Friday 29 February 2008

Bear Shits In Woods Shock.

A soldier has been in a war. For some reason this took up a fair chunk of the six o'clock news last night.

http://news.bbc.co.uk/1/hi/uk/7270743.stm

Monday 25 February 2008

Quack update, again.

Her website's been down for the last couple of days. Wonder why?

http://www.glovers-health.co.uk/

Thursday 21 February 2008

Further Proof That Australians Are Not Like Us.

I discovered an astounding fact today while slogging through the Australian Medicines Handbook.


There. Is. No. Bendrofluazide. In. Australia.

Imagine that! In the Ghetto we order in bendrofluazide by the shipload. It's one of the most popular, cheapest drugs around. If I could be bothered, I'd look up the interwebs to find out how much of it was prescribed last year.

In Australia, they still use hydrochlorothiazide. Which is one benzene ring, and three fluorines away from being bendrofluazide.

Freaks.

Wednesday 20 February 2008

CAOP exam.

Holy Batman, I'm bored.

Thing is, there's not a whole lot of genuine revision you can do for this exam what with it being an open-book multiple choice thingy. So I've just written down a big list of drugs and looked them up in the AMH. I suppose knowing your way round the books will be more important than anything, because you would go fucking spare if you attempted to learn the entire BNF. Although I'm sure a pharmacist I worked with in the hospital had Martindale plugged directly into his brain.

Anyway, revising for this is incredibly boring. It's not helped that, by a chain of unfortunate events, I ended up "sleeping" in my car last night. When I say "sleeping", I mean "shivering and listening to Test Match Special".

Roll on March.

Tuesday 19 February 2008

Quack update, again.

Still no reply.

I wonder if she believes in the Tooth Fairy as well?

Monday 18 February 2008

Exubera?

Did anyone out there ever see a prescription for this then? For something that arrived on the market as the best thing since Brett Favre, it sort of sunk without trace.

Daily Heil At It Again.

Yet more proof, if it was ever needed, that the Daily Mail is written by thick bigoted twats for thick bigoted twats.


The Daily Mail has a reputation for insidious racism and xenophobic propaganda, however, this leaked email from features writer Diana Appleyard illustrates the extent of the Mail’s cynicism.


—–Original Message—–
From: rsreply@dwpub.com [mailto:rsreply@dwpub.com]
Sent: 13 February 2008 15:57
To:xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Subject: Response Source - Diana Appleyard , Daily Mail (Request for personal case study)

PUBLICATION: Daily Mail (Request for personal case study)
JOURNALIST: Diana Appleyard (staff)
DEADLINE: 14-February-2008 16:00
QUERY: I am urgently looking for anonymous horror stories of people who have employed Eastern European staff, only for them to steal from them, disappear, or have lied about their resident status. We can pay you £100 for taking part, and I promise it will be anonymous, just a quick phone call. Could you email me asap? Many thanks, Diana


HOW TO REPLY:
Email: mailto:dianaappleyard@aol.com

Phone: not provided for use

Fax: 01296 738083 (preferred)

How very unsurprising. Unfortunately, there's enough morons out there to keep vacant windbags like this "writer" in business.

Fuck off and get a real job, Appleyard.

LINK:http://www.recessmonkey.com/2008/02/16/incitement-to-hate-foreigners/#comment-198307

Sunday 17 February 2008

Revision.

Today, I have been mostly Procrastinating. This happens whenever exam time comes around, when I get the books out and start looking at stuff, and sitting round in my pants all day, and drinking tea all day, and re-reading The Invisibles instead of doing real work, and leaning back on my chair bouncing a table tennis ball off the wall.

The exam I will be sitting is a multiple-choice open book thingy. In theory, it should be easy. Word on the street, however, is that it is not. It is not a re-run of the pre-registration exam, which was not difficult at all. It is an ambigous race against the clock that will determine my success or failure.

It's struck me just now much I've forgotten since I left the hospital, where I had the sanctity of a billion different books, and Google to use if I needed to look something up, and where patients were, generally, more interesting.

