An Open Letter to our Culture

We have a fucking problem. I've seen it in pharmacy technicians (bless their little underpaid hearts) my entire career, and this same problem has seeped into even our allegedly world-class curriculum. This problem may be more of a personal one for me as I've had to deal with it on behalf of my own family and have had to be a patient's advocate in the face of people who "don't know their ass from a goddamn hole in the ground."

It comes from all sides. Ignorant pharmacists, technicians, patients, and doctors. I should never have to convince a doctor to prescribe TRAMADOL for someone with severe back-pain. Surprise motherfucker, that's apparently the world we live in. Who knows what someone could do with tramadol. They may feel slightly better than normal for hours! Other than doctors being abject shitheads when it comes to treating legitimate pain, there's the techs I've worked with in what has been a very diverse journeymanship. Most techs just count, lick, stick, and pour -- that's fine by me. You put stickers on Advair; I'll cover the "knowing shit" part of running a pharmacy and we'll be fine.

But occasionally a tech shits on that rosey idea of pharmacy. Exhibit A: just earlier this week a tech I was working with loudly declared that her favorite thing to do was find a way to cancel hydrocodone prescription. Sorry, not in your or my job description to seek ways to deny treatment -- go back to stickering Advair. Now I'm not saying some things come across as therapeutically inappropriate and actually deserve cancelling (I'm looking at you, ER prescription from February), but actively seeking ways to deny treatment means you'd be better off working in the insurance industry -- see what I did there?

And hey, if a patient decides they want to forgo controlled substances that's fine by me. Today I stumbled into an odd situation though. A mother dropped off prescriptions for her daughter in the drive-thru, one of which just happened to not have a name on it. A name on a prescription? I know, I'm setting the bar really fucking high here. So I called the doc's office and straightened that out and the nurse dropped that the patient's mother actually refused a prescription for five days worth of PRN (NOT "PHARMACIST RECOVERY NETWORK," GODDAMMIT) Percocet. Uhhhhhhhhh. Okay? So when talking to the patient's mother five minutes later concerning the teenager I'd saw in the fetal position earlier, I decided to ask her exactly what happened that she needed all of Naproxen and Skelaxin. Long story short: car crash, suspected whiplash/fractured neck, X-rayed to rule it out, and then decided they would treat asskicking pain with asskicking drugs. Logical. Too logical.

Mommy decided it was time for Daughter to put on the big girl panties and tough out the car crash on Aleve -- I take that shit when I stub my toe. But what could I do? I couldn't wave my hands and un-stupid her mom enough in five minutes to at least convince her to take some tramadol home. I couldn't explain that they probably gave her Percocet based on whatever she received in the hospital that actually controlled her pain. There are some people who we, inevitably, just won't be able to help. I can at least *usually* take solace in people being harmed solely through their own stupidity/stubbornness, and not someone else's though.

Turns out her mom's perfectly capable of learning how to rotate doses of Tylenol and Aleve, though.

I do what I can with what I'm given.

Awesome: