Love that Jonathan is the only person who does med rec correctly (and that I can tell it's Jonathan even though it's just a picture and ALL OF THE CHARACTERS ARE PLAYED BY THE SAME GUY).
It was bad enough one night I went to every floor and made each nurse come look with me. The only med not where it was supposed to be had been randomly tossed aside by another nurse who didn't need that one.
I laughed when Jonathan wins the Perfect Med Rec Award. I assume he doesn't speak and the pharmacist just assumes that he is making the correct med recs all the time
As a hospital pharmacist, I can confirm this is 💯 accurate. I recently was reviewing a med rec and it said the patient was taking 800 tablets of vitamin d per day. Just went ahead and changed that to 800 units.
@@bob8mybobbob How many meals a day are you eating?! Or.... do you consider the cereal bowl of vitamin D a meal and put yourself in an infinite loop? >.>;
Amazing how the pharmacist manages to maintain the same chipper, assertive-yet-not-condescending tone and demeanor with every call that comes his way. I dare say he's near the level of a Johnathan.
@@TheRayfield77 I don't imagine that real pharmacists are all like this all the time. I was mostly talking about the character that Dr. G plays. But I will say most of the pharmacists I meet are quite courteous and cool-headed despite how busy they are, and it is something to be appreciated. But it's not like nobody is allowed to have a bad day.
@@Soprano91396 I’m honestly happy no other place I’ve worked at but CVS has decided the phone needs to announce “ X Pharmacy calls “ every couple rings 😭
We have about 6 nurses who call CONSTANTLY and when their vocera shows up on caller ID, we all grimace before we paste on our customer service voice and answer. My least favorite is when nursing gives patient's family members our number...
Honestly I love the ones that are so egregious that I get to be a little rude. “You continued the patient’s home potassium when their K is 7.4. Are you going to fix that?”
As a doctor, I'll tell you there are times we deserve to be hit on the head with the entire Pyxis. Go ahead and be as "straightforward" as you need to be.
@@Makermook I work in veterinary medicine and have had some pretty bad encounters with vets. One time a vet demanded to know what vet school I went to and then made me repeat back that I will not question her dosing again. 😵💫 there are a lot of lovely ones too but you never know what you’re gunna get 🤦🏻♀️
Yeah no sometimes a doc deserves to be bashed upside the head just a little bit for a stupid med rec, my dad had a pharmacist directly call his doctor and go are you absolutely sure you want this man to take this medication... He's on warfarin remember (the medication in question thinned blood which warfarin also does(technically warfarin is an anti coagulant but potato potatoh similar function and you don't really want to mix the two willy nilly)) the doctor quickly rescinded the prescription and changed it to something else
As a hospital pharmacist, I appreciate every time you shed light on what we deal with. People already don’t really know what community pharmacists do and certainly don’t know what hospital pharmacists do
Pharmacists saved my dad's life post- back surgery. They knew what the prescribed medications would or would not do and my dad always consulted them after that.
Please call pharmacy if you aren't sure or need us. As a hospital pharmacist I can tell you we would rather you call then have errors found later. We have so many people calling for so many different reasons. At least with the hospitals I have worked at we are taught that doctor calls are the priority.
I swear pharmacists pay more attention than the prescribing physicians do. I had a psychiatrist once prescribe me a med that's contraindicated for people with epilepsy, and my pharmacist caught it when I was picking it up. What was less fun was that the psychiatrist refused to prescribe a new med until my appointment a month later, which I also had to pay for, just to tell them that yeah, I didn't take any of the med that was dangerous for me and I have no updates, please just write me a new prescription. Grateful for that pharmacist, tho.
The part when the pharmacist recommended the generic brand reminded me of the first time I bought my own prescription. I was in college and it was going to cost more than I had in my bank account. That Walmart pharmacist was the real MVP for making that call to my doctor and getting the prescription fixed to the $15 generic brand
Is this a state-by-state thing? I’m in Oregon, and I think the pharmacists just automatically substitute the generic unless the doc specifically says it has to be the brand name. There are signs about it in every pharmacy. Maybe I’m missing something behind the scenes… or maybe it depends on the medicine.
@@LexAnnalyn I'm pretty sure it's state by state. It's the same here in Massachusetts, its automatically switched to generic unless the doctor specifically writes not to do so. It ought to be every state!
