notageek

I worked slightly over half of today’s pharmacist-hours. Of the pitifully small number of scripts processed in that time, I dispensed half our Relenza and all of our Tamiflu, and I sold a bajillion boxes of surgical-style masks. Oh, and some lady freaked out because the cheapo off-brand surgical-style masks don’t have a particle micron-size filter label but the 3M ones do.

What the hell, people? We are nowhere near any of the documented swine flu cases. It is not a bad idea to have surgical-style facemasks around. It is not even a bad idea to read up on the situations in which an antiviral would be of use. But it is really, really dumb to go freaking out because somebody else already snapped up the last available box of Tamiflu in this neighbourhood. There is a supplier shortage of Tamiflu precisely because so many people are inappropriately panicking and filling scripts inappropriately when they will be of no anti-infective benefit.

YOU DON’T NEED IT, people in my patient population. And by taking it now, you are ensuring that, should this swine flu actually go pandemic, someone who needs it will go without; moreover, if you even do have flu of some kind, you are almost certainly not taking the antiviral in a manner which will reduce your symtomatic illness at all. Take your multivit, get enough sleep, eat un-crappy food and for fuck’s sake wash your hands and don’t pick at your nose. Take vitamin C, if you want. And quit listening to the “news coverage” on the “not-a-pandemic-YET!” because it will just make you stressed, paranoid, and ready to waste antivirals.

I now have a license, students and completed preceptor CE credits, which means that once I’ve been licensed for a year, I’ll also be a pharmacy preceptor.

I think this—in conjunction with other signifiers like the house, car and spouse—qualifies me as an adult, and true to adult form I cannot stop mining my past to try and figure out what actually happened, that my fifteen-year-old fuckup self ended up a “skilled professional”. The retrospective analysis is never enough, but it’s also all we have.

So this is something new for me and my weblog: a series. I had originally begun a list of “things I wish I’d known before rotations” as its own entry, but it was too long and too scattershot to be an entry, or even a FAQ. These aren’t the answers to frequently asked questions, anyway; they’re the answers to questions I didn’t know needed to be asked before I was a student extern, or a pharmacist. I want to tell you the material we should have learned in dispensing lab; the real complement to the PK/PD and medchem and therapeutics.

Also, I promise this series will still be about how I hate everything.

What I did not say to a patient today:

Should I hang up now, or would you like to continue insulting me?

What I did say to a co-worker today:

You should have contacted the doctor for X. You should have documented Y. Z is a transfer patient, we need to retain him, and to do that we need to maintain a high quality of service.

Both calls were unpleasant. All the younger versions of me seriously overrated this grown-up thing.

Dear nurse I talked to at a hospital I no longer work for:
The pharmacy is not calling you because we have nothing better to do. We are not bored, and we do not have a fondness for bothering office staff. I am calling you because the prescription is wrong and I need to correct it before I can dispense it. Legally, medically and ethically.
Do not tell me “Well, that’s what the doctor wrote.” I know that’s what the doctor wrote. It’s what the prescription says, and the prescription is wrong. I know you are trying to squirm out of dealing with this phone call.

Your office and my pharmacy are both on the hook until the patient is done with this medication. Don’t you pretend your responsibility ended when the doctor signed and the patient left the building.

If you don’t know how to pronounce the drug name, it’s OK to spell it out on the voice mail. An indication would be nice, too.

Still, there’s something uniquely poetic in dubbing an antidepressant “despairamine”.