Top 8 Traits of Highly Effective Pharmacy Technicians

Behind every good pharmacist is a great pharmacy technician. Things run more efficiently, staff relations are better and ultimately the patient receives better care with a good pharmacy technician. Here are my top 8 traits I look for in a good pharmacy technician.

1.      Team Player

A team player is willing to go above and beyond the normal job description and help with other job roles of the team when there is a deficit in the team. They will not worry about what others are doing on the team but be a positive team player helping serve the patient.

2.      Self-starter

Taking the initiative on getting things completed is a very desirable trait with a pharmacy technician. Noticing where help is needed and jumping in without being told is one of my favorite traits of a technician.

3.      Problem Solving/Critical thinking

Improving process and making things better is not just for the pharmacist but for the technician as well. Many times the pharmacy technician has a unique view into operations that the pharmacist may not recognize.

4.      Committed to Learning

Medicine is a fluid field of study. Not only do guidelines change for the patient, but patient care and pharmaceutical delivery changes happen as well. A good technician will be committed to the process of improvement and making things better by keeping up-to-date with the field.

5.      Customer Service/Communicator/Conflict Resolution/Empathy

Rather than showing defensiveness and pointing out errors with nursing, a good technician will be able to problem solve as mentioned above but also be able to deliver the message in a kind way. The pharmacy technician will be able to help when needed and be able to help diffuse emotional issues and be a “go to” person for the nursing staff when medication help is needed.

6.      Accuracy, Focus and Detail Oriented in a Busy Environment

Being able to focus on details with a lot of external stimuli is a plus! I know from first-hand experience how difficult this can be, but someone who can focus well and be very accurate is a trait I find important in a pharmacy technician.

7.      Prioritization, Organization and Time Management

When someone on the medical team needs something STAT, being able to prioritize and manage requests and know the timing is very important to flow and getting things done. Knowing that a medication is due later in the day and can wait versus loading a medication on the floor that will be needed at morning meds is part of knowing how to prioritize and organizing the day to complete tasks. It is also important to know how to manage the day when things are not as busy and going above and beyond to do the things that are normally on the bottom of the list.

 8.      Computer Skills

Last but not least, every technician needs to know how to work a computer and be able to quickly learn how to problem solve with a computer to help triage and manage problems.

Pharmacy Robberies: In the Crossfire

I graduated pharmacy school in 1999 and went straight into retail pharmacy. I had my reasons for not pursuing a residency (regret that) and went for the money and where I was comfortable. I had worked for Walgreens while in pharmacy school and had a knack for dealing with the public, or so I thought.

Two years after that decision, a patient with HIV, homeless and psychologically unstable threatened me over the phone for not refilling his alprazolam 2 mg four times a day prescription two weeks early. He was on our state's medicaid at the time and they would not pay that early. He told me that he knew my work schedule and my brains would be on the parking lot when I didn't expect it.

That pretty much sealed the deal for me to take a huge pay cut and beg for a new direction in my career. You see, my employer didn't allow concealed weapons so I had no way to protect myself from the fear of death due to benzodiazepine addiction and no reason to live. There are many other stories not so fearful of a man jumping over the counter and assaulting a pharmacist while the store manager jumped in to save the day and it goes on. I just was not in the place mentally to continue with the fear of being a sitting duck at the young age of twenty-five.

And so it goes, I read the news today and find:

• Gaston Woman Charged With Pharmacy Robbery
• Authorities Ask Public Help in Pharmacy Burglary Case
• Twin Falls Pharmacy Tech Sentenced in Federal Drug Case
• Box-toting Masked Gunman Rob Gretna Pharmacy
• Kearney Man Charged With Second Pharmacy Arson Attempt
• New London Police Release Sketch of Pharmacy Robber

And this is just a brief five minute search of what's happening in the world of pharmacy news today. The news is filled with addiction and robberies in the pharmacy. The war on illegal drugs that started decades ago is being trumped by the addiction problem to legal prescription drugs and the dealers out to exploit the addicts' addictons. In 2013, the top 10 states with pharmacy robberies were Arizona, Indiana, California, Pennsylvania, Tennessee, North Carolina, Massachusetts, Ohio, Texas, and Washington. 

Ken Fagerman wrote a book called Staring Down the Barrel which details how a group of pharmacists began a program with police that stopped rampant pharmacy robberies and at the same time uncovered widespread organized narcotic diversion.

