Majority of Pharmacists fail to follow mandatory pt counseling law ?

Ongoing issues that can obstruct safety at the drugstore

http://www.philly.com/philly/blogs/healthcare/Ongoing-issues-that-can-obstruct-safety-at-the-drugstore.html

From the article:

When a pharmacist dispenses a medication, especially a new one, it’s important to assure the patient has all the information they need to use the medication safely. For this reason, state boards of pharmacy in NJ, PA and DE have regulations on the books that require pharmacists to educate or “counsel” the patient. Yet, in most cases, when a prescription is dispensed patient actual counseling is only a veiled “offer” at best.

The effectiveness of patient counseling by a community pharmacist to detect and prevent medication errors, and its link to improved medication adherence and positive clinical outcomes, has been well documented in the literature. Yet studies place patient counseling rates at only 8% to 42% nationally. There’s no reason to think things are any different in the Delaware Valley. In fact, the next time you have a prescription filled, see for yourself. Or, the next time you shop at a CVS, Walgreens, Rite Aid, etc., just observe what goes on at the pharmacy counter. This critical interaction between pharmacist and patient almost never takes place, even for medications that are more likely to cause harm if used in error – those that healthcare professionals refer to as high alert medications.  
Imagine that … another medication safety issue in the news ….

Another investigative reporter story on MED ERRORS !

13 investigates medication mistakes by Maine pharmacists

Investigative reporter looking into med errors

Tonight on http://www.khou.com/

at 10:00 CST… suppose to be story on med errors in the community/retail setting… not sure if it will be broadcast live… hopefully will be able to put it up on my blog tomorrow…

Not all Walgreens’ Pharmacists are “not comfortable” with dispensing opiates ?

Here is a link to the website… if some OS’s don’t like this video player http://www.wftv.com/news/news/local/oviedo-walgreens-pharmacy-manager-arrested-drug-th/nhzZq/

If you are going to call your surgeon, I do have it in stock

stevemailboxWhen I first starting reading this email.. I had to start laughing.. from the term PILE… you know what else comes in a PILE !

I find it interesting because apparently the TECH made the decision of “I’m not comfortable” filling this..  Is it either that this tech has assumed “professional discretion authority” and the tech has heard the RPH’s so often making that statement to pts at this CVS.. that the TECH was just being a POLLY PARROT ? Amazing that they were comfortable filling the three NON- CONTROLS Rxs. Obviously – at least at this CVS .. “Health is Everything” has some limitations ?

Steve, I just wanted to relay my horror story to you to add to the pile.  Two weeks ago my mother had a total knee replacement done by one of the nation’s best knee surgeons who performs several hundred knee replacements every year in Jacksonville, FL.  After spending 3 days in the hospital she was released with 4 different prescriptions, one of which was for an opiate agonist called Nucynta.  I picked her up and drove her home from the hospital.  She lives in a small town with only one pharmacy, CVS.  On the way home, we stopped at the drive through to drop the scripts off.  After a few minutes of staring and frowning at the scripts, the pharmacy tech told us that she could fill all of the scripts except the Nucynta.  When I asked why not she said that she didn’t feel comfortable filling that one.  Now, I know the pharmacy jargon as my wife has to deal with this sometimes and thank God I was with my mom that day, as she no doubt would have just had to go home, or try driving 50 miles to the next town in pain and try to fill a single, out of town script for Nucynta.  I told the pharmacy tech that my mother, sitting in the passenger seat next to me, had just been released from the hospital for a total knee replacement, that this was the only pharmacy in town, and that she knew very well that by giving her back just the script for Nucynta she was basically dooming her to driving around north florida visiting different pharmacies and being treated like a criminal.  I think its worth noting, that my mother, a devout Mormon, has never taken anything stronger than Tramadol, and certainly had no flags on her record or anything like that.  So, I demanded to speak to the supervisor.  The tech receded from the window and conferred with someone else who came up to the window to inform me that she didn’t like to fill Nucynta.  I told her that there was no way she could have contacted my mother’s doctor in that short period of time, so why did she now appear to be altering her treatment plan?  I had the surgeon’s pager #, given to my mother for emergencies, and made a display about paging him right there in the drive through.  The manager then tried to tell me that they were out of that medicine.  I told her “Stop lying to me. I’m calling Dr. X”  We sat in silence for a minute as I dialed on my phone, when the manager suddenly said, “Oh wait, I thought these were for a different strength, I do have these in stock after all!”  I hung up my phone and thanked her, she said they would be ready in an hour.  My mother was visibly shaking after this experience, after having been treated like a criminal, when she was just in pain and trying to make it home.  If this is what people have to put up with, I see this issue coming to a head.  Please keep doing what you’re doing and raising awareness on this issue!

I’m not comfortable… PART FOUR

sweatingsorry I could not get the video to directly display on this post…but.. it should play when you click on the link..   VIDEO

Here is a video of a doctor… talking to a Pharmacist in a grocery store pharmacy.. I have seen this pt’s PMP report.. like clock work every 30+ days has been getting this medication.

