Stupid lazy dispensers

[Tesh]

Worked in a store recently and was checking stuff for a nursing home. I was presented with a px for erythromycin on its own for a 90 or so year old resident. Because I'm a paranoid bugger I like to see the PMR when checking drugs that trigger alarm bells. As I'd expected the patient was on a statin so I asked the dispenser to write "***DO NOT TAKE ATORVASTATIN for 7 days whilst on this medication***"

She was like aww we can't do that because it doesn't say in on the script and then proceeded to ring the home. She then told me that the home said the doctors have already told the patient to stop the atorvastatin and the doctors usually do all that. I said I still want it on the label because we have to do our bit as pharmacy. She then said I could do it myself. I then said you'll still have to print the MAR out won't you.

The store uses a web based PMR which shows interactions in red on the dispensing screen. I told her that she should bring interactions like that to the attention of the pharmacist or even print them out. She then told me she's got 400 patients to do so she doesn't look at that part of the screen and that pharmacists get payed 'mega bucks' so its our job!!

I then told her that we do the checking and fair enough if I'd dispensed it but you're the one who's using the PMR so you have a DUTY to query any interactions with the Pharmacist! Couldn't believe the cheek. So defensive! All coz I asked to put some extra info on the damn label.

Is it just me or do all you locums check PMR's as much as me? I did spot checks the rest of the day and found a few other more instances of macrolide-statin interactions and then the final one with erythromycin/carbamazepine interaction. None of the dispensers drew the interactions to my attention even though it shows the damn interaction in a red box!

Is it just me or would all you guys like to be brought attention to interactions immediately so you don't look like a bloody idiot after a patient has waited for 15 mins already to tell them you have to make a call and they might have to come back if the doctor is in surgery?

Rant over....sorry if I over reacted!

[Pharmanaut]

Its a problem with our current workflow and the computer system being a bottleneck.
Everything has to go through the system.
Hopefully our system suppliers will look at this and give us a checking screen so the dispensers can get on with their bit without calling us over all the time.

Hello - Are you listening Proscript, Cegedime and Pharmasys?

[Dodger]

Is it just me or do all you locums check PMR's as much as me?

I do it all the time, don’t care what others think, value my good night’s sleep...

[Koul Kougar]

Please don't think all dispensers are like that. It's part of our job to make you aware of any significant interactions by either telling you or printing them out.

400 patients? We had nearly 600 patients in our MDS system from various nursing homes and because we had so many and it was always a rush to dispense and check and then get it out to the home in time, it was so important to discover any posible queries early on in the labeling and priming stage. ESPECIALLY if we had a locum checking a home, because they always check the PMR's

[LeftArm]

In proscript the warnings have an option to print them on a label as they pop up. When I'm labelling (which is not often these days) I always print the ones that are not repeats of previous PMR so that the pharmacist can check. After all they are the responsible one.

....sorry if I over reacted!

Not at all. regardless of the clinical implications this is insubordination. Stagging or Queen Bee syndrome.

[Pharmanaut]

The workflow and computer access needs changing so that the pharmacist can look at the history, potential interactions etc up front.
But flexibility is needed so that scripts can be done while the pharmacist is on other tasks, so that it can be done at any stage including before final bagging.
We need this soon before we all ** disappear under the mountain of baskets or blow a fuse due to stress.
** By "all" : the whole pharmacy/dispensing team.

In the meantime leep safe, work safe and don't get too stressed.
(Or Keep Calm And Carry On)

[LeftArm]

The workflow and computer access needs changing so that the pharmacist can look at the history, potential interactions etc up front.

I don't know of any pharmacy where this is the case.

In the meantime leep safe, work safe and don't get too stressed.
(Or Keep Calm And Carry On)

Tins of Altoids Curiosly Strong Mints have a piece of white paper inside with the words "WAVE THIS I CASE OF SURRENDER".
May come in handy if it gets too much

[tinx25388]

I was trained that it is our duty to flag to the Pharmacist any interactions on new drugs or new patients.
There are some interactions (eg Levothyroxine & Calcium, or Macrolides & Statins) where we take appropriate action before it goes to the Pharmacist (eg put on label "to be taken two hours apart from calcium/levothyroxine", or "stop taking ...statin whilst on this course") but even so, it still has to be brought to the Pharmacists attention.

Dispenser in this case has a serious attitude problem!!

[Web Ferret]

Its a problem with our current workflow and the computer system being a bottleneck.
Everything has to go through the system.
Hopefully our system suppliers will look at this and give us a checking screen so the dispensers can get on with their bit without calling us over all the time.

Hello - Are you listening Proscript, Cegedime and Pharmasys?

4 years ago I asked Cegedim about a server and six terminals so that there were plenty in 700+ a day pharmacy. In the end I had three and they were not enough. When EPS2 comes and there are no scripts. more terminals will be needed to dispense, check and hand out unless you want to print those 300 scripts out each day ( you do have enough paper, toners and spare printers don't you?)

A big doctors surgery will have 20 terminals. Pharmacy IT is completely missing the point. Can you imagine your local bank or supermarket with 2 PCs. Even out local taxi firm has a better integrated IT system than a pharmacy.

[johnep]

2 PCs. What luxury. I often found myself completely unable to get to the PC because constantly commandeered by a dispenser getting labels done on PCS. Cannot stop for a moment to check PMR because the order was due to go shortly!
johnep