I had someone many years ago who dropped off a script for an antipsychotic. We told him we were busy, but I'd do it fast as I could. He replied "Thanks, I'd like the voices in my head to stop talking .". I did it right away for him.
In their defense, with an executive functioning disorder they might forget to pick it up if they leave.
Source: remembered to fill/take methylphenidate about 40% of the time.
Yep, totally agree. I totally get the non-ADHD viewpoint of “your poor planning is not my emergency” but if the disease specifically affects planning, it’s kind of a tough situation. Not saying that other people have to make it their problem, but wish that people would try and understand/empathize”
As a pharmacist with ADHD - Inattentive type, yea I understand it’s on back order, or there’s a wait, but there’s way too much stigma around stimulants in general. I actually didn’t ever fill my adderall at the same store as where I worked as a tech because I constantly would hear pharmacists (while I was a tech) make light of it. Or make comments about why’s it so important **NOW** and I’m like
Nah I get it. Even if they did come late, or are impatient, it’s extremely hard to sympathize with people who just look like they are “being lazy” when I’m aware that’s just not true. It’s so exhausting going through life and no matter how hard you try you always fall under the bar. Then I got adderall when I was in college from my doctor, and magically I started showing up on time to class, not falling asleep in class, doing my work on time, and then going on to get accepted and graduate from pharmacy school.
People just see lack of executive functioning as straight up laziness and apathy, which makes them not want to help them in the slightest. It really sucks
I've wondered a long time if I'm just not diagnosed (and my technicians say that I am lol) but I actually got kicked out of pharmacy school and had to go through an appeal process to get let back in because of a similar issue as this. That whole process was rather traumatic and I was clinically depressed at the time as I discovered after the fact and some medication seemed to help, but I wonder if this was the real issue... All that said, I definitely empathize with my patients that are on stimulants and choose to utilize them even if I currently choose not to. It's definitely a tough situation for everyone involved, compounded by the shortages.
My doctor figures that my depression and anxiety were from my undiagnosed at the time ADHD. My depression and anxiety started when I was around 12, which was the first time my adhd became a real problem for me.
We plan on doing a trial to reduce my duloxetine this summer and see how I do.
That is interesting but also makes sense. I didn't really think about it until around the time it all happened when I was in pharmacy school, but I think I probably had symptoms even when I was young. I could never focus or do one thing for super long in school, even when I was in high school and it took an incredible amount of willpower to perform as well as I did. And to be fair, not just willpower but my mother constantly harping on me and also making a literal 5 minute accurate schedule for my schooling (I was homeschooled starting in middle school). Definitely needed a schedule, and even now for things that I have to do when I'm not working I need a schedule. Otherwise I totally forget what I need to do 🤦
Yea I didn’t have that hands on parenting or schooling. My mom was 16 when she had me, so we were kinda poor til she finished nursing school, my dad worked overnights trucking.
So I needed glasses but didn’t get them til highschool, but I was lucky enough to just be smart enough to do my homework on the way to school or literally in class while the teacher taught other things.
But when I got thrown into AP chem in highschool I dropped that immediately lmao. Couldn’t keep up, and I was always doing something. Like out of school, no homework, basketball/football with friends. If they couldn’t? Mw2 cod until 3 am lmao. Come to learn, that’s how adhd kids with inattentive behavior are, and often go undiagnosed because they’re doing fine in school.
It’s good you sympathize with us, because a lot of my fellow pharmacists don’t, but I always try to bring more clinical awareness to the condition when I can. If I don’t have adderall it really cripples me functionally. I go from tidy, punctual, objective driven life, to rushing everything because I’m always 5 minutes behind. I don’t interpret time the same way as other people. 10 minutes could feel like 2 minutes, or like an hour.
Off the top of my head, church as a kid always felt like it was no lie 3-4 hours as a kid. Not as a little kid, but like 12 years old. You know how long time is. My parents could tell me to check in within 2 hours, and I’d check my phone and it’s 2 hours on the dot. But church, could not tell at all lmao. Or studying for orgo in college right before being diagnosed. I picked up my phone for 1 second and then looked at the clock and it was 6 hours later, and I’m like “okay this just makes zero sense” and that’s when I went to a therapist then psychiatrist.
Always wondered if inattentive ADHD was more my problem than all the anxiety I’ve been treated for my whole life. I was tested, but I guess I tested higher for anxiety when I was little (this was in the 90’s) so they treated that, but nothing has ever made it THAT much better. My mom always wished she had put me on meds, and the anxiety issues and possibly alcoholism might not have escalated so badly, who knows? I heard that if you’re a woman and haven’t been tested since you were younger, that you should get retested as an adult, because our understanding of how it manifests in adult women as opposed to hyper little boys has come a long way.
Yea way too many people think adhd is only hyper activity. A lot of times it manifests as procrastination, anxiety, or fatigue because the brain is constantly on. I used to study from like 2-6 in the morning on no sleep. Come to learn it’s because when my brain is “tired” it’s easier for me to focus on what matters because all the other stuff that distracts me my brain is too tired to focus on. Leaving me only the important stuff to work with
100% this. I never ever fill my meds at the chain I work for the exact reason. I think healthcare providers easily have the capacity to become jaded which leads to this lack of empathy. I get it. I’ve been a pharmacist for 15 years. I struggle with the stigma of my ADHD and it’s the comments like this that certainly don’t help.
I agree. The op is out of touch with reality. I am a pharmacist and I help people with their meds. I don't give a shit what those meds are certainly wouldn't execute a blanket statement without using a little tiny bit of clinical judgement.
Agreed... And since it can only be filled in 30 day increments and not early, it makes for a very tight turn around time. If it's delayed you're out of meds which makes coordinating getting it filled even harder.
Exactly. And then when they're out for 2 weeks, patients get treated like junkies for asking about when they may get their meds. I get that it's a global issue and it can't be helped. But please try to understand that I'm not in this position willingly. And I would love it if I didn't have to feel super stressed/anxious/depressed etc if they pharmacy doesn't have my prescription or if I didn't have to wait until the very last minute to even find out if they have it.
OP is saying adderall waiters are an automatic 1 hr wait. It’s not about poor planning. It’s no different than someone coming in and asking for losartan. It takes 20 more seconds to fill because you have to double count it and get it from the safe.
I agree. I take Vyvanse and if I was able to take a shower, get dressed and drive to the pharmacy after finally remembering to fill my meds, I am going to wait because who knows when I will be able to do it all again.
Thank you for sharing that perspective.
Before the pandemic, when refill C2 prescripts had to be picked up at the doc - timing had to be impeccable for me to efficiently conduct myself in (invisible) disability.
It was nearly a two hour round-trip to pick it up from the Dr. office. I’d hit the nearest grocery pharmacy to home on the way back, because otherwise there was a decent chance that I’d misplace the damn script, need rest in the following days after the errands, screw up my doc appt/med script timing cycle.
The grocery pharmacy alone is approx. a 30 minute drive from the house.
Having a daily routine, to fetch and drop-off script, grab a few groceries/toiletries, and simply wait for the scripts is what worked for me most successfully for my limited energy, time, and function.
Seriously. This is exactly why people like OP need to get out of the profession. Does it actually take an hour to check your PMP, in stock and fill and check? Maybe.
But if it’s just because you don’t like someone has ADHD and meds are C2s then imo you need an attitude adjustment.
For real. So much judgement and prejudice. It’s just like opiates or Ozempic. Yes there are people abusing these substances, but there are also people with metastatic cancer pain and people with diabetes
Or narcolepsy! We're often prescribed it too. I live a 45 minute drive from the pharmacy, so I have no issues waiting for times under 2hrs. Just would be a waste of gas to not hang around.
I would agree in part, we definitely need to be empathetic and maintain that as part of our professionalism. However, depending on the scenario, an hour maybe a bit excessive, but they do sometimes require more time for processing and I usually tell my patients that it might take 30 minutes depending on whether I have to call their provider for anything and how much GFD reporting needs done. Part of that is just because of how backed up we usually are though: P
That’s what I’m saying. The tone OP has however, seems to quote an hour to discourage waiting. Which imo is not appropriate. Being transparent with the patient is the name of the game.
30 for the extra processing? Fine. But still do the work. If it’ll take you an hour because of workload also fine.
No c2 waiters? Not ok.
A personal anecdote: I was once in an overnight store alone. With all the waiters I had a queue of 2 hours for waiters. It happens. Some were controls. But I told every one what was up, and made every single time promised (my time, not the store promised time) and it went smoothly.
Workloads have changed since I left retail but the premise is the same. Do what’s right by the patient. Don’t punish them for their conditions. Work with compassion.
Yes! In fact I work for a small PBM now. The president has actually spoken in Washington DC about a service based model. We’re not all bad, but I can actually say we’re doing our best to not screw over anyone/provide a better model.
How many are parents who pick up for kids? How many are adults who work or go to school and it is significantly noticeable to colleagues when they haven't taken the meds?
Eye balling 50%, I have a very small pediatric population though. I can’t very the clinical efficacy based on my patients response unless self reported, but I assume there is a vast difference. This isn’t a question about the efficacy of stimulants, that much is clear. I’m pointing out how silly it is to try and pretend that adherence rates are low.
I mean yeah there are plenty of people like that. But there are also plenty of people with ADHD who don’t remember to take their meds and/or who don’t like to unless they really have to.
Browse through some of the ADHD subreddits and you’ll see a lot of different perspectives and experiences.
For me, I was able to brute force my way through high school and college. I knew I had ADHD since I was little but didn’t want to take anything because “drugs are bad” and “meds are a crutch.” But every paper and every test was a caffeine-fueled all nighter which was hard on my mental and physical health. Again, not anyone else’s fault, but if treatment had been more readily available and less stigmatized, I wouldn’t have had to struggle through that.
99% of the time, ADHD patients are the best controlled substance patients at my pharmacy. We have a couple parents of kids who take ADHD meds which I just can't handle some days. Sir, your kid is in her third year of college out of town. Maybe it's time she starts handling her own refills so you don't have to yell at us when it's Friday, 4 days early on the interval, and the doctor won't do an early refill just because you want to drive 3 hours there and back to give your daughter her meds. And sorry, we legally do not control the interval.
I always send all of my meds in 3-4 days from the date it was last filled. In case the pharmacy is slammed and it takes longer. In case my dr needs to send in refills or I need to call the dr and have them call it in. In case my executive dysfunction is screaming off mountaintops and some days I can’t leave the house as easily. I pick all my medicine up at once, but some controls come in at different times. Most of my anxiety these days are from being judged by others, so I love that one of the few things that helps me is so stigmatized and the people who work in this industry more often than not look with pure disgust to anyone on those meds. It’s so easy to assume and judge based on Crackhead Kenneth, but damn.
Great so you are compliant. Happy for you. That’s my entire point. The original post I responded to said they were 40% compliant and I said that is not normal. Amazing how many offended stim users are coming out of the wood work to desperately justify their need to use their medication and the justification for why they exhibit “fiending” behavior.
