Tag Archives: Pharmacy

Pharmacy Night before Christmas

‘twas the night before Christmas, when all through the pharmacy.

Not a dispenser was stirring, not even Tracy.

The Activa stockings had been ordered with care,

in the hope that the driver soon would be there.

Mrs Jones had already rang 6 times to ask where her stocking was. Frank Dispenser and the rest of the pharmacy team were shattered. It was 5.45pm and it had only just quietened down. Frank hadn’t even had time for lunch. He was working his way through the celebrations tin that the area manager had left.

They had got lots of biscuits and chocolates from patients too. Some were not out of date which was a bonus. Mrs Smith had baked one of her special cakes for them. Frank had been initially dubious about selling citric acid to Mrs Smith. He had asked her what the w/w% of citric acid there would be in the final cake. Mrs Smith didn’t know but said that she would bring in some of the cake for Frank. He accepted as he was a reasonable man. Carol the dispenser was singing in the staffroom. She always sang at Christmas.

Mrs Smith and Mr Smith could not have been more different. Couples who order their repeat meds together, stay together longer. This didn’t apply to the Smiths. Mrs Smith used our repeat prescription order scheme. Mr Smith did not. It was then that he burst through the door. A feeling of dread came over Frank. Mr Smith was a large man in his seventies and always dressed in red for some reason. ‘Here is my list of medicines that I want’ he bellowed as he handed over his prescription.

Mr Smith was holding a sack. Susan the technician wondered if it contained biscuits for the pharmacy team. Susan was unfortunately mistaken. Mr Smith had been naughty, not nice.

‘I don’t want these tablets anymore’ he said.

Susan sighed. ‘As well as safely disposing of unwanted medicines, we also dispose of uneaten, in-date chocolates, cakes and biscuits, you know?’

Mr Smith looked confused.

 ‘We don’t have all your tablets’ said Frank.

 ‘Why the hell not?’ Mr Smith replied.

‘Well it is 5.45pm on Christmas eve’.

‘I’ll come back tomorrow then’ said Mr Smith.

‘You can come back but we are shut for the next two days’ Frank sarcastically replied. One day Frank would get a punch because of his sarcasm.

‘SHUT FOR TWO DAYS!!! WHY DIDN’T YOU TELL ME BEFORE?’

‘We told you last year too….’ 

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That was close!

 

Please put your hands up if you have never made a mistake? If you have your hands up, please see me after. I want to offer you a job. Everybody make mistakes.

We learn at university and during pre-reg about how to let prescribers know when they have made mistakes and the best way to do it. However, no one ever told me how to let the staff know when they have made an error when dispensing.

There are five ways of doing it:

1] Throw the wrongly dispensed medicine back at them.

2] Shout at them.

3] Don’t say anything and correct it yourself.

4] Call them over and discreetly tell them.

5] Call them over and tell them that they have a made a mistake but let them figure it out for themselves.

 

Let’s go through the different options.

1] This may be the most satisfying but will result in more paperwork. I hate paperwork.

2] This is also satisfying but may result in tears or a punch.

3] This doesn’t help the person learn about their mistakes. Sometimes it’s the easiest option and doesn’t result in them spitting in your coffee.

4] They don’t get embarrassed using this technique. Be prepared for them to tell you that it wasn’t them or offer an idiotic excuse.

5] I prefer this option if it’s not busy. You can see the wheels turning in their head when they figure out their mistake. Although, sometimes they still can’t figure out their mistake….

 

Just be prepared when they re-dispense it with a different mistake…

Breaking Bad Pharmacy

1] “You clearly don’t know who you’re talking to, so let me clue you in. I am not in danger, Skyler. I am the danger. A guy opens his door and gets shot, and you think that of me? No! I am the one who knocks!” – Walter White: Walt wasn’t allowed to do any deliveries after work anymore after getting upset at the time it took Mr Smith to answer

 

2] “If you don’t know who I am then maybe your best course of action would be to tread lightly” – Walter White: The new area manager needed to work on his people skills

 

3] “Stay out of my territory” – Walter White: The multiple wasn’t happy with the 100 hour pharmacy

 

4] “Say my name” – Walter White: The addict wouldn’t dream of getting his methadone without having his identity confirmed.

