What does your pharmacy manager hate most about you?

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I often step out of the counter to do OTC consult. I consider it my responsiblity. My manager consider it not efficient and not going with the workflow.
 
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...That I take vacation...
 
Praziquantel86 said:
I tend to curse like a sailor when I'm still not quite out of earshot.
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well, there's that (thank god I work inpatient!)

I think they hate that I send long e-mails complaining about workflow issues. Especially during rotations when I'm only working, at most, once a week.
 
5minutes said:
Why not asking: what does your pharmacy manager love most about you?"
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Because there are too many to list. :D

But if you would like to hear them:

-Intern with the least amount of errors.
-Intern with the most experience.
-Intern with most customer compliments.
-Fastest data entry.

Shall I continue?
 
Sparda29 said:
Because there are too many to list. :D

But if you would like to hear them:

-Intern with the least amount of errors.
-Intern with the most experience.
-Intern with most customer compliments.
-Fastest data entry.

Shall I continue?
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Are you actually proud of "fastest data entry"??

Having the most experience (as an intern by the way, which is ******ed) isn't even a skill.

So yes, please continue.

Perhaps you'll also get the fastest checking out Mrs. Smith's doritos and glyburide award - managers fiend for that one.
 
I ignore some of the protocols in place that are not backed by any sort of empirical data or rationalization. I.E., I will used a Vd=0.7 when dosing Vanc even if they tell me not to. The protocol they have is 0.9. To heck with that...

Of course THEY think that the 0.9 is backed by something or another...but...hey...whatever...
 
Requiem said:
Are you actually proud of "fastest data entry"??

Having the most experience (as an intern by the way, which is ******ed) isn't even a skill.

So yes, please continue.

Perhaps you'll also get the fastest checking out Mrs. Smith's doritos and glyburide award - managers fiend for that one.
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Not really, I'm just saying that the pharmacy flows more smoothly when I'm there.

Most experienced meaning that I can get around the computer system and deal with insurance issues quickly.
 
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:laugh: that was mean.... but hes not an intern yet. Sparda, its a real accomplishment to be trained. However rotate around some other stores to know what is considered "good". You'll be surprised.

Requiem said:
Are you actually proud of "fastest data entry"??

Having the most experience (as an intern by the way, which is ******ed) isn't even a skill.

So yes, please continue.

Perhaps you'll also get the fastest checking out Mrs. Smith's doritos and glyburide award - managers fiend for that one.
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My manager hates that I get all my work done (and other people's work) quickly and accurately, and then ask for more work. What she hates more is that if there's no work to be done, I'm gonna goof around on the internet/intranet until she gives me something to do. If I'm not productive, I'm bored, and I do "interesting" things when I'm bored.
 
Aznfarmerboi said:
:laugh: that was mean.... but hes not an intern yet. Sparda, its a real accomplishment to be trained. However rotate around some other stores to know what is considered "good". You'll be surprised.
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Well, I don't have an intern permit but I guess CVS classifies me as an intern so that's what I'm going by.

My main store does 1400 prescriptions/week, but I also work at a store that does 3800 prescriptions/week.

At the 1400 store, I pretty much handle dropoff, insurance issues, control the time flow, doctor calls, pull medications from the shelves, count them.

At the 3800 store, its kinda more lazy since they have like 6 people on at the same time and 2 pharmacists.

I thought that I'd be able to do all of that over there but its almost impossible, so whenever I work there, I'm the designated doctor call person.
 
Are you actually proud of "fastest data entry"??
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Why is fastest data entry NOT something to be proud of? That's a desirable trait to have as long as the person is as accurate as quick - I believe its called efficiency.
 
They love:
My multitasking, I can usually type and fill while handling and insurance call on another page and meanwhile handle drop off. This is at the store where we're averaging close to 3200 scripts/week and we only have 3 techs at most and 1-2 pharmacists.

They hate:
My insensitivity to benign customers who have no idea the workload im balancing and continue to demand faster service. Needless to say, I've offered my job experience to a few people only to recieve the bird and a lost customer.
 
