I. Rotation VIII.
II. Guide to getting narcotics.
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I.
Rotation VIII: Community PharmacySo my 8th rotation was labeled as "Advanced Practice Community." This is essentially a euphemism for "spend 4 weeks counting by 5s". It wasn't really all that bad. It was a little independent chain. The dude owns five stores in the North Central WV region. The store I was at was doing 300 scripts a day - absolute insanity for an independent. From my old Kroger days, I really envy the guy, too. He has the power to hang up, tell off, or ignore anybody he wants to without the possibility of some retard district manager coming along later and giving the offender a gift card for being an asshole.
The joint was also a professional compounding center. Interestingly, his best sellers were this methimazole topical cream for cats with hyperthyroidism and a nifedipine/hydrocortisone/lidocaine suppository for hemorrhoids.
Whenever I wanted, they let me hide in the back and work on the retarded assignments the school of pharmacy forces them to make us complete. They also didn't mind that I took hour long lunches. I probably only ACTUALLY spend 2 hours a day counting and 6 hours doing busy work or just kinda spacing out. It was quite nice, actually.
But, man, it all makes me remember why I hated retail. All you are anymore is an insurance billing technician and narcotics diversion officer without any actual power. I'm being 100% serious - I think pharmacists should have the right and authority to arrest anybody on the spot who is forging a script. In fact, give us all guns, too. Then nobody sure as hell would rob us anymore. I want to be sitting there, counting pills, with one of those over-the-clothes gun strap things over my labcoat.
I want a .50 caliber Desert Eagle, too. Check out what this thing does to a watermelon (about halfway through video):
Hell yeah. I want THAT on my side when Mr. Oxyhead comes in to rob me.
So back to the point, the druggies were running strong in the particular area I was in. The second week I was there somebody called us up and asked for brand Oxycontin 80s. And what makes it worse is that you know the type as soon as you pick up the phone, too. Every other word is sir this, sir that, please this, thank you that. They are the only nice patients you have. Hell, I wish only druggies came in...at least my day would be pleasant. On the other hand, it pisses you off that they think you are being fooled by their facade.
Anyway, after I said "no," she asked if I had any of the "blue round ones with the W in the middle of a box on one side and 03 then 52 on the other side...I think it's Watson brand" (Note: it's actually an "M" and Mallinckrodt brand...but I give her points for effort) Impressed by her opiod-addiction-fueled knowledge, I actually went to see if we had them for shits and giggles. I go look at the ones we have..and they weren't the Mallinckrodt brand. So I get back on the phone and I say "All we have are green ones with 33 on one side and 93 on the other."
And what does the woman say?
"Oh, no, the
Teva ones really don't do me that much good, thanks, I'll call elsewhere!"
I mean, c'mon,
she can tell
me what freakin' brand it is by the imprint. WTF?
All in all it was a good rotation for what it was. The folks there were friendly as hell and made me feel at home. They even bought me a going-away cake when I left. Awww...how sweet.
My preceptor didn't really like the ratings thing on the evaluation form, so just gave me 4.5/5 on everything. So...yeah.....no comments page this time around. He told me I should get a PhD in pharmacology.....which is honestly the best idea, based upon my talents, I've heard so far.
...and this bring me to another thing that bugs me....
...why the hell do people think that the "next step" for pharmacy graduates is a residency? I swear to God, the next person who looks at me and asks if I want to do a residency I will douse in gasoline and set on fire. (Note to FBI: Not really.)
Ok, ok. I understand that if you want to pursue some sort of specialized clinical pharmacotherapy career path, it's definitely what you want to do. However, what this fails to realize is that clinical pharmacy is the most boring thing on the damned planet.
There is a reason why I got straight Cs in therapeutics in the actual school part of pharmacy school....it is basically the equivalent of memorizing an encyclopedia. The only real interesting part of pharmacy school is pharmacology and biochemistry. It's cool shit. You know how shit works and you can brainstorm how doing shit to said shit will make other shit happen. It's pretty sweet.
But anyway, I just don't understand why "residency" is considered the "next step". If I had to sit in a hospital and deal with applying guidelines to patients, I'd probably kill myself.
The next step is PhD in pharmacology or medicial chemistry for me. That's the real science right there. If I had the personal motivation, didn't care about money, had a desire to actually help humanity, etc, etc, I'd probably do it.
Ah, oh well.
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II.
The Pharmacists' Guide to Scoring NarcoticsI feel as though this should be available to the public. I figure the more druggies know, the less I have to deal with actually noticing their obvious BS and, thus, annoying me by making me do something about it.
