Friday, January 9, 2009

Makin' 'em love ya

I usually post about stupid shit in pharmacy, including mean people. I've noticed that many of my fellow pharmacy bloggers write about the mean people they experience, too. In a comment to a recent post on my friend JP's blog, one technician estimated 98 of 100 customers were nasty. Some days it certainly feels like that, but I've tried to change that by befriending my nastiest patients, and I thought I'd share some stories about how I did that.
The first patient I'll call GS - for gunnery sergeant. I don't know if that was really his rank in the Marines, but he seems like a "Gunny" to me. GS is a crusty ol' Vietnam Vet - loud, obnoxious, and foul-mouthed. He's diabetic, and when I first met him, he had horrible neuropathy and persistent lower extremity infections. I'm sure his pain is what made him such an ass. But, he reminded me a bit of my dad, so I decided he was OK, even though my techs would practically run and hide when he'd show up, knowing he would pound his fists on the counter. I have some background in pain management, so I helped him with his meds, called the doctors with suggestions, and made sure he was never out. I think what changed our relationship was a hospital stay he had for a post-op infection shortly after having his leg amputated. I was still working on call at the hospital, and saw orders for him cross my desk. I went up to his room to see how he was doing. GS recognized me, knew where he recognized me from, but didn't know my name. I told him, and also told him that I had clarified some of his drug doses that the admitting doctor had gotten wrong. Now, GS says the amputation was the best thing that has happened to him, because he's in less pain and has fewer infections - and, he's one of my favorite patients. Sure, he's still loud and obnoxious, but when I hear fists pounding on my drop off counter and a "Get to work, girls!", it brings a smile to my face, and takes me out from behind the counter to get the biggest bear hug you've ever seen. GS got upset when I didn't invite him to my wedding, but forgave me and even offered to marry me if I was left at the altar (I told him his wife may not appreciate that). Even though I declined on that offer, I still get a loud shout of "I love you!" when he rolls his wheelchair out of the pharmacy.
Next, I'll tell you about TW - for train wreck. "Train wreck" is a term used in many hospitals to describe a patient who has MANY medical problems. TW is a woman, younger than me, who takes 30+ maintenance prescriptions. Having so many problems at such a young age, a lot of pharmacists assumed she was just a hypochondriac. It couldn't be farther from the truth - she had a pacemaker by her early 30's. When I first met her, the experiences she had with other pharmacies had jaded her. She refused to be counseled ("I know more about my diseases and meds than YOU ever could"), demanded brand name only ("I'm allergic to all generics"), and would demand that one person always be the one to help her. Over the first couple of years, she transferred her prescriptions around, mainly in response to my demand that she be counseled on new things. After 4 or 5 experiences with other pharmacies treating her like a freak, refusing to jump through insurance hoops to get her brand name drugs, and even having her scripts bagged in a garbage bag (the regular bags are too small), she came back, realizing that we really did treat her with respect. It was then that she realized she could trust me. TW not only lets me counsel her, she calls for questions before her doctor's appointments, so she can be prepared to make suggestions to the doctor herself. She now takes generic meds, after following my suggestion to be tested for allergies to dyes. Turns out the generics she was allergic to all had one thing in common - blue dye. I call TW my bread and butter patient (and she knows this) - when she picks up her scripts every 3 months, my sales for the day are boosted by about $10k - it paid off to make her love me...
Then, there's CP - for "crankypants". That's what I call him - right to his face. When CP first came in my store with a stack of new prescriptions, he immediately launched into a tirade. Threatening to sue us if we treated him the way his previous pharmacy did. He was yelling at my tech, who shot a "help me" look my way, so I walked up to the window and said "I'll make you a deal. We will treat you with respect if you treat us with respect. You have never been here before, we haven't even started on your scripts, and you're already yelling. So - you be nice, and we'll be nice. Deal?" He agreed. It's still pretty obvious to most people that CP is just a cranky old man in general, but he grins ear to ear when I say "Morning, crankypants! How are you today?"
Lastly, I'll tell you about AA - for addiction and Alzheimer's. That's not a good combination to have. For the first few years in my pharmacy, I mainly dealt with AA's husband. He would come in, looking defeated, telling me how AA was taking his meds, would physically fight him if he wouldn't give her more of her own, and asking if I could help by not filling stuff she called in. One time, AA called me and screamed at me because I had told her doctor she was taking her husband's drugs because she had used up her month's worth in 5 days. Her doctor was putting her on a short leash. I probably spent 30 minutes talking to her, explaining that she was putting her life at risk, that I couldn't let her do that, and that it was my job to work with her doctor to be sure she was taking her meds right. I finally convinced her that I do care. Her husband passed away a little over a year ago, so I have tried to work closely with AA, her caregiver, and her doctors to keep her on an even keel. Just before Christmas, AA's caregiver came in, and in our chit chat, I found out that AA's roomie had been stealing her food. I told the caregiver to go pick out a small refrigerator, and I'd buy it for AA as a Christmas gift, so she could keep some food in her room. AA came in a few days later, full of tearful thank yous. It made me feel so good - not just for the gift, but also for standing up to her when she was at her worst, to provide good care - she's doing so well now!