Prescribed dose is – IMO – not all that high … up to 60 mg Morphine Equivalent over 24 hrs as needed…

I wonder how “comfortable” the pt will feel as he/she goes into full blown WITHDRAWAL?

I wonder what this Pharmacist would say if he ever got a patient that needed U-500 Insulin.. and had to dose over 100 units at a time  maybe even more than once a day ?  Someone mis-read the syringe and the pt could DIE !

Is it all about the money ?

tugofwarGroups Angered Over FDA Warning on Epidural Steroid Injections

http://www.painmedicinenews.com//ViewArticle.aspx?ses=ogst&d=Interventional+Pain+Medicine&d_id=353&i=November+2014&i_id=1120&a_id=28660

From the article:

The FDA’s warning that use of epidural steroid injections (ESIs) may result in “rare but serious adverse events, including loss of vision, stroke, paralysis and death” drew a strong response from societies whose members offer such pain treatments.

The FDA required the addition of a warning to the labels of injectable corticosteroids to describe these risks. The FDA also declared on April 23 that the effectiveness and safety of ESI use has not been established. The International Spine Intervention Society (ISIS), an association of physicians dedicated to the diagnosis and treatment of spine pain, responded with the following statement on their website’s home page: “ISIS feels that the alert was misleading in its message regarding the safety of epidural steroid injections and contained inaccuracies regarding the effectiveness of this procedure.”

DEA on one side and FDA on the other… who is in the middle – THE CHRONIC PAIN PT !

 

Might as well put a RED “A” on their forehead for ADDICT ?

Patient of pain doctor under investigation: 'Now we are all treated like criminals, dopeheads' http://t.co/ApsAdjBeiR http://t.co/FSbU7JWXBh

Patient of pain doctor under investigation: ‘Now we are all treated like criminals, dopeheads

http://fox59.com/2014/11/03/patient-of-pain-doctor-under-investigation-now-we-are-all-treated-like-criminals-dopeheads/

From the article:

The doctor is under investigation for fraud, forgery, dangerous prescribing and violating his probation.  The state has identified eight former patients of Hedrick’s who have died of overdoses.

Now, former patients of Hedrick’s say other local physicians refuse to treat them.

 

The return of the “sweat shop” ?

stevemailbox

WOW… WOW…WOW… I have read/heard some comments from chain Pharmacists about their work environment.. never had one put in such detail.. this is a very long read…  but worth every word. This is about Walgreens, I am told that most/all of BIG BOYS operate in same/similar manner. If you patronize one of these chains.. that tell you to “be well”… because “health is everything”.. Do they really care about anything other than the money that you give them ?

Over the last 2 months, I have experienced a large amount of abuse from my employer.  This is my story of a Pharmacist at Walgreens.  

Initially, I went in with high expectations and enthusiasm.  I am a new pharmacist, so still learning.  After graduating pharmacy school, I was so excited to get my first position as a pharmacist.  After floating for a while in a large midwest city, I got my first store.  I enjoyed the staff there and still talk to them to this day.  Soon after this, I wanted to transfer to second large midwest city so that I may be closer to my family.  At the time, there was not an open position in XXXXX but one in a nearby city.  Since my sister lived in there, I accepted this position.  I floated in this area for about one year. Around April of , it was almost time for new pharmacy graduates.  I felt this might me a good time to ask to be transferred to a large midwest city, since this was my ultimate goal.    The District Supervisor approved the transfer  I was enthusiastic to get to finally move and felt great.

 Not long after this, my “write ups” began.  My home store had a large increase in business due to a large competitor closing down.  It was very busy and tough to handle.  In either the end of April or the beginning of May, I got “wrote up.”  The write up consist of incidences were patient had to wait to be counseled during rush.  The Pharmacy manager listed dates and times that patients had to wait, stating in the write up that I was conducting “personal business.” The Manager literally had been keeping a log and watching me, to record incidents were patients had to wait.  Specifically stated, on this date a patient had to wait 10 minutes to be counseled.  No mention of what I was doing, how many other tasks I was completing at the time, and how many patients were there before this one.  This left me completely confused, because every day I work without getting to eat or use the bathroom in the name of taking care of patients.  This is acceptable for a pharmacist because we are salaried employees.  

After this occurred, I decided to take it with a grain of salt and to do the best I could to not make patients wait for anything.  I thought well maybe the techs don’t understand what I am doing, so I will voice to them regularly I have to finish this or that and I will be with you in a moment.  This went over well and I was told I was doing a great job to overcome this obstacle.
 Soon after this, I received another write up for a compound I had made.  Walgreens insisted that I made this compound incorrectly, so being a new pharmacist; I accepted this as my personal error and decided to learn from this incident.  2 weeks later, I received another “write up,” This time I was written up for leaving a vaccine out (No knowledge of this prior), and rebilling a control substance, which I was asked to do by the insurance company.  
After this I became severally stressed, these write-ups were done at the 24 hour Walgreens store in that area, in which my pharmacy manager was a tech for many years.  I still decided, I moving in a month or so, so I will stick it out, learn from my experiences and become a better Pharmacist.  Then it was time for my evaluation, I knew it might not be good, do to the last 2 months of constant “write ups” but I went in with an open mind.  To my dismay, there were so many “bad” allegations against me in my evaluation I was in tears.   I couldn’t believe, after helping so much, going out of my way to help patients, leaving the pharmacy to assist patients, waiting on patients, staying over my shift to help, not using the bathroom or eating, doing everything in my power to make them not wait for anything, this was my evaluation.  The Pharmacy Manager insisted to me that I had overcome all of these challenges and I would do great in my future.  To the point she offered to call my New Pharmacy to explain I had fixed any issues that I had.  The stress of all of this was immeasurable.  This evaluation was done 2 days before my time to move.  I was heart broken; I had worked so hard only to go into my future this way.  

