BenJammin]

It depends, we aren't naive, and owners think like businessmen as well. You think pharmacy is all easy, but it's just up to individual professional judgements.

At the end it is your license on the line, DEA will get you rather than the board of pharmacy if you dispense a control to a drug dealer. Only person who can take your license is board of regents

But you're not even bothering to fill it, you're just turning it away. Despite what your professors may teach you, the state board can't fault you for filling a legitimate prescription only for the customer to turn around and sell it on the streets. There has to be a reasonable suspicion.

 

[zelman]

Quit being such a complainer and take action.

If I'm not mistaken, refusing to fill the prescription is taking an action.

 

[BenJammin]

If I'm not mistaken, refusing to fill the prescription is taking an action.

Take action by getting a new job. Not doing your job is not taking action.

 

[zelman]

Take action by getting a new job. Not doing your job is not taking action.

Not your preferred action. But still an action.

 

[KARM12]

The issue is saying you aren't going to fill the Rx because you don't have time...that is different than not filling it because you suspect it is a fake. To me, saying you don't have time is not an appropriate reason to refuse an Rx...suspecting a fake Rx is reason to refuse a fill. The two are totally different.

 

[vistaril]

Thanks to everyone with constructive and helpful responses. Contrary to what 'Vistaril" believes, I fill most of the C-II prescriptions I get and do so willingly as long as they are legitimate and I have been able to verify them. I would say I fill about 70% of CII scripts and turn down the other 30% either because they are too soon, they are suspicious, I don't have it, and, yes, a small percentage I have turned down at random.

Only people who practice here in Florida know and understand the problem we have with Adderall, Percocet, and other controls. It is a huge challenge and burden assessing the authenticity of each and every script and many of these patients do not cooperate as well. Broward county, Florida, is number one in the country for the largest number of prescriptions written for oxycodone (and filled). In fact, several Walgreens' locations have lost their licenses to dispense narcotics and pharmacists as well as certain M.D.s have had their licenses revoked. Some of these other pharmacists and physicians have also been disgraced and sent to prison.

Being cognizant of the issues in my state, I find it a part of the job if I have to turn down these scripts. Ultimately, it is my license on the line and a few posters here don't seem to comprehend what's going on here. Reporting me to the board of pharmacy for what? Because I am not comfortable filling a script and lie to the person about not having it? Especially when I am a FLOATER and don't really know who is a regular customer or not.

Sadly, I think it is safe to say EVERY pharmacist out there, myself included, has turned down prescriptions for legitimate patients at one time or another- it is the nature of the beast and this profession. Unfortunately, a few patients who may truly need these medications pay the consequences for the abuse and diversion by drug seekers. But to suggest I am a horrible person, given the fact that the retail setting is absolute lunacy, especially if you are short-staffed (as I have been at times), is ludicrous.

\

you're(i suspect intentionally) confusing two very separate issues. Randomly lying to customers that you don't have a c2 because you don't have time to do your job vs what threshhold you use to deny suspicious C2 scripts. Two different things.

You say the retail setting is 'absolute lunacy'.....well if you feel that way(and you clearly arent capable of doing your job as you lie to pts indiscriminately because you arent efficient), you should probably get a job in a different setting. Or get better so that you are able to actual meet the requirements of your job.

You're also trying to deflect blame from yourself to drug dealers and abusers....which is bogus in this case because you are DOING NOTHING to combat this.

 

[vistaril]

The issue is saying you aren't going to fill the Rx because you don't have time...that is different than not filling it because you suspect it is a fake. To me, saying you don't have time is not an appropriate reason to refuse an Rx...suspecting a fake Rx is reason to refuse a fill. The two are totally different.

exactly

 

[All4MyDaughter]

The issue is saying you aren't going to fill the Rx because you don't have time...that is different than not filling it because you suspect it is a fake. To me, saying you don't have time is not an appropriate reason to refuse an Rx...suspecting a fake Rx is reason to refuse a fill. The two are totally different.

\

you're(i suspect intentionally) confusing two very separate issues. Randomly lying to customers that you don't have a c2 because you don't have time to do your job vs what threshhold you use to deny suspicious C2 scripts. Two different things.

