What should I do with this site?
Jan. 26th, 2011 | 08:11 am
So I'm not really sure what to do with this site. I'm not an intern anymore. I'm not as angry/annoyed as I use to be. Maybe its because I'm the boss now. Maybe its because I don't work retail anymore (those RPHs have the patience of saints). I can't be the angry pharmacist - because well he's just to good at it.
So throw me some suggestions - assuming anyone still actually reads this site. Who knows if I'll even check it.
New email address [email protected]
So throw me some suggestions - assuming anyone still actually reads this site. Who knows if I'll even check it.
New email address [email protected]
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I hope you burn in hell
Oct. 7th, 2009 | 10:34 am
mood: 
pissed off
This was a reply to one of my post
"pharmacists are wannabe docs
why does it take 4 years to be a pill counter anyway? Come to medical school and we will show you what hard work is. Gimme a few weeks and I can teach a child to be a pharmacist...count to 30 and put in the shiny bottle."
Your ignorance is very present in the minimal 3 sentences that you have provided. Let us begin with "count to 30 and put it in the shiny bottle". This is what you visually are capable of seeing us do if you walk into a retail pharmacy. A good majority of the time, a pharmacist isn't even the individual counting out pills anyways, this is the technician. What pharmacist do is something you can't visually see. Let us look at few examples of why it takes 4 years to be a pharmacist.
1) To protect patients from retarded doctors
Doctor prescribes a medication to the patient, despite the patient telling the doctor numerous times of his or her allergies or previous adverse reations. Without us you potentially caused an adverse outcome in a patient. We sort of help you with that "do no harm" part of medical practice. We also sort of help you not get a malpractice lawsuit. Or do you still want me to have the technician count it out, and me say "oh it looks fine" without questioning it because the great doctor said to dispense it.
Doctor prescribes a medication incorrectly - wrong dose, wrong purpose, wrong everything. I have seen physicians "accidentally" (or so they claim) write strengths for children that would land me in jail if I even remotely thought about filling it. I even had a doctor write for warfarin for a child.
2) To provide alternative treatment options
Doctor has exhausted his drug knowledge of what can be used as treatment in a particular disease state, they come to us for advice. Yes, the good doctors know when to seek advice from their pharmacist.
3) Drug regimen review
Pharmacist look for drug drug interactions. Why do we do this? Doctors like yourself, who think they are gods gift to medicine, never consult with each other. Doctor A with specialty X will prescribe something that will interact with the drug prescribe by Doctor B of specialty Z. A good majority of the time "god complex" doctors never talk to each other, think their way is the best way, and end up fucking over the patient. Who is there to protect the patient? - The pharmacist who catches it and saves your sorry ass.
Theres also the case where physicians will prescribe medications that will never get to the site of the particular disease. Sure the drug kills the bacteria in a test tube, but not certain areas of the body. Without us there to tell you "hey its not going to work" and you actually listening to us, the therapy isn't going to be all that effective.
4) Therapeutic level monitoring
Doctor will prescribe Vacno, Gent, Tobra, Phenytoin etc etc etc and expect it to be all fine and dandy. I have never seen a physician follow therapeutic levels like a pharmacist. We make sure that the drug you want to give is at the optimum level to provide effectiveness to the patient.
5) Disease State Monitoring
Look at two of the nations largest health care organizations. Kaiser and Veterans Administration. They have diabetes, cholesterol, anemia, primary care, and anticoagulation clinics ALL RUN BY PHARMACISTS. Hurray your greatness has determined that the patient has diabetes, YAY for you. Now let us use our expertise to get them to their individual goals. Lets see you teach a child to sort through horribly written, detail lacking physician notes, access lab values, and make a clinical judgement.
