The Disenchanted Pharmacist

The History and Future of Nursing...

2010-06-06T15:40:00.009-05:00

A long, long time ago, when English was the primary language of physicians (mid-60's), nurses were allowed to go to junior colleges in order to get the Associate's Degree in Nursing (ADN). This was because there was a shortage of nurses (just like there is now). About a decade later, the nursing organizations had determined that this was a mistake. Knowing that it could not be undone, they made an attempt to relabel the two different classes of registered nurses as the following: Professional Nurses (with a Bachelor's Degree) and Technical Nurses (with an Associate's Degree). This, of course, offended the ADN's and spawned a debate that still rages on today. Recently, a little bird told me that there is a move to push the ADN's out of hospitals around the country.

The truth of the matter is that the big difference in the two programs is that the BSN programs incorporate more outpatient/community related material and have some written papers that are not required in the ADN programs. The ADN programs accept more minorities and males, whereas, the BSN programs are usually 80-90% white females. There are also more older (+25 years of age) students in the ADN schools, as well.

The removal of ADN's from the more intense work in the hospitals is being promoted by some powerful individuals within several of the nursing organizations. The only reason that it hasn't been acted upon is: 1). There is no feasible way to define what a Professional nurse can do versus what a Technical Nurse can do, and 2.) Hospital pay is lower for nurses.

From my own observations, here is what I have to say:
BSN's are spoiled little GIRLS that got drunk on a weekly basis with their sorority sisters. They have an inflated sense of entitlement, and their usable knowledge of medical knowledge is very lacking. Because of their immaturity as a person and a nurse and their crappy work ethic, they lack the ability to be superior than the less educated ADN's.
ADN's are hard working WOMEN that had to work while they were in school. They often already had a child or two, and some of them were married. They are almost always mature and rely upon themselves.

Who is a Professional Nurse?

One of my wishes came true...

2010-06-05T19:01:00.002-05:00

An ICU nurse that is stupid, yet an arrogant bitch has been promoted. Since she is terrible at her job, it was a perfect idea to move her up and out of our way. She is now walking around, reviewing charts, and trying to look important. My only regret is that she took a job that a much better nurse could have had.

Held back by our own kind...

2010-04-26T14:50:00.004-05:00

A certain couple of units got together recently to put together a rounding team. They wanted a pharmacist to be on it. They had a certain pharmacist in mind (that already covers the area anyway). The plan went to pharmacy, and was shot down. Not because of staffing reasons, but because the clinical pharmacists didn't want a pharmacist who hadn't had a residency be on the rounding team. Even though this guy knows a shitload more about this specialty than the other clinicians.

Total fucking bullshit!

The fact of the matter is that it wouldn't have got approved anyway, based on staffing hours, but it didn't even get that far. Our management has gotten past the part of "Mushroom Management", and has went to the "Fuck us in the Ass" management.

Counterintuitive...

2010-03-24T20:05:00.002-05:00

I had been caught up with my workload the whole evening, and after getting paged a numerous amount of times, I had to take a lunch (late, by the way). When I got back to my work, I was well over 30 minutes behind. The pages stopped. What the fuck?

From now on, I will be behind on my orders, so maybe I won't get paged as much.

Again, I wish I were a CRNA...

2010-03-13T14:46:00.001-06:00

http://finance.yahoo.com/news/Specialist-nurses-paid-higher-hmoney-2327465018.html?x=0

The above link will further prove my longing to be a CRNA rather than a pharmacist.

I came for coffee, but met a douche instead...

2010-02-15T15:42:00.003-06:00

Those who follow my posts probably know, by now, that I am a connoisseur of pussy coffee. Latte's in general (I'll drink regular coffee, but not black). I like coffee in my cream. My wife brought me something from the Joe Muggs in the Booksamillion store nearby a few months ago, I have been trying to duplicate that taste at home, with no avail. I went in today, and asked for the biggest caramel iced latte he could make me. I obviosly was not familiar with their menu, so I probably am not a big customer of theirs. The prick at the cash register then asked me if I wanted a discount card, so I ignored him. He asked me again, and I said "I just want the coffee I ordered." He then asked me if I wanted to two free magazine subscriptions on the behalf of Booksamillion, I said bluntly, "NO."

I love your crack-like chemical that you put in your latte's, but I am going to have to give them up. I'm going to just make my own, or go to Starbucks, where they don't ask me anything, except if I want an extra shot, because it was taking so long. I can deal with Starbucks; I can't deal with douche barristas.

I feel like I'm preaching to myself...

2010-02-10T15:15:00.002-06:00

I am tired of all the lack of comments written on my blog, despite the handful of people that read it. I have really never made my blog really public (advertised to other similar bloggers), but I think that I might in the next coming weeks. I want to see if it sparks my interest in making posts if someone actually gives some feedback. The only feedback I get now is a tech or pharmacist who knows about the blog telling me in the hall "oh yeah, I read [past tense] your blog." I am thinking to myself at this point, "Was it any good or am I a part of a fucking joke I don't know about?"

I should say to them, "I saw you through your bathroom window last night." I know they would be thinking of me as a stalker or something (that's the point), but deep down they really would want to know if I got a rise out of it or not.

Nothing to wipe off the sweat...

2010-01-12T10:01:00.003-06:00

This is off topic (again, as always). My gym is now charging a $5.00/month charge for towel service. They obviously can't do 2 loads of laundry a day, without losing money. I know the economy hasn't fully recovered, and they might be a little short on cash. Why don't they just up the membership fees? Why do I have to go up there and sign some fucking sheet to approve another $10/month (because my wife is on my membership) to go against my payroll?

Fuck them! I'm going to wipe my sweaty hands and forehead on their drywall. I'm going to put handprints on the mirrors, and I'm not going to make any attempt to wipe my sweat from their machines. I might even spit on the floor. I would teabag their equipment if I could get away with it.

Dr. Sulu

2009-12-22T12:21:00.002-06:00

Dr. Sulu is not his name, but he is a physician. He comes in about noon everyday he is to work. He looks around, and talks it up with the nurses on the unit(s) he covers. He goes to lunch at 2 pm, and comes back a little after 3 pm. He usually has addressed maybe 20% of the TPN (total parenteral nutrition) bags to be started by this time, and he usually only has 45 minutes to get the rest done. He never does have them finished by this time. Here's the problem.

We outsource our TPN's to a place that delivers them from an hour away, so you can see there is a time constraint here. We have to get the orders in by a certain time, or we will have to make each bag ourselves, which is labor intensive and cost-inefficient. I like to go up there and try to see if I can get the information from the horses mouth, so we can get stuff done a little faster. Everytime I go up there, he will look at a chart, and then chat with a nurse about nothing for 10 minutes. We always 2-3 TPN's that have not been addressed by the time we have to send all of our orders, so we tell the place to make the same bags that they made yesterday. He then changes all but one of them, and we have to make 1-2 of them ourself. Remember that we also have 1-2 that the outsourced company made also (extra money down the fucking drain).

