This is why it is hard to trust nurses

Patient walks up to the counter, asks for prescriptions.
I'm sorry we dont' have anything ready for you. No there are no refills from last month. You spoke with the doctor's office who said they sent them? Let me quick check our phone, fax, and escript lines. Nope sorry nothing there. Sure go ahead and call them.
Patient now on the phone: "No you were just suppose to refill them like last time. Last month you faxed them. Just do that again."

A few minutes later... Oh yes the nurse just called and left a message saying that she would be faxing those prescriptions right over, but that they may say void on the fax copy because they were printed on the worng paper. Wait which medication? No that nurse cannot fax that in; no they cannot call that in. That is a CII (class 2, most addictive/most abuse potential, highly regulated class II). The nurse knows that that can only be mailed or brought in by the patient after they pick it up.

Day 2: Nurse calling. We faxed that and called that in.
Why didnt we fill it? It's not a legal prescription, either one of those ways. I spoke with the patient and they know they have to come get that paper prescription.
What?! You destroyed it? But but but... you are suppose yo be smarter than the patients.

The countdown to the end of the year...

The now famous phrases that populate the last few days of the calendar year at a pharmacy:

- Can you fill all my prescriptions? (there are almost always at least 5) My insurancec is running out/my copays are going up/ I want to get as much as possible with no copays under last year's deductible?

- Can you fill this med (almost always birth control)? I'm going on vacation. What do you mean I cant get it today? So what if I filled it 10 days ago? But I'm going on vacation. How long do I have to wait for you to call my insurance company?

- Hi. Yeah I haven't picked this up in a while (since summer). I kinda forgot about it. Well no my blood pressure is still really high. My doctor said I should think about increasing my dose (I have a better idea, take your prescription first and see how it works.

and lastly our favorite line to hear amongst the chaos between holidays:
-Hey Im trying to use up my flex spending so can I buy these 50 million little OTC products here at the pharmacy?

Hi ho Hi ho... back to work I go

Back to the exciting world of pharmacy:
I had an elderly gentleman patient walk up to the counter, no regard for the other person patiently waiting in line, to ask for assistance finding this pill for his nose. He always gets it from us, and it's in a blue box. Why do we keep moving it on him? First it was over there in that section and then it was over there, and now it's gone again. Well, the only blue box pill for your nose that I can think of sir is Claritin. No no no that's not it. Could it be a combination cold product with blue on the box? No that aisle is all vitamins and supplements sir, I dont think what you're looking for is there. Oh you found it? But you're in the GI aisle. Oh it's that purple box of PRILOSEC?! (Not quite sure how that helps your nose) Oh sure you can come back and cut in front of the other 3 people now waiting in line to get their prescriptions.

Thatll bulk her up

So amidst all the hectic frenzy of the holiday, I somehow managed to find time to finally take Teaser (my 18 year old Siamese/ragdoll cat) to the vet for a long overdue appointment for shots and blood work. Turns out her hyperthyroidism is on the rise, so that means increasing her meds. This is no big deal really, actually easier to use half pills than quarter pills. But having to give her fluids for her "kitty dialysis" is a whole other story. And yes I am sure many of you will think I am absolutely nuts for being willing to do this for her, but she has spunk and a lot of life left. She's not in pain and the treatments don't seem to bother her...yet. I just can't pat with her when she has all that life left. But there will come a day when it will be time and I know it won't be easy. She's my baby. It takes a pet owner to fully understand that bond. And for today she has spend so much time curled up next to me purring, that I feel like now isn't her time. I feel guilty for leaving her in the hands of my sister while I leave, but know that she will get lots of love and attention. I'm sure she will be around for a while longer with us.

Winter Wonderland

I used to love winter, couldn't wait for it to snow as a kid. (Probably an early warning sign that I might do something crazy like go to Alaska in January.) That is until today when I got hit with that "ice pellet" in the eye, and then the wind so nicely blew my hood off my head. And on top of that, the weather is really throwing a wrench into holiday travel plans this year. I wouldnt mind a balmy 40 degree day this week instead of the barage of assorted precipitation.

It's getting closer

This week I have been in email contact with me preceptor for Alaska. It makes the trip more exciting and less daunting now. The fun activities will start right away; January 15th Bethel is hosting a qualifying sled dog race for the iditarod. According to my preceptor I should be able to meet some of the racers and their dogs.

My preceptor was very helpful in giving me information to make sure I pack appropriately: "There's no guarantee on the temp up here- we went from -15 ambient temperatures last week to +40 today. Windproof gear is key. ...Leave anything fashionable at home- trendy jackets will do you no good here...heels are a joke"

I think I like her humor. I will have more info on a phone number and address soon for anyone wishing to send care packages or to chat.

I'm going to start charging batteries now for all the pictures that will have to follow. But for today, after a lazy mornign in bed, it's time to clean and pack a little.

That's what we do

Amidst all the chaos of a typical Monday and the days preceding a holiday we were able to not only get a dose clarification from a doctor's office to only learn that it needed a prior authorization, but then have the nurse get the PA in place before closing. That is how pharmacy is suppose to work.

You think that dog's capable?

I'm sorry ma'am but our policy is no dogs in the store unless they are guide dogs. I'm pretty sure that daschund that just jumped out from under your coat is not guiding you through the store today. Nice try keeping it under wraps for the first 20 feet into the store.

Is common sense lost?

Many pharmacists take pride in knowing their patients, especially being able to recognize you when you come into the pharmacy. Despite that we do not have the capability of knowing each and everyone of our patient's voice on the phone... this makes the following conversation very hard to deal with, and yet it is so common:

Mr Cholesterol: I need my prescription filled. It's for lovastatin. Dr Cardiology called it in for me. Say how long is that going to take to be ready?
RPH: (Not having a chance to get a word in prior) What is your name?

