It was kind of a slow evening.

So there I was at Drug Depot, typing the following prescription:

Lamisil 1% cream
Apply to a.a. BID as directed x 1 week
#1 tube

Now, at Drug Depot, Terbinafine cream comes in a box that either says "Athlete's Foot Relief" or "Jock Itch Relief." I was standing in the OTC aisle, wondering to what "affected area" the patient was applying said cream, and which box I should select.

It wasn't a hard choice, really--of course I was going to give them the Jock Itch box, just for comedic value.

Jock Itch Relief box in hand, I went back to my computer to finish typing the prescription. Squinting to figure out the doctor's name, I suddenly burst out laughing, because it was incredibly apropos, almost as apropos as an orthopedic surgeon having the last name of Bones.

Let's just say this doctor's last name combined two words that quite literally mean pruritus of the genitalia, but in slightly cruder language. Oh the irony, Dr. Pruritisofthegenitalia prescribing medication to treat the very condition for which he is named!

Maybe I'm immature, but I thought it was funny.

Oh yeah some chick with MRSA came in tonight, too. It was kind of her to tell me what the big nasty sore on her forearm was from. I spent about 5 minutes dousing my hands with soap and rubbing alcohol after we got her out of the pharmacy and I had dropped a big nuclear bomb of bleach on the counter. Honestly I think I might have a bit of mysophobia. And to be honest that is really quite problematic for someone who deals with sick people all day.

--IISgirl ... MUST. WASH. HANDS.

1-2 shots, q half hour, prn a good time

Ahh, it has been a good weekend, from what I recall from it.

I went out drinking with the Drug Depot crew (what I formerly called Major Chain Pharmacy, but I like this name better) one of the nights, with entertaining results. The Law came out to the bar with a few of the techs and the other intern and I. Surprisingly enough, actually maybe unsurprisingly, The Law is a pretty heavy drinker. Anyway most of the night was on him. We just had to buy the first rounds, or egg him on, then when we got him trashed enough, he felt generous and bought the rest. He came up to me with a napkin that said, "Take 1-2 shots, q half hour prn a good time," and I don't know how many times I heard, "the doctor has authorized your refill!" When we ordered expensive drinks, The Law would laugh and say, "that's gonna need a prior auth!" My god pharmacy humor is so entertaining when you're drunk.

Maybe this was evil of me, but in his drunken state I also got him to agree in writing to buying us breakfast the next morning (Why did the entire 9am shift go out the night before? This was bad planning on our part.) and let me leave early later this week. The Law had a terrible hangover the next morning, but other than that, things weren't too bad the next day.

Today it was so slow, so I spent a couple hours playing poker with the tech.

The highlight of the day was a deaf old lady calling in and asking for "something over the counter like ex-lax." Apparently she had already spoken to the pharmacist, told the pharmacist she didn't know anything, hung up, called back a few minutes later, and got me.

I tried to clarify with her what she wanted. "So you're constipated?"
"Yes."
"Ok..."
"I need something to help me pee!"
"Then you don't need Ex-lax."
"Yes I do!"
"Do you want to pee or poop?!"
"Yes."
"What?"
"I said I want ex-lax!"
"Ex-lax is for bowel movements."
"WHAT?! SPEAK UP!"
"EX-LAX IS FOR POOPING!!!"
"I don't need to poop! I can't pee! I need *mumbles something that sounds like Lasix.*
"YOU WANT LASIX?! THAT'S NOT OVER THE COUNTER!"
"YES IT IS! I'VE BOUGHT IT BEFORE!"
"DO YOU HAVE A PRESCRIPTION? WHAT'S YOUR LAST NAME, I'LL CHECK OUR RECORDS!"
"I DON'T NEED A PRESCRIPTION!"
"THERE ARE SOME OTHER OVER THE COUNTER DIURETICS AVAILABLE IN THE WOMEN'S SECTION!"
"I NEEEEEED EX-LAX!"
"...hold on a moment I'll get the pharmacist."

Then I hear the old women screaming at the top of her lungs at our pharmacist, who tells her the same thing I just did.

--IISgirl ... ever notice how most of the day's calls are either people wanting to go to the bathroom, or wanting to stop going to the bathroom?

This is a bit heartbreaking.

There’s an old woman who comes into Major Chain Pharmacy every so often. She has been coming in and talking to me since my lowly beginnings as a clerk, those many years ago. So, over the years, she has essentially watched me grow up. Now she calls me “doctor.” She's a bit of a grandmotherly figure. For blogging purposes, I’ll call her Mrs. J.

Last month she came in with a prescription for Aricept, and as she was dropping it off, told me that she didn’t know what the drug was for or why she was prescribed it.

*sigh*

It’s for Alzheimer’s.

Mrs. J was very upset when I told her this. She was adamant that she did not have Alzheimer’s. For being a very old woman, I had always known Mrs. J to be remarkably independent, always having a story to tell, and always appearing very on top of things.

Saying she was very upset with her doctor for not telling her anything, she did not get the prescription filled, bought some bread, and went home.

She came back the next day and asked me if I knew of a doctor she could go to for a second opinion. I wanted to believe Mrs. J was right and that she was misdiagnosed. To me, she seemed just as sharp as ever. I gave her the phone number to a few doctors in the area, she thanked me, and left.

Today, almost a month later, Mrs. J came in again. I experienced an eerie sense of déjà vu. Almost word for word, we had the same conversation as last month. The same interaction. She did not remember at all that I had given her those numbers a month earlier. Although the date on her Aricept prescription was from April, she insisted she had been given it only the day before.

With a heavy heart, I realized that Mrs. J was not misdiagnosed. It’s no longer she who is watching me change, but sadly, it is now I watching her change.

I asked if I could please fill the script for her, and she refused. I tried to get the pharmacist involved but she would have nothing to do with that.

In any case, before she left, telling me she would call the doctors tomorrow and schedule an appointment, she asked if she could have my phone number. I really don’t think Mrs. J has anyone else to talk to, and she’s really a sweet old lady, so I obliged.

But I don’t think she’ll ever remember to call me.

--IISgirl … no more emotional posts or else I will have to change my name

Ding Dong the Wicked Witch is Dead...

I am so happy. The most terrible tech of the world (the one i mentioned be4) has been fired.
:) :) :) :)

--IIS, I am SOOO terrible.

Spider Bites

Well guys, my computer has been broken for a couple days. I haven't known what to do with myself in the meantime. I was so bored the other night, I actually *gasp* studied! Shocking, I know.

I was starting to believe I was addicted to the internet and that it's interfering with my school work, but thank god I had the experience of the past couple days to prove to me that I'm equally unproductive even when I don't have the internet, so we can't go pointing fingers just at that. I spent most of my time watching 80's movies and playing PS3.

I'm back with a little story from work the other night.

Lady: What would you recommend I put on this spider bite?
Me: Well--
Lady: *blood-curdling scream* SPIDER!!!!!!!!
Me: ...

Coincidentally enough, as if on cue, a spider had descended from the pharmacy ceiling and was now dangling in between us. I grabbed a 20 dram vial and caught him in it. I promised to kill the spider, but, bleeding heart that I am, I really just let it out the drive-thru window later that night after she had paid for her hydrocortisone and left.

The spiders. They are out to get her. I find it hilarious.

--IISgirl ... back to enjoying the internet

The Battle I Will Not Lose (nor remember)

This weekend at work was one of the most intense ever. Usually on the weekend, I am excited and eager to help people with their stupid little problems and issues. Why? Well, its because I have the whole week of school, friends, and alcohol to help distract me and forget about how frustrating working at a Pharmacy can be. Anyways my cheerful attitude was quickly shattered by the mass amount of post-nasal drip sickos complaining to me that it takes too long to buy psuedophedrine products. One guy even tried arguing with me by trying to have me respond to his question, "do I look like I'd be making meth!?", luckily I held my tongue and didn't tell that snaggled-tooth moron what I really thought. Whatever, the point is that my excitement for work turned into quick resentment...I was pissed off and I became a walking bob-omb, waiting for something or someone to come in my way and light the fuse.

Luckily for the world, things were going smoothly for a while and I was once more ready to do good deeds and help people. A woman comes asking me for a price quote for a medication for her dog and I quoted her somewhere around $105.00 for a 2 month supply, and she was excited at the price she quickly asked me to transfer it from her pharmacy down the street where she already has it filled (they quoted her 150.00). She told me she will call the pharmacy there and let them know that it's going to be transfered so I wait a few minutes until I call for a copy.
I finally find some time and called the pharmacy and let them know its for a dog named so-so, the pharmacist quickly snaps at me "yes! I know who you're talking about, gosh!"
I respond, "alright, so may I have the copy.....?"
"yea yea, but I just am curious... how much are you charging her?"
"about a 105"
"oh, hold on please"
***annoying elevator music for 5 minutes!***
the pharmacist comes back with a severe attitude, probably after calling the patient and was unable to reach her, "well, is the patient there with you!?"