Praziquantel86 said:
How can you make doctor calls yet? I can't think of very many things you can legally do without an intern permit.
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Maybe they have him make all the calls, go through the automated stuff and wait on hold, once a live person comes on the line, he hands it off to a real intern/pharmacist....I would love to have some slave do that for me.
 
PumpkinSmasher said:
Maybe they have him make all the calls, go through the automated stuff and wait on hold, once a live person comes on the line, he hands it off to a real intern/pharmacist....I would love to have some slave do that for me.
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That is what I do in my pharmacy. For new RX, for most pharmacists I have to get pt's info, dr's info then transfer the line to the pharmacist/intern.
 
PumpkinSmasher said:
Maybe they have him make all the calls, go through the automated stuff and wait on hold, once a live person comes on the line, he hands it off to a real intern/pharmacist....I would love to have some slave do that for me.
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Nope, I answer the doctor calls, I take the ones from the messages, I call up the doctor's office. Sure, if the doctor asks me a question they have to wait a few minutes for me to check the information in the PDR and my iTouch drug application to make sure dosage and conditions are right.

I mean, just today some idiot resident prescribed Levaquin for a pregnant lady with a UTI (I didn't need to look this up.), I called him up to ask him if the drug was correct, he said yes, so I asked him to give it to the attending physician. From my end of the phone, I could hear the attending physician yelling and cursing the hell out of the resident (Kinda felt bad for the guy.). We ended up changing it to Augmentin.

There aren't many things that I can do legally but the pharmacist trusts me to do them. I do MD calls, I compound prescriptions, I count narcotics, I know the narcotics combination.

The only thing I'm not allowed to do is verify prescriptions and order narcotics.
 
Sparda29 said:
...have to wait a few minutes for me to check the information in the PDR and my iTouch drug application to make sure dosage and conditions are right...

...I compound prescriptions, I count narcotics, I know the narcotics combination.

The only thing I'm not allowed to do is verify prescriptions and order narcotics.
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I honestly don't know what your pharmacist is thinking. When you get caught for screwing up (it's not a matter of if, it's when), it'll be his license and job on the line.

What makes you think you have the ability to compound a prescription? Do you have anything more than (at most) a few introductory compounding classes at this point? There's a little more to it than squeezing two creams together and hoping for the best.

Do your patients know that the person responsible for checking dosages and making their prescriptions has no license and no legal ground to do so? I don't think they would be happy if they did.

Remind me never to go anywhere near your store.
 
Praziquantel86 said:
I honestly don't know what your pharmacist is thinking. When you get caught for screwing up (it's not a matter of if, it's when), it'll be his license and job on the line.

What makes you think you have the ability to compound a prescription? Do you have anything more than (at most) a few introductory compounding classes at this point? There's a little more to it than squeezing two creams together and hoping for the best.

Do your patients know that the person responsible for checking dosages and making their prescriptions has no license and no legal ground to do so? I don't think they would be happy if they did.

Remind me never to go anywhere near your store.
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Depends on what state he's in. In WV, an intern can do everything a pharmacist can do as long as it is "under their supervision" except make the final check. I compounded things, took scripts over the phone, and counseled as an intern. Nobody was harmed.
 
WVUPharm2007 said:
Depends on what state he's in. In WV, an intern can do everything a pharmacist can do as long as it is "under their supervision" except make the final check. I compounded things, took scripts over the phone, and counseled as an intern. Nobody was harmed.
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That's the thing, he's not an intern yet. You don't get the permit until after your P1 year in New York.

If he had the intern permit, this would all be a moot point.
 