So - all you pharmacists, interns, and techs - next time a really obnoxious person comes through your doors, make it your mission to make' 'em love you. Not only does it reduce the nastiness in your waiting area, it will make you feel like you've accomplished something - you've done the right thing. Not all jackasses can be befriended, of course, but you won't know who can if you don't try...

8 comments:

Wunderwoman said...

Thank you for this post, I was beginning to think all pharmacists did was complain....

sickofstupidpeople said...

WW, we complain online because it would be extremely unprofessional to do so at work. It's just venting. Personally, I don't think I can imagine myself doing anything else other than be a pharmacist. For the most part, I really do enjoy it. But, there are some things that I have to bitch about at home, because it's not worth destroying my career to bitch about it at work. And writing about the happy stuff just isn't as therapeutic - or funny.

mensch said...

I had one prescription customer who has the distinction of being BOTH the worst one AND the best one I ever had.

Her transition from "worst" to "best" came when she unilaterally stopped taking all of her medications.

She went from "hell on wheels" to total peaches and cream.

What does that tell you about prescription medications?

TGCougar86 said...

You know, I got tearful reading this post cause I know each and every patient you are referring to. I'm beginning to love them just as much! :P

Spankie said...

way to go

sandygts said...

Why can't I find a caring pharmacist like you? I applaud your generosity and urge you to teach people like the angry pharmacist a thing or two:)

Kara said...

"I have some background in pain management, so I helped him with his meds, called the doctors with suggestions, and made sure he was never out. . . I told him, and also told him that I had clarified some of his drug doses that the admitting doctor had gotten wrong."

I highly doubt that your input was more valuable than the doctor's was. Maybe the reason you have so many "stupid people" come in is because you're a nosy, busybody twit who is so busy self-assuring herself that she's smarter than everyone else. Also, telling the patient that his doctor fucked up, so that you could brag about how you fixed it? Not the best strategy when it comes to a grumpy old man who is probably already distrustful of his doctor. actually, probably the worst strategy ever when it comes to showing professionalism and respect within your field.
hop back to cvs, and do the world a favor and realize that you're not really that smart, or funny, and that you're just some snotty pharmacist who thinks she's the greatest person ever.

Candida Gomez said...

Don't listen to Kara. Doctors can and do screw up, or worse, don't want to admit that they're wrong to keep prescribing medications to 'fix' side effects instead of pulling a full evaluation.

There was an article in Reader's Digest years ago about what pharmacists do. One poor guy was taking over 30 meds, many to alleviate side effects. His pharmacist looked up every single one, printed out a *nineteen page* page report on them, including interactions, and added his evaluation of how they were messing the patient up with their interaction and side effects.

His doctor looked through maybe five pages of the report, then started griping about how the patient needed all the drugs, without explaining why. The patient found a new doctor.

A year later, the patient was down to six medications. Apparently most of his medications were to treat cascading and accumulative side effects, not the conditions themselves.

The doctor goes to school to learn how to diagnose conditions and what might be the best way to treat them; the pharmacist goes to school to understand drugs inside and out, and know where to research if he doesn't know.

And there is never anything wrong with understanding people.