 

5] “Shut the fuck up and let me die in peace” – Mike Ehrmantraut: Substitute the word ‘die’ with ‘check’ and it sums up my working day

 

6] “You asked me if I was in the meth business or the money business.  Neither. I’m the empire business” – Walter White: The medium sized multiple had plans to expand

 

7] “You are not the guy. You’re not capable of being the guy. I had a guy but now I don’t. You are not that guy”- Mike Ehrmantraut: The staff appraisal didn’t go well

 

8] Tuco: “Have a seat, Heisenberg”.

Walt: “I don’t imagine I’ll be here very long”

The waiting times at the pharmacy were excellent

 

9] “We’re done when I say we’re done” – Walter White: The pre-reg didn’t want to put his pencil down at the end of his exam

 

10] “So, right now, what I need is for you to climb down out of my ass. Can you do that for me? Will you do that for me? Will you please, just once, get off my ass. You know, I’d appreciate it. I really would” – Walter White: The best way to respond to a request from your area manager for more MURs

 

Guest Post by @Mrsfinn86 ‘My role as an ACT’

I have worked in pharmacy for ten years now.

To many of you, that won’t seem like a long time. I was only 17 when I joined and I’m 27 now, so basically all of my adult life I have given to pharmacy.

I started off quite by accident in a supermarket pharmacy. I used to work as a shelf stacker in the health and beauty department. One day I’d had enough and handed my notice in. I was SURE I could find a better job elsewhere, two weeks passed and I could find nothing that interested me. Then I was approached by the pharmacy technician Debbie, was I interested in taking a role in their pharmacy?

Now I had spoken to the pharmacy crew a lot, my health and beauty section was built around it so I knew all of them anyway. What I was shocked about was they had been watching me too, liked what they saw and offered me the job!

I was now a counter assistant in a pharmacy. I was ecstatic! I read all those counter pharmacy magazines and completed my level one counter assisted course in super quick time. I was like a sponge just soaking it all up. And the more I learnt, the more I wanted to know.

Pretty soon I was helping my manager put away the POM medicines and tapping out a few labels for her. I also walked back and forth to the local doctors surgeries collecting prescriptions. After nearly a year, I asked if I could go into the dispensary.

There was so much more that side of the counter that I could learn. Sure, I was still learning at the front. You never can know it all (though some think they do!) But I craved to know more, I was told no. They simply did not have enough work to warrant another dispenser. I was crushed.

Then one evening I was working with my absolute favourite locum who told me there was a dispensary assistant position in a large chain pharmacy that she worked in on Sundays. She had told them about me and I needed to go in and have a chat if I was interested.

The very next day I walked the 8 mile trip to the pharmacy and had my interview there and then. What I hadn’t been told, was they were looking for a qualified dispenser. I asked what system they used, she said link. I told her I was not qualified but I had basic knowledge and could I show her? I had never blagged so much in my life, but I so wanted the position!

I showed her I could print labels out, read dosages and stick a label on a box neatly. A massive pet hate of mine is wonky labels!

She offered me the job! I was ecstatic, even though it meant taking a large pay-cut; it’s what I needed to do to progress further. I was to start in a month.

Saying goodbye to my current pharmacy was hard, without them I never would have got to where I am now and I will always be thankful for them taking a chance on me.

A month into my new job I was halfway through my NVQ2 dispensing assistant course. I had also decided I was going to apply for college so i could go on to university to get a pharmacy degree. I left school with no GCSE results due to leaving school at 15 to get a job.

After completing my NVQ2 my manager signed me up for my level 3NVQ technician course. This one was a lot more difficult and took me a little over two years to complete. I did change stores halfway through my course though due to bullying and was unable to find time to study in my new very busy branch!

It was in this new branch that I decided pharmacy wasn’t for me at all. I adored my job, but the daily stresses I see pharmacists go through every single day. The huge amount of paperwork that has to be filled in and it all seemed to be about figures.

Now I’m not stupid, far from it! I understand that pharmacy is a business, but the amount of pressure put on pharmacy managers is crazy. I was told by half a dozen newly qualified pharmacists to look into becoming an ACT. They pretty much all agreed that that’s what they would have done instead had they have known about it. So that’s what I did.

In September 2009 I qualified as an accredited checking technician. This basically meant I could help take the heat off the pharmacist by checking any repeated medications or anything else as long as they had done a clinical check except controlled/toxic and epilepsy medications.