Retail pharmacist here, likely scenario is the doc wrote for a brand only medication when there is a perfectly acceptable generic in the same family that is much cheaper and preferred by insurance
@@bronwynhl They can do that here in the US as long as the doctor doesn't specifically write the prescription "dispense as written" - which most don't unless there's a good reason. And a good pharmacist doesn't even have to be asked, you get the cheapest generic. That said, I've used DAW prescriptions to my advantage before, DAW + a copay discount card can burn through your out of pocket maximum REALLY quickly without you having to actually pay out of pocket. I know, not an issue in Australia, but healthcare is stupidly expensive here.
Context for some of the less obvious screw-ups for any non-medical peeps - - Creatinine is a measure of kidney function, this patient has a kidney injury and NSAID's like ketorolac can cause/worsen kidney injuries - Hydralazine is for blood pressure, hydroxyzine is for itching (everyone gets these confused at some point) - Warfarin is kind of an old school blood thinner (but still pretty common) that can be a pain to manage/keep at appropriate levels because it requires regular follow-up visits and lab checks. So docs who don't typically see patients long-term or deal with a lot of chronic conditions would not be the best choice to manage it, to put it mildly
@@livewithmeterandnomeasureb1679 I had to look up hydralazine, but while watching the video my immediate reaction was "That sounds like they meant to order hydroxyzine, but didn't." For somebody in IT, maybe I know too much about meds.
I’m a hospitalist who worked in internal medicine for quite some time. I actually said “OH GOD” out loud when I heard it was ortho managing the warfarin. 😂
You would not believe how often the pharmacy gets called about a med and it turns out it's just sitting in the tube. Once in a while you go down there yourself to get it out of the tube for them haha
I love that Jonathan is getting the recognition he deserves for his excellent care and service. Also, he was the employee of the year before and after 2022. Meaning the Pharmacist just made his job easier by putting pictures up in advance. He knows no one will ever beat Jonathan!
Thank God for the Pharmacy! I was dog tired after an night of call, eight admissions, and, since it was a weekend, I had to write the hyper-al orders for the patients on my service before I could hand off. I had about ten orders to write and was rushed because they HAD to be in the pharmacy before 1:00 PM. I had just finished and was wrapping up to go home when the Pharmacy called. Damn it! “Hey, Wayne, Pharmacy. Did you mean to write for one unit of Norcuron per cc on the HAL for pt, ____?” “What? No, of course not. The patient is on the floor and unintubated. I did want a unit of heparin per cc in the solution, though.” “Thought so, but I wanted to let you know. I’ll make the changes” Holy crap! Saved my patient’s life and my career, all in one phone call! For the non-medical: 1) Norcuron is a paralytic agent that will make the patient stop breathing. 2) Norcuron isn’t measured in units.
Hospital pharmacist here: It’s true, all of it and more. We’ve finally semi-beaten the current crop of residents into submission, just in time for another batch to show up and make all the classic errors 😂
Thank you, as a pharmacy technician, I think you may be one of the only nurses that don't blame pharmacy for when you can't immediately find you neds! You are right, we are all on the same team!!! 👏👏👏
@@scgirl9310 nah Every nurse I know and myself too love pharmacy We’re short sometimes I think because by the time we’re talking to you we’ve been dealing with an issue for a while and it’s holding us back from doing our other work.
As a hospital pharmacist I think of Jerry McGuire when I see crazy orders "Help me, Help you?". I will give the doctor most things they want but it needs to make sense. We can decipher a lot but you would be surprised how often orders come through that make no sense what so ever. I had a doctor order Aspirin rectally every 4hours scheduled, when I asked him he blames Epic and said he basically just punched at the keys. 😂
100% accurate. One time I had to call a doc who meant to order Thorazine (brand name for an anti-nausea/vomiting med), but instead ordered thioridazine (used exclusively for schizophrenia). Dr. G out here being a great advocate for hospital pharmacists.
Thorazine is brand name chlorpromazine, a typical (first gen) antipsychotic. It's primarily used as a sedative antipsychotic that also has potent antiemetic effects. Thioridazine is also a typical antipsychotic.
@@lindseybrown1683 probably not. They’re both “psych meds”, but some like Thorazine and Compazine are often used for big time nausea/vomiting. Whereas thioridazine is effectively used exclusively for psychiatric indications.
I'm a pharmacist and every time I watch your videos I keep thinking that it would be nice to have a vid about hospital pharmacy. Thank you so much and this is accurate!
Hi Big Fan from Thailand, This is my first time to watch your video before it hit 10,000 views. As a former hospital pharmacist, now studying medicine, I laugh out loud. LITERALLY. Your mocking skill about our routine jobs is ANOTHER level. It is so real, especially the pharmacist-to-dose things. Great job as always sir. !!