Unfortunately, this time I'm doing it on my own, and have no-one else to ring up for pep talks and crisis management. I will not, for example, be benefitting from The Farmer's Selective Revision Guide for Neuropharmacology. Instead, I will be reading the BNF and the AMH from cover to cover, going back through my notes from the Hospital, sitting around scratching, and hoping that something sticks.

Some traditions still hold however, and I intend to have a pint in my hand within ten minutes of the exam finishing.

Friday 15 February 2008

Where The RPSGB Produces A Shotgun, And Shoots Itself In The Foot.

I am not a big fan of the RPSGB. I think that their entire raison d'etre is to make money out of the membership. I think that the financial management of their rather large funds has been nothing less than criminal. They have offered me no support whatsoever, apart from a phone call couched in vague terms of menace. Their treasurer is useless. In any other form of business, there would be some accountability to their membership for fucking up the finances to this degree.

However.

It seems that they are not content with raising the membership fee by almost 50%. Bernard Kelly, who is something called a "finance and resources director" at the RPSGB has been quoted as saying

"I don't like putting up fees one year and putting them down the next.

"I don't think you'll see us putting up fees by 40 per cent again in the next few years, but I don't think you'll see us saying: 'things are great so we won't put things up'."


Mr. Kelly's name does not appear on Our Beloved Society's Register of Pharmacists. I suppose this means that Mr. Kelly is too stupid to go to university and pass a few exams. No-one should have a problem with that, Mr. Kelly can't help being a bit thick. However, what really rankles is that Mr Kelly is now in a position to have the power to tell people with a real degree, in a real science, what to do.

This just goes to show that the RPSGB have zero interest in anyone other than themselves. I can't wait until they become obsolete, and will gladly piss on their metaphorical grave.

Perhaps we will see Mr. Kelly justifying his statement. Perhaps pigs will fly. Perhaps all homeopaths will throw themselves off a cliff. And if my aunty had bollocks she'd be my uncle.

Tuesday 12 February 2008

Nexphase

If a thousand monkeys typed for a thousand years, one of them would eventually produce the complete works of Shakespeare.

The other nine hundred and ninety nine monkeys would produce Nexphase.

Interesting article.

http://www.usatoday.com/money/industries/health/2008-02-11-prescription-errors_N.htm

Some quotes from it:

In its responses to USA TODAY, Walgreens said, "Errors don't occur more often at a busy pharmacy than a slow pharmacy."

Philip Burgess, national director of pharmacy affairs for Walgreens, testified in a 2007 deposition for a different case that he saw no link between pharmacist workload and errors. He said mistakes were "more related to lack of focus."

This is complete and utter dishonest bullshit from a man who has completely forgotten what it is like to be a real pharmacist. If, indeed, he was ever bright enough to be one.

USA TODAY found Walgreens and CVS have policies that seem to stress speed in filling prescriptions.

Walgreens' budget guidelines for work hours, never previously publicized, say a pharmacist at a typical store might have as little as two minutes to verify the accuracy of a drug, its dosage and directions.

"That's not enough. They allow no time for counseling" patients about their medications, checking the work of technicians and fulfilling other duties, says Kennedy.

"We have never dictated the time a pharmacist spends on a prescription," Walgreens said. "Pharmacists are licensed professionals; we expect them to exercise good professional judgment." Stores may adjust the guidelines "as needed," the chain said.


Kennedy challenges that assertion: "Walgreens corporate (executives) will tell you … that there is no pressure to increase speed, and that pharmacists are supposed to use their professional judgment and go at a pace where they're not going to make errors. … What filters down to middle management is completely opposite. They're in the stores pushing the volumes."

Quite. All I hear from the overpaid, overpromoted middle management at the Ghetto is that we must cut waiting times, and increase item volume. This is bullshit. It's unsafe bullshit. There are nowhere near enough staff to cope with the Ghetto as it is. Are we going to get any more staff? Are we bollocks! Plus, we have to put up with a Fantastic New Computer System that crashes at hourly intervals.

If pharmacists are being flogged far and away beyond what it is safe for any man to do in a day, it is no wonder that mistakes are being made. If pharmacists have to put up with useless quipment foisted on them by some piston wristed gibbon who is easily impressed by flashing lights and little pictures, then they will make mistakes. If pharmacists have to work in shitty conditions, then they will get pissed off, stressed, and think "Fuck this, I'm off to do something easier".