Devastated by this, all I could do was move forward.  I was called prior to this, by Walgreens, and told that they had a position at a Walgreens in a city near where I wanted to be.  I was excited, I thought they will get to know me and see how much I care for patients and love being a Pharmacist.  I started on a Weekend, it started out okay but I soon realized that this pharmacy had new techs, which were poorly trained.  I thought well this is the situation handed to me, all I can do now is try and train the techs to do better.  That Monday, the store manager came in an introduced himself and stated we will talk later.  That Wednesday, I was working on 5 prescriptions; the patient was in drive thru and was told they would be done in 15 minutes by one of the techs.  As I start to complete these prescriptions, I soon realize 2 of them are CIIs and fall under Walgreens GFD medications, in which, I am required to follow a checklist before I can fill the prescriptions.  Next thing I know, the store manager comes into the Pharmacy, while I am working on the prescription and states “A patient just made a complaint in drive thru about having to wait for his 5 prescriptions.”  I say nothing and continue to complete the 5 prescriptions, at this time the Pharmacy manager states, “A patient needs to be counseled,” Looks at me to counsel, while I am trying to complete the 5 prescriptions in drive thru.  Confused as to why the other pharmacist did not counsel, so I may complete these prescriptions, I stop, counsel the patient and complete the prescription for drive thru.  A few days after this, the Store Manager has a talk with me.  During this discussion, he informs me that he thinks I was “written up” in my past because the Pharmacist “did not like me.”   Continues to tell me that the district Supervisor called him about me and stated, “Document anything she does for me,” in such a way that it is being held over my head.  Additionally I was told to “Fix” the pharmacy.  
Worried after this conversation, I thought well I will just do my best, I will show them who I am.  This started out great, I worked very hard and stayed over shift to help counsel and complete prescriptions on daily basis.  I started coming in early to help train techs.  I constantly tried to get things “caught up” to keep the patient’s happy. The pharmacy started to improve.

Soon after the “doing things faster” policy was put in place, all the techs were “talked to” about increasing the numbers in the pharmacy.  I felt a bit uncomfortable because the techs were still new and currently were not doing things correctly.   How could they now do things faster when their not even doing them correctly?  I became concerned, errors started to occur; policy/safeties were being overridden to do things faster.  I started seeing Antibiotics dosing that were incorrect, wrong medications being typed in, prescription bags for 2 different patients stapled together on at least 4 occasions, the wrong medication in the wrong bottle (2 recent STARS events), 2 medications (Citalopram and Simvastatin) in the same cell in the robot, different medications on the shelf together that looked similar (Amoxicillian with Cephelexin and Citalopram with Simvastatin), multiple manufacturers of one medication in the stock bottle (Clopidogrel and furosemide).  

Becoming concerned, I talk to the Pharmacy Manager and let her know about these errors.  When I did so, I got no response and no action.  This all was completely ignored, I mean I understand mistakes happen but pharmacists are required to work to prevent them at all times. I started to become more concerned, no one will follow the standard policies.  Stock bottles are left on the counter, auxiliary labels are not being used, and everyone is acting chaotic when the pharmacy gets busy.   Yet everyone is being pushed to “do things faster, to the extent I am told to “ride” the techs to get things done faster.  So becoming very worried, I came in on my day off to speak with the store manager.  

He apparently had just had a conversation with District Supervisor about me and stated, “I sang your praises.”  We start to talk about the issues in the pharmacy and tell him about the amount of errors, including a STARS event that I had found and was told that it would be completed by the pharmacy manager, the fact that “out of dates” were not done in a year, patients could receive out of date medications.  I explained that this situation is getting out of control and he assured me that we would fix the problems.  I also voiced my concern about the treatment of a particular tech and that the “yelling” at techs in front of patients was inappropriate.  As we talked, he reassured me that he was “on my side” he asked me if I had been written up there, to which I reply no.  He states, ” when I start writing you up, you’ll know, you’re on the way out the door.  