I worked with a pharmacist once who had owned his own store and told stories of chasing criminals down the street with a shotgun and was a big part of the decision to sell his second generation pharmacy to a retail chain, "It wasn't worth the risk with a wife and kids."

A Walgreens pharmacist who tried to defend himself during a pharmacy overnight robbery loses his appeal against Walgreens who fired him over using his concealed weapon in defense. No one was injured but the pharmacist lost his job.

A Rite Aid pharmacist was killed last year for no other reason than explaining to the customer that he needed a prescription to obtain a medication he wanted, and in WV, an independent pharmacist shot and killed a robber holding a gun at his staff. 

The DEA has an office of diversion control with a website that offers tips on what to do after a robbery and how to  prevent one from happening.

RxPATROL® (Pattern Analysis Tracking Robberies and Other Losses) is an initiative designed to collect, collate, analyze and disseminate pharmacy theft intelligence to law enforcement throughout the nation.

I am not sure what the answer is to lower the risk for retail pharmacists. I feel lucky that I was able to leave retail after the incident since there were more job opportunities. I don't feel retail pharmacists can always make the same decision today since pharmacist jobs are scarce and high student loans must be paid.

5 Things I Wish I Would Have Learned in Pharmacy School

LINK to Pharmacy Times article

I noticed when I enrolled in pharmacy school that there were no courses in things that I could have really used in the profession. Here is a list of the things that I wished pharmacy school taught and required prior to becoming a pharmacist grad.

1. Teamwork: In my opinion, one of the biggest problems is the lack of teamwork among pharmacists. The profession tends to attract the introverted personality. These people like to work alone and receive their energy from being alone and become drained in social situations. Brainstorming and collaboration can be lost because this requires working together as a team and supporting one another. One of the biggest themes running through my career is not working as a team but as a loner to only further your own agenda. The best run pharmacies today no matter the setting has strong teamwork and collective pride. I wish in pharmacy school this would have been addressed in a class or two. Not only does the department need to be a team but we need to work together with nursing and physician teams among others. Another issue within this category is the divide between clinical and distribution roles in the hospital. In the hierarchy of treatment, distribution pharmacists seem to be on the bottom though I know many order entry pharmacists who could run circles around a clinical pharmacist who just graduated and completed a residency or two. 

2. Management skills: We do not learn management skills in pharmacy school and most of the time on-the-job training by another manager only passes along the same bad habits of the previous pharmacy manager. In the many years of working as a pharmacist, I can only think of a couple of really good leaders. What made them excel was their grasp on how the pharmacy should operate and also being willing to step in when needed. Most of the time, management in pharmacy means a 9-5 (or whenever you roll in) and no weekends or holidays. Very rarely do I see middle management taking the opportunity to really lead rather than believing management equals pharmacy order entry and clinical shifts are not in their job description anymore.

3. Conflict resolution: I believe conflict resolution should be taught in pharmacy school to be able to handle issues where a couple of people may not agree. Many times in the day-to-day grind there are opportunities to have a good grasp on how to deal with conflict. Emotional intelligence goes a long way and I would have liked to have been taught this skill in pharmacy school.

4. Financials: I had one semester of accounting, and I believe learning more about finance within the healthcare model would have been worth it after graduation whether you are running your own store or managing a hospital department budget.

5. Emotional Intelligence: A higher emotional intelligence usually equals better job satisfaction, good job performance and better leadership skills.

BCPS Mock Exam by Med Ed 101

Eric Christianson, PharmD, BCPS, CGP the founder of Med Ed 101 has created a BCPS mock exam that is full of valuable clinical content that will help prepare you to pass your BCPS exam.  There are numerous case studies that are similar in style and format to the actual BCPS exam.  There are also a bunch of statistics questions that will be excellent practice for anyone taking the exam.  Another part that many who’ve taken the practice exam like is that you get the answers, and also get a good explanation (when necessary) for why each answer is correct. 