I love my job, no two days were ever the same. Even more so as ACT roles in my company are so few, I would sometimes work in three or four different branches a week! Good job I’m a sociable easy to talk to type 🙂
The hardest thing about my job is definitely working with “old school” locums. I had one want to “test” me before he would “allow” me to do my job. The one that I’m qualified to do. I was outraged! I would never dream of questioning a pharmacists ability’s to do their job. So why is it acceptable for them to question mine?

I do understand that if I did make a mistake then it falls back on the pharmacist in charge at the time, but his whole attitude was awful. I requested to work in another local branch that would appreciate my help and left immediately. That pharmacist never caught up with our huge workload 700+ items normally and apparently was heard saying that girls should not work in pharmacy.

9 times out of 10 I love my job, I am easy to get on with. So if you are a locum about to work in a new pharmacy that has an ACT, please respect that they can do their job and perhaps I will enjoy my job 100% of the time.

Remember, I’m only here to make your job easier!

Which?

Guest Post

These are the personal opinions of an anonymous pharmacist and do not mean much – apart from them having a rant!

So maths then. Maths that great subject where you can add and subtract, multiply and divide. Where numbers can be manipulated into percentages and fractions. Manipulations that can bring forth great tools such as statistics…and tables and graphs.

Maths is a great tool which informs people as to whats going on within areas of interest.

And – maths can be abused.

In maths the very tools that can be used to express larger numbers as percentages can then also be used to show the effects of smaller numbers and the changes and differences that these smaller numbers can mean as percentages and can be confusing! And (far worse) damaging.

Within the world of pharmacy maths is a great tool. It is used extensively when checking to see if medicine X is better then medicine Y and/or placebo. It can help people check to see if people are prescribing effectively, in audits to find out if SOP’s are being used correctly.

And then maths can be used to make something look shocking.

Recently the Which? consumer people went round a “selection” of pharmacies around the UK and used 1 of 3 scenarios to check on the advice etc given and then compiled a report. I have now read articles in a few magazines which was saying how bad we were in response to the Which? consumer report, well that’s how it felt to me.

The results in the Which? article weren’t good!

In fact, the results showed that whilst multiples had improved, for independants there had either been no change or a worsening in advice given since the previous Which? report a few years earlier.

This doesn’t look good for any profession.

HOWEVER. Which? only visited 122 pharmacies. Out of (in the region of) 13,500.

There are approximately 92 counties in the UK.

So….

122 out of 13,500 = 0.9% of the toal number of pharmacies
122 in 92 counties = Which? visited just over 1 pharmacy per county on average. (1.33 to be exact – assuming 92 counties)

From their 122, they visited multiples, small chains and single independents. They must (surely) have visited some inner city pharmacies and some in the countryside within the 122.

It’s at this point that you have to stop and ask yourself..how relevant a sample size was this. To me the numbers don’t stack up. How can you visit 122 pharmacies and then compile a report that basically says “Pharmacy isn’t doing its job”

I have also heard that academics may have viewed this sample size as “good”..

Which propaganda machine do they work for? The “Ministry of Truth”

What size were the error bars again….

Or am I missing the point?

A less then 1% sample size is enough to tarnish a profession and seek much hand wringing from within the profession. If the sample size was 50% then fair enough. We would have to sit up and take notice. but 1%…

I also note that one of the situations has been challenged by a group of people regarding warfarin interacting with pantoprazole…

If a drugs manufacturer used data from 1% of the available “population” to get a new medicine to market – they would be laughed out of town. Application denied.

This report does highlight one big problem. We are being asked to provide more and more healthy living advice to members of the public, yet regardless of this we are still stuck to the dispensing bench.

More then anything, I am somewhat annoyed by the tone of the magazine’s columns which i believe should have chosen to look at the report more objectively and reported as such with much less bias and more balance – rather then decry against the profession! We are taught (as any good scientist is) to evalute data and then dissect and check to make sure the data and the conclusions are valid.

Any new scientific paper published is open for checking by peer review – quite honestly it feels like no one has done this and taken the Which? report at face value.

The Which? report is nothing more then a tiny snapshot of pharmacy life on a single visit. Pharmacy does a fantastic job at providing excellent healthcare to the general public and this should not be lost in the maelstrom.

Mystery shopping is a very useful tool to provide some information as to what happens. Maybe in future mystery shopping in Pharmacy needs to have a different approach. By all means have your “test the knowledge” questions, but maybe allow the shopper to rate the approach of the staff of how they deal with all their customers – before and after them. ie an all round approach rather then just “narrow focused”.