Why are there precisely zero articles in the Pharmaceutical Journal about this? It's all very well focusing on the 0.001% of pharmacies that have well-trained staff, leaving the pharmacist free to do Other Stuff. Most places are vastly understaffed and with an ever increasing prescription volume there's going to be a very, very serious fuck-up sometime soon. And the supermarket it happens in will wash their hands of the whole affair.

Edit: Should point out that I found this here: http://pharmacygod.blogspot.com/2008/02/usa-today-today.html, which is a better site than mine.

The Ghetto

I've been thinking about this a bit recently, and have decided that there is a strange sense of wrongness about the Ghetto. There's a strange, malevolent evil in the air, an underlying aggression which I have never experienced anywhere else. Driving in the other day, the road was blocked off. Turned out someone had been put in hospital the night before after an "incident" outside the local pub. He was in a critical condition, apparently. A couple of months ago, some young guy was kicked to death outside the pub in what passes for the town centre.

It's manifested in everyday life as well. Mothers screaming at kids in the street, women screaming at men, in the middle of the afternoon, on the public street. People wandering around with cans of Stella. People wanting their tablets now with a furosity unmatched anywhere else.

There's a strange black cloud of depression that hangs over the entire town, with the epicentre being the slough of despond that is the Ghetto Pharmacy. Whatever it is, it is not a healthy environment to be working in.

Monday 11 February 2008

Quack update.

I emailed the Quackmeister general to ask her what the evidence for homeopathy doing, well, anything was.

Clearly, the Quackmeister general must be preparing a mountain of well-researched evidence, because she hasn't replied yet. That, or she's desperately trying to make something up. It will probably involve the words "emotional", "spiritual" and "laughing all the way to the bank".

Best Rant Ever.

http://militantmedicalnurse.blogspot.com/2008/02/matrons-shoot-them.html


"When do we see Matrons? When there is an inevitable cock up. Then they are down to the ward like flies to a horses ass to ensure that all blame is directed onto the staff nurse and the hospital does not appear negligant or liable. Then the same error happens again with a different nurse because these are SYSTEM errors not NURSE errors. Once again Matron comes down hard on the individual member of staff without troubleshooting the problem. Fucking worthless whores. I saw it happen to too many of my colleagues and I got the hell out before the day came when it was my turn.


As far as I am concerned, most of our so called nursing leadership are traitors to nurses and patients alike. Don't even get me started on the NMC, the RCN or any of the other worthless pieces of crap who refuse to address the real issues. I'd like to see them all lined up and shot*. "

Truly brilliant stuff. And very very worrying. But unsurprising.

Things I have no interest in whatsoever in work.

1) Stockings. Not the fun kind of stockings, but more the Scholl Class II honey coloured below knee open toe things. They are the least sexy things in existence. There are 240,000,000 different types, and the chances of picking the right one on the order screen is about the same as Wales qualifying for a football world cup. I hate them more than Hitler.

2) Dressings. As above there are fifty squillion different types. Mepore. Mepore Ultra (sounds like a bloody tampon). Adhesive. Non-adhesive. Lite. Non-lite. Added Silver. Added honey. Added iodine.Bordered. Borderless. When the nurses come into the Ghetto I tell them to help themselves and leave a script behind.

3) Vet stuff. I love dogs, love them to bits. But. If i have a problem with my dog, I take him to a vet. This is because vets are trained in diagnosing and treatment of animals. I am not. I have no training or interest in vet stuff at all. Therefore, I cannot recommend you anything for your cat. It's not because I'm being mean, it's because I don't have a clue what I'm talking about. Two legs good, four legs bad.

Friday 8 February 2008

Urgent Message For All Doctors, Especially Hospital Outpatient Doctors.

You are a doctor. You have, literally the power of life and DEATH in your hands. You can write prescriptions for the magic drugs that work. If you are a twat, you can write scripts for homeopathy. If you are a doctor and reading this, for God's sake please make sure you have the following on the script:

1) The correct date. Not tomorrow, or the day after. If you're lucky, the pharmacist may not notice until after the drug has been given out. Usually because I am not entirely certain what the date is myself

2) A quantity would be nice. 1/12, 5/7, anything like this is fine. "For one month" is fine, this means I can give a complete pack.