WVUPharm2007 said:
Depends on what state he's in. In WV, an intern can do everything a pharmacist can do as long as it is "under their supervision" except make the final check. I compounded things, took scripts over the phone, and counseled as an intern. Nobody was harmed.
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hes in NYS and he is not legally an intern. He can't use the title. Period. you are only an intern when you have the little paper in your hands. Sparda is a tech. period.
Sparda,
I agree with others, you are flirting with danger, heaven forbid medicaid should do an audit. What store do u work at again?:D You lack the training at this point in time. I wish the attending knew you were a mere tech. Your ear would be ringing too. I hope you learn your lesson, but not any patients expense. If anything were to happen, it is this **** that gives pharmacy a bad name
 
Besides that, everything I do is checked over by the pharmacist to make sure.


I have only messed up on two things so far. On a compound I messed up, once I realized I messed up, I told the pharmacist, we reordered the ingredients, and the only harm done was that the patient had to wait 1 more day and money was wasted.

The other thing I messed up on was because I have a tendency to knock stuff down, so I ended up knocking down a bottle of hydromorphone, and it spilled all over. We spent 4 hours looking for all of the pills, which we eventually found.

By me checking dosages, that makes it so that there are 2 people checking dosages, much more of a chance that you can catch an error.
 
Like everybody said, he and the pharmacist is flirting with danger. However there are pharmacists that do it and it is their license at risk, not ours. I have floated in several stores when I was an intern where techs overstep their boundary and took oral RX from doctors but once again, its the pharmacists license so I didnt comment.

Sparda, just keep in mind that you may not realize how important it is that you do not do any of the above forementioned until you actually go through the courses. In any case, it is only a few more months until you get your intern permit "and are actually legally covered in whatever malpractice insurance your school or work provides you with". Just keep in mind that the danger lies in what you dont know than what you do know. Pharmacists and pharmacy interns are legally required to take the oral rx because it is usually not a health professional on the other line that is giving the order and have no clue most of the time what they are saying.
 
Dude, I don't walk into doc's offices and look up DSM-IV criteria and then diagnose.

That's exactly what you're doing, for pharmacy. You have no pharmacy school experience, and I have no med school experience.

I hope to god you stop pretending to be a little guru and masquerading around looking up lexi-comp and start acting like a tech. It'd be a shame to have to start pharmacy school already having harmed patients based on your clinical recommendations, make that lexi's recommendations. Which are to be interpreted with clinical judgment.
 
Aznfarmerboi said:
Pharmacists and pharmacy interns are legally required to take the oral rx because it is usually not a health professional on the other line that is giving the order and have no clue most of the time what they are saying.
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This is why it is ridiculous that an RPh/intern is required to be on the phone to take new prescriptions from a doctor's office. If it was really about patient safety the law would require an MD, NP, PA, RN, or licensed medical tech to give oral prescriptions over the phone with the direct supervision of prescribing personnel. As it is, all of this legal ballet dancing is rendered moot when you have some dip**** high school kid calling in Oxycontin 80mg for urinary incontinence.

It's extra hilarious with no diagnosis being required so the pharmacy has absolutely no clue why the drug is being prescribed and only cares about what is being prescribed. It depends on the technician, but probably 90+% of licensed technicians out there know more about medications than the ******s calling in the scripts themselves.

Does anyone honestly think it takes 4 years of professional school to be able to take most prescriptions? Stop fooling yourselves.
 
Requiem said:
Dude, I don't walk into doc's offices and look up DSM-IV criteria and then diagnose.

That's exactly what you're doing, for pharmacy. You have no pharmacy school experience, and I have no med school experience.

I hope to god you stop pretending to be a little guru and masquerading around looking up lexi-comp and start acting like a tech. It'd be a shame to have to start pharmacy school already having harmed patients based on your clinical recommendations, make that lexi's recommendations. Which are to be interpreted with clinical judgment.
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I never said I made clinical recommendations. If they ask me a question, I'll look it up, I'll verify with the pharmacist that my recommendation is correct, and then I'll talk to the MD.
 
meister said:
This is why it is ridiculous that an RPh/intern is required to be on the phone to take new prescriptions from a doctor's office. If it was really about patient safety the law would require an MD, NP, PA, RN, or licensed medical tech to give oral prescriptions over the phone with the direct supervision of prescribing personnel. As it is, all of this legal ballet dancing is rendered moot when you have some dip**** high school kid calling in Oxycontin 80mg for urinary incontinence.