Why is it this way? Because nobody over me gives a fuck. That's why. They might care a little, but Dr. Sulu has been here so long, nobody has the balls to say anything about it. There is nothing but dead weight above me in management, and I say let the dead weight sink and drown. Someone needs to breathe new life into our pharmacy administration.

Don't mess with pharmacists...

2009-12-20T09:18:00.004-06:00

You don't fuck with a pharmacist, especially a retail pharmacist in Alabama.

This is something that was sent to me over a week ago:

http://blog.al.com/spotnews/2009/12/pharmacist_charged_with_killin.html

I went to school with Bart at some point in my life, and we have had mutual friends. I have never known him, but I do know some things about him. He had a temper, but he was not the kind of person you think would shoot a cop in the face. I initially thought that drugs or alcohol were involved, but that has been ruled out publicly by the investigators. I've heard several rumors about either him or his wife knew the police officer, but nothing has been made public. The truth is that there HAD to be something else going on for this to have happened.

No matter what happened, one thing is clear: There was absolutely no reason for it. Nothing that can be brought to the public's eye will change the fact that Bart ruined his family and the family of the police officer.

If their are any cops reading this, ask your perp if they are a pharmacist, because they go postal more than postal workers do. Trust me on this one.

For the pharmacists that read this, never talk back to a cop or piss him/her off. No matter how bad a day you've had, know that a cop can do about anything to you if provoked. Never bring a gun in your store, and never shoot to kill (UNLESS YOUR LIFE OR OTHER'S LIVES DEPEND ON IT).

Shooting Blanks...

2009-12-17T09:57:00.005-06:00

I've heard of Alpha-1 blockers inhibiting ejaculation, but this is pretty funny and painful. This particular alpha-1 blocker, silodosin (Rapaflo), is being investigated as a potential male-birth-control pill. There are 3 big problems with this:

1.) Guys don't want to be responsible for the action of contraception. They really only want to wear rubbers to prevent STD's.

2.) Ejaculation does happen. It actually causes retrograde ejaculation, which essentially means ejaculation into the bladder. OUCH!!!

3.) This one is pretty graphic right here, so don't read it if you are easily offended: Where is the fun of shooting your load? ;) (the eye is closed because it would get in her eye if it weren't closed.)

Well, anyway, visit here for more info: http://en.wikipedia.org/wiki/Silodosin

The Enforcer...

2009-12-17T09:43:00.003-06:00

My new title is now "The Enforcer." From this point on, when I have to replace my name when quoting a conversation, I will refer to myself as "The Enforcer". Here is the reason why:

Another pharmacist had a bad day yesterday, and I was asked to cover his/her shift today to set the nurses straight. They have been calling her telephone (a big no-no since we have pagers) and bursting into her workspace to alert her about their missing medications. They were also sending missing med requests via the scanner every 10-20 minutes, when it obviously takes about 45-90 minutes to get them up to the floor.

Management thought of my hard-ass attitude and wanted me to set these bitches straight. I am the enforcer; my will be done.

Does this medicine really work?

2009-12-08T19:45:00.005-06:00

Everyday this season, pharmacists from all over will be recommending OTC medications for people who have cold or flu symptoms. It's a very common request, and I fucking hate doing it.

Why you ask?

Because I have absolutely no faith in most of the shit out there on the shelf. It never works for me (a pharmacist), so why the hell should it work for most people. On a side note, I would like to remind you that I know that different meds work differently on different people. I just have a lot of trouble recommending things that don't work for me. Here is a list of bullshit drugs that are available in OTC preparations:

1. Guaifenesin- Tastes like shit if you drink it; Goes down uncomfortably if taking the tablets; and best of all--- it doesn't really work. In fact, drinking water without it works just as well.

2. Loratadine - Doesn't work unless you are actually allergic to something. Don't take loratadine to dry up your sinuses, because that's not what it's for. I'm willing to bet that 75% of people who have bought it aren't actually suffering from allergies, and it does absolutely nothing for them.

3. All other antihistamines (excluding cetirizine and diphenhydramine) - They are suppose to not cause drowsiness, but they are good sleeping pills for me. I might be missing a few, but the agents in this group are: chlorpheniramine, clemastine, brompheniramine, and doxylamine(not really non-sedating).

4. Oral decongestants - Now I have to take pseudoephedrine to drain fluid off of my ears, but it does nothing for my nose. Phenylephrine is a placebo, by-the-way. If you want to clear out your nose, use saline nasal spray or a decongestant nasal spray. This oral stuff will really only clear out your other sinuses (above and below your eyes).

So, what drugs do seem to be beneficial? There are several, but most of them have the side effects that people really don't want.

1. Cetirizine - it will flush your nose out, but about half the people that take it get very very drowsy. It was made and marketed to be non-sedated at first, but they stopped pulling that crap years ago. It puts me in a 36 hour coma.

2. Diphenhydramine - It will dry your nose out, but you WILL get sleepy. You MAY get constipated, and you MAY have dry mouth. If you're older, it WILL make you disoriented, and it MAY cause you to take a nasty fall.

3. Decongestant nasal sprays - work well, but only for about 3 days.

4. Dextromethorphan - morphine's friendly twin brother. Enough of this will stop your coughing, but a little more than that may put you to sleep. The liquid form of this (delsym) tastes like shit.

5. Acetaminophen and NSAIDS (not aspirin) - are probably the most beneficial ways to help tone down pain, such as a sore throat. The anesthetic sprays (Chloraseptic and Cepacol) are effective, but using them more frequently than every 2 hours or so is not recommended (which is pretty stupid since they only work for about 5 minutes).

This might surprise the public (not many pharmacists), but the most useful items in my arsenal of remedies for myself are the simplest things:

1. Saline nasal spray - It really can clean your nose out, and open it up.
2. Salt water gargles - It help soothe a sore throat, and it also loosens up the crud in the throat.
3. Drink plenty of water - It thins out the crud.
4. Vicks Inhaler / Mentholatum - great remedy for opening up your nostrils.

If any pharmacists are reading this, please leave comments on how you feel about this topic.

Poor Judgement on Their Part...

2009-12-02T19:24:00.003-06:00

For me, it seems that as time goes by, more clinical judgement is removed and replaced by monotonous policies and procedures. I'm feeling like less of a pharmacist and more of a technician. The workload is building up, and I'm sure my hands will be very arthritic in only a few years time (I'm not even 30 yet). Dosing and choosing antibiotic therapy is going away and replaced by home medication clarification, medication administration record maintenance, and being forced to follow policies I completely disagree with.

At least my feet don't hurt.

Pharmacist = Physician Safety Net

2009-11-24T09:19:00.004-06:00

I am going to scratch off the word pharmacist on my name badge and put the words "Physician Safety Net" instead. That's all I am (besides a safety net for nurses).