Ohh soo many times have I seen doctors adjust insulin incorrectly. Blood sugars will be high in the afternoon, so they adjust the afternoon dose of insulin. Then there was the doctor who prescribed an oral hypoglycemic to a Type 1 diabetic. Lets see how effective that will be for the patient
So back to the original question you had of "why does it take 4 years to be a pharmacist?" Well lets see, we have to learn about all the drugs you oh so great doctors (if you can't sense the sarcasm - IM BEING BLOODY SARCASTIC HERE) prescribe, the disease states associated with them, how to monitor their effectiveness, how to identify problems in drug therapy, so we can protect patients from everything you potentially fuck up. Add on top of that we have to learn to diagnosis to an extent as well. Private physician offices close earlier than pharmacies, so sick people tend to come to us and ask us for advice (when to use OTC drugs vs seeing a Physician). Oh they tend to come to us because we're also more respected by society as well. (See Gallops Honesty and Ethics Poll).
Teach what I have described to a child and get back to me.
"pharmacists are wannabe docs
why does it take 4 years to be a pill counter anyway? Come to medical school and we will show you what hard work is. Gimme a few weeks and I can teach a child to be a pharmacist...count to 30 and put in the shiny bottle."
Your ignorance is very present in the minimal 3 sentences that you have provided. Let us begin with "count to 30 and put it in the shiny bottle". This is what you visually are capable of seeing us do if you walk into a retail pharmacy. A good majority of the time, a pharmacist isn't even the individual counting out pills anyways, this is the technician. What pharmacist do is something you can't visually see. Let us look at few examples of why it takes 4 years to be a pharmacist.
1) To protect patients from retarded doctors
Doctor prescribes a medication to the patient, despite the patient telling the doctor numerous times of his or her allergies or previous adverse reations. Without us you potentially caused an adverse outcome in a patient. We sort of help you with that "do no harm" part of medical practice. We also sort of help you not get a malpractice lawsuit. Or do you still want me to have the technician count it out, and me say "oh it looks fine" without questioning it because the great doctor said to dispense it.
Doctor prescribes a medication incorrectly - wrong dose, wrong purpose, wrong everything. I have seen physicians "accidentally" (or so they claim) write strengths for children that would land me in jail if I even remotely thought about filling it. I even had a doctor write for warfarin for a child.
2) To provide alternative treatment options
Doctor has exhausted his drug knowledge of what can be used as treatment in a particular disease state, they come to us for advice. Yes, the good doctors know when to seek advice from their pharmacist.
3) Drug regimen review
Pharmacist look for drug drug interactions. Why do we do this? Doctors like yourself, who think they are gods gift to medicine, never consult with each other. Doctor A with specialty X will prescribe something that will interact with the drug prescribe by Doctor B of specialty Z. A good majority of the time "god complex" doctors never talk to each other, think their way is the best way, and end up fucking over the patient. Who is there to protect the patient? - The pharmacist who catches it and saves your sorry ass.
Theres also the case where physicians will prescribe medications that will never get to the site of the particular disease. Sure the drug kills the bacteria in a test tube, but not certain areas of the body. Without us there to tell you "hey its not going to work" and you actually listening to us, the therapy isn't going to be all that effective.
4) Therapeutic level monitoring
Doctor will prescribe Vacno, Gent, Tobra, Phenytoin etc etc etc and expect it to be all fine and dandy. I have never seen a physician follow therapeutic levels like a pharmacist. We make sure that the drug you want to give is at the optimum level to provide effectiveness to the patient.
5) Disease State Monitoring
Look at two of the nations largest health care organizations. Kaiser and Veterans Administration. They have diabetes, cholesterol, anemia, primary care, and anticoagulation clinics ALL RUN BY PHARMACISTS. Hurray your greatness has determined that the patient has diabetes, YAY for you. Now let us use our expertise to get them to their individual goals. Lets see you teach a child to sort through horribly written, detail lacking physician notes, access lab values, and make a clinical judgement.