3) A signature. No signature, no drugs, simple as. You wouldn't take an unsigned cheque, would you? This especially applies to Dr. Beelzebub's practice round the corner, who seem completely incapable of signing scripts.

4) THE FUCKING NAME OF THE FUCKING DRUG. I don't care if you are a consultant with 240,000,000 years experience, if you can't write the FUCKING DRUG NAME on the prescription, I can't dispense it. "30mg bd" is not acceptable

5) Stop. Think. Make sure that the prescription you have written makes sense. If you do this, everyone is a winner.

Tuesday 5 February 2008

It's not about the numbers.

"500? 600? Hell, I do 1000 items a day, and then I shag Angelina Jolie!"

Bollocks.

The other week I did 110 items in a day, well, mainly in an hour and a half in the afternoon. Amazingly, this gave me time to talk to patients. This is what you are taught happens all the time in pharmacy school. It does not.

If you do 1000 items a day, you cannot talk to patients, FACT! The best you can hope for is to ship them in and ship them out as quickly as possible.

I like talking to patients. Sometimes. If it's not frantically busy, it is possible to talk to patients. Sometimes, you learn something. Sometimes, they learn something. Sometimes, you can do something useful, not very often, but it happens. Then, they bring you in beer and chocolate. More importantly, gratitude.

Goodnight.

Fuck Tha Ghetto

As Snoop Dogg, or other esteemed rappers might say.

I've had enough of it. Enough of not having a piss for hours, enough of being banned from drinking tea, enough of having to put up with Fucking Nexphase, which crashed/froze literally every twenty minutes today. I've had enough of running around chasing my own arse because we are at least two dispensers and two Offensive Line members short all the fucking time, because The Higher Echelons decree that we are not understaffed. Patient care has gone out of the window, all that matters is speed, speed, speed, and why wasn't it done yesterday, and "I don't want those ones, I have those ones". Hitting pissing targets for the sake of it is not my idea of what is right and proper. Hearing the words "Can the lady have a word with you please?" is enough to make me shudder, because there is no time.

I have about six days left in the ghetto, and then I'm done. Fuck it, it's not worth the risk to my sanity, the lying awake at night wondering if I remembered to order catheters. I should not feel like punching the wall every time I come home from work. It is not enjoyable when you see four scripts waiting, all with more than fifteen items on them, and the phone just won't stop fucking ringing.

Oh, and I would like five minutes in a dark room, no questions asked, with whoever decided that the new style CD registers were not good enough, and then replaced them with the new new CD registers. Idiots.

And I pissed off one of my favourite Offensive Line members today, due to a communication breakdown. Bugger.

Monday 4 February 2008

Back to the Ghetto

I'm back in the Ghetto tomorrow, the place where dreams go to die, where youth withers on the vine, where all that is virtuous is destroyed. On the plus side, I get to drink my tea out of a Cialis mug, which offers the opportunity for plenty of innuendo with the Offensive Line. On the minus side, I will be drowning in a tsunami of amoxicillin.

It's like going back to school after the long holidays really. I just do not want to go back in. This has been a good weekend really, The Miracle of Twickenham, a trip to North Wales, and one of the most dramatic Superbowls I've ever seen. (OK, it was only the second one I've watched.)

But, it shouldn't be like this. In the Ghetto, I actually dread talking to patients. Because the script volume is so damn high, if I spend five or ten minutes talking to one old dear, the baskets pile up and up, and the rest of the Lost Souls in the Ghetto start giving me evil looks, like I'm keeping them away from their diazepam on purpose.

One day, I will post something about good, nice pharmacies that I have worked in, where the size of your cock is not dictated by the number of items you do, to put it crudely.

Friday 1 February 2008

Hopes and Dreams

If this happens again, I'll, I'll...err....I'll not get frustrated with anyone for being ill for at least a fortnight.

http://www.youtube.com/watch?v=rcEHCOIa7Qk

Glovers Integrated Healthcare

Post removed due to legal (ish) advice.

Still, if it walks like a duck, and talks like a duck...