A few days before I met with the store manager, He had his yearly evaluation.  During the meeting, he let me know that his evaluation was bad because of the issues in the pharmacy.  He went over it with me, telling me how coaching cards had not been done, they had 3 tech employment failures, orders were not posted, retunes weren’t done, adherence calls were not done, etc.  This meeting lasted 4 hours and I was hopeful that the issues would be resolved.  The next day, the senior tech and I worked to do things properly. We had all the prescriptions done for that day except 30, all the stock was up, all the daily tasks were completed and this was by 4:00 that afternoon.  The floater Pharmacist that had came in was very thankful; she had worked the day before (Thursday my day off) and stated, “This is the most stressful pharmacy I have ever worked in, I wasn’t sure I could handle another day of it” The Store manager agreed to talk with the Pharmacy Manager about listening to others, instead of insisting on her way.  Again I was hopeful, but here is where things starting falling apart.  

This weekend was my weekend to work, it was great, ran smoothly had 70 % verified by promise time and low wait times.  I was ecstatic, the only complaint was a patient wanting the tech to fill “all of her prescriptions” on file and the tech stated we need to know which ones (The tech let me know that this was the Pharmacy Managers policy). I took the call from the tech and the patient told me, “This is why I left CVS” so I went through her medications with her and filled the correct ones. Other then that a perfect weekend, I was very hopeful going into the next week, even though I knew we would be a tech short.  I filled the queue and all the cells for the next week so that it would not be so bad.  
That Monday However, things only got worse.  Things are moving along normally that Monday, the senior tech was not working and I had a certain tech working.  She had given her noticed a few days before, she is another story, and was not “happy” about her treatment at Walgreens.  She had filed a complaint and soon after was ‘bullied” into quitting.  

 Neither of the techs there are capable of typing to quickly, and the number of prescriptions in our queues start to pile up.  At that moment, I had about 200 prescriptions in my queue ( at 9 o clock that day 52 new prescriptions came in for ERX and there were 50 already on the counter to be filled.  I start typing and then F4ing (verifying) which is dangerous for a Pharmacist. Studies have proven that when you type and verify the same Rx, the rate of error increases substantially.  This is due to the brain “filling in the holes” an example of this is edge induction. The neurons in the visual cortex will fill in the gaps on a visual image.  
Not long after I begin to tackle the tasks in front of me, a Patient comes through the drive thru, she gets upset because her doctor did not call in refills, a tech prompts me to give her an emergency supply.  Patient leaves the drive thru and we put the emergency supply in the bin.  Soon after the doctor’s office called to give the patient refills (she called their office upset).  One of the store leads adds the refills and starts to fill the prescription. The patient comes to the front to pick up her emergency supply, Tech Pam looks in the computer and sees that it is in printed status and informs the patient it is not ready.   At this time, I tell the tech no it’s ready, right here it is.  The patient storms off angrily and complains to the store manager.  At this time he came back to the pharmacy to inquire about the complaint, I go over the details with him and everything I say to him has some response, why I am wrong.  He tells me finally, “why can’t we take care of the patients!” I respond, what do you think I’m doing?” He then states, why did she have to wait?” Why wasn’t her prescription ready?” I explain that she did not have any refills, he tells me I was arguing with the patient, I state, I never talked with the patient, he said she over heard you say the prescription was ready and thought you were arguing with her. Then he says, “How are we going to fix the pharmacy!” All of these patient complaints are your fault,” I reply with, “ I’m doing everything I can right now” he then states, “I have one of my shift leads back here helping, throws his arms back and yells “What else do you want from me!” Now I’m almost in tears and have to get all of the prescriptions done for the day, mind you after this, my thinking was a little off.  What went through my mind was focus on what you’re doing and do it correctly.  

I knew that if I continued this way, patient safety would be compromised.  I looked at the numbers from the last month and realized I had done over 4,000 prescriptions.  On top of doing double the prescription load, I was ensuring all of the tasks were completed for the pharmacy.  The work load was tremendous, to the point, I stayed over my shift almost 2 hours everyday.  The stress became so great that at my young age.  I got Shingles.  At the same time, I was constantly being told about patients complaining about having to wait. On Tuesday, everything ran normally, everything was behind, we were still a tech short (from the techs quitting).  At 2 pm, the floater pharmacist came in, he was in a very bad mood, obviously angry about something.  The Pharmacy manager was there to, doing extra work.  The floater pharmacist was not doing anything, wasn’t counseling, giving flu shots or anything except standing at his computer.  It was obvious he was mad; he turned to me and stated “This place is a freaking circus.” A gentlemen was mad about his prescription being brand OPANA and not generic (which I was told never give any one generic unless they regularly got the medicine from us).  The floater stated you deal with this.  Another patient was leaving cursing voicemails on the phones and I was told once again to deal with it.  I become concerned about this, because if I could not resolve this patient issue I could get blamed.  The patient was on many psyche meds and I knew this would be difficult.   At this time it’s over my shift and I’m trying to get our order done so that we don’t have any more people upset.  We were having major problems ordering patient medications.  The order was not done the day prior so I had 2 days of OOS/partials to go through.  Since the other pharmacist was not doing anything, the techs got me over and over and over to counsel patients, it’s going on 6 pm at this point and I got off at 4pm.   Finally, a tech looks at me and states, “are you on the clock?” after he had asked the floater to counsel. I stated, No, I’m doing the order.  The tech turns to the patient and states, “the other pharmacist will be with you in a moment.”  I move to the farthest computer to finish the order then went home.  