For a limited time, Eric is offering a 20% discount to followers of this blog!  Use the discount code “blonde” when checking out.  This offer will expire May 8th, 2015. Here’s the link to check out more on the exam, and don’t forget to use the discount code:  blonde   -   https://www.meded101.com/downloads/bcps-practice-exam/

Here’s a few more details on the exam from the website:

“This BCPS practice exam was created to help you maximize your productivity by helping you identify weaknesses that you need to spend more time on.  If you enjoy the free content on meded101.com, you’ll love this exam.  The content is good, the explanations are solid, and compare it with the cost of ACCP mock exam at 100$.  The other neat thing is you get it as a PDF so you can refer back to it if necessary.

It is a 90 page PDF that includes 200 questions with the answers, an explanation for each answer, and lab values table.  In preparation for your BCPS exam, this practice exam will test your pharmacotherapy skills on the following topics:

•Pediatrics

•Geriatrics

•Gastrointestinal Disorders

•Oncology Supportive Care

•Endocrine and Metabolic Disorders

•Men’s and Women’s Health

•Ambulatory Care

•Neurology

•General Psychiatry

•Nephrology

•Infectious Diseases

•Pharmacokinetics: A Refresher

•Biostatistics: A Refresher

•Study Design

•Fluids, Electrolytes, and Nutrition

•Critical Care

•Cardiology

•Dermatology

•HIV/Infectious Diseases”

If you’d like a free 10 question trial, you can go here: https://www.meded101.com/bcps-practice-test-2/

How Pharmacy Provider Status Will Change Pharmacist Roles in Different Healthcare Settings

Pharmacy provider status is a movement that many pharmacists want with active bills in the House in Senate. Pharmacy provider status would open up many opportunities for pharmacists in a variety of settings.

Hospital pharmacists will be able to take a more active role in medication management while a patient is in the hospital. Labs could be ordered to assess adherence and adjust accordingly prior to discharge for a variety of healthcare conditions. Pharmacists could also have more opportunities with a bigger demand for pharmacy specialties. Perhaps managed care organizations could tap into the potential of having pharmacists manage medications to save companies money and for better public health.

In California (who has always been cutting edge in healthcare), the (California created/named) Advanced Practice Pharmacist (APP) recognition gives pharmacists authority to do the things already being done by many clinical hospitals across the nation with the ability to bill. APPs must also complete two of three criteria to earn this designation: Earn certification in a relevant are of practice, complete a postgraduate residency program and/or provided clinical services to patient for one year under a collaborative practice agreement or protocol with a physician, APP pharmacist, CDTM pharmacist, or health system. SB 493 was also passed: Bridging the Provider Gap.

In North Carolina, there is a Clinical Pharmacist Practitioner (CPP) designation. In this state, you must be a licensed pharmacist with an agreement with a physician. In addition, you must have either: (1) have completed a BPS certification or geriatric certification, or the ASHP accredited residency program and have 2 years clinical experience OR (2) you must have earned a PharmD degree, have 3 years experience, and have completed a Certificate Program OR (3) you must have earned a BS degree, have 5 years experience, and have completed two certificate programs. North Carolina defines CPP as "Clinical Pharmacist Practitioner or CPP" means a licensed pharmacist who is approved to provide drug therapy management, including controlled substances, under the direction of, or under the supervision of a licensed physician who has provided written instructions for a patient and disease specific drug therapy which may include ordering, changing, substituting therapies or ordering tests. Only a pharmacist approved by the Pharmacy Board and the Medical Board may legally identify himself as a CPP.

New Mexico and Montana also have legislation to initiate some drug therapy.

Ambulatory care pharmacists could make headway with patient medication adherence. Centers for Medicare and Medicaid Services (CMS) base many of their quality measures on adherence. Ambulatory care pharmacists could also be paid for services with immunizations and diabetes self-management education along with home infusion and other areas of pharmacy practice.

What can a pharmacist do today to be prepared for the change that is on the horizon? First, get your board certification. Second, become involved in the movement. Not only will this designation open doors for all of us, we will also be able to show our place in the healthcare team and for better public health.

Write Your Senators and Congressmen/Congresswomen!

Dear Dr. Lofgren,

Thank you for taking the time to contact my office about the status of pharmacists under federal law. Your input is important to me, and I appreciate the time you took to share your thoughts.

Pharmacists are a vital part of our country's healthcare delivery system, and I agree with you that there are important ways in which pharmacists can help to improve patient care. You are right that proper use and management of prescription medications can save lives and health care dollars, and I appreciate the information in your letter about the need to designate pharmacists as providers. The insight you've provided here will help me and my staff more effectively look into this issue.