One off situations do not give the full picture of how all pharmacy works. But if this approach is the only way forward and the sample findings of future reports are deemed to be the same.. what then.. more outcry and more beating and berating.

It’s funny, we have a book in our pharmacy – in fact ALL pharmacies have one – it’s called the “complaints book”. This is indicative of how i feel things are stacked against us. We always focus on the negative – why cant we have a “congratulations book”… The more negative we have, the more feelings of doubt we instill, the more the profession feels apathy.

It’s hard to walk upstream wading through treacle when you feel that the people connected to your profession are diverting more treacle into the mix.

Dispensersize

DO YOU WORK IN PHARMACY?

DO YOU LIKE CAKES?

Then this work out video is for YOU

I guarantee that you will lose pounds! 39.99 to be exact!

1] Encourage people to not pay for their prescription. Give them a 30 second head start and then run after them. Great for cardio.

2] Stretch for those items on the top shelf

3] Keep making near-misses when dispensing so you have to walk back and forth to the pharmacist. A great way to increase your steps

4] If short, stand on your tiptoes so you can see over the counter. Great for your calves

5] Engage in NMS: No More Sugar

6] Do more MURS: Motivate Urself Really Severely

7] Step aerobics using the kick stool

8] Popping tablets makes your fingers stronger

Was Shakespeare a pharmacist?

@pharm112: “You are a tedious fool” = To want your 24 item script with stupid quantities done in 10 minutes.

@pharm112: “You are strangely troublesome” = Reading a handwritten script…is that four times a day or three??

@alilvshk : “Better three hours too soon than a minute too late.” If only addicts felt this way

‏@alilvshk: Hell is empty and all the devils are here. = Saturday mornings in the pharmacy

@weeneldo: Had it pleas’d heaven to try me with prescriptions… I should have found in some place of my soul a lot of patients.

@MrDispenser: For I can raise no money by vile means. = I refuse to sell homeopathic products

@MrDispenser: I dote on his very absence = I like it when my pharmacist is off

@pharm112: “For my part, it was Greek to me” = parallel imports

@pharm112: There’s not a note of mine that’s worth the noting = Dispensers near miss log.

@pharm112: There’s many a man has more hair than wit = #finasteride

@pharm112: The golden age is before us, not behind us = With regards to Nexphase…

@pharm112: The lady doth protest too much, methinks = My ACT. ‘Okay, there’s two S’s in ‘Spoonful’ so what??

@SegundemArtem : “what’s in a name? That which we call a rose…..” Try selling that after a propriety-generic switch!

@pharm112: Suspicion always haunts the guilty mind = ‘No, there’s no interactions’

@googlybear84: “All that glitters is not gold” Pointing out how ‘tacky’ that one staff member looks in her ‘Bling’

@googlybear84: “Deny thy father and refuse thy name” That rebel who refuses to be part of the system and goes rogue

@googlybear84: “My best beloved and approved friend” Sweet-talking THAT one GP who never amends their scripts

@googlybear84:”It is the green-eyed monster which doth mock” when that rival pharmacy has a sweet-as makeover
‏‏
@KevPharmacist: “Not poppy nor mandragora Nor all the drowsy syrups of the world, Shall ever medicine thee to that sweet sleep”

@googlybear84: @MrDispenser “For I ne’er saw true beauty till this night” When you have your first staff night out

@googlybear84: “Out, damned spot! out, I say!” when trying to clean that damned Methadone stain which refuses to go

@googlybear84: “I love you now; but not, till now, so much” That one patient who always, without fail, brings goodies

@MrDispenser: Listen to many, speak to a few. = follow a lot of pharmacy people on twitter but only speak to a few of them

@googlybear84: “Once more unto the breach my friends, Once more” Boss to staff upon bringing shutter up on Monday morning

@MrDispenser: Nothing can come of nothing = If you have no methadone left but your CD register disagrees

@SiobhanAbrahams: ‘Out out damn spot!’ =roaccutane

@SegundemArtem :”the course of true love never did run smooth, now azithromycin should be taken an hour before food”

@SiobhanAbrahams: ‘Tomorrow & tomorrow &tomorrow, creeps in this petty place from day to day’=we’ll collect ur repeats

@MrDispenser: Neither a borrower nor a lender be = I don’t go to your house to borrow sugar so please don’t ask to borrow tablets

@KevPharmacist: “Be not afraid of being manager. Some are born management, some achieve management, & others: management thrust upon them”

@josh6h: “He’ll is empty, and all the devils are here” = were being audited

@KevPharmacist:: “prick us do we not bleed? And wrong us shall we not be avenged?” Shylock complaining over warfarin error

@josh6h: “Expectation is the root of all heartache.” =There are no jobs left

@MrDispenser: “I’ll not budge an inch” = It’s my pen. I found it. Finders keepers.