After the last few days I knew something had to give, everyone was so stressed out it was like a bomb ready to go off in that pharmacy.  I started reading studies and soon realized that these numbers are impossible, I could not keep this up on my own, and the risk for error was too great.  I soon realized that the facts are clear; this amount of prescription done by one pharmacist is proven to cause error over and over again in studies.  On top of everything else in the pharmacy, at this point is was not a question if errors would occur but when.  Why was I being pushed to do all of this work? At this point, I knew that I could not continue this way.  I emailed the district Supervisor and asked for a meeting with her.  She agreed and set up a time to meet with me that Friday .  I went in and spoke with her; we spoke for about 30 minutes.  I voiced to her that I was concern about the errors and that I needed the staff to stop doing things quickly instead of correctly.  I listed the errors and we talked about training issues and working with the other staff.  I was asked why I didn’t meet with the Pharmacy Manager, I stated that I had tried to talk with her almost everyday and got no response, I explained I had met with the store manager and now I was worried.  She stated, her time was valuable and kept looking at the clock.  She did talk with me about a few issues and stated that her and the tech trainer would assist me however they could but was leaving for vacation so had to go.  She got up to leave the room in an angry fashion and started walking fast toward another room.  This took me back a little, but I said enjoy you vacation and leave the district office.   

The next week, I come in after being off that weekend, nothing had changed except the fact that are senior tech was on vacation and we were still a tech short (This was also the week hydrocodone became a CII and complaints were to be expected).  Monday and Tuesday were okay; I was 2nd shift and as always stayed over to get things completed in the pharmacy.  For some reason though I get this “off” feeling from the shift lead, you know when someone doesn’t want to look you in the eye.  That Wednesday, I come in as normal, about an hour into working; the store manager calls and says he wants to talk to me in the office.  I go in and one of the shift leads is there.  He begins to tell me that he is writing me up because I refused to counsel a patient after my shift had ended.  This is in response to the tech asking me if I was “on the clock” and me responding no.  He continues the write up and it is almost exactly the one my previous manager had given me at my old store.  I became upset, I told him that I needed him to call the scheduling and I can not work.  I am to upset and at this point I know that if I work today I can cause error.  He stated to me. “If you can’t handle it you don’t need to be here, what are you doing? Walking out on your job?”  Are you quitting?  I’m just sitting there not knowing what to do.  The only thing I could think of is that I know right now I don’t need to be verifying prescriptions.  I asked if I could step out, I called the scheduler and asked her about another pharmacist coming.  She told me there could be more disciplinary actions for me leaving work, I stated I work 2 hours over everyday, I stayed and worked when I had shingles.  I’m telling you right now that if I work today, it would be dangerous; it is not in the best interest of the patients.  She told me she got another pharmacist to come and I should go home tonight.  After this my stress level had reached it limits.

 I called the scheduler the next day and she had me switch to another store for the weekend because the district supervisor was on vacation.  I called the corporate compliance hotline to report my treatment the last few weeks. I reported everything that I had told the supervisor in our meeting along with the things that had been said to me, specifically him yelling at me in the pharmacy I let them know that it was not okay how a specific tech was treated and then forced to resign after she made a complaint.  I also emailed District Supervisor and asked to leave this store and go to 2 days a week.  The weekend was nice because I was at a store with experienced techs.  On Sunday, I did 250 prescriptions and 22 shots and never felt stressed once.  Monday came and I had a conference call with the District Supervisor and Loss prevention.  This call was recorded, and they were on speaker.  The reason I know this is because when I started mentioning medication error at a specific pharmacy, the district Supervisor quickly picked up the phone. I explain everything to them and they told me they would look into it.  They said neither the store manager of the pharmacy manager would be working on Tuesday, so go ahead and go back to work there.  I agreed, although hesitant and the day went by normally.  Wednesday came and there were no issues as well, so I awaited a response from Walgreens.  Thursday I was off and had not heard anything from them. So I decided to give it time and went to work on Friday.

 That Friday afternoon, the Store Manager brought me into the side room with Pharmacy Manager.  He began to tell me that I must sign the write up that he gave me.  I responded with I will not sign anything without talking with someone first.  He told me that if I wanted to continue to work for Walgreens I will sign.  Furthermore, that it was unprofessional of me to ignore everyone in the pharmacy the last few days.  I responded I was upset and I haven’t been ignoring anyone.  He stated that he said, “Good morning to me” and I ignored him.  I responded with it was busy, it wasn’t purposeful.  He again told me I must sign and I refused.  He said okay and I turned around and walked back into the pharmacy to complete my shift.  He comes back and tells me we have to finish this conversation.  He then continues to tell me that if I want to stay employed with Walgreens I must sign the write up.  I state again no, I will not sign anything without talking to someone first.  We started to talk about the write up and I explain the situation, he tells me that this is not how this works, that he decides if I get written up. I ask him about what he said to me in the pharmacy, I recapped the conversation:

He tells me finally, “why can’t we take care of the patients!” I respond, what do you think I’m doing?” He then states, why did she have to wait?” Why wasn’t her prescription ready?” I explain that she did not have any refills, he tells me I was arguing with the patient, I state, I never talked with the patient, he said she over heard you say the prescription was ready and thought you were arguing with her. Then he says, “How are we going to fix the pharmacy!” All of these patient complaints are your fault,” I reply with, “ I’m doing everything I can right now” he then states, “I have one of my shift leads back here helping, throws his arms back and yells “What else do you want from me!”

