The time for candy coating it is over….

I’m tired of candy coating and being all “politically correct” about this issue, so I’m just going to come right out and be an asshole. You’ve been warned:
If you cannot speak clear English, do NOT call in prescriptions. Yes, I’m calling you all out: STOP FUCKING CALLING IN PRESCRIPTIONS IF YOU HAVE A THICK ACCENT. PUT DOWN THE FUCKING PHONE, AND EITHER FAX OR GET SOMEONE WHO SPEAKS CLEAR ENGLISH TO CALL IT IN.
Do you know how fucking frustrating it is to have to have a ‘nurse’ repeat him/herself about 20 times because it all sounds the fucking same?
Now I’m not saying that you aren’t smart, or capable, or a bad person. I’m making a statement of fact that when lives are on the line, pharmacists need someone who can speak clear English when calling in medications. I’m tired of this happy-go-lucky huggy embrace everyone society that we have now that just looks the other way when some un-educated foreign drone calls in 20 Rx’s that all sounds like vowels on my answering machine. I’m sorry, but stop it. Get someone who can speak English to make that call. Me calling you back to “confirm” is not only a waste of both of our times, but 100% unnecessary if it was done correctly and clearly in the first place.
You think I’m being an insensitive racist asshole. You’re right, I care about my patients, and my state license/livelihood/my patients life is riding on your piss-poor language skills coupled with a ‘degree’ from a 3 month community college program. I’m sorry if I hurt your feelings, welcome to the world of medicine. I’m sorry if you cant help your accent; doesn’t mean you need to change jobs, just don’t call in Rx’s. They don’t let retards fly fighter jets and you don’t see them getting butthurt by this.
So pony up and accept it. Drugs sound the same. Obviously you don’t know this because you are still calling in Hydr-vowel-vowel-bok-bok-bok and require an interrogation session for me to determine if you mean HydrALAzine vs HydrOXYzine, TopROL vs TopaMAX, BID vs TID, etc etc etc.
This doesn’t stop at nurses, oh no. Pharmacists and Doctors are just as bad. If I request you to fax over that copy, and you are “too busy” and want to give a verbal, I’m just going to come right out and say that I want it faxed because I can’t understand what the fuck you are saying. I pressed “1” for English bitch!
So yeah, I’m an asshole. However I’m an asshole not because I hate you, or your race, or where you came from. I’m an asshole because you don’t seem to get the very clear and very important concept that you lack a very vital language skill that puts not only my patients life on the line but my license and store as well. Medicine requires clarity or people get hurt, you should of learned that in school. Sorry for fucking caring for the whole at the expense of insulting a few.
Oh, you know when I said I was sorry up there? I lied. I’m not sorry. I shouldn’t be sorry for standing up for patient safety when nobody else seems to have the balls to confront this issue (and make people upset? Oh no!).

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57 Comments

  1. enrico says:

    “vowel-vowel-bok-bok-bok”
    ROFL! It’s “Robot Pharmacy Chicken!”

  2. rph3664 says:

    The megaclinic at the town where I once did retail had a phone nurse who had to be have been deaf. She was highly intelligent and probably a very nice person but had no business working in that capacity.
    Needless to say, she didn’t last very long.
    This happened around the time when “Being John Malkovich” was in the theaters. If you saw that movie, you will know what I am talking about.
    The hospital where I work has a lot of foreign-born nurses who mostly work the night shift. Many of them can write English but have difficulty speaking or understanding it, and it is a patient safety hazard.

  3. Carol says:

    Abso-fuckin-lutely! In addition, if you fax the thing in, then you can do it at any time of night or day and you won’t tie up anyone’s time.

  4. Herro Kitty says:

    great post…btw it’s “should have learned that in school” not should of.
    do you speaka da englese?

  5. Tyler says:

    This is true. I hate having to listen to voice mails 10 times to try and figure out what the heck is going on, only to have to call them back to have someone clear things up.