1)
Do not address a pharmacist as sir/ma'am.
Why? Because retail pharmacists don't get praise or a general happy/nice attitude from ANYBODY before we actually bend over and let you ram us in our collective asses via making us do your bitch work (call the Dr, call the insurance, diagnose your allergic rhinitis, etc).
We are like your spouse/friends/family. We KNOW that whenever you are nice to us, you just want something. I swear to God, whenever I answer the phone and the first thing that comes out of your mouth is "Hello, good sir, how are you this morning!" I know you are one of two things. A guy trying to sell me something or a drug addict looking for Xodol 10/300.
This is what you do. After I give you the stock phone intro, just say, "Hey, you guys got any Xodol in stock?"
Simple.
2)
Do not wear anything that says the words thug, g-unit, sean jean, or is the logo of some hippy band from the 1960s. A tshirt from an 80s hair band is questionable. Also, be sure to shower.Why? Personally, I don't discriminate, but from my limited experience, your average retail pharmacist is one prejudiced ass motherfucker. Usually with reason. If you look like a shady character, you'll be put under a microscope.
This is what you do. Go to Target and buy one of those decent looking suits they have that costs like $70. Wear it to pick up your Vicodin. In fact, treat PICKING up you drugs like a kid on his first job interview. Uncharacteristically wear a suit, show up a few minutes late, only answer when spoken to, and act like you've never done it before.
3)
I know it's hard....but don't call your narcs in early.
Why? It makes you a marked man. If you call a script for a narc in any more than 1 day early, we make a note of it and we NEVER EVER FORGET.
This is what you do. Suck it up. Call the day it's due. Triple bonus points if you actually wait an extra day or two.
4)
Don't tell me you dropped your pills down the sink.
Why? Because this is easily the most commonly used bullshit excuse in the history of opiate addiction. By my count, around 25% of all hydrocodone preparations produced wind up in the sewer system of every town in the US. In fact, it wouldn't surprise me to find out that hydrocodone has some sort of static-electrical attraction to running water or something.
This is what you do. DON'T LIE TO US. Every excuse you come up with sounds absolutely retarded. No matter how brilliant you think your excuse is, we've heard it before. Do you honestly think we believe that you are going to allow the drug you've been trying to get filled early every day for the last 3 weeks to "accidentally" be consumed by your Poodle? Please. We all know you have that shit locked up in a damned fire-proof safe in your bedroom. I'm sure your birth certificates and social security cards are probably on an idle table next to a fireplace, too.
5)
When getting your script for a narc filled, do not stare at me like I'm Natalie fucking Portman walking around topless.
Why? Because you are making it bloody obvious you are doing something shady. Sometimes I like looking right at them for a few seconds, then go over and pick up the phone. Their eyes get as big as a damned basketball. I did that once and the dude got up and ran out of the store.
This is what you do. DON'T STARE AT ME. For one thing, this isn't Subway. You don't have permission to watch me, anyway. And secondly, again, you are just creeping me out. LEarn to use your ears or something. Christ...seriously, anything, just don't stare at me intently for 5 minutes straight.
6)
If you have a prescription for an antibiotic and a painkiller, for the love of God, don't tell me you "only need the painkiller."
Why? Because we aren't a bunch of fucking morons. If anybody is given a script for an antibiotic + pain med, it is 100% of the time more important that you get the antibiotic before you get the pain med. And, again, WE JUST KNOW YOU ARE TRYING TO PULL ONE OVER ON US. It's like a freaking innate instinct. We are the most omnipotent, omniscient, omnimalevolent sons of bitches you will ever know.
So what do you do? Jesus, just pay for the damned amoxicillin.
7)
Don't tell me to not bill a narc to your insurance because it's too early to go through.
Why? Because, again, we aren't fucking stupid. Why in God's holy name would anybody waive the chance for an insurance company to pay a large portion of the medication cost? We're gonna run it through your insurance anyway just to see what happens.
This is what you do. Go somewhere else. Duh.
8)
Don't ask for brand name anything.
Why? Because, once again, we aren't fucking stupid. We know you are going to sell whatever goes out of our store with a brand name on it. We also know that there is about a 0.00001% chance that there is a legitimate medical problem that prohibits you from just taking the generic product. It's called an AB rating.
This is what you do. DON'T ASK FOR BRAND. Instead, educate your customer about the wonders of bioequivalancy and FDA Orange Book ratings. Tell them they can get equally as high at a fraction of the cost. If they still think they feel a difference, educate them on the potential of placebo effect.
That's all I got for now. Till next time.