You say the retail setting is 'absolute lunacy'.....well if you feel that way(and you clearly arent capable of doing your job as you lie to pts indiscriminately because you arent efficient), you should probably get a job in a different setting. Or get better so that you are able to actual meet the requirements of your job.

You're also trying to deflect blame from yourself to drug dealers and abusers....which is bogus in this case because you are DOING NOTHING to combat this.

Agree. The OP started off saying he was turning away C-II scripts because he was too busy to be bothered to look in the cabinet and didn't want to deal with them. Nothing in the OP about thinking the scripts were not legit. When people started criticizing him, he started talking about drug dealers and the DEA, etc. 🙄

 

[Dr Wario]

First of all, please do not speak as if you know the work environment in this type of pharmacy unless you have been there. Secondly, it is not as if you are a specialist and the only possible way for this patient to be treated is by you and you are denying care because you are not "efficient", there is literally a pharmacy on every corner and I'm sure they have your dop...er medicine. Thirdly, yes this is a mistake and experienced pharmacists will not deny care to legitimate patients, however this problem is going to become really simple as the DEA is majorly cracking down on prescribed controlled medications, and in many cases, are severely restricting order quantities, thus you probably won't have the meds in stock.

Again, denying care to legitimate patients is not a good thing, but very rarely is the pharmacist to blame alone. You have to consider the entire system, and understand that it does take time to learn to skills required to efficiently run a high volume pharmacy. To those of you who say you would report him to the board...I really hope that you are reported every single time you make a mistake.

 

[vistaril]

First of all, please do not speak as if you know the work environment in this type of pharmacy unless you have been there. Secondly, it is not as if you are a specialist and the only possible way for this patient to be treated is by you and you are denying care because you are not "efficient", there is literally a pharmacy on every corner and I'm sure they have your dop...er medicine. Thirdly, yes this is a mistake and experienced pharmacists will not deny care to legitimate patients, however this problem is going to become really simple as the DEA is majorly cracking down on prescribed controlled medications, and in many cases, are severely restricting order quantities, thus you probably won't have the meds in stock.

Again, denying care to legitimate patients is not a good thing, but very rarely is the pharmacist to blame alone. You have to consider the entire system, and understand that it does take time to learn to skills required to efficiently run a high volume pharmacy. To those of you who say you would report him to the board...I really hope that you are reported every single time you make a mistake.

A lot of what you write above is vague....but I would say that in this case the pharmacist/OP is the only one to blame. He/she was presented with a prescription and, instead of doing his job, chose not to do his job. Seems pretty simple.

 

[eagles22]

Honestly, I can see where the OP is coming from. It's not like s/he doesn't have other rxs to fill. The rx isn't being turned down so the OP can go play solitaire or sit on his ass. The rx is being turned down because the pharmacy is short staffed and the disruption to workflow is significant any time a pharmacist has to do tech work. There really is no loss in business because most people who have never been to a certain pharmacy are not likely to come back. There's very little loyalty in the field on the customer's side. And in the time it takes the pharmacist to find, count, recount, and possibly check a database, he could have verified 5 other rxs.

That being said, I'd probably just tell the person that it won't be ready for 6hrs- a day if I'm really busy. After all, the job of a pharmacist is to fill the rx correctly, not quickly. Your duty to the patient is to make sure the medicine is the right dose, a safe dose, legally filled (which take longer with controls) and won't interact with any other meds. If that is going to take you 6 hours to get to it, then that's the fact. You need to protect the patient medically and yourself legally. If the patient can't wait a day (and isn't in visible distress), give him the rx back and let him go on his way.

 

[2012PharmDgrad]

\

you're(i suspect intentionally) confusing two very separate issues. Randomly lying to customers that you don't have a c2 because you don't have time to do your job vs what threshhold you use to deny suspicious C2 scripts. Two different things.

You say the retail setting is 'absolute lunacy'.....well if you feel that way(and you clearly arent capable of doing your job as you lie to pts indiscriminately because you arent efficient), you should probably get a job in a different setting. Or get better so that you are able to actual meet the requirements of your job.

You're also trying to deflect blame from yourself to drug dealers and abusers....which is bogus in this case because you are DOING NOTHING to combat this.

Vistaril, with all due respect, get whatever stick you have up your a** and quit sounding so judgmental. You don't know me and the situation. First of all, from the sounds of it, I doubt you've even worked in a retail setting before. If you did, you would probably agree with my statement about the retail setting being absolute lunacy because that's precisely what it is: most pharmacists agree it is risky, stressful, and not exactly conducive to optimal patient care. My point is not an exaggeration.

Believing the environment is hectic does not make me or anyone else unfit for the job. Who are you to judge me and my capabilities? Contrary to your beliefs, I have actually done quite well as a brand new pharmacist who had NEVER worked retail in the past (except for 6 months as a drug clerk/tech prior to pharmacy school) and have been at least moderately successful at handling high volume stores despite being short-staffed on several occasions.

I am far from perfect and have plenty of new things to learn and skills to acquire. As I stated earlier, I fill at least 70% of CII prescriptions after properly verifying them. Have I made a mistake by occasionally rejecting a prescription at random? YES, I have. But I came to this forum and created this thread asking for constructive feedback and not judgment. Unless you have worked in the retail setting as a pharmacist, I suggest you keep quiet and not cast judgment on me or anyone else who has made a mistake that you consider worthy enough to report to the BOP.

I can't be strong in all my job functions right off the bat and that is something you don't appear to understand. What kind of a colleague are you as a fellow pharmacist? Report a new grad because they turned down a script at random a few times? WOW- you have no problem destroying someone's livelihood, do you?

And I am not just throwing out the drug trafficking problems and abuse in Florida. It is a very real threat. You claim I am DOING NOTHING to combat the problem? Tell me how do you know that? Because thanks to the prescription drug monitoring program in this state, I have caught several people who are doctor shopping and getting the same medication filled at more than one pharmacy. How is that not doing anything?

No hard feelings, but I truly think you should get off your high horse. Your posts sound full of resentment and disdain as well. Cheer up- the stress from your residency will be over in due time. 👍

 

[2012PharmDgrad]

\

you're(i suspect intentionally) confusing two very separate issues. Randomly lying to customers that you don't have a c2 because you don't have time to do your job vs what threshhold you use to deny suspicious C2 scripts. Two different things.

You say the retail setting is 'absolute lunacy'.....well if you feel that way(and you clearly arent capable of doing your job as you lie to pts indiscriminately because you arent efficient), you should probably get a job in a different setting. Or get better so that you are able to actual meet the requirements of your job.

You're also trying to deflect blame from yourself to drug dealers and abusers....which is bogus in this case because you are DOING NOTHING to combat this.

Vistaril, with all due respect, get whatever stick you have up your a** and quit sounding so judgmental. You don't know me and the situation. First of all, from the sounds of it, I doubt you've even worked in a retail setting before. If you did, you would probably agree with my statement about absolute lunacy because that's precise what it is: most pharmacists agree it is risky and stressful. My point is not an exaggeration.

Believing the environment is hectic does not make me or anyone else unfit for the job. Who are you to judge me and my capabilities? Contrary to your beliefs, I have actually done quite well as a brand new pharmacist who had NEVER worked retail in the past (except for 6 months as a drug clerk/tech prior to pharmacy school) and have been at least moderately successful at handling high volume stores despite being short-staffed on several occasions.

I am far from perfect and have plenty of new things to learn and skills to acquire. As I stated earlier, I fill at least 70% of CII prescriptions after properly verifying them. Have I made a mistake by occasionally rejecting a prescription at random? YES, I have. But I came to this forum and created this thread asking for constructive feedback and not judgment. Unless you have worked in the retail setting as a pharmacist, I suggest you keep quiet and not cast judgment on me or anyone else who has made a mistake that you consider worthy enough to report to the BOP.

I can't be strong in all my job functions right off the bat and that is something you don't appear to understand. What kind of a colleague are you as a fellow pharmacist? Report a new grad because they turned down a script at random a few times? WOW- you have no problem destroying someone's livelihood, do you?

And I am not just throwing out the drug trafficking problems and abuse in Florida. It is a very real threat. You claim I DOING NOTHING to combat the problem? Tell me how do you know that? Because thanks to the prescription drug monitoring program in this state, I have caught several people who are doctor shopping and getting the same medication filled at more than one pharmacy. How is that not doing anything?

No hard feelings, but I truly think you should get off your high horse. Your posts sound full of resentment and disdain as well. Cheer up- the stress from your residency will be over in due time. 👍

 

[vistaril]

Vistaril, with all due respect, get whatever stick you have up your a** and quit sounding so judgmental. You don't know me and the situation. First of all, from the sounds of it, I doubt you've even worked in a retail setting before. If you did, you would probably agree with my statement about absolute lunacy because that's precise what it is: most pharmacists agree it is risky and stressful. My point is not an exaggeration.

Believing the environment is hectic does not make me or anyone else unfit for the job. Who are you to judge me and my capabilities? Contrary to your beliefs, I have actually done quite well as a brand new pharmacist who had NEVER worked retail in the past (except for 6 months as a drug clerk/tech prior to pharmacy school) and have been at least moderately successful at handling high volume stores despite being short-staffed on several occasions.

I am far from perfect and have plenty of new things to learn and skills to acquire. As I stated earlier, I fill at least 70% of CII prescriptions after properly verifying them. Have I made a mistake by occasionally rejecting a prescription at random? YES, I have. But I came to this forum and created this thread asking for constructive feedback and not judgment. Unless you have worked in the retail setting as a pharmacist, I suggest you keep quiet and not cast judgment on me or anyone else who has made a mistake that you consider worthy enough to report to the BOP.

I can't be strong in all my job functions right off the bat and that is something you don't appear to understand. What kind of a colleague are you as a fellow pharmacist? Report a new grad because they turned down a script at random a few times? WOW- you have no problem destroying someone's livelihood, do you?

And I am not just throwing out the drug trafficking problems and abuse in Florida. It is a very real threat. You claim I DOING NOTHING to combat the problem? Tell me how do you know that? Because thanks to the prescription drug monitoring program in this state, I have caught several people who are doctor shopping and getting the same medication filled at more than one pharmacy. How is that not doing anything?

No hard feelings, but I truly think you should get off your high horse. Your posts sound full of resentment and disdain as well. Cheer up- the stress from your residency will be over in due time. 👍

again, you're rambling on about irrelevant things to the matter in an attempt to justify something.

For starters, no, you don't appear to be doing very well in this environment. People doing 'very well' don't lie and tell customers they don't have something in stock because they are behind and don't have time to check.

Additionally, I'm not sure what sort of 'constructive feedback' you expect on the matter. In this very post you mentioned that it was a mistake to do what you did. I and others have told you that, yes, what you did was innapropriate. It's generally not a good idea to engage in such innapropriate and unprofessional behavior. Beyond that, what else is there to discuss on the matter?

And when I said you were doing nothing to combat drug traffiking in florida, I obviously meant in the context of lying about not having the drugs. For all I know outside of that you have another fulltime job as a DEA agent.

 

[rx1345]

Wow, there is so much judgement going around here.

This thread should have ended with owlegrad's post.

 

[grumps]

You really can't punt and push the wait time out so it becomes the next pharmacist's problem. A C2 has to be addressed right away. A staff rph will know the legit regulars from the shoppers right away. A floater will have to scan the profile before even looking in the cabinet. If it is a new patient and the script is for oxy 30 or xanax 2mg or the typical pain clinic crap then if the work environment dictates that there is no time to grill the patient then a practiced snap judgement comes into play. If you don't like what you see, look them in the eye, say you have to check inventory, walk away, do a little dance, return with a sorry I don't have it. Accepting the script even with a caveat of MD verification just leaves a torpedo in the water for the next pharmacist. Again this is procedure for just crazy days. You must always stay focused and pick the battles on which to expend your finite mental energy so you can accurately verify every rx throughout a nonstop 8-12 hour shift. When the students get in the workforce they'll understand this.