He states I never said any of those things to you, I said “you never said those things to me?” He stated again, “no I did not.” At this time, I’m thinking, if he did nothing wrong, he wouldn’t have lied about it. I explain to him once more that I will not sign anything without talking with someone.  He states okay, then that’s all…so its 4pm and my shift is over.  I get my stuff and head home.  

I email both the District Supervisor and Loss prevention inquiring if I have to sign this to keep my job to which I get no response.  I get a call from the district supervisor, she tells me that she was told I walked out of work and that I threatened to resign. I tell her the manager said, “That’s all” and my shift was over, how is that walking out?  She tells me to enjoy my weekend and come to speak with her and loss prevention on Monday.    

Monday comes and I meet with District Supervisor and loss prevention, this was honestly the worst experience I have ever had.  No Matter what I said the conversation was turned to me.  I was told again that I walked out of work, to which I replied once again, my shift was over and the manager said, “That’s all.”  The district supervisor then went on to tell me that is not what her statements say. I was just thinking “There’s obviously nothing I can say to this except what I know.”  Loss prevention explains to me that regardless if you sign it or not, it doesn’t change anything and then the District Supervisor states and you have another finally written warning when you get back for insubordination which is very serious.
 Honestly, at this point I have no idea what to say, I guess I shouldn’t have thought the company would admit wrong doing on their part.  My beliefs, at that moment, that the world is fair and just were shattered.  They went on to tell me that on Friday I let the pharmacy “Get back up” and made patients wait for Flu shots.  I explained to them that the Pharmacy was “backed up” from the night before.  I came into the pharmacy with 30 labels on the counter and no patient waits for more then 10 minutes to get flu shot from me.  I start to think, as we do, when things are brought to us like this.  I’m thinking I’ve been doing more then double the prescriptions of the other pharmacy staff in this pharmacy, I’m the only person that cares about filling our waiters, to the point I fill them myself.  Something doesn’t ring true about this.  Then I’m told that I didn’t counsel fast enough, to which I reply, “patients do not wait on me for anything,” Then I realize, there’s nothing I can say at this point, everything I say, they come up with something else.  The reality of the two people before me sets in.  

Loss Prevention goes on to tell me that the Store Managers conversation with me in the pharmacy was not hostile, he was upset with you but did nothing wrong, basically acting as if I was a silly girl.  I respond directly and state, “No, what he did and said to me is not okay or acceptable, especially when I am verifying prescriptions.  I was left almost in tears on a Monday morning; while I was short a tech, this is not okay.”  Additionally, he lied about what he said; he wouldn’t have had any reason to lie about it, if it wasn’t wrong.  I realized that this whole conversation was to make me feel “bad” or “silly” for being upset about anything.  They would say anything to make me feel bad and I started to see right through them.  Loss Prevention then brings up a CII, I reported to them that had been completed after the 3 days had passed.  He shows me the paper work and somehow my initials are on it.  I get upset and confused because I know I did not complete this CII, I asked them to look into that and I stated I may get a lawyer something is wrong here (Not against them but why were my initials on a prescription I did not complete?)  I watched the other pharmacist complete this CII and fill it herself.  She was the only one who spoke to the patients about this.  All I could think is something is severely wrong here.  

The District goes on to tell me “I don’t think retail is right for you” all of these things we are talking about, I’m hearing the same things, do you really think the store manager went into you file to make the same “write up?” I state firmly, Yes actually I do, to which she responds, “Why do you think that?” I reply because he told me, 3 days after I came to this pharmacy, that he read my file, talked with me about the contents and stated that you told him to document “things” about me before I ever started working there.  At this point she starts to get irritated and mean.  She goes on to say, “I hear a lot of blaming from you” this is a managerial tactic to shift any blame from the person your speaking to, which actually made me giggle a little because I knew what she was doing, the store manager used this tactic on me in our conversation as well.  Also, she had gone from angry to nice very quickly.  
The district supervisor then went back to angry, she started saying, “all of your write-ups are not my fault, I never made you do anything.” To which I replied directly any errors that I have made are my fault, I have not blamed anyone for them and I never will.  This practice is unethical and it not something I will ever do.  This violates the oath I took as a pharmacist and who I am as person.  The district supervisor then states, “how was your evaluation? Not good right? I would say now you haven’t improved at all and actually you may be a little worst.” I just sit there thinking wow you are a really mean person.  They go on to ask me what I will do to improve my actions, I tell them there is nothing I need  to do, after this point I am no longer stressed about this, I have been doing a really good job, I love being pharmacist and all I want is to be happy and I will be.  They state you can just turn it off (stress), I say yes I am no longer stressed.  At this point, they want to speak to each other in private.  I say I need to use the restroom so I will return shortly.

As I return, their whole demander had changed; they were both smiling and happy.  They go on to ask me what would make me happy at Walgreens.  I reply to them, I was happy, till 2 weeks ago. They both said, “We want you to be happy” and we don’t think you are.  Loss Prevention goes on to say, your record with Walgreens is tarnished, what’s after a final written warning?” I respond, “You get fire.”  He said,” that’s right.  Things will only get harder for you from here on out.”  District Supervisor states, “Do you like getting wrote-up?” loss prevention continues, at this point we are suspending you; you are not going back to the pharmacy today.  We will then get with employee relations and decided whether to keep you are not.  I can not tell you what to do, but why continue to torture yourself.  We’re just saying we want you to be happy.”

I then start feeling extremely suspect of this conversation, if they really had grounds to fire me, they would just fire me.  I’m currently doing a large amount of work at this pharmacy; corporate wouldn’t get rid of someone doing that.  Why do they want me to resign? They wouldn’t spend the time to do this if there was a reason.  The district Supervisor made it very clear to me that her time was valuable, yet they continue this meeting.  I then realized that something in this scenario is off, that these complaints that I made are valid and I am being coerced to resign for a reason.  As I’m thinking about this loss prevention states so what are you going to do? Thinking to myself, let me test this theory, I look at him and say well I guess I should resign then huh, I stated, as he’s shaking his head yes I say, “I have a resignation letter.” Quickly loss prevention chimes in, “Is it on your phone?” Print it off now, sign it here.  I then know something is severely wrong here.  I look up, say thank you No, I would like to run this by someone first, Stand up and say ya’ll have a nice day and walk out of the office.  

The next day I talk with my lawyer, called Walgreens compliance line to file this report and emailed the district supervisor to let her know I would not be resigning.  My lawyer informs me of 3 legal issues with my experiences 1) Violates the Public Protection Act and 2) This is called constructive dismissal and is not legal 3)saying you will talk with employee relations to find a reason to fire an employee not legal

 As of now, I am still employed by Walgreens; they continue to add PTO days to my schedule.  Today, I spent this day writing my story, as I wrote it I was almost is disbelief, see I had all of this is logs and notes I had kept over time. As I re-read my story in completion, I felt completely saddened by my experiences.  I love Pharmacy, I love being a pharmacist, I truly care about people and I was so excited to graduate school to full fill my life long dream.   

After I emailed that I would not resign, Walgreens added 2 more PTO days to my schedule while figuring out how to fire me (I have a screen shot of the entire week . I was a salaried pharmacist and their lawyers are aware that they could be at risk if they cut my pay.  I sent them reasons why they have violated my rights as a pharmacist and an employee.  I also emailed Employee relations, stating that I am a salaried pharmacist and this is the last day of my PTO.  I have not resigned nor been fired and I have no schedule.  Shortly after this email, I receive a call from the District supervisor.  I sent her an email stating that I can not call her back and speak with her unless my lawyer is present, I got no response.  I made an official retaliatory complaint with OSHA, letting them know I was forced to resign after making complaints about patient safety issues.  

The district Supervisor emails me and states “she accepted my verbal resignation.”  To which I reply, “I did not resign.”   That Friday, I receive my pay, minus the 4 PTO days they had added.  You see if they paid me those days, they could not have stated I resigned.  The funny thing is I got added PTO days within 10 minutes of stating I was not resigning, yet their saying I resigned.  Really? Do corporations usually add you more PTO days after you resign?  Well, I guess they didn’t factor my screen shots of my schedule.  I wonder how they will argue this?  That question is for you lawyers in employee relations.  So, I did not receive paid days after my meeting. This way they think they can say, “She resigned.”  I’m sure they will try and refuse any unemployment for me, its they do.  

Now I tell you what I have learned, this company is rampant for employee bulling.  All the while they are disgracing the profession of pharmacy.   In General, they put employees on a “list” if they want to get rid of them.  There is no open door policy, you either shut up and do what they say, or they will make your life horrible until you have to other choice but to quit.  It doesn’t matter to them if patient safety is at risk, why? Well, the money paid for malpractice is less then what they make for an increase in prescription. Also, the errors are on each individual pharmacist license. But you see, their staff cuts and volume increases are more then any one pharmacy can safely do.  That is, studies have proven that no matter how perfect a pharmacist is, the % of error is inevitable with in this a certain volume.  That does not even include the extra duties.  

Currently, they are terrorizing to the “older” pharmacist, writing them up constantly so they will resign.  Why are they doing this? Well, they are higher paid pharmacist (we currently have a large influx of new grads) so how are they cutting pharmacist pay? Well, getting rid of the higher paid pharmacist with bulky 401Ks seems to be their move.  Most of the Pharmacy Managers getting replaced by brand new grads, which is absolutely insane! Almost all of the pharmacy managers, which have been around for many years, are on an “improvement plan” in preparation of their exit.