It's extra hilarious with no diagnosis being required so the pharmacy has absolutely no clue why the drug is being prescribed and only cares about what is being prescribed. It depends on the technician, but probably 90+% of licensed technicians out there know more about medications than the ******s calling in the scripts themselves.

Does anyone honestly think it takes 4 years of professional school to be able to take most prescriptions? Stop fooling yourselves.
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True but then logic is its better to have somebody who knows what they are doing than two people who doing taking the script. A pharmacist/intern can verify bogus scripts (we have been hit with a bunch of them from a person), to somebody who can question if there is anything right/wrong and making sure scripts meet legal requirement. (Something that techs messed up on a lot here).

Another good percent of scripts that I took (~3 %) also have problems with look a like/sound a like drugs. Something that happens when the physician communicates to office manager orally, and she communicates it to me.
 
I think the bottom line is that at our current level of technology, it should be required that all Rxs are either handwritten, faxed, or e-prescribed. Oral prescribing should only be done in "emergencies," and in that event it should be MD/RN doing the talking on the other end, not some uneducated *****.

As it is, it doesn't really matter that it's an RPh because of the other person on the phone.
 
Sparda29 said:
I never said I made clinical recommendations. If they ask me a question, I'll look it up, I'll verify with the pharmacist that my recommendation is correct, and then I'll talk to the MD.
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Acting like some tough guy and calling out a resident for prescribing levaquin sounds pretty much like a clinical recommendation. But what do I know? I'm just a pharmacist with a license, not some pharm tech with an iphone and lexi. Like we all said, please don't kill anyone, xthnx:xf: I hope you're not trying to council a patient when OPD comes in for an inspection
 
meister said:
. As it is, all of this legal ballet dancing is rendered moot when you have some dip**** high school kid calling in Oxycontin 80mg for urinary incontinence.
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bingo, this is exactly why techs shouldnt take phone orders. Without formal training, how do you know what is allowed, day supply, limits... etc. Do you even know how many times techs in my store gave the "law" incorrectly.... even on simple **** like how long a CII script is good for.


in fact mr hero may not even know the answer to those questions, have you even taken law yet?

how many darvocet N-100 am I allowed to take over the phone?
 
He hates that I'm more committed to pharmacy school than to working.

He loves that I just jump in and act like the intern pharmacist I'm licensed to be, which makes his job easier. I'll do anything that I know how to do, which is quite a bit. Too bad I'm not there much.

My pharmacy manager and I have a great working relationship.
 
Sparda29 said:
I never said I made clinical recommendations. If they ask me a question, I'll look it up, I'll verify with the pharmacist that my recommendation is correct, and then I'll talk to the MD.
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Does this also correspond to the OTC recommendations that you probably make at this point?

I doubt you do a full history with a patient asking for something for his muscle aches. Instead of finding out that they're taking Coumadin for their A. Fib, or that they had a reaction to aspirin many years back, you probably just send them straight for the Aleve.

You're not going to realize how many people you've potentially harmed until later on in your schooling. Stop messing with peoples' lives just to make yourself feel better.
 
Requiem said:
Dude, I don't walk into doc's offices and look up DSM-IV criteria and then diagnose.

That's exactly what you're doing, for pharmacy. You have no pharmacy school experience, and I have no med school experience.

I hope to god you stop pretending to be a little guru and masquerading around looking up lexi-comp and start acting like a tech. It'd be a shame to have to start pharmacy school already having harmed patients based on your clinical recommendations, make that lexi's recommendations. Which are to be interpreted with clinical judgment.
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Let's not get into a paradigm where "pharmacists eat their young". Requiem, I've bumped into your attitude before and have always found it pretty distasteful and unprofessional. If Sparda's pharmacist/preceptor is comfortable with his recommendations, who are you (and others) to attack him? It's his preceptor's license, not yours.