  6. Jeff P. says:

    I totally agree with you. Not only that, but I work with another technician (if you can call her that) that has been in the USA for 10 years and still we have to repeat things 3 times for her to understand. We also have to ask her to repeat herself and she doesn’t answer the phone. Now isn’t that part of the job description of being a pharmacy technician? Last time I checked I thought so.

  7. DownonthePharm says:

    Ahaha.. You said it LOUD and clear!
    Actually the school i’m going to right now has a strict policy when it comes to “accent” individuals applying to pharmacy school. Honestly i can say out of the 87 students in my class there is only 2 that have heavy accents. So maybe the pharmacy schools will help get rid of these med errors!
    I am currently working in a hospital setting. Therefore i feel your pain. The RUSSIANS are coming! =D
    You make my long days of studying just a little bit better. Thanks for the laughs.

  8. Sara says:

    Or when they say the medications wrong.. or write it down for a strength that doesn’t exist, or write it out for a medication that isn’t even on the market anymore, then get pissed when you call to verify what the medication is supposed to be?

  9. Joe the Pittsburgh Intern says:

    wow.. that was fucking hilarious. Thanks for the laugh!
    “I pressed 1 for English, Bitch!”

  10. BlueTech says:

    TAP. Has. Huevos!!!
    That’s right. I don’t really have the balls to tell a nurse/receptionist/doctor-in-law to transfer me to the janitor, who at least speaks white trash english that I can sorta understand…
    But then again, I have a technician and two pharmacists who are fluent in spanish, an intern from poland, and the pharmacy manager holds a green card since he was made in Taiwan. ^_^;;

  11. PharmGirl says:

    OMG, I had to call our help desk the other day b/c we were having issues and the call went to some guy that couldn’t speak english. I asked him, “What is your name?” He kept responding, “HUH, I don’t understand?” I respond, “WHAT-IS-YOUR-NAME?!!!?” He responds, “HUH?” I respond, “DO-YOU-SPEAK-SPANISH?” He responds, “HUH?” so I go a step further and respond, “COMO SE LLAMA(what’s your name (in spanish)” Come to find out, the guy was in India…I was freaking laughing at myself when I got off the phone and complained to our coorp office…Thankfully we have super nice people that gave me their direct line so I don’t have to call India next time and get someone who is reading from a script…UGH! I AGREE, can’ speak the language, go home!! They WOULD NOT DO THIS FOR AMERICANS in another country, we would be SOL!!!! I would NEVER move to another country unless I could communicate in the countries native tongue. OH and don’t get me started on pts that can’t speak english and you have to tell a 6 yearold how their mommy or daddy should take the medication b/c they and their parents can’t read english, but the child speaks it very well!!!

  12. Gary says:

    hahahahaha awesome!! I loved this entry. It is so true it should be illegal for someone who doesn’t speak English clearly to call in rx’s then have to audacity to get mad at us because we cannot for the life of us understand what the fuck they are saying.

  13. Brandon says:

    Yeah, this should go for patients too.
    Amazing how you get a patient who speaks no english come up, and you ask date of birth. They look at each other and shrug, then look back at me. THEN THE PHARMACIST says some stupid shit and come to find out he asked them for the date of birth. They laugh like IDIOTS and bicker among theirselves AGAIN before getting probably some random numbers strung together.
    And you can never tell what the fuck the gender is on a name like (these are fake) cogita, armando, gradginit.
    And you know the local community clinic won’t call in the date of birth on them either.
    Fun times.

  14. Terrence says:

    I’ve woked on retail for 8 years and long-term care for 2 more, and you say it like it is. Good Job. Please add me to your blog update notification list.

  15. EdM says:

    I have been going thru this for many years. I have called help desks and talked to people in India nd the Phillipines etc. Of course the language barrier is always there. Try to get and Indian to take an ID # or to tell me a way to resolve the problem is next to impossible. I always read your blog first and if you are an A-hole so am I because I totally agree with you.