"No, shes around here somewhere, uhhh we're kind of busy, can I have the copy? she's expecting it done in about 15 minutes..."

"well, I am sure shes transferring it over because of the price and she doesn't know she is on this special program where we are only going to charge her 68.00; I misquoted her when she called"

"Oo, I see. Well hold on. [I talked to my pharmacist about price matching and insisted to allow me to take care of this matter]...hello? Hi. Well, its okay, you can just give me the copy and if she wants it back there, we'll transfer it back. Ok?"

"Noo, I rather wait for the patient to call me back"

"It's okay, we'll price match your store and we will give her 10% off too. So don't worry about the price the patient needs to pay--we got her covered!"

"well, no--im not obligated to give you the copy without the patient's consent"

"excuse me?! (this is when i start getting tense) I obviously have the patient's CONSENT to get this copy because I am not wasting my time to just call and talk to you! You, ma'am are being very unprofessional. [I see the patient coming toward the counter, so I hang up!]

I tell the patient about whats going on and she quickly gets on her cell phone and totally BITCHES out the pharmacist! Two minutes later, that pharmacy calls us and gives us the copy.

I win.

After I told what happened to my pharmacist, he laughed and said he hated that lady anyways and would've said something worse if he was in my position! (what a great mentor!)


---IISBoy, drowning away this memory and others with a lot of EtOH

The Pharmacists You’ll Meet in Internships--Community Edition

A while back, we had a post, about the people you will meet in pharmacy school.

Our latest installment is “the pharmacists you’ll meet in internships--community edition.”

It would be an interesting study to conduct, to see who the people you’ll meet in pharmacy school will become when (if, in some cases) they are pharmacists. Do they hold true to their pharm school categories? What were the pharmacists I characterize today like during pharmacy school? Check back with me after 2011, when our study is continued.

Without further ado, and in no particular order, I give you The Pharmacists You’ll Meet in Internships. Community edition, of course. Hospital installment coming within the next 2 to 3 years.

The Genuinely Good Pharmacist.
She may be like the Generally Nice Guy of pharmacy school. She always tries to do what’s right. She is what every pharmacist should aspire to be. She treats her techs well and never hides from patients. She is also a preceptor. She is calm, and never takes a bad day out on her techs or interns, as some other pharmacists are prone to do. She is also the one who probably takes the most crap from the district manager, because she does care and she will do something about it. It was this pharmacist who first encouraged me to go to pharmacy school—I’m still not sure whether or not I should love her or hate her for that. Anyway, this person takes a real interest in your internship and is always trying to come up with a new learning experience for you. She has taken you under her wing and you will probably turn out ok thanks to her guidance.

The Ancient Relic.
This isn’t just a middle aged pharmacy student, as our last list suggested. This pharmacist has been known as “druggist,” “apothecary,” and “chemist,” in his lifetime. When he went to pharmacy school, there were only two drugs: aspirin and penicillin. So he thinks that it is entirely reasonable for you to memorize everything there is to know about any given drug, including its structure. The first prescriptions he filled as a young pharmacist were probably written in Latin and had to be compounded. Later, his pharmacy had a soda fountain in it, where he may or may not have dispensed cocaine-cola. Although this pharmacist may or may not be crotchety and unreasonable, his vast experience is still nonetheless a valuable resource, if he thinks a young whippersnapper such as you deserves to hear about it.

The Law.
He has actually become one of my favorite pharmacists. At first I thought he was kind of a tool, but he’s actually pretty valuable for getting things done. Young and ambitious, with a possible diagnosis of obsessive-compulsive disorder, this pharmacist likes everything to be just-so. He likes to see diagnosis codes on pathoamines, won’t cave when being harassed for an early refill on a control, and god help you if you don’t make an offer to counsel if you’re on pick-up duty. He is also a stickler about company policy, which is annoying at times, but is ripe for mockery on his days off. He is not afraid to say no to gift card scammers or to yell at people for going the wrong way through the drive-thru. He is also a pretty good advocate for his patients, and has been known to bitch out many receptionists, nurses, PAs, and physicians for not authorizing refills, submitting prior auths, or clarifying prescriptions quickly enough. Nothing thrills him more, however, than catching a fake prescription. He should probably work for the DEA. He is mildly interested in your internship and makes an effort to keep you occupied and doing more than just tech work, but couldn’t hide his disappointment when you reveal that you have no intentions of staying at Major Chain Pharmacy, or even community pharmacy, upon graduation.