Thank you again for your letter. I hope you will continue to share your thoughts with me.

Sincerely, 

Bob Corker
United States Senator

Pharmacists Prepared to Implement MEdication Therapy Management

Every single day, patients are admitted to the hospital with a laundry list of medications taken at home. The primary care physician is nowhere to be found in the hospital, and the hospital physician has to take on the job of looking at the patient's home medications and deciding what to do. What usually happens is the hospital prescriber or specialist checks to continue all home medications without a second thought. Why? It's the idea that the patient has presented for an acute process that needs to be managed, and assessing a medication taken for UTI suppression at home isn't their job. Or is it?

This “continue without a second look” approach causes errors that can affect days admitted to the hospital, medication interactions between home and hospital medications, and duplication in therapy. Pharmacists in hospitals attempt to intervene, but with the current setups of distribution pharmacy versus clinical pharmacy, this caveat can slip through the cracks without proper billing/payment, so that hospitals can justify another full-time equivalent solely for this purpose.  

See more at:

http://www.pharmacytimes.com/contributor/beth-lofgren-pharmd-bcps/2015/03/pharmacists-prepared-to-implement-mtm

Another Sunday Night...

There are Sunday nights where I really dread going to work on Monday morning. The reason is because of the great divide between what I believe pharmacy could be and what it actually is. I try very hard to have a positive attitude about our profession, and there are moments of hope, but then I return to work the past few years where dreams are crushed and change is regarded with disdain.

Pharmacists as Providers: This would be a huge step forward for our profession; however there are those who mistake provider status with wanting to be a physician. My mother, who is a licensed clinical social worker, has provider status! She cannot prescribe, but here unique skill-set is recognized by the Social Security Act and therefore can bill for services. The next pharmacist that tells me that they don't want to be a doctor may hear a speech from me! (just kidding)

Board Certification is Important: The debate continues in the workplace on this one. There are hospitals who recognize the value of having a benchmark of certification in any clinical work and others who do not. I give it five years and it will be mandatory by JCAHO. Just a prediction and an opinion, but I'm making it.

Pharmacy Technicians' roles are evolving: Like it or not, techs check techs in some states and their credentialing process is changing drastically in the next couple of years.Will the ratio continue to change so that hospitals and retail can hire more techs with less supervision?

I have a lot of hope for the profession of pharmacy and when I return to work in the morning will be back in the middle reminding me what we do not have in March 2015. We have more pharmacy students and graduates chomping at the bit for every single job (no matter how meaningless) out there. Because of this, pharmacists need to find a way to do the best job possible for their patients while we wait and see how things settle out for us.

Pharmacists as Leaders

Pharmacists do not learn how to be a leader in most pharmacy schools. There is a big difference between holding a leadership position in the pharmacy setting and actually being a leader. In the past fifteen years I have found that leadership is a rare quality to find in our profession mostly because we learn from other pharmacy leaders who were not trained to be leaders either. And while immediately you may think I am referring to operational directors or directors in general, I am talking about any pharmacist who works in a setting where they are leading other pharmacists or other technicians in any situation at work which covers most aspects of being an actual pharmacist.

John Maxwell says "The true measure of leadership is influence - nothing more, nothing less." A good leader will inspire and influence others in profound ways to do a good job. Can a staff pharmacist do this? Absolutely. 

In the midst of phones ringing and nurses asking for medications, there are opportunities to do more than just the bare minimum. How can you improve your existing conditions? How can you make the operational flow better? Are there ways to inspire those around you with positive leadership to actually WANT to do a good job? It doesn't matter what position I think of in the past, I can still find issues with every single arrangement whether it was poor leadership, lack of teamwork among the team and/or apathy. The very best pharmacists I have worked with were not necessarily the ones that were promoted beyond staff or basic clinical positions, they were the ones that came in daily and were inspiring in how they handled stress of the job itself or stress from how things were run that were out of their control. 

Here are a few ideas in how to be a leader when you don't necessarily carry the title of manager but carry the daily role of being in charge solely by default (since most managers carry an 8am-5pm job and meetings that keep them away from where the job is happening - in the pharmacy).

1. A good leader will take time to find out about members of his/her team. What are each member's strengths and weaknesses? If you have a problem-solver on your team for the day, why wouldn't you utilize that talent to solve daily problems? If another has a weakness, why wouldn't you figure out a way to either help with the weakness or find another who is strong in that area?