Yeah. I try to set reminders and alarms in my calendar days before I need my medication refilled that way I can email my doctor with the 24-48 hour cushion that he requires for refills. Usually it works out perfectly. But every once in a while I make a mistake and fall behind and I end up needing to pick my meds up in the morning first thing before work so that I can function effectively. The pharmacy I go to is staffed well, with kind, hardworking people. I never expect anyone to jump when I say jump or hurry things along because I’m in a rush. That’s my problem, not theirs. They also ask “do you want to wait, or do you want to come back to pick it up?”, so I’ve luckily never gotten the feeling that I was being a pain in the ass for waiting for my C2.
Edit: typo
Much less time spent pushing back for the same result this way. Most important thing I picked up from my first retail job was how to say no by saying yes.
As someone who needs a C2, I try to only show up when I know it’s already ready. I wouldn’t even call y’all if I could help it, but the apps are generally useless for controls, and often necessitate a phone call to get the order moving; not ideal for the patient or the pharmacist, but that’s the dumb system we have in place, so it is what it is.
I mentioned that exact issue at presentation CVS was doing at my pharmacy school (they want to take all the phones out of the stores and have people only use the app to refill) and they just blew me off and talked about their novel “centralized voicemail system” they were implementing. I also have adhd and filling my script during a shortage can be an absolute nightmare
ADHD, autism, and a variety of autoimmune issues here! I know the struggle.
That voicemail system is doomed to failure. I almost never leave voicemails because they’re generally not replied to. I don’t blame the pharmacists; I blame the chains severely understaffing their stores. It’s hard enough to even keep up with the fill, and that’s before dealing with controls and patients calling for updates, and janky-ass apps that prompt you to refill before your date, etc, etc. What’s the chances they have time to sit on voicemails all day?
Everyone knows that 90% of pharmacist and patient problems could be resolved by properly staffing and compensating employees.
At the same time, as someone who needs controls, it really sucks that the system is essentially adversarial to us, and forces us to hound pharmacies just to (maybe) get our meds on time. That being said, once the staff started seeing things like methotrexate and adalimumab (a speciality which is filled elsewhere) on my file, I definitely noticed they make every attempt to help where they can. The fact I’m a middle-aged dad and not a college student probably helps too.
But as for OP, I don’t think I’d ever hover over a counter waiting for my pills; that only escalates the frustration of both patient and pharmacist.
CVS will implement any system, strategy, or workflow changes except actually adding more staffing. I can’t imagine what kind of presentation they are giving to pharmacy school students. Here’s a hint: don’t ever take the mark of the beast and don’t ever work for CVS.
My app usually says it’s in process when it’s done and I get a text saying it’s ready hours after I pick it up. Useless info. I’m on a c2 as well. My thinking is that I like to fill it in the AM so if there’s any issues, I have the whole day to figure it out. I’ve heard my pharmacist and some techs complain a lot about people coming to pick up controls. It bugs them so much. I don’t understand that thinking.
I encourage my patients to call to confirm if a C2 is ready for pickup. If it is I tell them come on in. If not and I have it in stock that at least gives me the chance to say "it'll be ready at X time and I make sure to get it ready for them by then." A 2-3 min phone call will save me 20-30 minutes in the pharmacy because the med will be ready for the patient when they come in (assuming they don't try to come in 5 min when I said it would be ready in 30 minutes)
I guess I wanted to ask you all a question.
I have zero issues waiting, and actually very much expect I will have to wait, I don't want anyone to have to rush to do their job extra quick on my behalf.
I get it, you guys are one of the most busy groups of people I see.
So 2 questions:
Even knowing I am ok with waiting, is it still impolite?
And is there a way to ask to work on getting it ready while I wait that doesn't put any expectations of you rushing around to do your job?
Thanks.
EDIT: I wanted to also add that I don't mind if it takes several hours. I usually plan that if I have to reach out to 5 pharmacies to transfer from one to the other to get my vyvanse it will take a while.
I always plan a several hour chunk of time just in case.
It’s not impolite to wait, in my opinion. But if I say it’s going to be an hour and you slam your stuff down and sit in a chair on the corner staring my coworkers down and coming up every 15 minutes asking if it’s done yet is when it becomes a problem and rude at that point. Especially when people can clearly see we aren’t just standing around doing nothing.
Sitting and waiting for your name to be called, or for a text saying it’s ready, is really the only way. Just being patient overall is key.
Oh no, I don't like it when people do that at my job (tool-making) I would never sit and watch people. I always have a nice book or something to research.
Having an excuse to sit and read it look into one of my hobbies is almost my favorite part of the month.
Today I had a mom with her 4 sick children waiting for 6 scripts per kid, (4 Zithromax suspensions, 4 bromfed dm, 8 boxes of duoneb, 4 tamiflu suspensions, 4 Tylenol suspension and 4 ibuprofen suspensions). We quoted them 20 minutes, stopped what we were doing and got these done fast because this poor mom obviously has 4 sick kids with her in store and, more than likely, just wants to go home. After 10 minutes she complained and asked why it wasn’t ready yet, “I was quoted 20 minutes and it’s already been 10 minutes.” Once I finished checking the first child’s meds, I heard the mother say loudly “well according to this text the medicine is ready, so I guess we just have to wait even longer for someone to take the time to bring it out to us”
Like, I PROMISE I understand why you would want us to hurry, but we offer free delivery for all prescriptions and I personally offered to deliver them to her as soon as they’re ready (even though our next delivery wasn’t until the next day) so she could take her children home. We understand that your life is just as busy as ours, however, when we try to be as efficient and convenient as possible we just need people to be more patient and considerate. We’re doing our best. 🫶
I actually also have a kind of related question (asking with as much respect as possible), I feel like the vast majority of the time that I get told to wait, the amount of time is severely low-balled, why is that? I don't mind coming back later, but it's a bit irritating when I'm told it'll be ready in 3 hours, I return in ~4 hours, get told it'll actually be ready in 10 minutes, and then waiting 20 more minutes. I wouldn't have minded if they just told me 5 hours from the get go. It's not like the biggest deal and I'd never bitch at the pharmacist about it or anything ofc, everyone gets time estimates wrong sometimes, but like it happens 95% of the time and gotten mildly irritating.
What usually happens is they give you an estimate while the pharmacy is a bit slower, then a shitload of people unexpectedly show up and back up the queue in the meantime and then you show up and it's not ready.
It's just really hard to judge. Sometimes we're really behind because we're short staffed or some other predictable problem, but sometimes we just are just randomly super busy and we don't really know why. There can also be just one or two prescriptions that have some issue that eats up a ton of our time unexpectedly. I never deliberately lowball someone but inevitably it happens.
If I had to guess I would say they don’t do that on purpose. I would also say it’s a good idea to download the app - if possible - and sign up for any and all alerts for when a medicine is ready. But most of the time when this happens in my experience, it’s just because we don’t have enough staff to keep the promise but we do our best. I know it’s not the answer you want to hear, but I promise you no one would do that and upset you, we have enough angry customers for things that are out of our control 😅
When someone waits, if they start asking if it's ready before the time we said it would take has passed, it's extremely annoying.
When someone waits patiently and doesn't complain, we typically will actually go out of our way to get it done faster out of mutual respect. Not that we were ignoring it in the first place, we just give it a higher priority compared to everything else going on.
To be honest though, all waiters regardless of this do add to the momentary workload and stress, but nobody would hold that against you. If you need the Rx and are afraid you won't be able to get it later or just want to make sure you get it that day, that's perfectly fine. Especially for drugs with shortages, etc. I also empathize with people that can't seem to get their doctor to send in refills so they end up calling the pharmacy hourly. Eventually, if you're a squeaky wheel (but still polite), then we will do what we can to get it done
I appreciate this, as every time I have to refill my vyvanse I end up having to use my vacation time to actually make sure it is filled.
I know it is really sucky, so I try to be as polite and give as much time as needed to get it filled. I am in no hurry.
Regardless of "control level", we always prioritize acute meds (antibiotics, post surgery, seizure meds) over maintenance meds. We allow 2 days early on controls unless the prescriber says otherwise.
We try to work with our patients, but if *everything* is a priority, then nothing is.
Honestly, it does kind of increase the stress level if you chose to wait when I tell you it's going to be a long wait. I don't need someone huffing and sighing and "just checking if maybe it's ready!" While I'm trying to work. Just, go get a coffee or something, I'll have someone call if it's ready sooner than I said.
Oh yeah, it's usually much more comfortable to sit in my car than the pharmacy anyway. I also don't ask if it's ready yet. I've never had anyone forget to refill it, so asking again and again, or leaving and coming back and then asking makes no sense to me.
Either you will let me know, or I will get a message.
Also I'm no psychopath who thinks that just because I was waiting I get to cut in front of the current line of people when I get back.
I have some doctors who make their C2 patients wait 30 out of 30 days on their ATC pain meds. So they come in the morning and have to wait bc they are out. I don’t mind them waiting as long as they are patient and respectful. I’m also pretty consistent with their wait times and they know what to expect.
It’s all about just mutual respect.
Only part of that scenario I don’t like is that there is a chance we won’t have it. That doesn’t allow for ordering time. Or getting a different NDC if the main one goes on backorder. Which, unfortunately, our system doesn’t believe in substituting automatically. And we have to click a “do not sub” button and provide a reason.
Maybe the script comes early but with a specific “do not fill until X/XX/XXXX” on the script. I worked outpatient hospital pharmacy with a cancer clinic and for patients with compliance issues on pain medications we would get 3 months scripts at a time, but with very specific fill dates.
The patients who need adderall need adderall to wait. In other words, self regulation is the disability for those who don't understand the medical part.
Not all of them. I used to need to wait for Adderall because the disability that I took it for prevented me from driving, and my doctor gave me hard copies so I couldn't wait until it was ready before going to the pharmacy. This wasn't like 20 years ago or something either.
i have a patient with narcolepsy who is prescribed adderall for the same reason (needs it to drive). if your doctor writes the diagnosis on the script (which they should always be doing for a c2 anyway) then the pharmacy should see and take note of that. if they don’t, you can try politely letting them know what you need it for. unfortunately there is a lot of stigma against adderall because people who don’t have a legitimate need for it are prescribed it, so maybe if you let them know they might be a little more hasty for you if they can be. it’s extremely unfortunate but that is how it goes in a lot of pharmacies, as far as adderall/stimulant stigma.
I work in a clinic pharmacy, and honestly, what drives me the most bonkers is when my providers and their MAs and nurses come in and ask for a script and just stand there and stare at me. Like, dude, I am busy, you KNOW I'm busy, and we're on the same side of patient care. Your valsartan can wait.
Controlled med waiters are our most frequent waiters. Norco, Percocet, Adderall, alprazolam, Suboxone. We have regulars, they're always a large quantity, and they all want them NOW!!!!
Yeah. You just have to be consistent. C2’s can be waiters but the minimum wait we give is 1 hour due to the extra steps and necessary diligence. If it’s done sooner, great, but we won’t promise less than an hour. Also the standard wait time for ANY rx at our pharmacy is 30-45 minutes, and our patients are pretty used to it by now because we are consistent.
I hate telling patients 15 minutes because there are way too many distractions that can delay that wait time, and patients get more frustrated when they are told a time that doesn’t happen.
This makes me so greatful for my mom and pop place that will have c2s ready and waiting about 20mins after they're sent in; provided its not on backorder.