  16. Jayson says:

    Fuck you….do you speak all languages mother fucker? Any person can have accent…
    YOU’RE ASSHOLE

  17. rph3664 says:

    I would rather see a child translating for his or her parents, and the parents can comprehend, than have to explain something to the child because the parents (okay, mother) are mentally retarded.
    There seemed to be a lot of that where I used to work. I’ll never forget one woman whose oldest child was an 8-year-old of average intelligence and he was smarter than she was.
    Judge Judy has said that those are the most difficult cases to deal with. She said, “A lot of them don’t know how the process works but they have children anyway.”

  18. I have to agree that people assigned to calling in prescriptions should speak with complete clarity. But, how do we solve this problem? Do we have the power to start refusing the phone calls and forcing the issue despite the fallout that is sure to follow?
    My solution is simple, but would be hard to win: BAN verbal prescriptions. I know you can phone in an account number and a routing number, but, in most places, can you call in a personal check? Can you call in a college application? NO, these things have to be in writing. If MONEY has to be in writing, why can’t live-saving (life-taking?) chemical orders have to be in writing?

  19. PanaT says:

    I guess we’re lucky here in Australia, if the doctor is giving a verbal order, he/she has to give it themselves…. the secretary at the front of the desk cannot give you the order legally. I’ve had instances where the secretary has tried to give me the order, and I’ve said I won’t accept it unless I speak to the doctor – they get v shitty at that, but the law is the law.
    Had a secretary once say the doctor has ordered Lamictal, I demanded to speak to the doctor, when he finally got on the phone, he said the order was for Lamisil!!! – just slightly different – wouldn’t want to think what would happen if I had given the patient 250mg of Lamotrigine…….

  20. Frustrated pharmacist says:

    When I was in pharmacy school 5 years ago, they ATTEMPTED to make the ESL requirement more stringent and were met with massive resistence…”This is racism in disguise…” NO…it is ESSENTIAL for PATIENT SAFETY! I wouldn’t count on the schools to make this happen!

  21. antpharm says:

    Brandon: I hope you remember your comment the next time you’re visiting a country where you don’t speak their language (Cantonese? German? Swahili?) and desperately need medicine.
    I don’t know if you’re a complete idiot, but your comment sure makes it sound like you are.

  22. Cathy Lane RPh says:

    Yiyiiiyiaaaaaaaaaaaa. Egadzook, I don’t only think it’s merely an accent, I think it’s the capability of the listener, and the incapacity of transmission equipment. I attended a lecture the other day in which the speakers were carrying on a normal tone, but the sound equipment was amplifying gobbledegook, and people in the audience were leaving left and right. In desperation, I went up to the front and asked that the sound equipment be turned off, and time allowed for everyone to come to the front of the auditorium so that the guests could simply talk louder. On most phones, and I work all over so I get the southern accents, the Texan accents, the Minnesotans, easterners, etc., plus any recent foreign-born, I explain quickly that I cannot understand what is being said and excuse myself as I try adjust the volume on the phone amplifier, or whatever it takes. Many times the other speaker will either try to accommodate the situation by speaking more slowly or at least understandably. If they don’t make an attempt, then I figure I did all I could and it’s an attitude issue. We pharmacists aren’t the only one in healthcare that are interested in happy outcomes! As they say, ‘communication is two-ways’…

  23. Ingrid says:

    COMPLETELY valid point, but the battle’s already lost. You can’t understand what the frickin’ DOCTOR is saying half the time, you think anyone’s going to do anything about the nurses? As far as the faxed orders go, it’s not much of an improvement. Trying to decipher horrible handwriting can be just as dangerous as trying to understand what a person of the thick-accent persuasion is saying. At least you can get someone to spell for you when you’re on the phone with them (another ball of wax —
    “B as in Boris…..”
    “Hold on, D as in Doris? T as in Taurus?”).

  24. Target_RPH says:

    Honestly, i just say we don’t have it some of those people, mind you i’m in socal so theres alot. Its better in the long-run anyhow, they just end up going to Rite-aid, the place where they also hire all the RPHs who can’t specak engeissh! Even if its something like IBU 800, if i can’t understand your name, address, and date of birth, why should I put my career on the line.