Seriously, dude. Pharmacy is not some secret society. I have family members with some pretty astute knowledge of drugs. Lexi-Comp is a valid resource for drug information - he's got to start somewhere. Where did you start?

In Colorado (as WVU pointed out), I do everything a pharmacist does. I just have to be supervised, but once a pharmacist is comfortable with me and my abilities, that supervision becomes less intense.
 
I'm only part-time due to classes I'm taking. I don't think she dislikes me as much as she would like me to work some more hours. I have a few things about me, I'm fast on the register (Like mad quick), but I look slower in filling because it seems like a task that can't be rushed. I do find the drugs fast, but I still make sure I'm getting the right one while not tripping over myself. I don't know, I've been working there only 8 months so I still have a lot to learn. Even though I can make my way around the Pharmacy, I want to really be able to tackle troubleshooting, and get better at insurance. I'm sure I'd be pretty good if I worked full-time.
 
twester said:
In Colorado (as WVU pointed out), I do everything a pharmacist does. I just have to be supervised, but once a pharmacist is comfortable with me and my abilities, that supervision becomes less intense.
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the fact remains, this is not colorado, this is new york state. Legally, he cannot do what he has been until he gets a permit in about 4 months. He cannot even tell them to shake their amoxicillin susp. well. When he gets his permit he can tell people that their pain meds turns their poop purple for all the state cares. This is our system, each one of us here has to go through with it. It sucks, but thats the way the cookie crumbles. I am sorry that you do not like our rules. There is a reason for them, experience and the lack of malpractice insurance, and funny rules of new york state law that others have brought up. To be an intern in this state you have to have a working knowledge of that.

What he does is not where the preceptors/pharmacists comfort level is, it is being negligent to laws and regulations, and he is begging for something to happen to him. You should understand that if its not his place to be doing this, then it shouldn't. I don't think you would like your techs over-stepping their bounds (and I don't care if you have a PhD in Chemotherapeutic Pharmacokinetics, if you don't have an intern permit, you are a tech). This is law, end of story.

I know people have to start somewhere, but this is not his time because he cannot. People will make mistakes, I know I've made a few. I am still learning. pharmacists and interns may end up hurting a patient or worse, these experiences make us better practitioners. But what all these practitioners have is a professional license, when he gets to that point, he then can begin to develop his clinical knowledge. Until then, you have to do like the rest of us did.
 
The fact remains, it's the pharmacist's license. It sounds like we have a progressive preceptor in a regressive State. I salute him.

I'm glad I can practice pharmacy supervised. I like that the tech is a part of my education. I worked with an abrasive tech who was instrumental in teaching me about pharmacy administration. I worked with a pharmacist who allowed me to practice pharmacy - supervised. You students in New York are being cheated out of your educational experience. Rules or not..
 
Last edited:
We're not being cheated of an education; we're receiving it in a logical order.

New York State simply assumes that before an intern can adequately perform his/her duties, that intern must have finished off the first professional year of the program. The P1 year is used to gain the knowledge and clinical foundations to back up the work that in intern will be doing.

I see no problem in the preceptor allowing the P1 tech to observe him performing his duties as a pharmacist, but once that role goes beyond observation, it becomes illegal and dangerous.
 
ok, so person in question is not yet an intern. Licensing is the same here in NM - once you have the intern license (after completing 30 credit hours, so end of 1st year) you can legally do everything but the final check. Once there is an intern license issued, excellent! None of the things mentioned have been out of the scope of practice for an INTERN.

But even if your pharmacist has all the faith in the world in you, the law does not allow you to do some of the listed activities as a technician. And personally, when I "catch" a tech (esp if I know they are a P1 or pre-pharm) counseling or otherwise I ask to speak to the pharmacist and loudly comment on the illegality of that. I've been standing in line and heard incorrect "counseling" and stepped in and said something. I legally can do so, I am an intern.