Ohh soo many times have I seen doctors adjust insulin incorrectly. Blood sugars will be high in the afternoon, so they adjust the afternoon dose of insulin. Then there was the doctor who prescribed an oral hypoglycemic to a Type 1 diabetic. Lets see how effective that will be for the patient
So back to the original question you had of "why does it take 4 years to be a pharmacist?" Well lets see, we have to learn about all the drugs you oh so great doctors (if you can't sense the sarcasm - IM BEING BLOODY SARCASTIC HERE) prescribe, the disease states associated with them, how to monitor their effectiveness, how to identify problems in drug therapy, so we can protect patients from everything you potentially fuck up. Add on top of that we have to learn to diagnosis to an extent as well. Private physician offices close earlier than pharmacies, so sick people tend to come to us and ask us for advice (when to use OTC drugs vs seeing a Physician). Oh they tend to come to us because we're also more respected by society as well. (See Gallops Honesty and Ethics Poll).
Teach what I have described to a child and get back to me.
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The Angry Interns Past and Present
Aug. 14th, 2009 | 09:04 am
I thought I'd use one of the replies to create a new entry. I figured it would be easier this way. I was recently asked
Prior to interning/working at the pharmacy have you ever had a job in which you interacted with customers?
Before going to pharmacy school I worked at a bank as a lead teller. In life people want access to their money, even more so than access to their medications. I actually dealt with more shit from people working at the bank than in the pharmacy. Its surprising how many people don't understand the concept of only spending the amount of money that you have in the bank, and when you spend more than you have, the bank is going to charge you. I would get tons of people who could never figure out why they were in the negative and it would drive me nuts.
Conversations would run something like this:
Them: Why can't I cash my check?
Us: You account is XXXX dollars in the negative, you owe the bank, we have to deposit the check, and the rest you can take out tomorrow?
Them: Why am I in the negative?
Us: .....because you spent more money then you had....
Them: .... no I didn't.....
Us: Show them a printed sheet of their transactions with account balances detailing how they got into the negative
Them:..... so why can't I cash my check?
Us: Pounding head against the countertop
Do you like what you do?
I like what I do now, now that I don't work retail. Angry Intern is well now a licensed pharmacist working for a closed door pharmacy servicing hospices, SNFs, LTCs etc. I only talk to nurses and doctors. No more dealing with retail crap. WOOO HOOOO.
It seems as though every time I go to get a prescription filled the pharmacist is in a bad mood.
This is probably because some customer came in before you and put us in a bad mood. Or big retail corporation has implemented a new policy that just pissed off the entire staff, or both. Just like any other job, there are good days and bad days.
What made you want to pursue a career in pharmacy?
Anyone that answers this with "I want to help people" is full of shit in my opinion. Everyjob is essentially helping someone else. Whether it be you helping customer, or helping your boss, you are helping someone no matter what job you do. My honest answer, beside the fact that this career pays pretty well, is that I liked medicine, but didn't want ot be an MD due to how long it takes to actually become an established physician. Also, I'm not really a fan of blood. Pharmacists get to work better hours too. There was also no way you could get me to stick my finger up someones ass for a rectal exam. So in the end thats how I became a pharmacist.
Prior to interning/working at the pharmacy have you ever had a job in which you interacted with customers?
Before going to pharmacy school I worked at a bank as a lead teller. In life people want access to their money, even more so than access to their medications. I actually dealt with more shit from people working at the bank than in the pharmacy. Its surprising how many people don't understand the concept of only spending the amount of money that you have in the bank, and when you spend more than you have, the bank is going to charge you. I would get tons of people who could never figure out why they were in the negative and it would drive me nuts.
Conversations would run something like this:
Them: Why can't I cash my check?
Us: You account is XXXX dollars in the negative, you owe the bank, we have to deposit the check, and the rest you can take out tomorrow?
Them: Why am I in the negative?
Us: .....because you spent more money then you had....
Them: .... no I didn't.....
Us: Show them a printed sheet of their transactions with account balances detailing how they got into the negative
Them:..... so why can't I cash my check?
