Actual conversation between a pharmacist and a nurse.
RPh – “Hello, this is the pharmacy.”
RN – “Yes, hello. I am calling to inquire about Mr. Xs medication.”
RPh – “OK, what’s going on?”
RN – “Well, the problem is this: He’s supposed to get 20 mg of this medication, but you guys sent me a 40 mg tablet.”
Rph – “OK, so what’s the problem?”
RN – “Well now, that’s not the correct dosage.”
Rph – heavy sigh…. “Here’s what you do… Take the tablet, break it in half across the score in the middle and give half the tablet to the patient.”
RN – long pause…. “Which half?”
This is the type of crap that scares the hell outta me.
Its common knowledge that a prescription can only get to a pharmacy to be filled 3 different ways:
Now lets focus on the third one, telephone.
State law allows prescriptions to be phoned in by a doctor or a doctor’s agent. “Doctors Agent” pretty much means anyone with a pulse. It does not specify the education needed, nor any requirements short of working with the Doctor.
State law only allows pharmacists to recieve the verbal prescription over the phone. Tech’s cant do it, clerks cant do it, janitors cant do it. Only a licensed pharmacist can accept a verbal from the phone.
Whoever wrote this law must either hate pharmacists, or have not stepped one foot in a pharmacy in their life; because now every doctor’s office has some minimum wage making minority who can barely speak english calling in medications for YOUR mother. Thats right! Someone who has zero medical knowledge and has no clue what they are saying are calling in medication for YOUR LOVED ONES! HU-FUCKING-ZZA!
Bah, so they got hydralazine and hydroxyzine mixed up, or Lamictal and Lamisil confused. Or Lamictal and lomotil, no biggie! Your loved one only ended up in the hospital, and a big fat lawsuit pending on yours truly.
Now dont get me wrong, there are lots of doctors offices out there who employ nurses and other very qualified (meaning they speak english) personel to call in prescriptions. Its just that one cheap-ass doctor who gets some phillipino or chinese fresh off of the boat for $4.50/hr to phone in prescriptions to pharmacies which are blaring loud already, they cant pronounce the drug, and to make it worse they speak super super quietly on the phone!
It just pisses me off to no end as well when they get offended when you ask them to repeat it about 10 times, then spell the damn drug. Its not my fault you cant speak english clearly. Its not my fault you cant pronounce the drug. Its not my fault you dont know any medical shorthand so you have to waste my time and ask what ‘po tid uf’ means.
So please, for the sake of your patients, your liability insurance, and my sanity get someone who can speak clear english on the line when you need prescriptons called in. Your pharmacist will <3 you for it.
Its amazing how the medical community has ‘evolved’ in the past few years. Back when I started this profession, only Doctors (MD/DO/DDS/DVM/etc) and Nurse Practioners/PA’s could write prescriptions. Everyone was happy, and the world was at peace.
Well some idiot decides to allow Certified Nurse Midwifes and Holistic Medicine (or some bullshit like that) to write prescriptions. Head, meet table.
When is the madness going to stop? Are janitors going to be the next ones to have prescriptive authority?
I went to college for 7 years, and I only have the ability to prescribe the morning after pill. Some idiot goes to a Career College, pops out a CNM in 5 months, and can write for anything (yes, I know they are under protocol, but thats not my point).
It makes my blood boil when I see these idiots churn out Rx’s that look like this:
Amoxicillin suspension, 234.3 mg three times a day for 10 days.
Now that may look good to you, but any pharmacist will say “Hey! Amoxicillin suspension only comes in 125mg/tsp, 250mg/tsp and 400mg/tsp!”.. Are we to have some mother who can barely wipe her own ass (but can pop out a kid) measure out 4.7372143 mL’s? Hell no! Its fucking amoxicillin! You round up to the nearest strength! Its not rocket science! You could give the kid 2 grams of this shit three times a day and nothing will happen.
If you dont work in the profession, you may wonder where im going with this. Well its a fact of book learning vs common sense. Obvously a “real” doctor would use common sense and just dose said amoxicillin 250mg/tsp three times a day for 10 days and make it easy for everyone. However some CNM looks up in her little drug book (which is probably wrong) and uses her little calculator to do 20mg/kg/day (or something like that) and just blindly writes for whatever number appears as the result. Use your fucking head!
It doesnt end there, oh no!
I’ve seen them write Hydralazine for itching (supposed to be Hydroxyzine, whoops, you just killed someone). As well as give strengths for drugs that they obvously pulled out of their ass (Ultram 100mg when it only comes in 50’s) as well as write for the latest and greatest shit not knowing that it costs 1000 bucks (Zyvox)..
Blah is all I have to say.. But of course because of them us pharmacists can never be replaced by machines.