Failure To Communicate

I've read a lot of blogs, Twitter posts, and other forums over the years where pharmacists discuss working conditions, and I've come away with the feeling that most pharmacists haven't encountered the same type of outrageous supervisor behaviors that I've experienced in my career. I find it hard to believe that these type of things only happen to me. But, I'll share them anyway.

I remember one time about ten years ago while practicing community pharmacy in a very rural area, when a drug rep came to the pharmacy unannounced to "tell" me that I'd better be dispensing the Brand drug that she represented, regardless of whether the doctor wrote that substitution was permissible and when the patient wanted generic.

This rep was angry and caught me off guard, so I just stood there and looked at her while collecting my thoughts. She then gave me a contemptuous look, threw her business card on the counter and said her company had an agreement with my employer that they would always dispense her Brand dug, and that I'd better be doing just that. Then she demanded that I give her the records of all patients who were prescribed her company's drug, but were substituted with the generic version.

I kid you not! Like they say, truth is often stranger than fiction.

Of course, I told her to take a hike, that I wasn't going to give her any patient records, or explain myself to her. Personally, I wasn't aware of any company policy about this, nor was I sure I would comply with it if there was one. Thereupon, the woman got even angrier and said, in a threatening tone, that she was going to talk to my supervisor about it, and stormed out.

Yes, if I remember correctly, it could have been a Monday.

Now I don't know about you, but over the course of my career I've only had just a few supervisors who knew how to effectively communicate with their staff. Like I've said before, it seems to me that most supervisors are trying to escape working the front lines, have little or no management training, and will do anything to avoid being a staff pharmacist again.

It would seem to me that whenever there's some sort of disagreement in the workplace, the most appropriate response from a supervisor would be to investigate both sides of the story in a cool, calm, and objective manner. But, for the life of me, most of the supervisors I've had usually have done just the opposite, choosing to believe what was said about me without investigating or asking my side of the story first. I can't ever remember a time when a supervisor said to me calmly - "Hey CP, I've just received a [insert complaint here] and wanted to hear what you have to say about it."

Pretty simple, huh?

Here I am trying to provide the best patient care I can, to get along with everyone, to be successful, and to make both my supervisors and my employer look good. You would think that my efforts would be rewarded with a little professional courtesy in return, but no. My supervisor in this instance came in and reemed me a new one in front of my techs without ever once asking me what happened.

The conversation went all downhill from there, and with it somehow being my fault.



Truthfully, I'm very easy to get along with and would prefer to get along with everyone else. But once you cross the line by abusing me, especially without provocation, there's no going back. And it's all because of a failure to communicate appropriately. Needless to say, my rose-colored glasses lost more of their tint after this incident and I gave a two-week notice to move on to my next adventure.

Verbal Diarrhea

A few years ago, well maybe 6-7 years ago. Or was it about 8 years ago? No, no, it was about 5 years ago, maybe 5 & 1/2 years ago. Let's just say it was somewhere between 4 or 5 years ago, I used to work the night-shift for a chain pharmacy located in Tucson. If you haven't worked the night-shift in a chain pharmacy before, especially a pharmacy located in a bad neighborhood (like Tucson), then you won't know that, except for doing a vast amount of refills, most of your night is spent either dealing with drug abusers, shoplifters, or crazy people who can't sleep.

Well, after working this one particular pharmacy for a little while and becoming more known in the community, people started calling me in the middle of the night, just to chit-chat - like I had nothing better to do. Almost every single night, this one older woman used to call me out of concern for her sister's bowel habits. It was like clockwork - the same time every single night that I worked just so she could describe to me the color, frequency, consistency, and smell of her sister's turds to me and to ask what she should do about it. That's right, TURDS.

Now, contrary to what you may think of me, I actually like people. It's just that I'm not much of a chit-chatter. If you've got something important to say, I'm listening. Heck, I sometimes may even be interested. But, when the conversation starts to drone on, gets too boring and filled with inane bullshit, my tolerance level tends to drop drastically and I'm looking to part ways in a hurry.

Of course, it didn't take long to realize there wasn't anything seriously wrong with her sister. This lady liked me, was lonely, couldn't sleep and just wanted to talk. But, I had lots of work to finish, didn't have the time to chit-chat, and truly - just didn't want to listen to her verbal diarrhea. I swear, if I didn't try to interrupt her, she would continue talking for hours. Unfortunately, there were no verbal clues, no body language, no excuses, nothing I could say or do to convince her not to keep calling me.

It even got to the point where I would put her on hold whenever she called, hoping that she would get the message and hang up. But, she would continue to hold forever! It got so bad that I eventually had to bluntly tell her that I didn't want to talk about the subject again, and not to call me anymore.

But, do you think that would stop her? HELL NO! If I refused her calls, she would get in the car with her sister and pull up to the drive-through window at 3AM just to describe her sister's stool, and still want to chit-chat.. through the drive-through window! There was nothing I could do to get rid of this crazy woman. It drove me fucking nuts! Eventually, and for other reasons too, I transferred from that pharmacy to another one located in Phoenix.

No wait.. it was 10 years ago. Or was it 9? No, more like somewhere between 9-10 years ago.

So, when I tell you that I can identify with George Carlin on so many levels, I'm not lying.