The Cool Pharmacist.
You love to work with this guy. He is usually at odds with The Law. He is probably a recent graduate, most likely still on good terms with the professors and thus a good resource, and often-times a floater. His approach to pharmacy is rather laissez-faire. He rolls with the punches and never gets very worked up over anything. He jokes around, may be known to prank call other pharmacies or give copies in weird voices, and treats you to Starbucks, Taco Bell, or pizza on a pretty regular basis. He will bring his iPod and speakers on weekend shifts and may be known to burst into a song or dance routine on occasion, too. Also mildly interested in making sure his interns have some sort of learning experience under him, in fact he may have a really interesting project, article, or some good insight for you from time to time. He really knows his shit, but unfortunately his nonchalance will probably earn him a hearing in front of the Board of Pharmacy some day, provided his disregard for authority doesn't get him fired first.

I'm Just In It For the Good Hours and Pay.
This pharmacist is pregnant about once a year. She only went to pharmacy school because the job is easy to leave and she only has to work 20 hours a week. On the rare occasions you work with her, she has little if any useful input for you and your internship. Once she hits 8 months pregnant, she sits in the corner, complains about her feet being swollen, and makes you bring her scripts to check.

The Angry Pharmacist.
We have all read his blog. However, I'm pretty sure TAP is really a nice guy at work, and all the day's frustrations come out in his blog, as is true for most of us internet pharmacy ranters. Unfortunately, some pharmacists I’ve had the displeasure of working under are always that angry, both on and off the internet. Angry at you, angry at patients, angry at doctors. I'm pretty sure this person's blood pressure is through the roof. They are kind of the bane of your existence and you find yourself always needing the day off for exams whenever they are scheduled to work.

The Jaded Pharmacist.
Different than the Angry Pharmacist, the Jaded Pharmacist has probably been practicing at least 5 to 10 years. They are fed up with chains, with bureaucracy, and disrespect. But, you know, the hours are too comfortable, and the money too good for them to leave. This pharmacist’s contribution to your internship is giving you advice on life, such as not selling your soul to Major Chain Pharmacy and not listening to a word the district manager says to you.

The Apathetic Pharmacist.
They usually work midnights. They don’t even care enough anymore to be angry or jaded. They might also overlap a bit with the Lazy Pharmacist, but not necessarily, although they may still lash out in a passive-aggressive manner against Major Chain Pharmacy by doing small things such as filing any "important" faxes with the district manager's header on them in the trash can.

The Lazy Pharmacist.
This pharmacist probably gives his interns the most responsibility out of any pharmacist, just because he doesn’t want to do a damn thing. Go counsel those patients, prepare that compound, and talk to that physician on line 8. I will be sitting right here reading a magazine.

The Hospital Pharmacist.
They fill in on weekends for the extra money. They don’t have a clue about how things at Major Chain Pharmacy work, so good luck if the computers crash, you are faced with an obscure insurance problem, or you don’t know where a particular binder of paperwork is kept, because you're flying solo. Usually pretty interesting to talk with, these pharmacists are also some of the happiest you will ever meet.

The Moral Crusader.
The infamous type, who places personal beliefs ahead of his patients and refuses to dispense birth control or Plan B. Thankfully, I have never worked with this pharmacist, and were one to come to Major Chain Pharmacy, I would make sure I never did work with this character, but unfortunately this type does exist, and must be included.

The Spazz.
Nice when it’s slow, a terror when it’s busy. When she wasn't taking her anxiety out on technicians, our particular spazz was known to stand in the derm section, crying or hyperventilating, although thankfully she has moved on from Major Chain Pharmacy to a place that is hopefully less stressful. She is also probably a drama queen, and often a very bad influence. Once the people start lining up at the counter, the queue fills up with scripts, and the phone lines start flashing, this pharmacist is in the corner popping Xanax.

--IISgirl ... as always, hit me up if you've got something to add! comment or email irritableinterngirl at gmail dot com