Sunday, August 28, 2011

The Category: Potpourri

I've fallen behind on the blog writing for a couple of weeks. I've taken on a slightly different work schedule which has left me kind of wiped out. August has been surprisingly busy, though. Anyway, here are some of the totally random things that have broken through my foggy mind lately....

1. When someone is discharged from any sort of health care facility they usually have a bunch of discharge instructions and crap thrown at them. In fact, the more elderly the person, the greater the volume of overwhelming crap. One of the things people invariably get is a "medication list." They bring it to the pharmacy, thinking it's a prescription. It's not. By the way, I maintain that anybody who wants to get involved with MTM should be looking at hospital/long term care discharges before anything else. Most medical errors occur during 'transitions' in care, and maybe an added bonus would be simplifying things for everyone involved. Figure out what the person has been taking, what they need and don't need, what they need to continue or discontinue, and generate prescriptions that are pharmacy-ready for the doc to sign. What doctor/on-call person/first-year resident wouldn't like that?

2. A woman brought in a single pill (yes, just one tablet) and said she wanted a refill on 'that.' Quickly relieved of the notion that she might know the name of it, or what it was for, I finally got to use my Epocrates Pill ID function on my smartphone. Man, that is slick!

3. Thank you, someone at Big University Clinic, for giving my customer a prescription for Percocet. The signature is illegible, the 'printed name' is illegible, the DEA number I might be able to guess at (but all possible guesses match no one in my system), and of course there's no NPI. The customer is bellowing at me because it's taking so long. The recording on the other end of the phone number on the prescription says you are 'unavailable to take my call.' This makes me very, very grumpy.

4. It's back to school time and the ADD prescriptions are flowing like water after a hurricane. And naturally, the wholesaler's running out of Adderall. Again.

5. I can't get over the number of highly educated and otherwise very competent people who can't spell. My current pet peeve is two words: "LOOSE" is the opposite of "tight" , while "LOSE" is the opposite of "win." So for instance, when I read that someone is about to 'loose' their insurance, I wonder why it was so tight in the first place. It's just a thing with me....

7 comments:

The Ole' Apothecary said...

thewidespread spelling and grammatical errors are going to be SO widespread that they will eventually make their way into dictionaries as being correct, pecially it reaches when it reaches the point that the dictionary arbiters themselves think they are correct.

The Ole' Apothecary said...

I share your frustration at people who bring in something they think is a valid prescription when it is not. But, do we really expect people to know, especially the elderly? These same people might tell you that they are not going to vote for Nixon next year.

Anonymous said...

My personal favorite is the Percocet rx written on a generic hospital pad with the very clear notation on the bottom that reads, "Not valid for CII prescriptions without personal confirmation from physician." Three things usually happen. 1) We have no idea who the MD is. 2) The MD justs draws a line thru the notation and initials it. 3) When we call, they scream, "Just fill the damn prescription!"

MDB said...

Even worse are the idiots I seem to get that come in and say we gave them the wrong medication. It really doesn't help your case that you claim we gave you some mystery pills instead of your percocets when you don't keep the bottle with you but instead you just dump the pills in a unlabled plastic baggy because it is easier to keep in your pocket. If my counts are correct and what we later identify as some dollar store knock-off APAP are the tabs then don't expect us to replace the percocets. It is probably one of your friends who just also happens to be taking them that switched them out when you were passed out on the couch drunk and/or high.

Anonymous said...

I like the point about reconciliation records and medication lists in the patient transition from hospital to home and home to hospital. In my hospital job, patients often are seeing a regular doc, or doctor with hospital privileges for the first time when admitted to the hospital --or sometimes the patient sees a VA doc or is from out of town (we're on a major north-south interstate), even women show up for delivery without ANY pre-natal care. So, the big deal is figuring out the patient's routine medications, and the beef is all the mail-out companies that won't share information!! Then, the discharge lists are composed by nursing [and, sometimes there are grammatical errors and other instructional discrepancies...but, our pharmacy staff is too small to accommodate more (better) patient teaching].

My most unfavorite irritation (predictably makes me cringe) is the neurologist that prescribes Haldol (or Ativan) for 'aggitation'. He's been making the same mistake no doubt for 35 years.

When I picked up a few retail shifts in small county hospital towns, it WAS irritating to be handed a 'medication list' from a nursing home or hospital to be used as bunch of prescriptions by a family member of the discharged patient on the way home (sick patient in the car waiting) at the end of the day or weekend. No contact with MDs (usually illegible residents) and irate or stretched thin nursing supervisors trying to get the whole thing straightened out before we closed for the night. Family member saying, 'but he has to have it'. Ugghh.

Hey, about those legible scripts...I had a call from a 'nurse' calling in an Rx for Lortab. When she gave me everything in perfect order, the game was up. I called the doc and found the nurse had been fired a short time before.

no-one said...

Last year I took a medical terminology course taught by a medical professional who kept saying 'prostrate' instead of 'prostate'. I eventually had to say something because it was driving me mad.

AmyMaiers said...

The #2,my father does that, and it drives me crazy.One time he fished one out of his pocket and my son thought he was hiding candies.But i think that app totally rocks!My cousin wants to be a pharmacist and we've been looking at different pharmacy colleges. I think she's going to learn a lot more about this profession from blogs like yours.