I don't doubt that some of us are excellent interns, and have excellent preceptors who will help us become excellent pharmacists. I received a letter of rec from an inpatient supervisor that almost made me cry. In a good way. But I'm not perfect and I don't know everything - I do catch myself getting a little overconfident at times and while I haven't made any grave errors (That I know of), you have to keep that in check. It is important to remember that even through your 4th year you are a student pharmacist and that soon it will be your license under scrutiny, and your job to catch those little mistakes.
 
They hate that I question the system.
 
twester said:
The fact remains, it's the pharmacist's license. It sounds like we have a progressive preceptor in a regressive State. I salute him.

I'm glad I can practice pharmacy supervised. I like that the tech is a part of my education. I worked with an abrasive tech who was instrumental in teaching me about pharmacy administration. I worked with a pharmacist who allowed me to practice pharmacy - supervised. You students in New York are being cheated out of your educational experience. Rules or not..
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its not the pharmacist's license, its the lack of an intern license that is at stake. You are falsely practicing pharmacy posing as a pharmacy intern. I am pretty sure that is criminal. It has nothing about being progressive, its about the rest of the country lacking some educational standards. My regressive state is progressive in ensuring adequate patient care, someone who doesn't understand law, someone who doesn't have a basic understanding of the kinetics, drug design and pharmacology, or compounding has no business in calling themself an intern. Learn it in school before you practice, so you don't make a fool lof yourself and hurt a patient. Thanks.

Its kind of like letting a 1st year medical student practicing in real clinical situations, this is proposterous and I would even bet you wouldn't feel comfortable with that thought. As a doctor, I certainly wouldn't feel comfortable getting my information from a 1st year pharmacy student. Someone who does not even understand what the pharmacology of a quinolone, and why there is CI in that said drug.

your argument is based around the idea that there has to be a starting point, and to this I agree. The starting point is having some formal education before you can consider yourself as an intern and get some hands on experience.
 
Quiksilver said:
its not the pharmacist's license, its the lack of an intern license that is at stake. You are falsely practicing pharmacy posing as a pharmacy intern. I am pretty sure that is criminal. It has nothing about being progressive, its about the rest of the country lacking some educational standards. My regressive state is progressive in ensuring adequate patient care, someone who doesn't understand law, someone who doesn't have a basic understanding of the kinetics, drug design and pharmacology, or compounding has no business in calling themself an intern. Learn it in school before you practice, so you don't make a fool lof yourself and hurt a patient. Thanks.

Its kind of like letting a 1st year medical student practicing in real clinical situations, this is proposterous and I would even bet you wouldn't feel comfortable with that thought. As a doctor, I certainly wouldn't feel comfortable getting my information from a 1st year pharmacy student. Someone who does not even understand what the pharmacology of a quinolone, and why there is CI in that said drug.

your argument is based around the idea that there has to be a starting point, and to this I agree. The starting point is having some formal education before you can consider yourself as an intern and get some hands on experience.
Click to expand...

:thumbup: now lets close this thread
 
Quiksilver said:
its not the pharmacist's license, its the lack of an intern license that is at stake. You are falsely practicing pharmacy posing as a pharmacy intern. I am pretty sure that is criminal. It has nothing about being progressive, its about the rest of the country lacking some educational standards. My regressive state is progressive in ensuring adequate patient care, someone who doesn't understand law, someone who doesn't have a basic understanding of the kinetics, drug design and pharmacology, or compounding has no business in calling themself an intern. Learn it in school before you practice, so you don't make a fool lof yourself and hurt a patient. Thanks.

Its kind of like letting a 1st year medical student practicing in real clinical situations, this is proposterous and I would even bet you wouldn't feel comfortable with that thought. As a doctor, I certainly wouldn't feel comfortable getting my information from a 1st year pharmacy student. Someone who does not even understand what the pharmacology of a quinolone, and why there is CI in that said drug.

your argument is based around the idea that there has to be a starting point, and to this I agree. The starting point is having some formal education before you can consider yourself as an intern and get some hands on experience.
Click to expand...

Just a tad melodramatic........
 
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