A reality check

A lot of people have been complaining about the cold weather here in Wisconsin, but as they pointed out yesterday in the pharmacy, it isn't anything compared to Alaska. If you really want to know, check out Weather Underground at www.wundergroud.com and look at the local weather for Bethel, AK. I believe the high for today is -15.... that's right the HIGH is still below zero.

Additionally many of you have been asking about a mailing address. The best I can do for now is the address of the facility:
Yukon Kuskokwim Health Cooperation
PO Box 528
Bethel, AK 99559

You can also check out their website at www.ykhc.org. This has some great pictures of the area that I'll be staying.

Mom's the word

Happy belated birthday to my mother!

Okay, so... (over here we have the earth. It's round. Some might say that is a sweet earth...diversion to The end of the world flash cartoon. Cracks me up everytime.)

Anyway I have not been getting to this blog as frequently as I would have liked. Sorry for that.

Today my rant from the pharmacy is that no patient ever has any right to call technicians any sort of obscenities. This especially holds true for when they have done nothing to provoke such namecalling. I stand by them, most of the time, and they need to be respected as do I (even if at times your pharmacist may look like they are 15 years old). So please respect your local, friendly pharmacy team; we'd all appreciate it and it would make your trip to the pharmacy a lot better.

Manic Monday

First off Happy Birthday to my Patti!

Now let's see. Today it is going to snow again.... oh joy. I have my presentation on calcium supplementation tomorrow morning- let's just say girls in their 20s get nowhere near enough calcium which is sad because they can still be building bone at their age. I'm hoping maybe we can change that in the future. Let's fight osteoporosis now.

And it's my last week in my tthird rotation :(. It's been a lot of fun, many laughs, and a great experience. I must say if I didn't have Alaska, it would be much harder to leave.

But speaking of Alaska, I was contacted by my preceptor this weekend and am making the connecting flights. She also had some great insight as to some touristy activities that I should look into while there too. One highlight is looking at their scenic rails. Stay tuned for more on that in the coming months.

And I still have yet to figure out what safe place I tucked my pharmacy school badge into, because it is so safe I can't find it. I'm going to need that soon...

Ok time to get out of bed and start another Monday.

Good to know

I discovered last night that one of my favorite pairs of boots is not so waterproof. Glad I found that out before I went to Alaska. On the plus side, it is one less thing to pack.

Just another example....

A patient walks straight up to the pick up window and says "I'm here to pick up a medication" .... well you are at the right place, but who are you?

Think before you speak

My favorite moment today at the pharmacy:
I need to call a doctor's office for refills on some prescriptions. The patient is in hospice care so they are bedbound.

The nurse politely asks, "Is the ptient there waiting at the pharmacy for these medications?"

Can't make this stuff up.

What am I doing?

Well it occurred to me today that not everyone knows what Im doing in Alaska. I figured I better share. First of all if you aren't aware I'll be there for 8 weeks. That's right 2 months in Alaska in the dead of winter, but it's for school. I didn't choose to go at this time. I simply said I want to go to Alaska, how can I make it happen? There are some pluses to traveling there this time of year though: the Northern Lights, the Iditarod, and no bugs. Since Bethel is near the coast they have somewhat tempered winters and so it won't be any worse than this weather here back home. So I should be fine. I am not sure how the continuous darkness will affect me though. Come back in a month for an update. To prepare myself though I am supplementing with Vitamin D in advance and will continue a higher dose when I get there.

So to their description:
YKHC provides comprehensive healthcare services for patients in 50 rural communities of southwest Alaska spanning a region the size of the state ofOregon. Services within the system include ambulatory clinics, subregional clinics, dental and optical clinics, mental health services, and a 50 bed hospital providing adult and pediatric medical-surgical, emergency, and obstetric care. This site provides hospital care and ambulatory pharmacy practice experience in a rural, public health setting serving a primarily native Alaskan population of over 25,000 people. This rotation will allow you to participate in direct patient care through professinal interaction with patients and providers. This rotation requires an Alaska intern licence. Hours are flexible, mostly 830-530 with an hour lunch. Some weekends may be substituted for weekdays for intern activities.
Responsibilities will include patient counseling, monitoring drug therapy, case presentations, drug utilization review, providing drug information, and shadowing selected providers to experience rural medical care. Village travel may be included. Common medical conditions include: infectious disease, diabetes, cardiovascular conditions, and psychological disorders.

And that in a very large nutshell is what I'll be doing in Alaska. Are you thinking I'm crazy?

Clarification

For those of you who may not have heard the story about my user name. It all started with my Aunt Joann calling me Kata-Potata. Well my sister Claire latched on that nickname and loves to use it. When it came out amongst my college friends, it took a whole new twist. There are several variations, but I've learned to embrace the nickname of potata. Hopefully I'll become your favorite potata soon, if not already.

Countdown begins

I am now officially less than a month away from my big departure to Alaska. I thought I better get this started and tested. It just so happens today is a great opportunity as we have a snow day. Madison received over 12 inches of snow in the last 24 hours and everyone is hunkered down to avoid the whiteout conditions now entering the area. I really can't complain; I just keep telling myself it's preparing me for Alaska... but everyone else keeps asking why they have to deal with it too even if they aren't going to Alaska. My only regret is that I haven't gotten my snowshoes yet. Today would be great for testing them out.
In the meantime I have a project on calcium supplementation to go work on and some cleaning and packing to consider.