Start Levaquin on a cardiac patient on an amiodarone drip? Order vitamin K with an INR of 8, but fail to actually hold the Coumadin? Start Zosyn on a patient who has an anaphylactic reaction to penicillin? Continue a home medication of simvastatin when the patient's LFT's are above 1000? Put a patient on an insulin drip when the blood sugar is 120, but you claim the patient is in diabetic ketoacidosis?

This shit happens everyday, and I want a cut of all of the malpractice insurance premiums these physicians have to pay. These aren't primarily residents making the mistakes; the majority of them are made by over-confident physicians who need to pull their head out of their ass so they can smell the shitty orders they write.

Privacy...

2009-11-21T14:09:00.004-06:00

The fact is... I have none. I can't walk around in my underwear at home anymore. (Shut the fuck up! You do it too.) There are windows everywhere, and curtains are just not going to happen. The only place I can sport my tightey-whiteys is in bed or in the basement. (I need containment to keep the trouser snake from hitting my knees.)

Is this a bullshit post? Yes, but I'm bored as hell.

By the way, if you ever are using any kind of aerosol spray in which it's contents are meant to stick permanently to the object you are spraying, remember to wear gloves. I spent well over 2 hours scraping off foam insulation from my hands; lesson learned.

FYI: I was not spraying the foam insulation in my underwear. I had socks on too.

I think the word you are looking for is weathered.

2009-11-17T16:04:00.007-06:00

In line for food recently, a lady probably my age was looking at my picture on my namebadge. She told her friend that I didn't look much like my picture. She asked how long ago it had been since I had my picture taken, and I said "3 years." Then she asked if I had gained about 10 pounds since the picture, and of course I said "no." (I actually had lost 50 pounds, then gained 65, then lost 15- so no net loss or gain since the picture.) She just said that I looked much older than my picture. Her friend told her to be quiet, since there was no real nice way to say it.

I think the word you are looking for is weathered. Pharmacy does that to you. If I were in retail, then the skin on my face would probably feel like a ball sack, but I still have some "youth" left working in the hospital. Keep your compliments to yourself next time.

Fospropofol...

2009-11-17T15:54:00.007-06:00

Some have heard of it, but most haven't. It is the new water-soluble prodrug form of propofol. It has a little longer onset of action, and little longer duration, since it has to be metabolized to propofol. Those numbers are not really significant. What is significant is the fact that it isn't in a lipid solution that has to be accounted for when doing nutrition.

I have learned last week that it had been approved already, but was to be a scheduled 4 narcotic. Why? Propofol is not scheduled. Based on pharmacodynamic data, propofol should have more addicting properties than fospropofol. An example of this would be to schedule primidone, but leave phenobarbital unscheduled. It's fucking stupid. I wonder if this has anything to do with Michael Jackson? Surely not...

I'm just saying make propofol scheduled too if it's that big of a deal.

I'm not dead...

2009-11-17T15:40:00.004-06:00

I'm Not Dead. I'm just chewing on my anger like cud. The only problem is this anger is not being generated from work, just my own personal life (too boring to involve the public).

Also, my prayers have been answered about irresponsible CRNA's, and maybe my work will be more enriching, since I won't have to police their asses around so much.

ESPN Gameplan is a Scam...

2009-09-14T20:29:00.003-05:00

I've been gone a while. I haven't been fired, fortunately. I've just been too "busy" to give a shit about a blog that does nothing for me monetarily. I've also had nothing to fucking gripe about, and that just pisses me off!

Anyways....
ESPN is a total fucking ripoff, and I hope the people who run it get their nutsack ripped open via an unfortunate accident. They advertise all of these fucking games, and their definition of the word blackout before and after you pay for it are two opposite things.
If it is in your local viewing area, the Gameplan channel for that particaluar game will be blacked out, but to me that doesn't include pay-per-view. Pay-per-view is not in my local viewing area because I still have to pay extra for it. That's not what they say afterwards... they use the word "market" then.

After two weeks of college football, the only games I can actually watch (games that are not blacked out or on my basic service already) involve teams like Idaho St., Wyoming, North Dakota St.... What the fuck!!!

ESPN Gameplan sucks balls!!! The only reason why anyone should get it is if they live outside of the area that the majority of fans for a team reside. For instance, if I live in Texas, I can pretty much see every Alabama, LSU, Florida, or Tennessee game, but I'm fucked if I live in any of the SEC states. So I have decided to move out of the southeastern United States in order to watch every SEC football game for the price of $116. Fuck Yeah! Maybe I'll just lie to DirecTV about my zip code. That'll probably be a more cost-effective way to do it.

Commentary on "Universal Health Care"....

2009-07-20T18:42:00.009-05:00

I consider myself a moderate, so I'm on the fence about universal health care. There is over a hundred million people in this country without health insurance, yet workforce in the health care industry could not possibly handle the whole population if it were able to afford health care via insurance. I'm for small government, so I oppose the extra taxation that this would bring, but as a supporter of human rights (even though health care is a privilege, not a right), I believe it is the right thing to do.

Here is another negative of the universal health care plan that is being planned as we speak:

Once the ball get rolling, it will only increase in size as time goes by. The estimated amount of money that is going to cost the government is based upon the average cost of health care per individual multiplied by the number of uninsured (plus the bureaucratic bullshit cost on top of that). Once universal health care is available to everyone, large corporations will drop their health care plans and pass the bill to the government. Then the smaller businesses will follow suit. This will all occur within 10 years, and is the birth of socialized medicine in the United States. Over 90% of the population will be on this insurance, and the few that don't have it will have private insurance because of the horrible quality it will have. It will take over 20 years for the health care workforce and infrastructure to compensate for this increase in access to care.

But what the hell, it will be cheaper right? What will it cost you? What will it cost those who already have access to care? What will it cost the politicians pushing it?

Another bright idea...

2009-07-17T17:42:00.004-05:00

Here's another bright idea:
If you trip over a fucking cable to a server, put it back in its correct spot. Don't just put it in whatever jack that fits. I swear you dumbfucks will end up getting fired from Mcdonald's one day.

A Bright Idea...

2009-07-14T18:01:00.003-05:00

Here's a bright idea!

How about you dispose of the fucking skunk that died in the elevator towers two months ago.

It fucking stinks!

The most horribly designed software ever!

2009-07-13T21:25:00.005-05:00

There is no easy way to determine what the most horribly designed software ever is, but I can assure you that McKesson probably distributes/designs it. It ranks up there with Windows Vista (which I'm so fucking glad it isn't compatible with).

Imagine a computer program that fucks up more than it is operational, and costs more than a pharmacist's monthly salary to "rent" for one year, per terminal. You would probably need about one terminal per 40 beds. It's the single worst program in history, and it's distributor advertises it like fucking gold. To top it all off, the previous version, which is now 10-15 years old, was BETTER than the most current version.

I miss Meddirect.

These healthcare initiatives are driving me up the wall!

2009-07-12T15:49:00.006-05:00

If you have worked in a hospital the last 2 years or so, you probably have noticed the IOM (Institute of Medicine) health care initiatives. They are used by third parties and CMS to determine what the standard quality of care should be. For instance, it says that the third parties shouldn't have to pay for care involving DVT's, stress ulcers, bed ulcers, and other preventable conditions, if they develop in the hospital. It makes sense, but it is driving the fuck out of me!

All of the hospitals are trying to cram this shit down every body's brain: pharmacists, nurses, respiratory therapists, and everybody else involved in patient care. Are they really informing the physicians? Who the hell knows? That's what's bothering me the most.

The hospital pays the physicians who are consulted for a patient, per day. That's right, per day. Insurance companies pay the hospital for an admission reason/disease/condition (not per day). Why the fuck is it this way? Because the physicians run the show. They are always in demand, and they call the shots. They are also the majority of the people who run each hospital.

This is how it should be: If a patient has a condition that occurs while admitted to a hospital, someone should determine who was at fault. This person/department at fault should get penalized monetarily for their negligence. This means that if a physician fucks up and forgets to start DVT prophylaxis or to start famotidine/lansoprazole, then the physician gets all the extra cost taken out of his/her total compensation. If nursing fucked up, then the imaginary dollars their department has is reduced (that's a long story if you don't understand the imaginary part). What incentive does a physician consulted for patient care have to get the patient out quicker? If any, not much at all!

So hospitals around the country, please make sure you send your health care initiative information to your physicians too, because they are ultimately responsible for the care of the patient.

Get it right the first time, you lazy asshole!

2009-07-10T22:30:00.004-05:00

This is not a specific rant. I'm just really tired of changing orders I put in because the fuckstick nurse didn't write the order correctly. "Oh, I meant IV not PO." Well you're in luck, because I'm a fucking mind reader!

It gives me extra work that I don't have to do! It gives you extra work (I mean dicking around) that you don't have to do. You could have more time on facebook or twitter (whatever the fuck that is) if you would get it right the first time.

The media is so damn inaccurate...

2009-07-09T22:25:00.003-05:00

I have watched over 2 hours of news related to Michael Jackson these last two weeks, and I've got to say that there are some huge inaccuracies in their information.

1.) Propofol is not a narcotic. Quit calling it a narcotic. It's shows no sign of being an addictive substance. It is a general anesthetic.

2.) Propofol isn't used only in the operating room. It isn't used in the emergency room hardly at all. The majority of propofol used in certain hospitals is actually in the ICU setting. It is used for sedation while the patient is on a ventilator.

Yes it is not intended for home use, and it is incredibly stupid to fuck with propofol. You got 2 out of 4 right. Now go do your fucking homework.

My Ipod is a temple...

2009-07-02T18:25:00.005-05:00

The great thing about hospital pharmacy is that I don't have customers to satisfy every single second of the day. This lets me unwind while I work, and jam to my ipod. It is the most important tool that I use at work.

The ipod has revolutionized music as I know it. Instead of putting in a Tool, Zeppelin, or Rage cd, I can have all of the songs that I want on the ipod to play at random, continuously. I can also put other music, like classical or country to mix in with my rock. I also have many songs, that would be embarrasing to me if others were to know if were on my ipod. That is why it is sacred.
A sanctuary. A temple. I clearly cannot function without it.

This one is for Flo...

2009-06-29T21:06:00.003-05:00

That's her real name, and she can suck my balls.

I was flying through orders on the computer as usual, when Flo takes the chart and puts it down on top of my hands and the keyboard. I turn my head slowly up to look at her, and she looks like she is completely unaware that I'm super pissed off. She reads this order that was written 2 days ago (that I wasn't responsible for catching, since I wasn't there that day), and indicates that there are some medications missing on the MAR. I was one little inch from losing it and punching her in her twat, but I composed myself to say "I'll take care of it."

Fuck you Flo! Fuck You!!
Bitch!

My dog hates black people...

2009-06-26T20:38:00.004-05:00

I really think that dogs that are raised by white people, are the most racist sons of bitches on the planet. Since they're not used to seeing black people, they go crazy when they see them. My dog is a very lovable dog that only really hates the bug man, but when she sees a black person, she goes into kill mode. I know that I'm always scared more of dogs that are owned by black people, but I think that is because the dogs that they own are mostly pit bulls and rottweilers.

Go figure

The door is locked for a reason...

2009-06-25T16:21:00.006-05:00

Have you ever went to a bathroom that is what I call a uniholer (one toilet), and you lock the door? I'm sure most of you have. I'm definitely not one to give a shit where I shit, unless it's filthy, but I know some people are funny about it sometimes.

Anyway, you're on the can, and the door is locked. All of the sudden, someone jiggles the doorknob one way, then the other. They push and pull on the door, as if it's jammed, and then they jiggle the doorknob again. Do you not understand the purpose of a lock? If you would at least have the fucking decency to knock on the door first, you would probably hear someone mumble "taken" (like the school bus scene on Forrest Gump).

Half a capsule? Yeah, just eyeball it bitch!

2009-06-24T17:34:00.007-05:00

Ok, I get an order for a drug that I've never seen before in retail or in a hospital. In fact, I've never heard of it, and had to look it up. Apparently it's older than my dad's balls. I'm not giving away the name of the med, because it's so fucking rare, that it could give my identity away.

The order was for 5 mg po bid, and all we had in the system was 10 mg capsules, and since the computer let me put it as "0.5 capsules", I just did it. Fuck it.

Of course, I get a call from the nurse an hour later: "Can you send 5 mg capsules up here?" I told her I'm not into torture, so why the hell wouldn't I send the 5 mg if it existed. I told her to just pour the capsule out on something, and just eyeball it, and if it were too complicated, then we could make a suspension/solution in the morning. We won't make it tonight though. She said, "okay." Problem solved? No.

The patient received this first dose, but the dumbfuck nurses failed to give the next dose. When the physician found out about this, she lost it and called the dayshift pharmacist. It turns out that even if I attempted make a compound out of it the previous evening, the administrators here have blocked us from using this product in a compound in the order entry system. What a load of shit! They do it to be safe is their reasoning. That's my fucking job! Not someone who hasn't practiced in about ten years.

Why can't the nurses just get this simple solution? Take the cap off the capsule, and pour onto a piece of paper. There should be a dome shaped stack of powder. Take half of it, and put it up your ass. The other half goes in the patient's mouth, orange juice, soda, or water. How fucking simple is that? It's not like it's going to be much less accurate than me making a suspension.

Drug rep, leave me the hell alone, and go suck off a physician...

2009-06-22T19:53:00.004-05:00

A drug rep came to talk to our buyer, and while he was waiting for him, a couple of pharmacists and I were listening to his bullshit (Yes, it was a dude. Actually most of them are around here. We don't have a lot of female physicians, but I guess the male ones could be gay?). He was trying to tell us that they are looking into extending the infusion time of Doribax to 3 hours, because it kills dependent on time (time-dependent).

I don't know if anybody know a lot about this drug, but it seems to be just a "Me-Two" version of Merrem, Invanz, and Primaxin to me. I've been shown some stuff that supports that it has better activity against Pseudomonas. I'm pretty sure that's why most of what we dispense is sent to the ICU's. With those facts, I can come up with a conclusion that many of these ICU patients who are on Doribax (especially the ones that have it bad) are on a ventilator (with propofol, midazolam, or fentanyl drips going) or is on some presser drips (norepi or phenylephrine, etc...). This is a relatively new drug with probably no iv compatability data. Who the fuck wants to give this drug over 3 hours, when we don't know what can run in the iv line with it? Why don't you go mumble this to a physician while his pecker is in your mouth, or better yet, go tell this to our ICU nurses. I'm sure they'll appreciate what your company is "looking into."

Go tell your company to look into finding a new class of antibiotics, and leave me the fuck alone.

Prozac hurts like a bitch sometimes...

2009-06-22T19:42:00.003-05:00

Depending on the generic brand of fluoxetine my local Walgreens decides to give me, I can have the nastiest fucking reflux in the world, even while on Nexium. If I belch, then it is all over; my throat feels like it's on fucking fire! It's like serious Actonel/Fosamax level shit.

Just in case any of you pharmacists read my blog, recommend to your patients to take it before a meal, and with a full glass of water. It takes a whole glass to dilute it down enough.

Just FYI.

Barney Fife strikes again...

2009-06-16T21:37:00.003-05:00

Our security (who is outsourced from an outside security company, like most other hospitals) are the dopiest sons of bitches you will ever see. Here are some instances that just piss me off:

They flex their "pseudo-nuts" [another pharmacy blog came up with that one] at the main entrance making everybody get out of the way, as if there was going to be a fire truck coming any second. My wife stopped for about 10 seconds before I got to her, when my car was busted, and a fucking Barney Fife is knocking on my wife's window, telling her to keep it movin'. The dude was probably just out of fucking high school, I should have kicked him in his vagina.

They keep a gun inside a locked box that they take with them to any potential "scene" that may occur. You'll see a fucking lard ass walking up the stairs with a lock-lidded lunch box and a skinny fucker behind him carrying the box of bullets. I AM NOT JOKING! They probably only bring it out 3-4 times a year, but it's worth it to see. The only thing they normally carry that could cause damage is a 6 inch flashlight. It's like a fucking E.T remake!

One night, as I came to work, the transport helicopter made a stop at the hospital, and there were 5 fucknut security guards standing around it. If they were outside, guarding the chopper, then who was in the fucking hospital? I seriously doubt the hospital would cough up the money for any more security guys to be there at 9 pm, so I KNOW for a fact that there weren't any in the hospital. Also, the pilot was still in the chopper, so someone would have to take the helicopter with force, and I doubt five guys armed with fucking flashlights and walkie-talkies could stop an armed robber.

The last instance, which actually happened before all the others was what really made it personal for me. It had rained on a weekend dayshift (I think a Sunday), and some lady drove her car through the exit side of the one-way drop-off street at the main entrance. In order to make sure it didn't happen again, the only unit (fucknut in a truck) was sent near the entrance. Why the entrance? I have no fucking idea, but it was the perfect spot for him to be, so the thugs in the neighborhood could do a smash-and-grab on my car stereo, without being spotted. I found my car window busted out, and the seats were all soaked. The assholes couldn't even figure out how to get the system out of my car! (That's what you get with a low literacy rate-- dumbass criminals). Anyway- I'm pissed, and the fucknut tells me everything that had gone down that day. Security didn't have their cameras pointed at my car, probably because they had to spot evil grannies going "in through the out door" [Zeppelin reference]. I bet she was the granny of the thugs that vandalized my car.

The whole point is that the security at the hospital where I work have the tactical IQ of a fucking doorknob.

1439 Minutes in a day...

2009-06-12T19:00:00.003-05:00

Yes, I have discovered that there actually 1439 minutes in a day, instead of the 1440 that we had always thought. Here's how I discovered it:

Hospitals use military time. There is no P.M. or A.M, just whatever hundred. Midnight represents the time 0000 ("O-hundred"), except for nurses. They aren't allowed to acknowledge the time 0000; they must use 0001. If you write "0000" out or say it to them, they say "huh?" It's like quantum physics to them, and it goes over their fucking head.

So, if you are a nurse, the time goes from 2359 to 0001, without hitting 0000. This creates a missing minute.

"ain't this place a geographical oddity...two weeks from everywhere"
If you don't recognize that comment, you suck.

New mood...

2009-06-11T16:41:00.003-05:00

As I have pretty much adjusted to my new shift (except sleep), you will notice a more cheerful mood (less F-words).

You're welcome.

There is no such thing as an upgrade...

2009-06-11T16:27:00.004-05:00

Unless you are talking about cosmetic surgery.

However, when referring to software, there is no such thing as a true upgrade, because for everything that is better, there are things taken away that we take for granted. Retail pharmacists probably have no idea what I'm talking about, since they get upgrades a lot less frequently than hospitals do. Retail pharmacies have one main piece of software that runs everything. Hospitals (or at least my hospital) has at least 3 that I can name, and there is software (one or more programs) that has to tie it all together. All in all, there is a software update about every 6-8 weeks. Other employees in all departments refer to an upgrade as a "downgrade," since it usually stresses the system a little more than usual. This is because they don't upgrade the hardware as much as they should, but we got to save money while we pay hundreds of thousands of dollars a year to "rent" the software.

True story about a nursing student...

2009-06-04T20:27:00.003-05:00

This may or may not have happened in a hospital that I may or may not have worked at.

A nursing student in a bachelor's program nursing school was on clinicals/preceptorship at a hospital. It was just after 1100, and one of her patients coded. The preceptor/instructor was doing chest compressions on the patient, and the nursing student asked the preceptor if it was alright if she went ahead to lunch. No Fucking Lie!!

Are coffee drinkers supposed to be green?

2009-06-03T16:48:00.003-05:00

If you've ever been to a very popular coffee shop (Starbuck's, for example), you've seen that they are big on being "Green." Their cups are made with X% of used products, which means cutting down less trees. It just seems like they want to attract the most number of left-wing customers as possible, and it doesn't end with being green. All of their non-coffee products are "all-natural" or "organic", with no preservatives. I love their coffee, but I hate to go in there.

Now, let me get on my tiny soapbox, because this is just a filler post BTW.

You may not know this, but the trees aren't' going anywhere. If no one will cut them down to make disposable coffee cups, then who will cut them down? There aren't any houses being built right now. Trees grow faster in Alabama than the national deficit does. It's not like the trees in the rain forests or national parks are being used to make coffee cups.

