Once upon a time, I was a pharmacist. I like to use the fancy terminology “clinical hospital pharmacist” because it ranks me higher than just the regular pharmacist, or at least, that is why I suspected others do this. I have always cared so much to do the best job I could always do.
I want to dive into a situation that happened to me a few years back. Something that I thought I would share with others who are considering a career in pharmacy. More than anything, you need to be very particular in where you work and what their goals are. In other words, if you are working for a company that is “for profit” and is traded as a public stock, the goals are not patient care. The ultimate goal is profit and making shareholders happy.
We had two different types of orders in the hospital. We had inpatient orders that the hospitalists and specialists ordered and we had home medications. No one wanted to take responsibility for home medications, but I always went above and beyond to call pharmacies and clarify. We were told that we could call where their home medications were ordered and correct them. After all, physicians regularly signed off on what the patient told them they were taking at admittance. Sometimes it was very clear to pharmacists when someone had albuterol and other meds with albuterol along with let’s say, two beta blockers at the same time.
In other words, there wasn’t really a process in place to make sure what the patient was reported was correct. Or if someone did check, it wasn’t a pharmacist. HCA didn’t want to pay for a pharmacist in the ER back then. I think maybe now they do?
HCA mandated back when I started with them that I was to verify (approve) 50 orders an hour. That is one about a minute or so. If we fell below that rate, we were given a warning. It was how we were graded… along with accuracy. Both were equally important. FAST and PERFECT.
Do you see the situation already?
I had a manager who was not a leader. In fact, he is one of the ones responsible for me deciding to leave the career after 18 years. I haven’t regretted it one day yet almost 3 years later, and in fact, I would thank him if I saw him in person.
I had a medication error. The cardiologist entered an order in order entry. You see, HCA was mandating that physicians do this, but didn’t require them to use the system they were to use. This particular physician found it easier to enter meds as home meds. I called to verify the home med since it was entered that way with CVS and found the correct entry. I copy edited it and sent it on. It was a home med after all.
A nurse caught it before the patient ever received it. Yet, the cardiologist wanted me to be reprimanded, likely fired by the way I, in hindsight, interpreted my manager’s actions.
We skipped verbal warning. He approached me a month afterwards and asked me to come to his office. He never once asked me what happened. Never sat down with me to look at meditech and see what happened.
I refused to sign because it had been a month, he didn’t ask my side of the story, and what he wrote here was incorrect.
“You better sign this…”
I told him no.
He said, “It won’t be good for you if you don’t sign.”
I said, “Then it won’t be good for me,” and I left.
I have never walked out of a meeting. I have always respected those above me, but so many things happened before and after this first incident. Mold was growing in the IV room a little later. Seriously. In the hospital. They cleaned it up, but not without the leader being really upset. When it was discovered outside the pharmacy, instead of pitching in and helping us, he came in and took out all the IV medications and pushed a cart at us with the contaminated medications and wished us good luck working short that night and walked out. He didn’t care.
D. was the worst manager I have ever had.
Many other things happened. I had lost all trust in this organization and hospital. I saw a pharmacist get fired for failing a drug test. Saw another fired for other reasons. All after major delays that D. ignored. I saw many good pharmacists leave for other jobs. I did as well.
This was the most toxic place I have ever worked, and I stayed there for six years of my life.
I hope it’s different now for those left behind. I really do.
He was fired a few months after I quit. When they removed him, they went to remove him from the computer system and never found he had ever been logged into the computer system. He had never once been a user in meditech. It’s likely why he never sat down with me to look at the error I was accused of making. Plus, he was too busy flipping houses instead of managing the pharmacy.
I am sure pharmacy isn’t like this everywhere. Perhaps the company that picked this manager up found a way to mold him into a better leader, but I don’t know if that is even possible. To have so many things go wrong under his watch really speaks volumes about his leadership, or lack of. I can’t even allow my family or me become a patient there, but truly, likely every hospital has its issues, just hopefully not as glaring as it was there.
The only reason I am writing this today is because I woke up this morning after a nightmare.
I was back at the hospital working as a pharmacist, and I am glad I woke up.
veritable faith 