Us: Pounding head against the countertop
Do you like what you do?
I like what I do now, now that I don't work retail. Angry Intern is well now a licensed pharmacist working for a closed door pharmacy servicing hospices, SNFs, LTCs etc. I only talk to nurses and doctors. No more dealing with retail crap. WOOO HOOOO.
It seems as though every time I go to get a prescription filled the pharmacist is in a bad mood.
This is probably because some customer came in before you and put us in a bad mood. Or big retail corporation has implemented a new policy that just pissed off the entire staff, or both. Just like any other job, there are good days and bad days.
What made you want to pursue a career in pharmacy?
Anyone that answers this with "I want to help people" is full of shit in my opinion. Everyjob is essentially helping someone else. Whether it be you helping customer, or helping your boss, you are helping someone no matter what job you do. My honest answer, beside the fact that this career pays pretty well, is that I liked medicine, but didn't want ot be an MD due to how long it takes to actually become an established physician. Also, I'm not really a fan of blood. Pharmacists get to work better hours too. There was also no way you could get me to stick my finger up someones ass for a rectal exam. So in the end thats how I became a pharmacist.
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Blood Pressure Machine
Jul. 14th, 2009 | 08:57 pm
location: In the bubble of the OC.
mood: 
tired
music: Ratatat - Gettysburg
So today, I am at the drop-off window, typing up a new prescription, when this middle-aged man pops up out of now where, and begins to question me about the blood pressure machine.
Him: How accurate is the blood pressure machine?
Me: I don't know within range it is capable of detecting your blood pressure, but It'll tell you if your in the hypertensive range.
Him: It says here something about lowering my blood pressure. So this machine will lower my blood pressure?
Me: Thinking: WHATTT? You really did not ask that right? - Saying: No - the machine can't lower your blood pressure sir.
Him: No, I think it will, my doctor said this will lower my blood pressure.
Me: Thinking: Wow...just wow - Saying: No sir, I'm fairly sure he meant to say you need to monitor your blood pressure, and need to do things to lower your blood pressure if it is too high.
Him: I'm going to try this out - lets see if it works, I wonder how much it'll drop my blood pressure.
Me: Thinking: How come I never get this moments on camera to prove that weird shit happens to me? - Saying: Ok, give it a try, but I'm pretty sure its not going to do anything but tell you what your blood pressure is.
Him: Its working. Look, the numbers are showing how much my blood pressure is being reduced by.
Me: Walked away to find a place to slam my head into.
Am I the only one that gets subjected to this? Do I some how attract the odd, strange, just not quite there, patients? I just don't get it. I really don't. Sigh
Him: How accurate is the blood pressure machine?
Me: I don't know within range it is capable of detecting your blood pressure, but It'll tell you if your in the hypertensive range.
Him: It says here something about lowering my blood pressure. So this machine will lower my blood pressure?
Me: Thinking: WHATTT? You really did not ask that right? - Saying: No - the machine can't lower your blood pressure sir.
Him: No, I think it will, my doctor said this will lower my blood pressure.
Me: Thinking: Wow...just wow - Saying: No sir, I'm fairly sure he meant to say you need to monitor your blood pressure, and need to do things to lower your blood pressure if it is too high.
Him: I'm going to try this out - lets see if it works, I wonder how much it'll drop my blood pressure.
Me: Thinking: How come I never get this moments on camera to prove that weird shit happens to me? - Saying: Ok, give it a try, but I'm pretty sure its not going to do anything but tell you what your blood pressure is.
Him: Its working. Look, the numbers are showing how much my blood pressure is being reduced by.
Me: Walked away to find a place to slam my head into.
Am I the only one that gets subjected to this? Do I some how attract the odd, strange, just not quite there, patients? I just don't get it. I really don't. Sigh
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Elmo Prank Call
Jun. 28th, 2009 | 06:56 pm
mood: tired
For your entertainment or not.