I admit it; I am a pussy coffee drinker. I drink lattes, and I cannot drink black coffee. When I stand in line and hear a tough looking guy with a lisp say "Grande soy caramel latte," I am like "what the fuck?" I would say what I think, but Hillary Duff said not to. I like pussy, and like it in my coffee.

Last point is that I want preservatives in my food. I want to outlive the cockroaches when the nuclear holocaust comes.

GLOBAL WARMING IS A FUCKING MYTH! The only reason why you might detect increased temperatures is that the fat asses of America are generating more body heat, by getting even fatter.

Is this post schizophrenic enough for you?

Hospital pharmacies now have an extra value meal!

2009-06-02T20:22:00.003-05:00

I got paged last night, by a nurse ( I assume) complaining about the timeliness of getting her heparin on the neonatal intensive care unit.

First of all, I didn't even see the order when I put it in. This is wrong, I admit. You wanted it; I didn't want to hear your bitching, so I printed a label without an order. You're fucking lucky you even got a bag, without an order. The IV room was slow about making it, but that doesn't gives you fucking right to rush anyone.

Listen up, fuckhead! I don't know if you've heard, but heparin is dangerous, especially when making special dilutions for babies. I know your ultimate goal is to be able to make it on your own, but many babies have died from neonatal nurses fucking shit up.

This fry cook passed it on to someone who got paid enough to give a fuck.

New Shift...

2009-06-01T22:45:00.004-05:00

I have paid my dues, and I am off of nightshift. (I did it for the Benjamins!)
What are all of these fucking cars doing here?
Where did all of the parking spaces go?
What the Fuck!

My hospital is undergoing multiple construction projects, so they have decided to infringe upon my parking rights. Fuck them! I will get here the same time I always have (before I started nightshift), and if it takes extra time to find a parking spot, then they can bill the fuckers that took my parking spots for my time.

Now, don't think I have this sense of entitlement. Pharmacists are actually lower or equal on the totem pole compared to nurses when it comes to parking at hospitals. The nurses that work in outpatient towers (the hospital's rental space for overpaid physicians) get to park in decks, often for free. While all the other nurses, other staff, and pharmacists have to work for 15-20 years before they get the privilege of paying to use the deck. Only the nightshift staff are even allowed to use the deck outside of VIP employees. Parking is a major downside to hospital pharmacy, especially in larger cities. It takes 15 minutes to find a parking space, 10 mintues to get to the hospital, then another 10 to get to the pharmacy/office. Put it on my fucking tab!

And now for something different...

2009-05-25T02:23:00.004-05:00

I had this idea the other day, and since I don't feel like talking about pharmacy-related issues, I'm going to start this new thing. I'm going to reinterpret the Bill of rights and all of the amendments in the Constitution of the United States.

Bill of Rights

I. I have the right to say whatever the fuck I want to, when I want to. You do too, but when your rights infringe upon mine, then fuck off. If prayer to a different or any God offends you, then GFY.

II. I have the right to carry as many assault rifles as I wish. Just trust me when I say they are for hunting purposes only. The government has no right to track which ones I have or the ammunition I carry.

III. I have the right to not give quarter. I also have the right to say my taxes will not help pay for a war I do not support.

IV. Search and seizure of my property is unlawful without a warrant or probable cause. Probable cause pretty much means that you found my semen somewhere.

V. If testifying against or for another criminalizes me, then I don't have to answer your fucking questions. "Yes, I did see him. No, I cannot tell you why I was there." Killing someone twice doesn't get me in any more trouble than the first time. The government cannot take my property without just compensation. Just compensation equals three times the tax appraisal value.

VI. We all have the right to a trial with a jury and legal counsel for any crimes we may commit. If we can't afford our own lawyer, then the government will appoint a shitty underpaid one for you. We all also have the right to no what crime we are charged with. There is no such thing as a speedy trial anymore. That went out the fucking window when lawyers could buy cars with money the received from one trial alone. The trial process must be long to make them earn that money.

VII. We have a right to a jury in civil cases. Simple.

VIII. Excessive bail and fines, and cruel and unusual punishment are forbidden. People who believe they will go to heaven by killing someone like me, however, should be punished cruelly on foreign soil.

IX. Anything not mentioned in this is for the PEOPLE to decide if it is right or wrong.

X. Powers not mentioned in the seven articles will be given to the STATE, unless it is unlawful. Then those powers will be given to the PEOPLE. This includes income tax, which is fucking bullshit.

POWER

2009-05-24T01:33:00.004-05:00

Yes, I'm going to comment on Walgreen's POWER. As a former Walgreen's pharmacist, I will have to side with Walgreen's on this one. I think it is great! Pharmacists who are against it are either scared it will hurt their own business or just scared of change. It can only have a positive impact on pharmacy. Put all of the numb-nuts pharmacists that can't speak English or have no fucking personality whatsoever in a warehouse checking pills and scanned images, and let the pharmacists who actually want to be involved in patient care in the community. Win-Win! Fuck this assembly line shit!

Love the job...

2009-05-24T01:11:00.005-05:00

Yes, I love my job. I love what I do. How often do you hear this coming from someone's mouth? Especially a pharmacist's mouth? Usually people who are truly happy about what they do are doing something fulfilling, like charitable stuff, or they are making an obscene amount of money for performing their hobby.

This is definitely no hobby, and it's hard to see any good that comes from my work. I could be happier being a musician or building things, but there's no money in it unless you get lucky or are awesome. I am definitely happy. The point is that I am "disenchanted" from the same stupid shit everyday in the hospital that nobody ever tries to improve.

Retail pharmacy is going to hell in a hand basket. It is failing, and that is why I left it almost exactly three years ago. Hospital pharmacy is doing well, and it will one day become a model for retail to have to imitate in order to survive. It makes me feel pretty good that I'm already here, while retail pharmacists are flocking to get on board.

I wish I were a CRNA...

2009-05-22T23:33:00.007-05:00

Here is a day in the life of a CRNA (certified registered nurse anesthetist):

You come to the office/hospital at 6 AM and goof off in the break room. Your first case doesn't start until about 7, so you go to the pyxis (or whatever machine you use) to obtain all of your meds you will for your case. You also make sure you have the proper med trays for whatever type of case you have. It's pretty easy so far. Next your case begins. I am not entirely sure of what they do in the room, but I'm pretty sure 7 years of school covers that. They are in charge of gases and meds during the case, and they must document everything they do on a graphic sheet. They then have to return what they don't use, and document the wastage of all controlled substances. Then they wait in the break room for another hour or so until the next case. They usually have between 2-4 cases like this a day, and they are under the supervision of the anesthesiologist. They get to go home usually about 2-3 pm.

