Saturday, January 16, 2010

Why me?

Figured since I was in the mood to vent today, might as well go ahead and post this gem from the past week:

Pretty much anyone who works in pharmacy is familiar with the I-Pledge program. A certain acne medication (isotretinoin and all its brand names) is known to cause severe birth defects if a female gets pregnant while on it. So in order to be prescribed the drug, there are certain hoops every patient must go through (even the guys.. though last I checked they can't catch preggers...) called I-Pledge. Female patients have to undergo a pregnancy test every month (which is only good for 7 days, this is important later), and be on two forms of birth control. The doctor and patient both have things they must fill out online before we can do anything with a prescription. Needless to say, it takes a certain amount of coordination between patient, doctor, and pharmacy to get one of these prescriptions filled.

Enter Mrs. PP, a forty-ish woman whose doctor had e-scripted an Accutane rx about four days before she came in. We hadn't filled it because we didn't have her I-Pledge card. She hands me the card, I navigate to the website to enter the required information, and up pops "Not authorized, prescription window has closed." This sucks. I relay information to patient. Patient freaks. Demands we call I-Pledge to fix it. Now, having dealt with this sort of problem before, I asked her when she had had her last pregnancy test at her doctors office. Of course she says "a few days ago." One thing I've learned, in pharmacy-patient speak, "a few days ago" can range anywhere from 2 hours to a couple months. It's like, as soon as they approach a pharmacy, any real concept of time completely disappears and "a few days ago" is the only way to express that it didn't happen right that second. But I digress.

I figure, whatever, we're not busy, I'll call. I get the automated system. After hitting random buttons on the phone (I've found this is the most efficient way to reach an actual person). I give patients info to representative, who tells me.... that patients pregnancy test expired...three days ago. I ask if representative would mind repeating this to patient, who is standing at the drop-off window, glaring at me the whole time. Patient hangs up phone, I tell her it would be best to contact her doctor and schedule another test. Patients leaves, muttering about incompetence under her breath.

About ten minutes passes...Mrs. PP gets back in line. Great. I help the patients in front of her. I steel myself for some verbal abuse. Boy was I wrong. She proudly presents me a freshly negative pregnancy test. Laid right on the counter. Uncapped.

I'll be honest. I truly couldn't hide my horror/disgust. I'm still pretty new to the pharmacy game. I mean, this was worse than the guy who drooled all over the counter while asking me how many tubes of anti-fungal it would take to cover his body. This woman PEED on the stick, and then thought it was okay to carry through an entire store, uncapped, and place it on our counter. And after telling her that we couldn't accept that, it had to be done at her doctors office, she stormed off. Leaving it there. On the counter. We had to hold up the line of completely disgusted, now agitated patients in order to follow biohazard procedures to dispose of it, then use pretty much all of our alcohol and EndBac sprays. Believe me, it wasn't enough.

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