 

[vistaril]

You really can't punt and push the wait time out so it becomes the next pharmacist's problem. A C2 has to be addressed right away. A staff rph will know the legit regulars from the shoppers right away. A floater will have to scan the profile before even looking in the cabinet. If it is a new patient and the script is for oxy 30 or xanax 2mg or the typical pain clinic crap then if the work environment dictates that there is no time to grill the patient then a practiced snap judgement comes into play. If you don't like what you see, look them in the eye, say you have to check inventory, walk away, do a little dance, return with a sorry I don't have it. Accepting the script even with a caveat of MD verification just leaves a torpedo in the water for the next pharmacist. Again this is procedure for just crazy days. You must always stay focused and pick the battles on which to expend your finite mental energy so you can accurately verify every rx throughout a nonstop 8-12 hour shift. When the students get in the workforce they'll understand this.

this is bull****...if it is oxy from a known pill mill type place, then use your clinical judgement and refuse to fill it based on that. And say as much. I'm not saying you should fill every c2, but pharmacists are highly paid and supposedly professional....act like it.

 

[Carboxide]

this is bull****...if it is oxy from a known pill mill type place, then use your clinical judgement and refuse to fill it based on that. And say as much. I'm not saying you should fill every c2, but pharmacists are highly paid and supposedly professional....act like it.

Lol...clearly you have no idea what RPhs face every day...you already look ignorant, don't make it worse.

 

[nomad339]

highly entertained, thank you.

 

[vistaril]

Lol...clearly you have no idea what RPhs face every day...you already look ignorant, don't make it worse.

again, if you can't do the job, get a DIFFERENT job. Blaming how stressful/busy/chaotic the job is doesn't excuse NOT DOING the job. Picking a high volume retail job in florida of all states isn't ideal for these people who clearly aren't cut out for it.

 

[zelman]

again, if you can't do the job, get a DIFFERENT job. Blaming how stressful/busy/chaotic the job is doesn't excuse NOT DOING the job. Picking a high volume retail job in florida of all states isn't ideal for these people who clearly aren't cut out for it.

You understand that chain employees don't get to choose their practice site, right?

 

[vistaril]

You understand that chain employees don't get to choose their practice site, right?

you get to choose whether to work in florida. you get to choose whether to work for cvs/walgreens(vs some other place that may pay less but the volume may be somewhat less). These are are just not excuses for failing to meet the basic requirements of performing a job.

 

[zelman]

you get to choose whether to work in florida. you get to choose whether to work for cvs/walgreens(vs some other place that may pay less but the volume may be somewhat less). These are are just not excuses for failing to meet the basic requirements of performing a job.

Your perception of "basic requirements" is uninformed. I'm trying very hard not to make comparisons to the small part of a physician's job that affects us. I really don't want to come across the way you are.

 

[eagles22]

you get to choose whether to work in florida. you get to choose whether to work for cvs/walgreens(vs some other place that may pay less but the volume may be somewhat less). These are are just not excuses for failing to meet the basic requirements of performing a job.

Just stop. You seriously have no idea what you're talking about. You don't understand anything about the workflow of a pharmacy. You seem to have no idea about the job market. Pharmacists would love to educate you about these if you asked nicely, but you're throwing baseless allegations at this person. You are making yourself look like a giant ass. Just leave this discussion.

 

[vistaril]

Your perception of "basic requirements" is uninformed. I'm trying very hard not to make comparisons to the small part of a physician's job that affects us. I really don't want to come across the way you are.

basic requirements involve dealing with the customers who present prescriptions. This may mean filling them, exposing the prescription as a forgery, not filling them because of a drug interaction, etc....

 

[vistaril]

Just stop. You seriously have no idea what you're talking about. You don't understand anything about the workflow of a pharmacy. You seem to have no idea about the job market. Pharmacists would love to educate you about these if you asked nicely, but you're throwing baseless allegations at this person. You are making yourself look like a giant ass. Just leave this discussion.

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.

 

[eagles22]

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.

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.

It's worth having the discussion with people who actually know how a pharmacy works. They were giving relevant and constructive feedback since they are pharmacists. You appear to know nothing about pharmacy from your posts. You're spouting inflammatory rhetoric and options that are clearly not feasible (i.e. just go get another job) because you don't know what you're talking about.