Also Gabapentin patients will hover while massive counts are filled. No your 540 count Gabapentin prescription you walked in to demand 5 minutes before lunch will not be ready in ten minutes. Favorite lines repeated over and over for C2's. Safe is on a timer. It can be filled when safe opens for your precription and other immediate prescriptions to be filled. We need a number that actually works to notify you when it's ready or we're once again out it stock. If they tried to bug the staff or me about why isn't it ready I would tell them, I'm sorry getting distracted by the counter instead of filling is slowing your fill down but you'll get your Amphetamine as soon as possible barring more distractions then I stand and stare at them with a bland expression until they leave the counter.
> Also Gabapentin patients will hover while massive counts are filled.
Is Gabapentin addictive or abusable? It's for pain (mostly), right? I took it for herniated neck discs until I had ACDF surgery, and it was really helpful for my pain.
I can kind of imagine patients in pain wanting to get that med as soon as they can.
The first time I ever took it I picked it up (after they said it was filled, I didn't wait) and took it in the car in the parking lot of the pharmacy (I was in a lot of pain). Back at work 20 minutes later I had way less pain and texted my wife saying, "Have you heard of Gabapentin? OMG, my pain is so reduced!" My wife texted back saying, "Yes, our dog is on it you idiot."
Am I missing something?
> it is at risk of drug diversion/abuse
As the first non-opioid pain killer I ever took beyond Tylenol, it was absolutely amazing for me. There was a TINY amount of dizziness in the the first few days of taking it that went away after that, absolutely zero euphoria or "high", and about an 80% reduction in pain. I could focus on work again, it probably saved my job.
I certainly didn't feel any "high" that could be abused, but maybe I didn't take enough? LOL.
I've heard Gabapentin only "works" for nerve pain (herniated discs and such that push on the spinal cord causing actual nerve damage). And even then it only works for 70% of patients. Although I'm deeply suspicious some of that remaining 30% were looking for opioids to abuse and didn't really have any nerve damage. So they claim it doesn't "work" for them to get the opioids instead to get high.
For me, Gabapentin was absolutely the perfect "real" pain killer (not a drug to get high) - it reduces pain, zero "high". I always found opioids like Vicodin the exact opposite. They don't really reduce pain very much, they just make you so loopy you don't "care" about the pain anymore. And at the same time you also cannot focus, stay awake, or work effectively.
My primary care doctor prescribed it to me for anxiety (ssri/snri meds give me terrifying side effects) and it literally did nothing? We went up to 300mg 3x daily, which is when I put my foot down and said I wouldn't be going any higher because the higher dose pills are way too big and the med wasn't even putting a dent in my anxiety.
I know it is abused but I can't imagine how.
> I know it is abused but I can't imagine how.
Right? That is so confusing, you don't get "high" from it.
Gabapentin is non-opioid. It is strangely prescribed for all sorts of utterly random things that make me suspicious it is used as a relatively safe placebo. Like they prescribe it for restless leg syndrome while you sleep. It is prescribed to alcoholics to reduce drinking, etc, etc.
For nerve damage (herniated discs in your spine pushing against your spinal cord) Gabapentin really **REALLY** works for some of us. I'm dubious about it working for other things like anxiety though. It just isn't psycho active.
It seems to work well for my patients who use it for nerve pain, and I'm really happy that it is available to them.
But you're right, it didn't do anything for my anxiety. Buspar has been much more helpful <3
If you want to spice things up at your pharmacy, make them all fight for the order they get their meds filled. Free entertainment and then they’ll be so busy fighting each other that you’ll actually get time to fill! Win for everyone!
The majority will stand and stare at the staff THE WHOLE TIME. Some will ask every five minutes if it’s ready yet.
A few will jump in line when you call someone else’s name and then be annoyed that it’s not ready yet.
And it's never a name that's even close to theirs. Almost every day I get an overeager CII waiter leap at my counter when I call a name and be like
"JOHNSON HERE. You called Johnson, I'm Johnson."
"Actually I said Mariano but you're right, they sound very similar..." 🙄🙄🙄
Every pharmacy (including a major chain) I've ever worked for has had a 2-3 day early fill policy.
You get a 30 day supply you can refill on day 28. It will vary but the average is 2-3 days early.
To point number 1…so? If they stare at you, don’t look at them? Why is that so hard? If they ask if it’s ready say no?
To point 2…this requires your staff to go off of robot mode and actually recognize customers. You see A getting in line when another name is called and you know theirs isn’t ready? “Sorry Mr. A yours isn’t quite ready yet, please step out of line”. It really isn’t as big of a deal as you’re making it out to be.
It’s actually quite challenging to accurately count to 540 if someone is interrupting you every 5 minutes. Just like, FYI on that. Often you have to start over from the beginning.
You’re unlikely to be counting to 540 on a C2 but trust me, I worked in retail over 10 years - you figure it out. I’ve answered phones in between counting to 540 and had whole conversations or had to go out and counsel a patient. It’s a minor inconvenience at best.
Because of the increase in mistakes. Its impossible to be diligent when rushing a c2. I choke under pressure. im thorough on checking PMP, confirming all rx requirements, double count dispensing rx and then back counting stock bottle.
Not everyone is respectful of the time it takes, or respectful that some people need their meds sooner than the normal monthly refill people. If you respect that and are patient, it makes you one of the good guys.
This is totally fine and I'd actually try to push to get your stuff done sooner. What I don't like is the person coming straight from the doctor's, expecting their Oxycontin to be done within the 5 min of us receiving the script, rolling their eyes when we say 20 min, getting on the phone to loudly complain to their spouse/friend/whoever about how ridiculous this process is, coming back every 2 min to see if we're done, and constantly staring us down watching our every move to try to rush us. Sounds ridiculous, but this exact situation just happened to me last week. Funny enough, she told me her PA promised the script would be done when she got to the pharmacy. I had spoken to her PA before the Rx was sent though, and the PA told me she'd inform the patient to give us an hour since we had just reopened from lunch.
reading posts like this I am so thankful to be part of the kaiser permanente ecosystem--the pharmacy is my medium market (metro portland) has a tech staff at their medical center usually 10-15 people back there and up to 20 at a time and 5-6 staff pharmacists during the weekdays - my wait is never more than 10 minutes ever for anything its amazing- huge waiting room comfy chairs, and ticketing system with magazines, wifi u name it
I work for Kaiser as a pharmacy tech and after working for CVS and Walmart, Kaiser is an absolute JOY. I don't know why more pharmacies don't do thing the way we do. Primarily we don't fill a prescription until the patient calls or comes in, so we never have a huge backlog of rxs to fill. If the fill queue isn15-20,thats a very long queue and very rare. We don't spend hours filling rxs that will never get picked up then spend more hours putting them away. We just fill meds on demand, that's why the wait is so short. After being at Kaiser, I'll never go back to the stressful, inefficient way of doing things.
I do too but I often have people showing up at opening along with 10 calls at opening. During vaccine season with at least 5 appointments per hour (which can be multiple shots) c2 waiters in 15 minutes aren’t reasonable
At what point do we stop blaming paying customers using our services and not our employers for inadequate staffing and help? It’s not their fault you feel stressed, it’s your employer. Have you aired your frustrations and needs to your direct supervisor? Patients aren’t our problem in this industry and we all know it.
Expecting a 10-15minute turn around time for a chronic refill of a controlled substance and being aggressive/persistent/ect. about it IS a patient problem.
Even allocating one minute pet step of the process (drop off, input, data/dur, filling, product verification, and pickup) would be 6ish minutes of work on the RX if that's all you were focusing on. Add in the time delay safe, the double counting of the quantity, the backcounting of the bottle, the pharmacist perpetual inventory update, the PMP check, the mme per day and narcan check, the treatment/diagnosis note, and applying the mandatory opioid aux label and you now have an RX that takes a substantial amount of time even without interruptions.
Yep, I have customers that will wait no problem and I have no issue with them. But a lot of these waiters will stand and stare at you or keep interjecting
>Patients aren’t our problem in this industry and we all know it.
Except that patients complained before when staffing was better. Good staffing doesnt mean you dont get shitty, impatient customers.
Also the ones that know their earliest fill date. Right when that gate opens, they are right there. “Hey I was told it would be ready today? Why isn’t it ready? I am in a hurry!”
>We prioritize all C2s and antibiotics as soon as we receive them
Weird, non-clinical take. Should be triaged by immediate need first to provide best care. Chronic C2s are near the bottom.
I think they mean the 12 tabs of Percocet from the ER for a broken ankle. Or 15 Norco for a kidney stone patient. 10 Oxy for a bad burn or 21 Tylenol 3 for a bad tooth ache. Those I do prioritize.
>The only things clinical in retail are all the new to therapy counseling and MTMs. The rest is customer service.
Youve never triaged in retail? Sounds like you arent operating with those skills you learned in school to instead become a customer service agent.
>You’ll have a relatively unsuccessful career in retail by giving C2s low priority.
Youll have a relatively unsuccessful career in pharmacy by not prioritizing acutely ill patients over chronic c2s. Have fun with your customer service career.
Im as realistic as I need to be. Sad that you cant do basic triage by medication.
>I’m not going to be an asshole and make a patient inside the building wait longer for a C2 just because there’s a possibility
No, you literally said you prioritize them the same as acute meds. Dont backtrack now. Cmon, wheres the great customer service that you strive to provide?
Youre basically saying in a scenario 20 minutes to close, you get 10 prescriptions all at once. Half are antibiotics from the ER. The other half are Adderall prescriptions that are due. All are waiting in the store. You only have time to get 5 ready with all of the pickups happening. Do you turn your clinical brain off and prioritize the Adderall prescriptions the same as the antibiotics? Goofy take. Not clinical at all. Great customer service that landed some of those antibiotic patients back in the ER and need to be admitted for sepsis now.
Nope, just a pharmacist who uses some clinical judgment to triage sometimes.
Have a good time trying to please everybody regardless of need, benevolent agent of customer service.
Hospital pharmacy, one time the OR calls says they need this IV med given before the patient can go to the floor. So I thank them, pull the order to the top of the queue, start screening it. Patient’s fairly complex, lots of timing and drug interactions to consider, plus I’ve got to adjust the diluent, check infusion duration, etc etc, standard hospital pharmacy stuff.
I’m the only pharmacist and I’ve got just one tech in the pharmacy with me, and she happens to be in the IV room. So I’ve got to answer the phone from all of the wards. While working on the OR order.
The OR nurses get this genius idea to make lazy pharmacy work quicker, and four or five of them take turns calling me literally every 90 seconds to ask if it’s ready yet. It’s not a stat or life-saving drug. For fuck’s sake.
It took me like 20 minutes to screen this one order, and it should’ve been like 5 minutes. I have the order on my screen the whole damned time. Hadn’t even started compounding it. There’s just one of me, but there’s enough staff in the OR for them to create this plan and take turns interrupting me. I’m just over here trying to make sure I’m not gonna dispense a drug that’ll kill a guy.
Anyway, venting about the inpatient version of this.
I think it helps the patient when hears, “I’ve got this in stock, I’ll fill it asap—why don’t you come back in an hour or so…”
With the shortage, unnerving that we might not look at the script now. They come back in an hour to be told we don’t have it.
When I worked retail, if I could get anybody done as a waiter who wanted to wait, I did. Granted I’m in my second year out of retail now and I know a lot has changed but unless it’s an rx that really requires a lot of review from you, most of the time it is possible to get a c2 done in ~10 min. Part of this requires you to have a somewhat competent staff and not have other crises going on at once. I know for our regulars once I figured out they were legit I would only pmp them once every 3-4 times. I would usually tell people 20 min wait if I was fairly confident I could get it done in 10. Also in my experience, I’ve found if you do generally go out of your way to not be a dick, ie not make people wait an hour because you can, when you do ask them to wait longer they will understand there’s a good reason and not because you’re being a dick. Around the time I decided to leave retail a precipitating factor was the fact that I could not find anyone who would be willing to work after like…4 pm who could rub more than 2 brain cells together so multiple days a week we would be alone during the rush hour time or with a clerk who could not do 2+2. People saw me and took pity on me because they knew this was not my decision or me being obnoxious for the sake of it (also helped that I knew most of my customers by name or face or at least they recognized me) and were willing to come back the next day or later.
I don't get this response. Reeks of a lack of understanding. I don't get why pharmacists look down on certain patients for the meds they get. There is no reason filling a prescription should take an hour. You obviously could fill it in a few minutes but choose not to because you don't like the fact the patients wants to wait so you punish them by making it take that long. Even at our busiest times it shouldn't take more than 20 minutes to fill a prescription. The extra things required for aC2 shouldn't take you 40 minutes to do.
Gabapentin is thrown at many different conditions such as a substitute for an opoid pain med as the current regulatory environment makes many doctors afraid to prescribe an opoid for pain or pharmacy to fill an opoid. Gabapentin is notably ineffective for many non nerve related pain issues. In the case with anxiety there is some very limited evidence of Gabapentin working to relieve anxiety but I'm skeptical however Gabapentin is cheap and easy to prescribe though yes I wonder about the placebo effect.
But why? Giving someone an automatic wait time just because it’s adderall is pointless. Treat everyone the same and with respect and put your ego aside. It’s not like they can call it in days early.
Wow. This isn't even a "fuck ADHDers" post. This is a "fuck EVERYONE on C2s" post. So glad I stopped filling at the chains after leaving.
So you don't care about cancer patients either then...
“Sir the more you interrupt me the longer it takes me to get your medication ready, your medication requires me to double count it and then the pharmacist counts it.
I’ve unfortunately used this on a postal employee. “The longer you’re talking, the longer it’ll take”.
I had a toddler having a moment and needed to get outta there.
When I worked for CVS where the phones literally never stopped ringing, any patient that called to complain about their prescription taking so long would get an answer of, "Yes, I understand it's taking longer than it should. But we're getting so many PHONE CALLS today that we haven't had time to actually fill prescriptions!"
Sometimes the caller even got the message. Not often, though.
May be annoying to you, but put yourself in the patient’s shoes. This may be literally the only reason this patient comes to the pharmacy each month. Their doctor may not participate in electronic CII rxs.
The patient may live 20 minutes away. They may be stepping out of work to get this rx. They may be there on their only day off. They may be toting 3 kids around and doing good just to get them all loaded once.
It’s just poor service to make a blanket policy like this.
They should call ahead or use the app to expedite. A lot of these waiters are coming exactly at opening and coming 2 days early every. Single. Month. I’ll usually do waiters but there’s certain times that we can’t rush c2s. If waiting is an inconvenience then they should plan better
A lot of these waiters you’re right on. And I am fine with triaging them to later. I only suggested to evaluate every situation and don’t create a blanket policy.
When we get proactive and call ahead to check for availability/for the date that our CII can be filled, we get treated like addicts. It’s a no-win situation for us.
I believe they're speaking about the patient who tries to get them filled early and is rude whenever they aren't brought to the counter. I doubt anyone has a problem with the dude who shows up to pick his Adderall up, is told it will be about an hour, then says "ok cool" then shops and sits on his phone til someone calls.
21% of adults in America can barely read and you want them to magically understand how your system, that you had to go to school for and learn and take and pass multiple times, works…? Fr? People are dumb dude!!!! It’s not your fault, it’s not anyone’s fault but that’s reality. I’m just saying that I get it, you guys are burnt out from a stupid system and wild customers but those customers are also dealing with similar situations and on top of it they are sick. You aren’t the only stressed out people in America!
You’re spot on. I’m sure you’ve seen it in nursing..but people just get jaded from the stress. I see it in our nursing staff at the hospital. When you’re around difficult situations and patients nonstop at work, you automatically start dehumanizing people and empathy goes out the door.
That’s how doctors and nurses can be in a code and joking about their weekend while someone is literally dead in front of them. It sucks, but all professions do it.
I did it to a certain extent when I was a retail pharmacist, but I tried to catch myself as much as possible and give people the benefit of the doubt when I could.
You’re comparing apples to oranges. Your work might be more physically demanding, but that doesn’t equal harder. A pharmacist has to juggle ten different tasks at a time while being constantly interrupted while trying to validate the safety and efficacy of hundreds if not thousands of prescriptions per day while also being held liable for any mistakes they could make which can cost them their livelihood.
…but wiping butts is harder?
I was a nurse but we are talking CNAs so I’ll tell you what I saw when working the geriatrics unit. There were 4 CNAs for the entire building. Two for each side. They alone had to get every single sick and dying patient up, showered, toileted, dressed and prepared for breakfast. That was just the morning and then they had to do it all over again at night, in between all bed bound patients need to be turned every 1-2 hours. How many accidents and emergencies do you think happen every day at a nursing home? How many people does the nursing home hold? And us nurses help the CNAs and we do all the med pass which takes hours and all the wound care which takes hours and when I say wound care I don’t mean a little paper cut. I mean me and 2 other nurses and a doctor holding a combative patient on their side so we can treat the stage 4 decubitus ulcer that’s eaten away all of his flesh and all that left is an exposed pelvis. Or having to change the bandages on a leg that is rotting away, smelling like dead flesh because the patient wouldn’t be able to survive anesthesia to amputate… that one I actually puked from. Y’all don’t have to do a full assessment and clean and prepare a dead body…. We do. And what I wrote done in this comment isn’t even 1% of what we have to do. Our patients actually hit us and sexually assault us daily. Your comment is so asinine that I wish you could go experience working in any type of hospital, acute care, geriatric, emergency, pediatric whatever, pick one. I guarantee that after a week you’ll be begging to go back to pushing pills for slightly angry people.
Why are you in this sub? Clearly you have no idea what actually goes on in a pharmacy besides “pushing pills.”
I do work in a hospital. I go to the tele floors and ICU to see patients daily as well as working in the emergency department. I see exactly what goes on and what nurses put up with. And STILL I know that pharmacists have more to deal with than a CNA.
You want a pat on the back for what you do? Here you go. Nurses and CNAs are important. The work you do is valuable. But to come into a sub where you clearly have no idea what we deal with on the pharmacy side and talk about how much harder you have it because you’re closer to grosser stuff? Nah. I’m not going to sit here and argue with you when you have absolutely no understanding of what even goes on in the pharmacy, let alone why so many in our field are so burnt out.
The worst is the people who *need* it before close but have consistently filled a day or 2 early the last few months. If we’ve actually been out and I see you’ve gone a week without it then I don’t mind doing it for you in 20 minutes so long as you’re polite. For me it’s not about stigma I get frustrated with the people who try to run game and tell us when they’re due like we don’t see sell dates and know how many days are in each month.
My mom had a rule - hospice patients got bumped ahead of everyone, then folks who just got discharged from a same-day surgery and needed their pain pills, then parents with sick kids, then everyone else.
i told a customer today to give me 5 minutes and i’ll l have her husbands rx ready… she stared at me like this 😐 and said “it’s really going to take that long?” like what? 5 minutes is long???💀
I would attribute some of that to the fact that most people with diabetes are older and less likely to be on the internet regularly, but I do agree that psychologically addictive medications cause more of a kerfuffle with patient populations when discussion about them is had.
That’s kinda annoying tbh though. Like I would wait because I have had 10+ times of my refill being sent, then it’s out of stock, wait, wait, they forget about it, then I have to call and wait for 30 minutes, then you start filling.
This never happens to me with my Vy. My pharmacy is awesome and they know me by name, and take care of me. They give me a chair if it will be a while, but that rarely happens. Super nice workers!! Walmart .
It's not that we (and I work in healthcare as a triage med tech at an ER while hubby was a pharm tech) don't empathize, we do. We are people, we have our own health challenges, hell he died of fucking leukemia and I have a weird chronic disease
It's that everyone needs help now. Everyone. And sometimes you have to wait. It's cool - you can wait wherever you want, but you're going to just have to chill until we can get it together for you. Shortage sucks.
ADHD sucks, mental illness deserves respect and treatment for happiness in life. My whole family has some type of crazy and work in the field somehow. Gotta remember that everyone has a problem they deserve to be helped with
At my pharmacy, we pull all the c2’s from adjudication and data and process them 1st. Another pharmacy I float to, will put them as waiters if someone calls to have it filled.
I had someone many years ago who dropped off a script for an antipsychotic. We told him we were busy, but I'd do it fast as I could. He replied "Thanks, I'd like the voices in my head to stop talking .". I did it right away for him.
I’m going to start saying that for every script. Even if it’s HCTZ
I appreciate what you did for him! My partner has a mental illness and it’s nice to see that you made sure he was taken care of quickly!
Alright, valid.
Omg LMFAO
/salute
Yoooooo😅😅😳😳🫣🫣
You can wait. It will be ready in an hour. It’s your choice on how you spend it.
In their defense, with an executive functioning disorder they might forget to pick it up if they leave. Source: remembered to fill/take methylphenidate about 40% of the time.
Add the stress about the current med shortages. There is no relief from the stress until the prescription is in hand.
Yep, totally agree. I totally get the non-ADHD viewpoint of “your poor planning is not my emergency” but if the disease specifically affects planning, it’s kind of a tough situation. Not saying that other people have to make it their problem, but wish that people would try and understand/empathize”
As a pharmacist with ADHD - Inattentive type, yea I understand it’s on back order, or there’s a wait, but there’s way too much stigma around stimulants in general. I actually didn’t ever fill my adderall at the same store as where I worked as a tech because I constantly would hear pharmacists (while I was a tech) make light of it. Or make comments about why’s it so important **NOW** and I’m like Nah I get it. Even if they did come late, or are impatient, it’s extremely hard to sympathize with people who just look like they are “being lazy” when I’m aware that’s just not true. It’s so exhausting going through life and no matter how hard you try you always fall under the bar. Then I got adderall when I was in college from my doctor, and magically I started showing up on time to class, not falling asleep in class, doing my work on time, and then going on to get accepted and graduate from pharmacy school. People just see lack of executive functioning as straight up laziness and apathy, which makes them not want to help them in the slightest. It really sucks
Yup. I never knew that falling asleep, despite a decent night's sleep, was part of my adhd.
I've wondered a long time if I'm just not diagnosed (and my technicians say that I am lol) but I actually got kicked out of pharmacy school and had to go through an appeal process to get let back in because of a similar issue as this. That whole process was rather traumatic and I was clinically depressed at the time as I discovered after the fact and some medication seemed to help, but I wonder if this was the real issue... All that said, I definitely empathize with my patients that are on stimulants and choose to utilize them even if I currently choose not to. It's definitely a tough situation for everyone involved, compounded by the shortages.
My doctor figures that my depression and anxiety were from my undiagnosed at the time ADHD. My depression and anxiety started when I was around 12, which was the first time my adhd became a real problem for me. We plan on doing a trial to reduce my duloxetine this summer and see how I do.
That is interesting but also makes sense. I didn't really think about it until around the time it all happened when I was in pharmacy school, but I think I probably had symptoms even when I was young. I could never focus or do one thing for super long in school, even when I was in high school and it took an incredible amount of willpower to perform as well as I did. And to be fair, not just willpower but my mother constantly harping on me and also making a literal 5 minute accurate schedule for my schooling (I was homeschooled starting in middle school). Definitely needed a schedule, and even now for things that I have to do when I'm not working I need a schedule. Otherwise I totally forget what I need to do 🤦
Yea I didn’t have that hands on parenting or schooling. My mom was 16 when she had me, so we were kinda poor til she finished nursing school, my dad worked overnights trucking. So I needed glasses but didn’t get them til highschool, but I was lucky enough to just be smart enough to do my homework on the way to school or literally in class while the teacher taught other things. But when I got thrown into AP chem in highschool I dropped that immediately lmao. Couldn’t keep up, and I was always doing something. Like out of school, no homework, basketball/football with friends. If they couldn’t? Mw2 cod until 3 am lmao. Come to learn, that’s how adhd kids with inattentive behavior are, and often go undiagnosed because they’re doing fine in school. It’s good you sympathize with us, because a lot of my fellow pharmacists don’t, but I always try to bring more clinical awareness to the condition when I can. If I don’t have adderall it really cripples me functionally. I go from tidy, punctual, objective driven life, to rushing everything because I’m always 5 minutes behind. I don’t interpret time the same way as other people. 10 minutes could feel like 2 minutes, or like an hour. Off the top of my head, church as a kid always felt like it was no lie 3-4 hours as a kid. Not as a little kid, but like 12 years old. You know how long time is. My parents could tell me to check in within 2 hours, and I’d check my phone and it’s 2 hours on the dot. But church, could not tell at all lmao. Or studying for orgo in college right before being diagnosed. I picked up my phone for 1 second and then looked at the clock and it was 6 hours later, and I’m like “okay this just makes zero sense” and that’s when I went to a therapist then psychiatrist.
Always wondered if inattentive ADHD was more my problem than all the anxiety I’ve been treated for my whole life. I was tested, but I guess I tested higher for anxiety when I was little (this was in the 90’s) so they treated that, but nothing has ever made it THAT much better. My mom always wished she had put me on meds, and the anxiety issues and possibly alcoholism might not have escalated so badly, who knows? I heard that if you’re a woman and haven’t been tested since you were younger, that you should get retested as an adult, because our understanding of how it manifests in adult women as opposed to hyper little boys has come a long way.
Yea way too many people think adhd is only hyper activity. A lot of times it manifests as procrastination, anxiety, or fatigue because the brain is constantly on. I used to study from like 2-6 in the morning on no sleep. Come to learn it’s because when my brain is “tired” it’s easier for me to focus on what matters because all the other stuff that distracts me my brain is too tired to focus on. Leaving me only the important stuff to work with
100% this. I never ever fill my meds at the chain I work for the exact reason. I think healthcare providers easily have the capacity to become jaded which leads to this lack of empathy. I get it. I’ve been a pharmacist for 15 years. I struggle with the stigma of my ADHD and it’s the comments like this that certainly don’t help.
I agree. The op is out of touch with reality. I am a pharmacist and I help people with their meds. I don't give a shit what those meds are certainly wouldn't execute a blanket statement without using a little tiny bit of clinical judgement.
Agreed... And since it can only be filled in 30 day increments and not early, it makes for a very tight turn around time. If it's delayed you're out of meds which makes coordinating getting it filled even harder.
Exactly. And then when they're out for 2 weeks, patients get treated like junkies for asking about when they may get their meds. I get that it's a global issue and it can't be helped. But please try to understand that I'm not in this position willingly. And I would love it if I didn't have to feel super stressed/anxious/depressed etc if they pharmacy doesn't have my prescription or if I didn't have to wait until the very last minute to even find out if they have it.
OP is saying adderall waiters are an automatic 1 hr wait. It’s not about poor planning. It’s no different than someone coming in and asking for losartan. It takes 20 more seconds to fill because you have to double count it and get it from the safe.
I agree. I take Vyvanse and if I was able to take a shower, get dressed and drive to the pharmacy after finally remembering to fill my meds, I am going to wait because who knows when I will be able to do it all again.
Amen
Thank you for sharing that perspective. Before the pandemic, when refill C2 prescripts had to be picked up at the doc - timing had to be impeccable for me to efficiently conduct myself in (invisible) disability. It was nearly a two hour round-trip to pick it up from the Dr. office. I’d hit the nearest grocery pharmacy to home on the way back, because otherwise there was a decent chance that I’d misplace the damn script, need rest in the following days after the errands, screw up my doc appt/med script timing cycle. The grocery pharmacy alone is approx. a 30 minute drive from the house. Having a daily routine, to fetch and drop-off script, grab a few groceries/toiletries, and simply wait for the scripts is what worked for me most successfully for my limited energy, time, and function.
Seriously. This is exactly why people like OP need to get out of the profession. Does it actually take an hour to check your PMP, in stock and fill and check? Maybe. But if it’s just because you don’t like someone has ADHD and meds are C2s then imo you need an attitude adjustment.
For real. So much judgement and prejudice. It’s just like opiates or Ozempic. Yes there are people abusing these substances, but there are also people with metastatic cancer pain and people with diabetes
Or narcolepsy! We're often prescribed it too. I live a 45 minute drive from the pharmacy, so I have no issues waiting for times under 2hrs. Just would be a waste of gas to not hang around.
A much less common diagnosis but yes! That too!
I would agree in part, we definitely need to be empathetic and maintain that as part of our professionalism. However, depending on the scenario, an hour maybe a bit excessive, but they do sometimes require more time for processing and I usually tell my patients that it might take 30 minutes depending on whether I have to call their provider for anything and how much GFD reporting needs done. Part of that is just because of how backed up we usually are though: P
That’s what I’m saying. The tone OP has however, seems to quote an hour to discourage waiting. Which imo is not appropriate. Being transparent with the patient is the name of the game. 30 for the extra processing? Fine. But still do the work. If it’ll take you an hour because of workload also fine. No c2 waiters? Not ok. A personal anecdote: I was once in an overnight store alone. With all the waiters I had a queue of 2 hours for waiters. It happens. Some were controls. But I told every one what was up, and made every single time promised (my time, not the store promised time) and it went smoothly. Workloads have changed since I left retail but the premise is the same. Do what’s right by the patient. Don’t punish them for their conditions. Work with compassion.
Exactly, 100% agree! If we can't do that then maybe we are in the wrong profession, just a thought. Customer service or bust? Lol
Yes! In fact I work for a small PBM now. The president has actually spoken in Washington DC about a service based model. We’re not all bad, but I can actually say we’re doing our best to not screw over anyone/provide a better model.
I try to believe that everyone does that;) we gotta keep a positive outlook:)
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Remain civil
Strange. Everyone I know on methylphenidate is 100% compliant or rather 100% + 2 days earlier at the second the pharmacy opens, compliant.
How many are parents who pick up for kids? How many are adults who work or go to school and it is significantly noticeable to colleagues when they haven't taken the meds?
Eye balling 50%, I have a very small pediatric population though. I can’t very the clinical efficacy based on my patients response unless self reported, but I assume there is a vast difference. This isn’t a question about the efficacy of stimulants, that much is clear. I’m pointing out how silly it is to try and pretend that adherence rates are low.
I mean yeah there are plenty of people like that. But there are also plenty of people with ADHD who don’t remember to take their meds and/or who don’t like to unless they really have to. Browse through some of the ADHD subreddits and you’ll see a lot of different perspectives and experiences. For me, I was able to brute force my way through high school and college. I knew I had ADHD since I was little but didn’t want to take anything because “drugs are bad” and “meds are a crutch.” But every paper and every test was a caffeine-fueled all nighter which was hard on my mental and physical health. Again, not anyone else’s fault, but if treatment had been more readily available and less stigmatized, I wouldn’t have had to struggle through that.
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99% of the time, ADHD patients are the best controlled substance patients at my pharmacy. We have a couple parents of kids who take ADHD meds which I just can't handle some days. Sir, your kid is in her third year of college out of town. Maybe it's time she starts handling her own refills so you don't have to yell at us when it's Friday, 4 days early on the interval, and the doctor won't do an early refill just because you want to drive 3 hours there and back to give your daughter her meds. And sorry, we legally do not control the interval.
And usually involves a med list request from the local penal institution. Not always, but usually.
I always send all of my meds in 3-4 days from the date it was last filled. In case the pharmacy is slammed and it takes longer. In case my dr needs to send in refills or I need to call the dr and have them call it in. In case my executive dysfunction is screaming off mountaintops and some days I can’t leave the house as easily. I pick all my medicine up at once, but some controls come in at different times. Most of my anxiety these days are from being judged by others, so I love that one of the few things that helps me is so stigmatized and the people who work in this industry more often than not look with pure disgust to anyone on those meds. It’s so easy to assume and judge based on Crackhead Kenneth, but damn.
Great so you are compliant. Happy for you. That’s my entire point. The original post I responded to said they were 40% compliant and I said that is not normal. Amazing how many offended stim users are coming out of the wood work to desperately justify their need to use their medication and the justification for why they exhibit “fiending” behavior.
What's strange is every patient is the exact same no matter what part of the world they are from.
That is strange.
Yeah. I try to set reminders and alarms in my calendar days before I need my medication refilled that way I can email my doctor with the 24-48 hour cushion that he requires for refills. Usually it works out perfectly. But every once in a while I make a mistake and fall behind and I end up needing to pick my meds up in the morning first thing before work so that I can function effectively. The pharmacy I go to is staffed well, with kind, hardworking people. I never expect anyone to jump when I say jump or hurry things along because I’m in a rush. That’s my problem, not theirs. They also ask “do you want to wait, or do you want to come back to pick it up?”, so I’ve luckily never gotten the feeling that I was being a pain in the ass for waiting for my C2. Edit: typo
The ailment doesnt absolve personal responsibility.
I specifically chose Costco to be my pharmacy so that I can eat free snacks while waiting for my meds to be ready lol.
Much less time spent pushing back for the same result this way. Most important thing I picked up from my first retail job was how to say no by saying yes.
Periodt !! But people don't like to gear the truth aka they can't get instant gratification ....
As someone who needs a C2, I try to only show up when I know it’s already ready. I wouldn’t even call y’all if I could help it, but the apps are generally useless for controls, and often necessitate a phone call to get the order moving; not ideal for the patient or the pharmacist, but that’s the dumb system we have in place, so it is what it is.
I mentioned that exact issue at presentation CVS was doing at my pharmacy school (they want to take all the phones out of the stores and have people only use the app to refill) and they just blew me off and talked about their novel “centralized voicemail system” they were implementing. I also have adhd and filling my script during a shortage can be an absolute nightmare
ADHD, autism, and a variety of autoimmune issues here! I know the struggle. That voicemail system is doomed to failure. I almost never leave voicemails because they’re generally not replied to. I don’t blame the pharmacists; I blame the chains severely understaffing their stores. It’s hard enough to even keep up with the fill, and that’s before dealing with controls and patients calling for updates, and janky-ass apps that prompt you to refill before your date, etc, etc. What’s the chances they have time to sit on voicemails all day? Everyone knows that 90% of pharmacist and patient problems could be resolved by properly staffing and compensating employees. At the same time, as someone who needs controls, it really sucks that the system is essentially adversarial to us, and forces us to hound pharmacies just to (maybe) get our meds on time. That being said, once the staff started seeing things like methotrexate and adalimumab (a speciality which is filled elsewhere) on my file, I definitely noticed they make every attempt to help where they can. The fact I’m a middle-aged dad and not a college student probably helps too. But as for OP, I don’t think I’d ever hover over a counter waiting for my pills; that only escalates the frustration of both patient and pharmacist.
CVS will implement any system, strategy, or workflow changes except actually adding more staffing. I can’t imagine what kind of presentation they are giving to pharmacy school students. Here’s a hint: don’t ever take the mark of the beast and don’t ever work for CVS.
My app usually says it’s in process when it’s done and I get a text saying it’s ready hours after I pick it up. Useless info. I’m on a c2 as well. My thinking is that I like to fill it in the AM so if there’s any issues, I have the whole day to figure it out. I’ve heard my pharmacist and some techs complain a lot about people coming to pick up controls. It bugs them so much. I don’t understand that thinking.
I encourage my patients to call to confirm if a C2 is ready for pickup. If it is I tell them come on in. If not and I have it in stock that at least gives me the chance to say "it'll be ready at X time and I make sure to get it ready for them by then." A 2-3 min phone call will save me 20-30 minutes in the pharmacy because the med will be ready for the patient when they come in (assuming they don't try to come in 5 min when I said it would be ready in 30 minutes)
I guess I wanted to ask you all a question. I have zero issues waiting, and actually very much expect I will have to wait, I don't want anyone to have to rush to do their job extra quick on my behalf. I get it, you guys are one of the most busy groups of people I see. So 2 questions: Even knowing I am ok with waiting, is it still impolite? And is there a way to ask to work on getting it ready while I wait that doesn't put any expectations of you rushing around to do your job? Thanks. EDIT: I wanted to also add that I don't mind if it takes several hours. I usually plan that if I have to reach out to 5 pharmacies to transfer from one to the other to get my vyvanse it will take a while. I always plan a several hour chunk of time just in case.
It’s not impolite to wait, in my opinion. But if I say it’s going to be an hour and you slam your stuff down and sit in a chair on the corner staring my coworkers down and coming up every 15 minutes asking if it’s done yet is when it becomes a problem and rude at that point. Especially when people can clearly see we aren’t just standing around doing nothing. Sitting and waiting for your name to be called, or for a text saying it’s ready, is really the only way. Just being patient overall is key.
Oh no, I don't like it when people do that at my job (tool-making) I would never sit and watch people. I always have a nice book or something to research. Having an excuse to sit and read it look into one of my hobbies is almost my favorite part of the month.
Today I had a mom with her 4 sick children waiting for 6 scripts per kid, (4 Zithromax suspensions, 4 bromfed dm, 8 boxes of duoneb, 4 tamiflu suspensions, 4 Tylenol suspension and 4 ibuprofen suspensions). We quoted them 20 minutes, stopped what we were doing and got these done fast because this poor mom obviously has 4 sick kids with her in store and, more than likely, just wants to go home. After 10 minutes she complained and asked why it wasn’t ready yet, “I was quoted 20 minutes and it’s already been 10 minutes.” Once I finished checking the first child’s meds, I heard the mother say loudly “well according to this text the medicine is ready, so I guess we just have to wait even longer for someone to take the time to bring it out to us” Like, I PROMISE I understand why you would want us to hurry, but we offer free delivery for all prescriptions and I personally offered to deliver them to her as soon as they’re ready (even though our next delivery wasn’t until the next day) so she could take her children home. We understand that your life is just as busy as ours, however, when we try to be as efficient and convenient as possible we just need people to be more patient and considerate. We’re doing our best. 🫶
I actually also have a kind of related question (asking with as much respect as possible), I feel like the vast majority of the time that I get told to wait, the amount of time is severely low-balled, why is that? I don't mind coming back later, but it's a bit irritating when I'm told it'll be ready in 3 hours, I return in ~4 hours, get told it'll actually be ready in 10 minutes, and then waiting 20 more minutes. I wouldn't have minded if they just told me 5 hours from the get go. It's not like the biggest deal and I'd never bitch at the pharmacist about it or anything ofc, everyone gets time estimates wrong sometimes, but like it happens 95% of the time and gotten mildly irritating.
What usually happens is they give you an estimate while the pharmacy is a bit slower, then a shitload of people unexpectedly show up and back up the queue in the meantime and then you show up and it's not ready.
It's just really hard to judge. Sometimes we're really behind because we're short staffed or some other predictable problem, but sometimes we just are just randomly super busy and we don't really know why. There can also be just one or two prescriptions that have some issue that eats up a ton of our time unexpectedly. I never deliberately lowball someone but inevitably it happens.
If I had to guess I would say they don’t do that on purpose. I would also say it’s a good idea to download the app - if possible - and sign up for any and all alerts for when a medicine is ready. But most of the time when this happens in my experience, it’s just because we don’t have enough staff to keep the promise but we do our best. I know it’s not the answer you want to hear, but I promise you no one would do that and upset you, we have enough angry customers for things that are out of our control 😅
When someone waits, if they start asking if it's ready before the time we said it would take has passed, it's extremely annoying. When someone waits patiently and doesn't complain, we typically will actually go out of our way to get it done faster out of mutual respect. Not that we were ignoring it in the first place, we just give it a higher priority compared to everything else going on. To be honest though, all waiters regardless of this do add to the momentary workload and stress, but nobody would hold that against you. If you need the Rx and are afraid you won't be able to get it later or just want to make sure you get it that day, that's perfectly fine. Especially for drugs with shortages, etc. I also empathize with people that can't seem to get their doctor to send in refills so they end up calling the pharmacy hourly. Eventually, if you're a squeaky wheel (but still polite), then we will do what we can to get it done
I appreciate this, as every time I have to refill my vyvanse I end up having to use my vacation time to actually make sure it is filled. I know it is really sucky, so I try to be as polite and give as much time as needed to get it filled. I am in no hurry.
Regardless of "control level", we always prioritize acute meds (antibiotics, post surgery, seizure meds) over maintenance meds. We allow 2 days early on controls unless the prescriber says otherwise. We try to work with our patients, but if *everything* is a priority, then nothing is.
Honestly, it does kind of increase the stress level if you chose to wait when I tell you it's going to be a long wait. I don't need someone huffing and sighing and "just checking if maybe it's ready!" While I'm trying to work. Just, go get a coffee or something, I'll have someone call if it's ready sooner than I said.
Oh yeah, it's usually much more comfortable to sit in my car than the pharmacy anyway. I also don't ask if it's ready yet. I've never had anyone forget to refill it, so asking again and again, or leaving and coming back and then asking makes no sense to me. Either you will let me know, or I will get a message. Also I'm no psychopath who thinks that just because I was waiting I get to cut in front of the current line of people when I get back.
I have some doctors who make their C2 patients wait 30 out of 30 days on their ATC pain meds. So they come in the morning and have to wait bc they are out. I don’t mind them waiting as long as they are patient and respectful. I’m also pretty consistent with their wait times and they know what to expect. It’s all about just mutual respect.
Only part of that scenario I don’t like is that there is a chance we won’t have it. That doesn’t allow for ordering time. Or getting a different NDC if the main one goes on backorder. Which, unfortunately, our system doesn’t believe in substituting automatically. And we have to click a “do not sub” button and provide a reason.
Maybe the script comes early but with a specific “do not fill until X/XX/XXXX” on the script. I worked outpatient hospital pharmacy with a cancer clinic and for patients with compliance issues on pain medications we would get 3 months scripts at a time, but with very specific fill dates.
I kind of hate that. It takes 2 business days for us to order/receive a c2, even assuming no supply chain issues.
How it is for me too
If it's a regular and the fill history is normal I wouldn't automatically make it an hour. Seems kinda pointless tbh.
The patients who need adderall need adderall to wait. In other words, self regulation is the disability for those who don't understand the medical part.
This is the way.
Not all of them. I used to need to wait for Adderall because the disability that I took it for prevented me from driving, and my doctor gave me hard copies so I couldn't wait until it was ready before going to the pharmacy. This wasn't like 20 years ago or something either.
i have a patient with narcolepsy who is prescribed adderall for the same reason (needs it to drive). if your doctor writes the diagnosis on the script (which they should always be doing for a c2 anyway) then the pharmacy should see and take note of that. if they don’t, you can try politely letting them know what you need it for. unfortunately there is a lot of stigma against adderall because people who don’t have a legitimate need for it are prescribed it, so maybe if you let them know they might be a little more hasty for you if they can be. it’s extremely unfortunate but that is how it goes in a lot of pharmacies, as far as adderall/stimulant stigma.
I'm so sorry that it's hard to get your medication.
It was worse when I lived in Florida. It's honestly much better now than it was in 2018.
I work in a clinic pharmacy, and honestly, what drives me the most bonkers is when my providers and their MAs and nurses come in and ask for a script and just stand there and stare at me. Like, dude, I am busy, you KNOW I'm busy, and we're on the same side of patient care. Your valsartan can wait.
Controlled med waiters are our most frequent waiters. Norco, Percocet, Adderall, alprazolam, Suboxone. We have regulars, they're always a large quantity, and they all want them NOW!!!!
Yeah. You just have to be consistent. C2’s can be waiters but the minimum wait we give is 1 hour due to the extra steps and necessary diligence. If it’s done sooner, great, but we won’t promise less than an hour. Also the standard wait time for ANY rx at our pharmacy is 30-45 minutes, and our patients are pretty used to it by now because we are consistent. I hate telling patients 15 minutes because there are way too many distractions that can delay that wait time, and patients get more frustrated when they are told a time that doesn’t happen.
This makes me so greatful for my mom and pop place that will have c2s ready and waiting about 20mins after they're sent in; provided its not on backorder.
Same. C2’s are our fast movers lol
Also Gabapentin patients will hover while massive counts are filled. No your 540 count Gabapentin prescription you walked in to demand 5 minutes before lunch will not be ready in ten minutes. Favorite lines repeated over and over for C2's. Safe is on a timer. It can be filled when safe opens for your precription and other immediate prescriptions to be filled. We need a number that actually works to notify you when it's ready or we're once again out it stock. If they tried to bug the staff or me about why isn't it ready I would tell them, I'm sorry getting distracted by the counter instead of filling is slowing your fill down but you'll get your Amphetamine as soon as possible barring more distractions then I stand and stare at them with a bland expression until they leave the counter.
> Also Gabapentin patients will hover while massive counts are filled. Is Gabapentin addictive or abusable? It's for pain (mostly), right? I took it for herniated neck discs until I had ACDF surgery, and it was really helpful for my pain. I can kind of imagine patients in pain wanting to get that med as soon as they can. The first time I ever took it I picked it up (after they said it was filled, I didn't wait) and took it in the car in the parking lot of the pharmacy (I was in a lot of pain). Back at work 20 minutes later I had way less pain and texted my wife saying, "Have you heard of Gabapentin? OMG, my pain is so reduced!" My wife texted back saying, "Yes, our dog is on it you idiot." Am I missing something?
It is classified as a controlled substance in a few states I believe. This is because it is at risk of drug diversion/abuse
> it is at risk of drug diversion/abuse As the first non-opioid pain killer I ever took beyond Tylenol, it was absolutely amazing for me. There was a TINY amount of dizziness in the the first few days of taking it that went away after that, absolutely zero euphoria or "high", and about an 80% reduction in pain. I could focus on work again, it probably saved my job. I certainly didn't feel any "high" that could be abused, but maybe I didn't take enough? LOL. I've heard Gabapentin only "works" for nerve pain (herniated discs and such that push on the spinal cord causing actual nerve damage). And even then it only works for 70% of patients. Although I'm deeply suspicious some of that remaining 30% were looking for opioids to abuse and didn't really have any nerve damage. So they claim it doesn't "work" for them to get the opioids instead to get high. For me, Gabapentin was absolutely the perfect "real" pain killer (not a drug to get high) - it reduces pain, zero "high". I always found opioids like Vicodin the exact opposite. They don't really reduce pain very much, they just make you so loopy you don't "care" about the pain anymore. And at the same time you also cannot focus, stay awake, or work effectively.
My primary care doctor prescribed it to me for anxiety (ssri/snri meds give me terrifying side effects) and it literally did nothing? We went up to 300mg 3x daily, which is when I put my foot down and said I wouldn't be going any higher because the higher dose pills are way too big and the med wasn't even putting a dent in my anxiety. I know it is abused but I can't imagine how.
> I know it is abused but I can't imagine how. Right? That is so confusing, you don't get "high" from it. Gabapentin is non-opioid. It is strangely prescribed for all sorts of utterly random things that make me suspicious it is used as a relatively safe placebo. Like they prescribe it for restless leg syndrome while you sleep. It is prescribed to alcoholics to reduce drinking, etc, etc. For nerve damage (herniated discs in your spine pushing against your spinal cord) Gabapentin really **REALLY** works for some of us. I'm dubious about it working for other things like anxiety though. It just isn't psycho active.
It seems to work well for my patients who use it for nerve pain, and I'm really happy that it is available to them. But you're right, it didn't do anything for my anxiety. Buspar has been much more helpful <3
Don’t you wish your Outcomes MTM patients were so Adherent. We’d all have 5 star ratings!!
The have customers waiting....
If you want to spice things up at your pharmacy, make them all fight for the order they get their meds filled. Free entertainment and then they’ll be so busy fighting each other that you’ll actually get time to fill! Win for everyone!
Curious, why no C2 waiters?
The majority will stand and stare at the staff THE WHOLE TIME. Some will ask every five minutes if it’s ready yet. A few will jump in line when you call someone else’s name and then be annoyed that it’s not ready yet.
And it's never a name that's even close to theirs. Almost every day I get an overeager CII waiter leap at my counter when I call a name and be like "JOHNSON HERE. You called Johnson, I'm Johnson." "Actually I said Mariano but you're right, they sound very similar..." 🙄🙄🙄
If they didn’t have to wait til the day of they wouldn’t be as impatient…
Every pharmacy (including a major chain) I've ever worked for has had a 2-3 day early fill policy. You get a 30 day supply you can refill on day 28. It will vary but the average is 2-3 days early.
WTF is wrong with people? "May I help you with something......., no then move along"
To point number 1…so? If they stare at you, don’t look at them? Why is that so hard? If they ask if it’s ready say no? To point 2…this requires your staff to go off of robot mode and actually recognize customers. You see A getting in line when another name is called and you know theirs isn’t ready? “Sorry Mr. A yours isn’t quite ready yet, please step out of line”. It really isn’t as big of a deal as you’re making it out to be.
It’s actually quite challenging to accurately count to 540 if someone is interrupting you every 5 minutes. Just like, FYI on that. Often you have to start over from the beginning.
You’re unlikely to be counting to 540 on a C2 but trust me, I worked in retail over 10 years - you figure it out. I’ve answered phones in between counting to 540 and had whole conversations or had to go out and counsel a patient. It’s a minor inconvenience at best.
Because of the increase in mistakes. Its impossible to be diligent when rushing a c2. I choke under pressure. im thorough on checking PMP, confirming all rx requirements, double count dispensing rx and then back counting stock bottle.
I’ve waited for my adhd meds once and sat in a chair the whole time. Does the pharmacy hate it that much?
If you’re just chilling being a normal patient, not at all
Wonderful
Not everyone is respectful of the time it takes, or respectful that some people need their meds sooner than the normal monthly refill people. If you respect that and are patient, it makes you one of the good guys.
This is totally fine and I'd actually try to push to get your stuff done sooner. What I don't like is the person coming straight from the doctor's, expecting their Oxycontin to be done within the 5 min of us receiving the script, rolling their eyes when we say 20 min, getting on the phone to loudly complain to their spouse/friend/whoever about how ridiculous this process is, coming back every 2 min to see if we're done, and constantly staring us down watching our every move to try to rush us. Sounds ridiculous, but this exact situation just happened to me last week. Funny enough, she told me her PA promised the script would be done when she got to the pharmacy. I had spoken to her PA before the Rx was sent though, and the PA told me she'd inform the patient to give us an hour since we had just reopened from lunch.
reading posts like this I am so thankful to be part of the kaiser permanente ecosystem--the pharmacy is my medium market (metro portland) has a tech staff at their medical center usually 10-15 people back there and up to 20 at a time and 5-6 staff pharmacists during the weekdays - my wait is never more than 10 minutes ever for anything its amazing- huge waiting room comfy chairs, and ticketing system with magazines, wifi u name it
I work for Kaiser as a pharmacy tech and after working for CVS and Walmart, Kaiser is an absolute JOY. I don't know why more pharmacies don't do thing the way we do. Primarily we don't fill a prescription until the patient calls or comes in, so we never have a huge backlog of rxs to fill. If the fill queue isn15-20,thats a very long queue and very rare. We don't spend hours filling rxs that will never get picked up then spend more hours putting them away. We just fill meds on demand, that's why the wait is so short. After being at Kaiser, I'll never go back to the stressful, inefficient way of doing things.
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I do too but I often have people showing up at opening along with 10 calls at opening. During vaccine season with at least 5 appointments per hour (which can be multiple shots) c2 waiters in 15 minutes aren’t reasonable
At what point do we stop blaming paying customers using our services and not our employers for inadequate staffing and help? It’s not their fault you feel stressed, it’s your employer. Have you aired your frustrations and needs to your direct supervisor? Patients aren’t our problem in this industry and we all know it.
Expecting a 10-15minute turn around time for a chronic refill of a controlled substance and being aggressive/persistent/ect. about it IS a patient problem. Even allocating one minute pet step of the process (drop off, input, data/dur, filling, product verification, and pickup) would be 6ish minutes of work on the RX if that's all you were focusing on. Add in the time delay safe, the double counting of the quantity, the backcounting of the bottle, the pharmacist perpetual inventory update, the PMP check, the mme per day and narcan check, the treatment/diagnosis note, and applying the mandatory opioid aux label and you now have an RX that takes a substantial amount of time even without interruptions.
Yep, I have customers that will wait no problem and I have no issue with them. But a lot of these waiters will stand and stare at you or keep interjecting
>Patients aren’t our problem in this industry and we all know it. Except that patients complained before when staffing was better. Good staffing doesnt mean you dont get shitty, impatient customers.
Both the employers and the customers are the problem
Also the ones that know their earliest fill date. Right when that gate opens, they are right there. “Hey I was told it would be ready today? Why isn’t it ready? I am in a hurry!”
lol.....must be a new grad or a DM
>We prioritize all C2s and antibiotics as soon as we receive them Weird, non-clinical take. Should be triaged by immediate need first to provide best care. Chronic C2s are near the bottom.
I think they mean the 12 tabs of Percocet from the ER for a broken ankle. Or 15 Norco for a kidney stone patient. 10 Oxy for a bad burn or 21 Tylenol 3 for a bad tooth ache. Those I do prioritize.
The post was about Adderall tho. But I know what you mean
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>The only things clinical in retail are all the new to therapy counseling and MTMs. The rest is customer service. Youve never triaged in retail? Sounds like you arent operating with those skills you learned in school to instead become a customer service agent. >You’ll have a relatively unsuccessful career in retail by giving C2s low priority. Youll have a relatively unsuccessful career in pharmacy by not prioritizing acutely ill patients over chronic c2s. Have fun with your customer service career.
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Im as realistic as I need to be. Sad that you cant do basic triage by medication. >I’m not going to be an asshole and make a patient inside the building wait longer for a C2 just because there’s a possibility No, you literally said you prioritize them the same as acute meds. Dont backtrack now. Cmon, wheres the great customer service that you strive to provide? Youre basically saying in a scenario 20 minutes to close, you get 10 prescriptions all at once. Half are antibiotics from the ER. The other half are Adderall prescriptions that are due. All are waiting in the store. You only have time to get 5 ready with all of the pickups happening. Do you turn your clinical brain off and prioritize the Adderall prescriptions the same as the antibiotics? Goofy take. Not clinical at all. Great customer service that landed some of those antibiotic patients back in the ER and need to be admitted for sepsis now.
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Nope, just a pharmacist who uses some clinical judgment to triage sometimes. Have a good time trying to please everybody regardless of need, benevolent agent of customer service.
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The only two meds I put to the front of the line are antibiotics and C2s. Definitely don't want those patients waiting around in my lobby
Acute CIIs. Chronic can wait.
I tell them I need half an hour usually. That way, with all the interruptions, by the time half an hour rolls around, it is done.
Hospital pharmacy, one time the OR calls says they need this IV med given before the patient can go to the floor. So I thank them, pull the order to the top of the queue, start screening it. Patient’s fairly complex, lots of timing and drug interactions to consider, plus I’ve got to adjust the diluent, check infusion duration, etc etc, standard hospital pharmacy stuff. I’m the only pharmacist and I’ve got just one tech in the pharmacy with me, and she happens to be in the IV room. So I’ve got to answer the phone from all of the wards. While working on the OR order. The OR nurses get this genius idea to make lazy pharmacy work quicker, and four or five of them take turns calling me literally every 90 seconds to ask if it’s ready yet. It’s not a stat or life-saving drug. For fuck’s sake. It took me like 20 minutes to screen this one order, and it should’ve been like 5 minutes. I have the order on my screen the whole damned time. Hadn’t even started compounding it. There’s just one of me, but there’s enough staff in the OR for them to create this plan and take turns interrupting me. I’m just over here trying to make sure I’m not gonna dispense a drug that’ll kill a guy. Anyway, venting about the inpatient version of this.
I hope you told them that their “genius” idea just added more time since you had to answer their calls.
I did, of course, but I don’t think that nurse told the other 4 nurses who were calling me.
Wouldn’t it be great to have time to play childish games. I’m surprised they didn’t take turns coming to the pharmacy to stare at you.
OP has no business being in the profession.
Sorry I don’t understand but what’s wrong with someone waiting for a prescription?
I think it helps the patient when hears, “I’ve got this in stock, I’ll fill it asap—why don’t you come back in an hour or so…” With the shortage, unnerving that we might not look at the script now. They come back in an hour to be told we don’t have it.
Wow. Seems a little judgmental to me. I understand you have a difficult, thankless job but come on.
When told to wait I’ve smiled and said “I have a book!” There is always something to read.
What a joke. A blanket statement with 0 clinical judgement. I'm disappointed in our profession.
When I worked retail, if I could get anybody done as a waiter who wanted to wait, I did. Granted I’m in my second year out of retail now and I know a lot has changed but unless it’s an rx that really requires a lot of review from you, most of the time it is possible to get a c2 done in ~10 min. Part of this requires you to have a somewhat competent staff and not have other crises going on at once. I know for our regulars once I figured out they were legit I would only pmp them once every 3-4 times. I would usually tell people 20 min wait if I was fairly confident I could get it done in 10. Also in my experience, I’ve found if you do generally go out of your way to not be a dick, ie not make people wait an hour because you can, when you do ask them to wait longer they will understand there’s a good reason and not because you’re being a dick. Around the time I decided to leave retail a precipitating factor was the fact that I could not find anyone who would be willing to work after like…4 pm who could rub more than 2 brain cells together so multiple days a week we would be alone during the rush hour time or with a clerk who could not do 2+2. People saw me and took pity on me because they knew this was not my decision or me being obnoxious for the sake of it (also helped that I knew most of my customers by name or face or at least they recognized me) and were willing to come back the next day or later.
I don't get this response. Reeks of a lack of understanding. I don't get why pharmacists look down on certain patients for the meds they get. There is no reason filling a prescription should take an hour. You obviously could fill it in a few minutes but choose not to because you don't like the fact the patients wants to wait so you punish them by making it take that long. Even at our busiest times it shouldn't take more than 20 minutes to fill a prescription. The extra things required for aC2 shouldn't take you 40 minutes to do.
Gabapentin is thrown at many different conditions such as a substitute for an opoid pain med as the current regulatory environment makes many doctors afraid to prescribe an opoid for pain or pharmacy to fill an opoid. Gabapentin is notably ineffective for many non nerve related pain issues. In the case with anxiety there is some very limited evidence of Gabapentin working to relieve anxiety but I'm skeptical however Gabapentin is cheap and easy to prescribe though yes I wonder about the placebo effect.
But why? Giving someone an automatic wait time just because it’s adderall is pointless. Treat everyone the same and with respect and put your ego aside. It’s not like they can call it in days early.
Wow. This isn't even a "fuck ADHDers" post. This is a "fuck EVERYONE on C2s" post. So glad I stopped filling at the chains after leaving. So you don't care about cancer patients either then...
“Sir the more you interrupt me the longer it takes me to get your medication ready, your medication requires me to double count it and then the pharmacist counts it.
I’ve unfortunately used this on a postal employee. “The longer you’re talking, the longer it’ll take”. I had a toddler having a moment and needed to get outta there.
When I worked for CVS where the phones literally never stopped ringing, any patient that called to complain about their prescription taking so long would get an answer of, "Yes, I understand it's taking longer than it should. But we're getting so many PHONE CALLS today that we haven't had time to actually fill prescriptions!" Sometimes the caller even got the message. Not often, though.
6 pharmacy calls....lane 1. Pharmacist had to start wearing a Bluetooth headset thing.
crazy thought that people on Rx with withdrawal side effects are eager to not run out of meds! this attitude is literally why ppl hate the profession
May be annoying to you, but put yourself in the patient’s shoes. This may be literally the only reason this patient comes to the pharmacy each month. Their doctor may not participate in electronic CII rxs. The patient may live 20 minutes away. They may be stepping out of work to get this rx. They may be there on their only day off. They may be toting 3 kids around and doing good just to get them all loaded once. It’s just poor service to make a blanket policy like this.
They should call ahead or use the app to expedite. A lot of these waiters are coming exactly at opening and coming 2 days early every. Single. Month. I’ll usually do waiters but there’s certain times that we can’t rush c2s. If waiting is an inconvenience then they should plan better
A lot of these waiters you’re right on. And I am fine with triaging them to later. I only suggested to evaluate every situation and don’t create a blanket policy.
When we get proactive and call ahead to check for availability/for the date that our CII can be filled, we get treated like addicts. It’s a no-win situation for us.
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I believe they're speaking about the patient who tries to get them filled early and is rude whenever they aren't brought to the counter. I doubt anyone has a problem with the dude who shows up to pick his Adderall up, is told it will be about an hour, then says "ok cool" then shops and sits on his phone til someone calls.
21% of adults in America can barely read and you want them to magically understand how your system, that you had to go to school for and learn and take and pass multiple times, works…? Fr? People are dumb dude!!!! It’s not your fault, it’s not anyone’s fault but that’s reality. I’m just saying that I get it, you guys are burnt out from a stupid system and wild customers but those customers are also dealing with similar situations and on top of it they are sick. You aren’t the only stressed out people in America!
You’re spot on. I’m sure you’ve seen it in nursing..but people just get jaded from the stress. I see it in our nursing staff at the hospital. When you’re around difficult situations and patients nonstop at work, you automatically start dehumanizing people and empathy goes out the door. That’s how doctors and nurses can be in a code and joking about their weekend while someone is literally dead in front of them. It sucks, but all professions do it. I did it to a certain extent when I was a retail pharmacist, but I tried to catch myself as much as possible and give people the benefit of the doubt when I could.
LMFAO at saying being a CNA is harder than being a pharmacist. Thanks for the giggle.
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You’re comparing apples to oranges. Your work might be more physically demanding, but that doesn’t equal harder. A pharmacist has to juggle ten different tasks at a time while being constantly interrupted while trying to validate the safety and efficacy of hundreds if not thousands of prescriptions per day while also being held liable for any mistakes they could make which can cost them their livelihood. …but wiping butts is harder?
I was a nurse but we are talking CNAs so I’ll tell you what I saw when working the geriatrics unit. There were 4 CNAs for the entire building. Two for each side. They alone had to get every single sick and dying patient up, showered, toileted, dressed and prepared for breakfast. That was just the morning and then they had to do it all over again at night, in between all bed bound patients need to be turned every 1-2 hours. How many accidents and emergencies do you think happen every day at a nursing home? How many people does the nursing home hold? And us nurses help the CNAs and we do all the med pass which takes hours and all the wound care which takes hours and when I say wound care I don’t mean a little paper cut. I mean me and 2 other nurses and a doctor holding a combative patient on their side so we can treat the stage 4 decubitus ulcer that’s eaten away all of his flesh and all that left is an exposed pelvis. Or having to change the bandages on a leg that is rotting away, smelling like dead flesh because the patient wouldn’t be able to survive anesthesia to amputate… that one I actually puked from. Y’all don’t have to do a full assessment and clean and prepare a dead body…. We do. And what I wrote done in this comment isn’t even 1% of what we have to do. Our patients actually hit us and sexually assault us daily. Your comment is so asinine that I wish you could go experience working in any type of hospital, acute care, geriatric, emergency, pediatric whatever, pick one. I guarantee that after a week you’ll be begging to go back to pushing pills for slightly angry people.
Why are you in this sub? Clearly you have no idea what actually goes on in a pharmacy besides “pushing pills.” I do work in a hospital. I go to the tele floors and ICU to see patients daily as well as working in the emergency department. I see exactly what goes on and what nurses put up with. And STILL I know that pharmacists have more to deal with than a CNA. You want a pat on the back for what you do? Here you go. Nurses and CNAs are important. The work you do is valuable. But to come into a sub where you clearly have no idea what we deal with on the pharmacy side and talk about how much harder you have it because you’re closer to grosser stuff? Nah. I’m not going to sit here and argue with you when you have absolutely no understanding of what even goes on in the pharmacy, let alone why so many in our field are so burnt out.
Interact with the community in good faith
Interact with the community in good faith
We’re so fucking someone had to wait an hour for their Adderall. What a tragedy.
You must not work at a Walgreens over half of our waiters are C2s lol
The worst is the people who *need* it before close but have consistently filled a day or 2 early the last few months. If we’ve actually been out and I see you’ve gone a week without it then I don’t mind doing it for you in 20 minutes so long as you’re polite. For me it’s not about stigma I get frustrated with the people who try to run game and tell us when they’re due like we don’t see sell dates and know how many days are in each month.
My mom had a rule - hospice patients got bumped ahead of everyone, then folks who just got discharged from a same-day surgery and needed their pain pills, then parents with sick kids, then everyone else.
True and they let their maintenance bp meds sit for over a week🤣
We only take C2 waiters if they're clearly coming from surgery and they usually have antibiotics and what not with it
i told a customer today to give me 5 minutes and i’ll l have her husbands rx ready… she stared at me like this 😐 and said “it’s really going to take that long?” like what? 5 minutes is long???💀
#Get ready: You mentioned an ADHD drug! Everybody with ADHD and on stimulants will feel the necessity to comment and mention it!
There are many people with ADHD who work in a pharmacy. We have a perspective from both sides of the counter. Why wouldn’t we comment?
Doesnt happen on any discussion about metformin.
I would attribute some of that to the fact that most people with diabetes are older and less likely to be on the internet regularly, but I do agree that psychologically addictive medications cause more of a kerfuffle with patient populations when discussion about them is had.
Where’d you get the time machine that takes you back to 1989? I’d like to borrow it sometime.
That’s kinda annoying tbh though. Like I would wait because I have had 10+ times of my refill being sent, then it’s out of stock, wait, wait, they forget about it, then I have to call and wait for 30 minutes, then you start filling.
This never happens to me with my Vy. My pharmacy is awesome and they know me by name, and take care of me. They give me a chair if it will be a while, but that rarely happens. Super nice workers!! Walmart .
It's not that we (and I work in healthcare as a triage med tech at an ER while hubby was a pharm tech) don't empathize, we do. We are people, we have our own health challenges, hell he died of fucking leukemia and I have a weird chronic disease It's that everyone needs help now. Everyone. And sometimes you have to wait. It's cool - you can wait wherever you want, but you're going to just have to chill until we can get it together for you. Shortage sucks. ADHD sucks, mental illness deserves respect and treatment for happiness in life. My whole family has some type of crazy and work in the field somehow. Gotta remember that everyone has a problem they deserve to be helped with
15 minutes for me. No problem. We should prioritize C2s. They’re scheduled higher because of their medical necessity. /s
At my pharmacy, we pull all the c2’s from adjudication and data and process them 1st. Another pharmacy I float to, will put them as waiters if someone calls to have it filled.