The corporate bulling is the company’s tactics to make the employee feel so bad that they resign, basically, to emotionally break you down.  One thing is clear about most pharmacists.  We agonize over error, we lose sleep, we think about them all the time. No matter whom you are, if an error occurs with your medication, you can be sure the pharmacist will torture them selves about the error.  The thing is the company knows that what it is forcing upon the pharmacist is proven to cause error, they just don’t care.  If a pharmacist speaks out about the risk for error to the patient, they are torn down by corporate.  All the while, they cap techs pay, cut hours (understaffed) and hire 18 year olds with no pharmacy experience.  I had a tech once say to me, after I pointed out an error she made (a triple dose of antibiotics for a child, that could have killed them), “well I just wanted to type quickly, ya know so the numbers are better. Really? This is peoples lives ” NO!!!  When will we stop and say NO this is not okay, we are risking lives here!!! Its not going to happen, the profession is overrun with new pharmacist, its only going to get worse.  At this point, due to Walgreens tactic, most of the “good” senior techs have moved on to other companies for better treatment and pay.  There is no way out of this and they know it.  Think back to my story, The Store Manager and District Supervisor used the phrase, “I’m hearing a lot of blame coming from you.”  Why did they use this phrase?  They know that it turns the blame to the one their are talking to.  They know that we as pharmacist agonize over error; they know this will make us feel bad.  It’s just another tactic to shift the blame off of the company.  

Let me explain some things, the Store Manager at this store is a New Store Manager, he doesn’t know enough to be directing the Pharmacist.  He wanted fewer complaints from patient about having to wait, so he encourage and threatened “write ups” to the techs to get them to work more quickly.  It is easy to see that this is a major major mistake in the world of pharmacy and is never condone by any board of pharmacy.  What is currently happening in the world of pharmacy? Well medication errors are on the rise, most retail pharmacies have new poorly trained techs, people are leaving retail pharmacy because of literal mental breakdowns, almost every retail employee in on antidepressant and anti-anxiety medications, even a few pharmacist have had to retired do to post traumatic stress disorder.  At the same time, corporate companies are pushing volume, flu shots, MTMS, more distractions for pharmacist (The one person responsible for the medication to get to the patient correctly) and cutting hours of the already poorly trained techs.  Factory workers have less distraction to ensure their products are made correctly than a pharmacist does.  This is a complete and utter idiocy.

  I took a poll on a popular pharmacy site; I wanted to see what people that worked in the retail pharmacy world thought of retail.  Do you know the consensus?  Retail Pharmacy stole my soul! Stole their soul??, wow, that is a strong statement.  Now as I sit here, not working for 2 weeks, my anger has subsided, I feel calm and peaceful; I’m laughing again and loving my life.  So, I understand this statement, although it seems completely outrageous but it’s true.  I don’t know about everyone but my happiness and my “soul” comes before any amount of money.  It seems everyone is so unhappy in this world and fear being “Blamed” for something; they manipulate and scheme to avoid it at all cost.  It’s very sad but you see if they blame someone else, they don’t get blamed.  The very real fact is that Pharmacist and Pharmacy Techs alike feel so bad all the time because they can’t finish everything, they never stopped to think, “Is what is being asked even possible?”  See I calculated the numbers, I even used best times, I calculated tasks, number of prescriptions, waiting on patient and it was easy for me to see it was impossible.  I realized that they are making all these employees feel like their not doing a good job at something that is impossible (A few years ago, this may have been possible, with multiple seasoned techs and pharmacist) these days, it’s just a disaster.  The thing is, the company is making more money, the employees are making less and patient’s lives are at risk everyday.  There’s nothing anyone can do and it’s sad.
 I am making my effort here, in my letter. Do I think any change will come of this? Not really, Do I think other pharmacist will stand up and say this is enough? Not if they want to keep their job, do I think Walgreens cares about my letter? No, they will break it apart; their lawyers will look it through it and figure ways to cover any legal liability they may have.  Why am I still sending it? Because I refuse to accept such irresponsible, unethical and just revolting actions of this corporation, I will always stand up for what is right and honorable regardless of the outcome.  I know I am a single Pharmacist, trying to fight a powerful corporation and the odds are not in my favor. I will not cower for anyone, no matter how much money of power they have.  I am a Pharmacist and my first responsibility is always my patient and that is what sets me apart.  One thing I now strongly agree with the company on, “This Company is absolutely not right for me.” For this I am thankful everyday.  

In closing I will say this, “The one thing that stood out to me, on my quest to become a pharmacist; Pharmacist, the most trusted profession! After one year of practicing I can tell you honestly, out of all the professions, this one I trust the very least” I have now questioned if I even want to stay in pharmacy after this and I still don’t know.  I went to school 9 years, spent $200,000 and I am ready to leave the profession.  I have already started my application to Med School.  I love Pharmacy or what it should be, my statements here are not true of all Pharmacists, most, in their hearts, are caring souls that truly want to help their patients.  But in retail, they have to play the corporate game or they will be dismissed and treated no better then trash.  Pharmacists are now disposable; honor and dignity have left the profession.  

Thank you for taking the time to ready my story

We only worry about human rights issues in other countries ?

http://youtu.be/749VPGWFkAs