@@ConstantineIII Thank ! To be honest, it's not a bed of roses. The only thing I know is meds LOL. I need to re-learn almost everything about human body.
Dr. Bill, I wish we could give our full attention to you but... phones. We appreciate the visit. Trying to answer all the phones, multi-tasking, trying to track down where x went. Resending a third of the meds we filled... Did you check the tube? The fridge? Bottom of the tube station? Underneath the pile? Med room? "I'm not trying to do your job for you, but you did write "pharmacy to dose on the order." I'm crying. All of this is so accurate it hurts.🤣 This is why you all get put on hold.
I've added onto my spiel to these mostly travel RNs that plague my hospital, "have you checked in with every single one of your coworkers on the floor to confirm that they may have taken it from the tube station and not told you?" It works magic because they seem so afraid to ask.
@Jagaroth They very well could be. I've met travel nurses who have met nothing but contempt from other nurses from places they went. Or just weren't helpful. So I always made it a point to introduce myself. It's nice to have at least one friendly face.
Knowing the many questions our antimicrobial stewardship pharmacist has to negotiate every day, plus the ones I pose to the rest of our amazing PharnDs, this brings me pure joy.
The ortho warfarin thing gives me deja vu. When I was a junior resident rotating through ortho I asked the boss what to do about the warfarin for his preop patient and he was like I don't know why don't you ask someone smarter than me who know. The trainee said try haematology... patient had a mech valve 😂
As a hospital pharmacist this was hilarious to watch but also so true. I wish more people understood what we do, most still think pharmacists just "count pills". I joke that 90% of my job is keeping doctors from making mistakes that will hurt patients but honestly it's true. It's kinda like doctors are writing a book and we pharmacist are the editors who come through and make sure the book makes sense.
Welp, my step mom was taking some rheumatoid arthritis drug Xeljanz. Had a stroke. Still kept her on it. Had kidney failure. Getting dialysis. They were still giving to to her up until I arrived (retired nurse) and demanded it get d/c'd. It eventually killed her. All she had to do was stop eating nightshades. The last 3 months of her life, i didnt feed her nightshades and all she needed for pain was tylenol. The medical field is useless sometimes.
You have outdone yourself Doc! I was laughing hysterically at the Vancomycin bit 🤣🤣 I am so grateful for all the pharmacists managing Vanco troughs, and INRs behind the scenes! Signed, a PGY12
as a nurse, the pharmacist does even more than what they show here. Here they just showed dealings with the doctor but I often have my own stuff they need to help me with. Kings and Queens I tell you
Yep and that doesn't include making IV meds, Chemo meds, and checking all orders to be loaded into the pyxis machines. Oh and medication timing! So much of our job is involved in medication timing. So often the doctor just enters the medication in and we have to call the nurse to double check when the last dose was given and is timed appropriately.
I really appreciate nurses so much. Especially when they call us to run things by before they talk to the doctor. I don't know how many times I have had nurses say they felt more comfortable calling a doctor after talking to pharmacy. Basically they feel like they can say they are concerned about something and they have already talked to pharmacy. All of a sudden they have more power in what they say since we backed up their concerns. I thank the nurses every time because honestly nurses catch so many problems.
As a hospital pharmacist, this is so real (I got twitchy just hearing the phone ring). It's killing me a little bit that he never heard or answered Bill's question though - now he has to make a note and come back to it later.
I find he's really impressive about that, the jokes never seem to be at the patient's expense either. I totally get medical professionals need to blow off steam complaining about patients to each other, but when you share it with the world it can make people who really should come in even more scared.
As a former hospital pharmacist now outpatient clinic pharmacist, everything about this is spot on. The phone never stops ringing, and every few minutes there's always an intervention that needs doing. To the point where, as a low social energy person I want zero human interaction after clocking out from work.
Hysterical... especially the last scenario! I ran an anticoagulation clinic for years and managed warfarin for lots of surgeons during the perioperative period. Like Ortho Bro they just wanted to operate and were happy to let me watch the bleeding and clotting risks. Actually, I really enjoyed our interactions and felt privileged to be part of the team.