@Pharmusician: “Neither a borrower nor a lender be” – always get a prescription first

@MrDispenser: “So wise so young, they say, do never live long” = that summer student better stop being cheeky to the staff or else

@googlybear84: “We few, we happy few, we Band Of Brothers” said the boss during Mondays inspirational speech

@SiobhanAbrahams: ‘Hubble, bubble, toil and trouble’ – making up antibiotics

@MrDispenser:’Now is the winter of our discontent’ = will you shut that door? It’s December! It’s freezing!

@a_lethal_dose: ‘it is the green eye’d monster which doth mock the meat it feeds on’ = methadone

@MrDispenser: ‘The lady doth protest too much, methinks’ = My technician is not doing as I ask

@MrDispenser: ‘What’s done cannot be done’ = Making a mistake in the CD register

@weeneldo: What’s in a name? That which we call lactulose, by any other name would smell as sweet.

@Xrayser didn’t The Bard also say “Get thee to a pharmacy”?

@Hobbesma: “to sleep perchance to dream” – got any Nytol?

@pharm112: “More of your conversation would infect my brain” = I just asked you to confirm your address, I don’t want your life story

How to annoy the rival 100 hour pharmacy

1] Ring them and ask if they have done a prescription for Hugh Jass

 

2] @dodgychemist: Tell all the local tramps that there’s somewhere warm with chairs where they can spend most of the week.

 

3] Ring every hour to see if they are open

 

4] @dodgychemist: Tell them clocks have gone back so they need to open for 101 hours this week

 

5] Send in your mum with her 15 item script at 10.59pm

 

6] @dodgychemist:  Phone and ask if they do enough items to cover their electric bills

 

7] Send your horrible patients to them

 

8] @dodgychemist:  Stick a “2 hour waiting time” notice in their window

 

9] Let pharmacy students know on Twitter and FB that if they ever need any help with coursework or any pharmacy questions then to ring the 100 hour pharmacy

 

10] @dodgychemist: When I’m bored I sometimes phone the 100 hour pharmacy and get them to order high value goods for me and promise to bring in a Rx.

 

 

Pharmacy Exams

 

 
Exams for pharmacy students are a time of great stress. However, for the exam invigilators, they are a time of great amusement.
 
In order to get through the long exam, invigilators take it in turns to stand next to the: 
 
1) Ugliest 
 
2) Best looking 
 
3) Most likely to fail
 
4) Most likely to be the first to get struck off
 
5) Most annoying 
 
6) Cleverest 
 
7) Most likely to cry
 
8) Students that look like lecturers 
 
9) Coolest 
 
10) Student that probably started revising last night
 
11) Most likely to start a Facebook campaign demanding the resit be easier
 
12) Most likely to appear on Jeremy Kyle
 
13) Most likely be the first to complain on Twitter later
 
14) Most likely to be a homeopath
 
15) Most likely to study medicine straight after
 
 
 
So be worried if an invigilator stands beside you!
 

What does 100 equal?

Dispensing is never simple!

Does 100 = 28 + 28 + 44
Or
28 + 28 + 28 + 16 ?

Tracey G: Surely it’s whatever mood the dispenser is in?????

Rai S: Depends on receptacle size.

Iman Z: To me 100 equals to 100! Pile them up in a single box! Cost effective

Lorna B: 4×28! (Usually!) God love the Scottish Drug Tariff

Claire B: And the drug… diazepam? codeine?

Catherine H: Depends on which company you are working for!

Kelly T: 28+28+44! Pregnant box or not, shove them in there and save a box!

Emily H: Are the 44 all the same batch & expiry?

Darshana T: When it’s a horrible patient 3 x 28 and last box of 16 in singles 🙂

Amit P: Turn each blister strip of tablets to face each other, interlock them and you may be able to save on labels as well 2×50!