The Art Of Communication

I've worked in many different community pharmacies throughout my career, in many different cities, and in many different types of neighborhoods - especially more than a few ethnic neighborhoods. Personally, I prefer the ethnic neighborhoods because I like diversity and I find the customers much easier to work with compared to the demanding upper-crust customers. As a matter of fact, I even choose to live in an ethnic neighborhood.

But, with such diversity sometimes comes problems with communication. Some of my neighbors have limited understanding of the English language or have such thick accents that's it's often hard to understand what little English they can speak. However, all it takes to prevent misunderstandings and to get along is a little patience and the simple acts of open communication and active listening.

I think this video best describes what I mean about active listening.

Are Your Kids Slomming?

The herd mentality is a dark and powerful force that pressures many adults to conduct themselves foolishly and inappropriately. Just imagine how that force must affect your kids?

Every teen's daily life is filled with that kind of pressure, some of it good, some of it bad. By staying involved in their lives you can influence them to rise above those negative peer pressures, to make smarter decisions, and to become better adults.


Slomming from Morgan Griswold on Vimeo and Above the Influence

AYK DOC IS CD9

Don't you know what that means, AYSOS?


PDFA "Teen Lingo" from Chemical Effects on Vimeo and DrugFree.org

Liespotting For Non-Pharmacists

I truly believe that pharmacists are experts at lie detection. I think we've all heard the old joke - How do you tell if a customer or patient is lying to you? His/her lips are moving. But, all kidding aside, I consider my ability to detect bullshit to be one of my strongest attributes.

However, if you're not a pharmacist and would like to learn why we are so good at spotting lies, here's something worth watching.

On any given day we're lied to from 10 to 200 times, and the clues to detect those lies can be subtle and counter-intuitive. Pamela Meyer, author of Liespotting: Proven Techniques to Detect Deception, shows the manners and "hotspots" used by those trained to recognize deception -- and she argues honesty is a value worth preserving.

Child-resistant Packaging

Take it from a pharmacist-jerk, we're not out to get you. Child-resistant packaging works. If you don't ask for them, and sign a release, you won't get easy-off caps.


Source: Project: Rant!

Pill Date

Be careful out there. Talk to your pharmacist, know your pills.


Pill Date - a commercial for pharmaceutical from Meissa Hampton on Vimeo.

The Perils Of Obedience

Have you ever experienced being an unwitting participant in the Milgram experiment at work? If you've been practicing pharmacy for any length of time, I'd bet you've experienced being at both ends.

One similarity that I've noticed in all of the different aspects of pharmacy practice in which I've worked over the years, is that many pharmacists are given supervisory or management positions without ever having had any education, training or prior experience in management.

In many of these instances, the pharmacists seeking these positions do so only in order to escape the absurdity that comes with working the front lines of pharmacy, or because they are unable or incapable of working the front lines for an extended period of time.

And why is that a bad thing? Because, IMO, it perpetuates a problem.

As Milgram points out - ordinary people, simply doing their jobs, and without any particular hostility on their part, can become agents in a terrible destructive process.

Moreover, even when the destructive effects of their work become patently clear, and they are asked to carry out actions incompatible with fundamental standards of morality, relatively few people have the resources needed to resist authority. They just can't seem to say that one simple word - "No".

I've seen many newly licensed, untrained, or inexperienced pharmacist managers blindly follow the same absurd, corrupt, or reckless orders of their superiors - the same orders they hated when they were working the pharmacy front lines - out of fear of losing their jobs or for fear of being transferred back to the front lines, where they can't cope.

And so, the vicious cycle of abuse continues.

Is there an absolute solution to the problem? Of course not. Each individual pharmacist will have to decide their own actions for themselves.

However, it is my opinion that Milgram's book, Obedience to Authority: An Experimental View, should be required reading for every pharmacist considering a supervisory or managerial position.

Preventing The Perfect Rx Storm

Pharmacists, doctors, and patients need to work in tandem to help prevent the perfect storm from forming, which could lead to a continuing medication error.

ABC-15 News in Phoenix reports on a recent prescription error in which a patient received 50 mcg of liothyronine instead of the prescribed 5 mcg dose. The unfortunate young lady in this incident continued taking the misfill for months, and experienced all of the adverse effects one would expect from receiving 10 times the prescribed dose of her thyroid medication.


The perfect storm in which I'm referring happens when all of the following occur together -

1. A prescription order is entered incorrectly and a prospective DUR fails to catch it.
2. The pharmacist doesn't counsel the patient at the time of dispensing a new prescription.
3. The patient doesn't take the initiative to speak up to prevent errors.
4. The provider doesn't review the patient's prescription medications with each visit.

Of course, I don't know all of the sources that led to this error, and while not attempting to assess cause or blame, it seems to me that all four of these contributing factors occurred in order of succession, which may have allowed this incident to continue for so long. Any interruption in that perfect storm may have prevented the error from happening or continuing.

According to the video, the Arizona Board of Pharmacy is still investigating this incident. If you'd like to know the results of the investigation, who was involved, including any possible disciplinary actions, the board posts their meeting notices and meeting minutes online.

The Universal Sign For Pharmacists

Gang members have their own signs, military people have combat signs, and deaf people have signs they use to communicate with each other every day.

So why shouldn't pharmacists have their own signs too? Here's the first sign every community pharmacist should learn before they begin their career. It just may come in handy.


I have been robbed. from Travel Signs on Vimeo.