Now, the wastage and returning of narcotics is very important, and must be compared to the graphic that they use during the case. Joint Commission (or JCAHO-[pronounced "jay-ko"]) says that this auditing must be done, and all hospitals perform this. Where I work, the pharmacist has to do it, and there are problems on about 75% of all cases that are audited. What happens is the CRNA tells the pyxis that the have returned an item, but returned a different one, or they forgot to document a dose they gave on the graphic. Sometimes, they forget to return drugs, and take them home (to bring them back the next day, of course). They are pretty much making careless mistakes on a consistent basis. I'm guessing that they aren't as careless when administering meds in the operating room, or we would be having deaths (we're not obviously). In other words, they take their thinking cap off when they leave the operating room, and become complete dumb asses until they return.

If I made these numerous errors with controlled substances, I would have to piss in a cup on a daily basis. They do not have to, and they get paid about $20 an hour more than me. What the fuck!?!? You're telling me that I could go to school for 4 years, work in the ICU for one, then go to school 3 more to make +$70 an hour so I can lose more fucking accountability?

This is evidence of a theory I have about nurses and education: Past the point of being an RN, for every year a nurse spends in school, about 20% of their common sense goes out the fucking window. The only evidence that can be used to disprove this is certain outlying nurse practitioners that are awesome. I've noticed that these nurse practitioners that are very good at what they do are in collaboration with specialists, like pulmonologists and cardiologists, and I've not seen a decent one outside of that. I think that these outstanding CRNP's (certified registered nurse practitioners) should be making more that what they make, which is even lower than what I make, and they go to school longer than pharmacists and CRNA's.

Oh how I wish I were a CRNA...

Syringes for all...

2009-05-21T23:23:00.008-05:00

I am familiar with syringe registries that we have in local pharmacies in Alabama, but I have always been confused about why we have them. When I was an intern at Walgreen's, the pharmacist always made me ask why someone needed syringes, and have them sign the registry. On this registry, I was required to get their name, address, and date of birth from their license and the reason for use of syringes, along with the signature.

I can't remember any federal law or any law specific to my state that says it is necessary, and I can't find anything about it now either. I found that there are states where a pharmacists are required to do something similar I have done in the past, and there are actually states where a prescription is required to obtain syringes. The question I am left here is: Why do syringes even need to be behind the counter, if there is no actual legislation that mandates it in Alabama?

There are two schools of thought when it comes to the sale of syringes. Some say it should be limited to keep intravenous drug users (IDU's) from obtaining them, and others, including myself, say that it needs to be unrestricted to prevent the spread of disease. The first group is pretty much in the wrong here, most likely because they have never met a real addict before. We all know addicts get crazy, but the average person addicted to prescription medications is pretty damn sane compared to IUD's. These crazy people wanting early refills won't suck a dick to get by; they just get by. IUD's will literally kill for another hit. They will either find syringes in a garbage can or steal them from a pharmacy or physician's office.

We really need syringe exchange programs (SEP's) everywhere, but there are currently only 28 states that even have them. These programs will not only help prevent the spread of disease, but it will also aid in the proper disposal of used syringes. If you have any information to offer me, please post a comment below.

When a doctorate just isn't good enough...

2009-05-21T02:35:00.012-05:00

Which is really never.

I remember going through pharmacy school, and all of the instructors there said that one day, a residency will be required for practice in pharmacy. BULLSHIT!!!

I can understand that there are several new pharmacists that are green as grass when it comes to practice, and they probably need further education to gain confidence and/or experience. I felt a little overwhelmed when I got into hospital/clinical work, but within about six months, I was superdick. I mouthed off at anyone who pissed me off, because I was the shit.

My point is that some pharmacists need a step stool to become successful at their job, some don't, and some need a fucking elevator. Residencies are a very vital part of the education process in pharmacy, but not everybody needs one. Offering positions only to participants who have completed a residency is asinine. It should never be a requirement. My talents/abilities/skills as a pharmacist far surpass many pharmacists with residencies (probably not most), and there are several others like me that fit the same description. So how do you compare pharmacists for employment?

Board Certification (Pharmacotherapy) is something that can be used for this. If you pass the test, it shows that you know your stuff. The only problem with it is that it is run by people with the same douche mentality that many pharmacy school instructors have. You can take the test in October after your residency or you can take it the October after you have 3 years experience under your belt. I'm sorry, but if anyone can pass the fucking test the October after they graduate, they should gain Board Certification, bottom line.

Here is the source of the problem. These assholes did a residency, so from now on, everybody else has to. They think they should go through schooling/education as long as physicians, because they wished they would have went to medical school before they got fat and old. I could have went to medical school (that's fucking cliche' as hell), but the fact is that I DIDN'T WANT TO. I am making more money per hour than several physicians out there. Why the hell would I want to go to school for +8 years and 4 years of residency/internship, so I can work +80 hours a week with ulcers the rest of my life? Fuck that shit. I want to enjoy my life. I refuse to be defined by my job. I am an asshole who happens to be a pharmacist. My only regret is that I didn't look into becoming a CRNA (more on that later...).

I am just a pez dispenser?

2009-05-19T22:30:00.010-05:00

Yeah, you know what I'm talking about. The public views us either as a means or a barrier to medication, nothing more. Oh sure, there are pockets of people that appreciate what we do, but get serious. I am a licensed drug dealer to the majority. You would think that were only the case for either the uneducated or some physicians. Even nurses have this same mentality when dealing with hospital pharmacists. Example:

"The medication for my patient in room XXX is missing, can you send it to me?" I say sure. Then she responds, "tube it to #XX."

First of all, when she tells me to "tube" it to a specific nursing station, she is assuming that I actually take the pill and physically put it in the tube to send to her. However, I am not a central pharmacist, and therefore am further away from the pharmacy than she is. I don't touch the medication; I don't even see the medication. I just type a couple of letters on the keyboard, and forget about it. It is automated; it is out of my hands at this point. The computer knows where it's going, and no specific instructions are required. This nurse thinks I have this magical workspace where I can put together several meds for 500 patients in the blink of an eye, all by myself, and that's just absurd. In reality there is a dozen people down there in the pharmacy tripping over each other getting it together, so call them and tell them where to send it.

It works the same damn way in retail as it does in the hospital. Customers think you are just a machine that spits out pills, but when they have a problem they come to you for free advice. Nurses think I am responsible for just sending up their patient's meds, but if they need any drug information, they won't hesitate to page me. I'll gladly help them, even though they're too fucking lazy to pick up one of the books the hospital bought for their unit and find the answer on page 1. It makes me feel needed when I help people who won't help themselves.

When Niacin just isn't Niacin anymore...

2009-05-19T05:23:00.012-05:00

I remember in pharmacy school, our OTC medication class instructor told us that we needed to try Niacin to experience what our patients feel when they take it. I forgot what strength it was (either 25 mg or 50 mg), but a friend brought a bottle to class the next day. My face, neck, shoulders, and upper arms were blood-red in less than 15 minutes after taking one tablet. It felt halfway between a sunburn and a bad acid trip. I thought to myself, "Why in the hell would anyone take this pill a second time?" Five years later, my cholesterol comes back "not so good" at a health fair. My HDL is way too low, and everything else is borderline high. Ironically, it's time to take Niacin. Shit!