I'm about to cry laughing. My parents were both pharmacy managers and I spent my childhood hanging out in the floor of the pharmacy reading pill bottles. The perfect smooth "Pharmacy" with the smile is uncanny. The exact movement and facial expressions my parents made 🥰🤣🤣
hahahhaa this is genius. please incorporate more sad trombone sounds/sound bytes. just wanted to say thank you to all hospital pharmacists out there. you are truly appreciated and i always seem to learn more from you than any other hospital staff. we have vancomycin per pharmacy order set because of all the shenanigans that we have to go through lol
I work in a tier 4 retail pharmacy, but the phone comments hit deep 🤣 I really do just start answering the phone at random intervals to get out of other things lol
I audit medical records for preventive care and one of the things we look for is proper medication reconciliation after a hospitalization. It's sadly true how many of these are done poorly and it is often due to multiple providers not sharing one record or a non-prescribing care giver (like an RN, LPN, or MA) doing the med rec without the doctor signing off that they checked it, too. In most industries, it's best to have someone double checking your work. We're only human. Thank you to the pharmacists and their software that make it clear and easy to see when a med rec was completed!
BAHAHAHAHAHA! Pharmacist here! Truer words were never spoken!! I’m retired now but a ringing phone is definitely a trigger for me to this day! Text me FFS!! 😂😂😂😂
I watch my pharmacist when I pick up a prescription. The phone has about a 20' cord on it so he can walk to every station in the pharmacy. He continues talking as he gathers meds to fill prescriptions. I'm starting to think the phone is actually attached to his ear. ☎️🤕 I used to work at a call center and obviously spent the entire day on the phone!🗣️ By the end of the day we would have 'cauliflower ear'! The pharmacist is the unsung hero and saves lives every day! They're the best source for information about any meds!💊 ⚖️ Who else in medicine can talk on the phone, carry on a conversation with the assistant and quote instructions to a customer all at the same time?!? 🤓
@@nooneyouknow4829 Yes, I know that. Thank you. Back when I started as a nurse, during the paper charting days and no EPIC, docs wrote orders on paper and “pharmacy to dose” or manage was commonplace. I do appreciate you trying to correct me though ☺️
Not totally true - I’m an RN and can tell you that AT LEAST 75% of the time when I call the pharmacist suddenly “finds” the dose they”already sent” OR seconds after I call the tube containing my missing dose suddenly drops into the station…LOL
@@cynthiayarger9757 I guess our experiences vary based off the hospital. Where I work, there is a high turnover for nurses. A lot of nurses here neglect to check patient specific, most don't know how to recover storage for pyxis, a lot of them don't even bother to check the tube station before calling, and most don't even check the medication fridge for refrigerated patient specific meds.
OMG the Vancomycin Phone! The hospital pharmacist was the absolute BEST when Infectious Disease ordered a continuation of vancomycin because they "couldn't be sure it was the vancomycin" that caused the adverse reaction after surgery. Bug Bro got his second dose, but the hospital pharmacist made sure that the nurses knew an allergic reaction was coming so they could prepare accordingly.
Don't forget the phone calls 30 seconds after the order is placed for X, Y, and Z, that you are in the middle of verifying but have to pick up the phone from said RN calling about said order like you aren't chained to you computer trying to prevent the phone from ringing!
As someone who used to work at a stool bank, I'm glad there's someone to tell doctors to stop prescribing Vancomycin. Uuuugh the horror stories... And also my grandmother, may she rest in peace, thanks you for the Warfarin emergency alarm.
@@nancylindsay4255 FMT baby, at the time you couldn't get it until you'd undergone a few rounds of vancomycin. And after the vancomycin hasn't worked for a few rounds you're in really rough shape.
My favorite part if these videos used to be other than the impressive world building of the Glauckomverse is looking at the comments and seeing "I am x kind of doctor. This is completely accurate"
I'm a pediatrician who is always asking question to a pharmacist about medical dosage, taste of the medicine, and so on. I really appreciate it!!! From Japan
This is gold. I have heard stories from my pharmacist sister-in-law (works at a hospital, maybe moved up the chain just enough to deal with other headaches). The warfarin bit also was priceless. I know enough about it from my dad being on it, but he is also a doctor and heard a story that makes me think it applies to ALL surgeons. (In short, he knew of someone who needed a surgery through a mutual friend, and the surgery team was wise enough not to operate with him on it, but did not realize that the chances of a clot forming from not taking it for a few days are small and in his case, worth the risk.)
10000% accurate as a hospital pharmacist. Those nonstop phone calls literally made me experience a short bout of PTSD just now. Did you get your examples from my pharmacy by chance?
Retired community pharmacist but was on a Medical Center campus. There were many times I had two phones in my hands juggling Drs and insurance companies. As others waited on hold , the walk in customers would be staring at me with a death glare because I was just “chatting on the phone” instead of doing my job. 🙄
I worked in an automotive dealership service department many years ago and still have 'ringing phone ptsd' and remember the baffled looks of customers being greeted by me with a phone to each ear. Argh.