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1 Year of Experience
Jun. 23rd, 2009 | 06:14 pm
location: Library
mood: annoyed
So recently I started to apply for Inpatient positions. However all of these positions require 1 year of inpatient experience as a licensed pharmacist. This is getting to be a bit frustrating. How am I supposed to get my 1 year of inpatient experience as a licensed pharmacist when no one will hire a new graduate with no experience? There's a ton of these positions being posted by various hospitals. Most of these say "PGY1 preferred" or "1 year of residency experience preferred." This is starting to annoy the hell out of me. They want someone with a residency, but seeing how this most recent match went, lots of people got screwed over. Yes I applied for a residency, and no I didn't get one. This is not why I'm mad. I just don't see how all these hospitals want inpatient pharmacists to have 1 year of experience or to have a PGY1 under their belt, but are unwilling to provide training. Maybe some of these hospitals in need of inpatient pharmacist should develop their own PGY1 program, so that more of us can get into a residency program, and they can produce more pharmacists with 1 year of inpatient experience.
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Graduate Intern
Jun. 11th, 2009 | 08:58 am
location: Library
mood: 
Boo studying for Naplex & CPJE
Hurray now I'm the angry Graduate intern. I've decided to sign on with a big retail chain because well, they pay pretty well, have good benefits etc. etc. They decided to have an Area meeting for all the new graduates that had signed on with them. Roughly 200 new grads from here to New Mexico. Essentially it was 2 days of brain washing. Do it this way because we said so! It wasn't completely boring though. They did infact have free alcohol. (WOO HOO FREE LIQUOR!). Oh, they also had a want-to-be Blue Man Group, dressed in red (red man group?) doing their drum thing, without being in sync with each other.
There was one particular segment in which they had asked people to give example of a "Coach" in their life; essentially a mentor they had growing up. This one girl volunteers and says something along the lines of "My coach is my mom, she came from Vietnam with nothing and has created an empire.....(insert momentary pause)....of nail salons.....(insert momentary pause)....in Kansas". At each pause you could see faces collectively generate the wtf? or o_O? look on their face. I wonder if she was trying to be funny, or if it just came off that way.
They also had raffle tickets, too win various prizes. If you answered questions, or volunteered to stand up and give your thoughts/opinions in various discussions you received more tickets. There were those 3 people, I swear this happens in any raffle situation, that would answer everything, to get as many raffle tickets as possible. When prizes were drawn, they would have a grid of tickets in numerical order placed on the table in front of them, just waiting to win. I wanted to walk by them, and blow really hard, like blowing out birthday candles, just to make their tickets fly away. Thank god none of these people will be working in my district.
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County
Apr. 26th, 2009 | 09:07 pm
location: Not at county thank god
music: Mychael Danna - We're gonna make it
Today's post is from a friend of mine describing her experiences at the county outpatient pharmacy.
Story 1:
So the outpatient clinic pharmacy's all have TERRIBLE wait times of 2-4 hours and while I was working the pick-up window today, this is the conversation I had with this old weird man. (Background info: when patients say they want to wait for their medication to be ready, they are given a number, which will pop up on the screen when their prescription is ready for pick up. Not a new concept, most retails function this way)
Man walks up to window and gives me his paper that says #76
Me: Um...your prescription is not ready yet. Did your number show up on the screen?
Man: Yes it did
Me: (after I go check) Sir, we are only at #54, so your number is still a long time away. Are you sure your number is on the screen?
Man: Ok, its not on the screen. But the line to pick-up the medications is always so long and I already wait a long time for my medication to be ready. Last time I came, I waited a really long time for my number to show up, and when it finally did, no one would let me cut in front of them to pick up my medication.
Me: Well, I don't think they let you cut in front of them because they have also been waiting a long time.
Man: That is why this time I just decided to get in line right away after I dropped off my prescription.