  25. Melissa says:

    That was awesome, you hit the nail on the head with this one. You have to be able to communicate clearly in this industry, I wouldn’t go to Mexico or Germany or India…or wherever and not be expected to know their language…so why do we have to accept it? Good work TAP

  26. Martin S. says:

    can you please add stupid as foreign language? I fucking hate it when the yutz at the doctors office sounds like the doctor just whistled them in off the street. They not only can’t read the doctors writing but when you tell them the drug and strength don’t match they just keep repeating it. Why? because thats what the doctor wrote. Do they think this will magically create such a product?

  27. hiptocode says:

    just when i thought i couldn’t fall any deeper in love with tap . . .

  28. Anon says:

    I love how these people are leaving comment like fuck you and you are a joke. I guess people cant quite comprehend the seriousness of getting the proper medicines because anyone with half a brain would realize the need for clarity when it comes to all these different look alike-sound alike drugs.

  29. PanaT,
    I visited your country in March and could have moved there for good, I was so comfortable. I visited Sydney, Canberra, and Melbourne. I’m good at driving on the left now. Too bad I didn’t stop and talk to a pharmacy. Too, too bad we didn’t exchange these messages before I visited. Where are you located? Tell me at
    trusten@grandecom.net.

  30. jeff says:

    i usually hate you but here, we agree

  31. john roman says:

    You dont have to post this … but how about this. A PartD HMO would not pay for a womans procrit today .. why ?? It is fucking working for her!!! She had a low normal value of HGB 12.4 using procrit. Im like duh its going to drop back to 8-9 if you pull it off her. To fucking bad ….
    How about this lets pull everyone off lipitor if it gets their cholesterol to normal …

  32. q says:

    i miss tap… can we get an update :-)

  33. robert barker says:

    Maybe you should get a fax. The reason you can’t understand the unfortunate SOB on the answering machine is bevcause we are not producing native M.D.’s. And I dohn’t mean American Indians. M.D.’s from India may be be more difficult for you to understand, but they probably use better grammer than you are used to, or apparently use yourself.

  34. SassyTech says:

    :::stands, nodding and slowly clapping with a solitary tear rolling down my cheek:::

  35. StarTrekRPh says:

    As a homecare pharmacist, most of our referrals are via the phone. And yet, I am the one in trouble if I ask Dr or pt to repeat themselves. Yikes!

  36. liz says:

    Happy pharmacist month!!!
    That’s right…when we make up a holiday, we don’t just give ourselves a day to celebrate ourselves. we give ourselves the whole damn month! and by golly we deserve it!

  37. PharmJew says:

    TAP-you are my hero. The sad/scary thing is, it’s just as bad on the inpatient side…

  38. Janice says:

    I laughed my head off. ITA with what you said. At our hospital a nurse put a foreign doctor on speaker phone so several rn’s could listen to what he said, and when he was done she said, gee I can never understand him and he reported her and she was fired.

  39. Chuck McKay says:

    Like everyone else, I’ve had trouble communicating with some foreign born people, but then, I’ve had equal difficulty communicating with people born in this country.
    I’ve found the vast majority of people only want to get along. Cut ’em some slack. A little understanding, and effort, goes a long way.

  40. SG says:

    Ingrid; I know what you mean; when I was temping as a receptionist I had to run a script back to the doc a time or two for things like “Umm, doc, it looks like this says Lomotil 25mg QID…two problems: (besides the obvious dose issue there) you’re a psychiatrist, and the patient is already full of shit.”
    It helped that Taco Bell’s menu is considerably longer than the list of meds she worked from, but we couldn’t expect every pharmacist in the county to know the list.

  41. April Rossmark says:

    I realize you accept call-in rx’s, to help your customers/patients. It may be a time issue, or the patient cannot get to the doctor, etc.
    However, if you can’t understand the person calling in the rx on the phone, can’t you just deny the fill ?
    Couldn’t you explain to the customer that you cannot understand the person ?
    Have the doctor’s office fax the rx over, or have the customer actually pick up the written rx themselves, and bring it in to you ?