I go to Sam's looking for a shitload of it for peanuts, and there are two kinds: Flush-Free and Time-Release. Okay now, I remember that Time-Release is somewhat risky, and there was some reason why Flush-Free wasn't great also. Being a dumbass, I get the Flush-Free kind, and come to realize that FLUSH-FREE DOESN'T WORK!!! It doesn't do shit, and it is a trap. I was so worried about flushing that I forgot that just because it says Niacin, doesn't mean that it's Niacin (Actually it is, but it cannot reach appropriate levels in the blood to help with dyslipidemia). I don't want to waste it, so I take titrate them up to 2 grams/day to see if I could flush. Didn't happen, so then I start taking Enduracin (kind of an off-brand of SloNiacin). I don't flush with it either. All I do is assume that it is reaching a therapeutic level, and go on my merry way. What the hell happened to those immediate release Niacin products? They're not in pharmacies, grocery stores, or Wally world. I could get them online, but fuck that. I'm just rambling on at this point, so I'll go ahead and start my point:

I can understand the bastards at Sam's, Wally World, and grocery stores carrying shit that is a proven gimmick. I wouldn't put it past them, but why the hell are chains and independent pharmacies with so much backing by pharmacists selling this Flush-Free shit? I'm not talking about staff pharmacists that just work in the pharmacy; I'm talking about pharmacists that own or are actually in charge of what goes on the shelf.

I guess that if a pharmacy will just give away antibiotics for free, they gotta have some kind of reimbursement by selling shit in a bottle.

What's the deal with this regiospecific bullshit?

2009-05-10T23:33:00.003-05:00

I'm not going to beat a dead horse about drug manufacturers virtually extending their patents by creating newer regiospecific versions of their racemic predecessors.

Prilosec to Nexium
Claritin to Clarinex
Effexor to Pristiq
Celexa to Lexapro
Zyrtec to Xyzal
Prevacid to Kapidex
Proventil to Xopenex

Did I miss any? Probably a lot, since there's so much bullshit out their. I'm actually shocked not to see a version of warfarin out there.

I haved bitched about this for a while, but I have realized that bitching does nothing.

My complaint now is: Where did they come up with the dosing of the newer versions?

Prilosec comes in 10, 20, and 40 mg, but Nexium comes in 20 and 40 mg. Nexium 20 is equivalent to 40 mg of Prilosec, but 40 mg of Nexium is equivalent to 80 mg of Prilosec. There is not 80 mg dose available for Prilosec. Prevacid/Kapidex has done the same thing.

I haven't read any of the literature out there that compares Kapidex and Nexium to other PPI's, but I am willing to bet they compared the higher doses of these agents to the "normal" doses of the others (Aciphex and Protonix).

Why can't they just release higher dose versions of their initial novel compounds? Because they are just a bunch of greedy mother fuckers!

Incompetence is Encouraged...

2009-05-09T01:31:00.004-05:00

Why do the most incompetent people get the best advantages? I am not the most productive person at where I work, but I am up there (probably in the 90%). There are certain individuals that cannot do their work, so they complain about it. They scream the loudest because they always have the feeling like they're getting their asses reamed, but they have the easiest damn job in the hospital. Of course, management has appeased them by taking certain responsibilites from them, and giving them to the other pharmacists working in the afternoon. That puts more work on me, since it usually makes all of the afternoon staff behind on their work. I know if I jacked-off on the job like these lazy asses do all of the time, I would get my ass chewed out. I would have no leverage.

I guess the moral of this story is to never show your true potential unless you want others to expect that level of work all of the time.

I'm still waiting for the search engines to crawl my website, but I'm being patient.

How am I supposed to give it rectally?

2009-05-08T00:41:00.005-05:00

I got a call last night from a dumbshit nurse asking if lactulose came in a suppository. Of course, the answer is no, and I said that she would have to use the solution that I sent her. Then she proceeded to ask how could she possibly give it rectally.

I said with her mouth and a straw. Don't backwash.

You call that a job?

2009-05-07T02:27:00.003-05:00

I'd prefer the word occupation, because job really sounds like work doesn't it?

When friends or family who are completely ignorant to pharmacy ask what I do, they are generally confused about every response I have for them. I tell them that I work as a pharmacist in a hospital. They say "you fill prescriptions for people leaving the hospital?" "No I handle the medication before it goes to the patients while they are in the hospital." The reason for this confusion, of course, is because we are hiding in our caves of the lower intestines of the building. Patients and visitors don't see us. We are invisible, and the medications just get to the patients by simple diffusion!

This post is to kind of describe what it is to be a hospital pharmacist to all who ignorant of our ways. I hope that it will be helpful to at least one soul out there.

There is no such thing as a prescription in a hospital. There are no refills, and there are no days supply. There is only drug, dose, route, and frequency. That is all. Everything that a patient does, sees, eats, drinks, and possibly thinks is mandated by physician's orders only. The pharmacist has to look at every order, and make a Medication Administration Record (or MAR for short) for the nurses, physicians, and everyone else involved to look at while they care for the patient. Every medication that the physician has ordered for the patient to take is on the MAR, along with the scheduled times that patient is to take them. The nurse is required to document on the MAR when the medications were given for a record.
While I am building the MAR, my computer is also telling another computer to dispense medications for each patient I am working on. Most of the medication is filled by a large machine with a conveyor belt, but some of it has to be picked off the shelf manually by technicians. A pharmacist (usually a different one) will verify that those medications are correct before sending them to the patient. That is the basics of it all.
Our additional responsibilities include verifying doses, interactions, IV compatabilities, and allergies (pretty much making sure the physician doesn't kill the patient before their condition does). Pretty simple right?

I decided to make this my first official post, because future posts may be hard to understand without knowing these basics. Stay tuned for more...

Introduction...

2009-05-07T02:07:00.005-05:00

While I am working the graveyard shift at the local hospital, I have found myself left with extra time to read some of the other (more original) blogs about pissed off pharmacists out there (TAP, TAestP, etc...). While I, myself, have serious unresolved anger issues, I realize that I have no real reason to bitch about anything and everything anymore. So why am I starting another one of "those" blogs? Like I said, I have extra time, and I am bored as hell.

I have worked retail. I know how hard it is. I don't want any piece of it. In fact I won't do it for less than eighty dollars-an-hour. I am glad about just getting ten dollars extra an hour for overtime. The work is great (ninety percent of the time, all the time). I sit in a chair (that's right! SIT!), and type in orders the whole shift. I eat whenever the hell I want to, and I shit whenever the hell I want to. The only people who tell me what to do are other pharmacists with more experience than me. It sounds like the perfect world right? Almost...

While it may sound very uninteresting to listen to a blessed man bitch, I promise you a few amusing stories from time to time.