Me: But, we specifically have a sign that says do not get into line until you see your number come up, b/c now you got into line too soon and your prescription is still not ready.
Man: Are you sure they are not ready? Can you go check?
Me: I already checked, it will still be awhile before your medication is ready. I'm sorry, but you will have to wait till your number comes up, and then get in line again.
Man: Do you think people will let me cut?
Me: I don't think so, but you can try
Man: Ok
(then he walks away)
I thought it was funny until 20 more people did the same thing to me...then I just got irritated.
Story 2:
Story 1:
So the outpatient clinic pharmacy's all have TERRIBLE wait times of 2-4 hours and while I was working the pick-up window today, this is the conversation I had with this old weird man. (Background info: when patients say they want to wait for their medication to be ready, they are given a number, which will pop up on the screen when their prescription is ready for pick up. Not a new concept, most retails function this way)
Man walks up to window and gives me his paper that says #76
Me: Um...your prescription is not ready yet. Did your number show up on the screen?
Man: Yes it did
Me: (after I go check) Sir, we are only at #54, so your number is still a long time away. Are you sure your number is on the screen?
Man: Ok, its not on the screen. But the line to pick-up the medications is always so long and I already wait a long time for my medication to be ready. Last time I came, I waited a really long time for my number to show up, and when it finally did, no one would let me cut in front of them to pick up my medication.
Me: Well, I don't think they let you cut in front of them because they have also been waiting a long time.
Man: That is why this time I just decided to get in line right away after I dropped off my prescription.
Me: But, we specifically have a sign that says do not get into line until you see your number come up, b/c now you got into line too soon and your prescription is still not ready.
Man: Are you sure they are not ready? Can you go check?
Me: I already checked, it will still be awhile before your medication is ready. I'm sorry, but you will have to wait till your number comes up, and then get in line again.
Man: Do you think people will let me cut?
Me: I don't think so, but you can try
Man: Ok
(then he walks away)
I thought it was funny until 20 more people did the same thing to me...then I just got irritated.
Story 2:
The perks of working in a pharmacy:
I'm working at the cashier today and the line is long as usual...my encounter with a lady today:
(lady walks up to me and hands me her medical record card and then i notice that my hand is all wet...so i look at her card and notice that it her card is all wet)
Me: Did you want me dry this card off for you? I noticed its all wet
Lady: Oh no, its ok. It is just that the line was so long and so my hands started sweating
Me (trying not to look disgusted..hands the card back to her)
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Sad Days =(
Apr. 16th, 2009 | 09:15 pm
mood: 
sad
http://www.presstelegram.com/news/ci_12160079
Today is a sad day in our honored profession. Two of our own are no longer with us. =(
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Online Pharmacy School?
Mar. 8th, 2009 | 11:42 am
location: the comfort of home
mood: its considered progress for me
So todays post is in regards to to following article from Yahoo.
http://education.yahoo.net/degrees/articles/featured_fifty_dollar_an_hour_earning_power.html
The jist of the article talks about what it takes to become a pharmacist; and in the end says "If six years of college education seems daunting, consider embarking on a pharmacy technician career with a two year associate's degree, and pursuing your Pharm.D. online while you work."
That last part concerns me a bit... "pursuing your Pharm.D. ONLINE while you work". I really hope they mean completing some of the undergraduate work to apply to pharmacy school. When you think about it, this shouldn't be possible. Most of the pre-reqs for pharmacy are science based classes with lab work. I don't see how you could do lab work online. Unless they start coming up with insanely crazy computer applications that simulate horrible stench of O-chem lab. Surviving the stench of O-chem lab and passing O-chem is a right of passage. How would you do this online?
There's also the possibility that the actual pharmacy curriculum is completed online. I don't think anyone would want their pharmacist to say they got their degree from an online university. It's just like asing your MD where he got is degree and him saying some shady online college - something just seems fishy about it.
I really hope there isn't an online pharmacy school. Otherwise those online schools just lowered our profession.