  42. Sara says:

    Update damnit!

  43. Nitcorvair says:

    Just a note from a fat girl that speaks good English. I have the devil of a time understanding pharmacists who are from goodness knows where.
    One paged me one night because Cholestyramine had been prescribed for diarrhea. Can we get some help here?

  44. 24hourslave says:

    In MD in order to apply for a pharmacy licence you have to pass an oral english equivalency test. Maybe the should be for everyone in healthcare?!

  45. bleh says:

    What a jackass you are.
    “Now I’m not saying that you aren’t smart…”
    “some un-educated foreign drone”
    “They don’t let retards fly fighter jets”
    Jackass.

  46. sorchagriannon says:

    Unfortunately, we have several md offices the REFUSE to fax rx’s in when we have not been able to understand the twit calling it in…how fun is my job:P
    Sorcha

  47. Google Account says:

    Hey, It isn’t just the nurses CAllING in the RX.
    I handed the RX to the patient, gave the obligatory 45 sheets of handouts on TX, DX, and the wife calls the pharmacy from the room, calls in the RX to the pharmacy…. HOLY CRAP.
    B4 she left I had determined she was a :housewife: unemployed, but knew the system.
    Wonder if the Sig was changed??? I pick my battles and I don’t care.
    10MG-IV
    Oh yeah,back in the 80’s A pharmacist called the ER and asked if
    Leroy Jones had been in earlier, he had, stole the rx pad back when the Doc use to carry a pad around. any way, He forged:
    MO FEEN 1 pound
    and signed the ER Dr. name. Poorly might I add.
    we had a copy in the ER for the longest time.
    Haaa haaa haaaa haaaaaa haaaaaaa HAAAAAAAA

  48. Hosptial Guy says:

    During my moonighting escapades, I’m forced to listen to the jibberish, sorry, phone messages letf by MD’s offices. Pretty dismal. Reading prescriptions is hard, but try reading physicians’ orders in a hospital!
    Retail is subacute. Hospital is certainly not. The orders coming in ARE life and death; that’s a perfect time to write shitty. Better yet, the majority of the orders are not written by the docs. They’re verbal orders written by RN’s who can hardly speak english themselves!!!
    We complain at P&T meetings a gazillion times to no avail. I firmly believe the docs write badly and so forth to give themselves plausible deniability; “I didn’t order that your honor!”
    I feel for you retail-heads.

  49. sheila from america says:

    I am a 4 year college RN and have been a nurse for 23 years. Only during the last few years, we have started getting more and more pharmacists that are foreign born and can not even repeat back what I said so clearly to them…..they can not even say their name clearly! So it is not just the NURSES whose fault it is, pharmacists are not all young white american born males. we are getting pharmacists from all over the world, and when they come on the phone and say”pharmacist” I ask what their name is and it is something very unintelligible, no do not place all the blame on the intelligent nurses

    • PharmIntern says:

      TAP: “This doesn’t stop at nurses, oh no. Pharmacists and Doctors are just as bad.”

      Obviously it’s not just nurses, it doesn’t matter worth a damn who it is, but the fact remains that ANYONE working in medicine or healthcare in general, for the sake of patient safety, NEEDS to speak clear English.

  50. Labrat says:

    This is such a common scenario; the kid is usally quite bright and is translating for their “too lazy to understand English” parent. I really adore these kids, but they shouln’t be expected to translate important medical information.

  51. Zacarias Nason says:

    ” I’m sorry if you cant help your accent”

    *can’t

    “…and you are “too busy” and want to give a verbal, I’m just going to come right out…”

    *i’m

    “…you should of learned that in school.”

    *should have

    Plenty of commas absent where they should be, but that’s negligible.

    Fix’d, (by no less than a scary foreigner) bruh.

    • JustthePOA says:

      Anyone can fix “punctuation”. You don’t see people solving the language barriers by adding the correct placement of a comma or apostrophe do you…Bruh?

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