2. Give recognition for good things. If a pharmacy technician handles an irate nurse waiting on medication well, let him/her know. "You handled that call well!"

3. Keep complaints about the job to yourself while working in the pharmacy. This one is a very hard one for me, and I justify this by believing it helps with my own frustration with things that could be better at work. However, complaining kills innovation and my own creativity to make things better which ultimately leads to apathy. What is the point in changing something, it won't work, right? Rather than complaining to each other in the pharmacy, take the complaints to someone who can do something about it. After that, there is really nothing else you can do but don't fall into the negative habit.

4. Rather than seeking to find blame for failures in the pharmacy, seek to find solutions. If the solution is out of your hands, let someone know who can do something about it. If you can personally implement a solution on a particular day, then DO it.

5. It is not a mistake to be friends with your peers even though most leaders mistake this as a flaw. As long as you hold your team accountable to what is expected of their individual job (which should be addressed in the job description), there should be no problem with having a friendship. It would be a lonely existence to show up at work daily thinking that the goal is to make peers believe you are above them. I have much more respect for the leader that holds his/her team accountable while still being warm enough to care. We spend too much time at work to NOT have some sort of relationship beyond making people believe we are only there to climb a ladder and step on each other along the way.

The Fine Line of Essential Oils and Treatment of Disease

Aromatherapy products accounts for millions of dollars in sales yearly in the United States. One of the most popular companies, doTERRA’s website states, “For people who care about improving their health and that of their loved ones, we provide simple, safe, and empowering solutions that enhance well-being.”  Also, ” (Be sure to use only 100 percent pure, therapeutic-grade essential oils and follow all label warnings and instructions. Essential oils should not be used in the eyes, inside the ear canal, or in open wounds. If redness or irritation occurs when using essential oils topically, apply any vegetable oil, such as fractionated coconut oil or olive oil, to the affected area. Consult your physician before using essential oils if you are pregnant or under a doctor's care.)” In other words, ask your doctor first since the majority of people are under a physician’s care.

The FDA sent a warning letter to reprimand these false claims made by three of the companies back last fall 2014, Natural Solutions Foundation, Young Living, and dōTERRA International LLC. According to FDA regulations, neither dietary supplements nor essential oils are allowed to be marketed by the company that sells them in such a way that it appears as though the products can prevent, cure or treat any disease. If a company does market in that manner, the product is considered a drug by the FDA. If a product is a drug, it must be approved by the FDA. So, any product marketed to cure, treat or prevent a disease that is not already an FDA approved drug, is considered an illegal, unapproved drug by the FDA.

The FDA found that one of the companies Young Living essential oils were marketed for “viral infections (including ebola), Parkinson’s disease, autism, diabetes, hypertension, cancer, insomnia, heart disease, post-traumatic stress disorder (PTSD), dementia, and multiple sclerosis.” Meanwhile, doTERRA consultants made claims that their therapeutic grade oils could treat “viral infections (including ebola), bacterial infections, cancer, brain injury, autism, endometriosis, Grave’s Disease, Alzheimer’s Disease, tumor reduction, [and] ADD/ADHD.” Given these marketing claims, the FDA sent out the warning letters allowing the companies 15 days to rectify the illegal marketing and respond before facing any punishment.

Just last summer, a friend sent me a message over Facebook stating, “Essential oils are plant extracts that are more potent than herbs. If you’re looking for a natural way to deal with stuff, they’re a great option. My sister had chronic headaches for 22 years, used peppermint oil and now she’s not getting headaches anymore. We still go to the doctor when we need to, but if we can handle some things naturally at home, when we do need those antibiotics then I figure we won’t be resistant because we haven’t used them 70 times on ear infections.” Also, “I’m also attaching a link of a quick news clip for a study Vanderbilt’s wellness committee did diffusing oils in their ER. 67 different hospitals and medical establishments are using essential oils now. And “Lavender naturally lowers cortisol. And it’s great for sleep and calming. It’s good for a lot of things. The citrus oils definitely help with stress. It’s a little tricky with this, because we definitely don’t want to seem like we’re making medical claims, but a lot of pharmaceutical drugs are derived from plants, so I guess it’s not that far-fetched that these oils have therapeutic properties!” She also claims that these oils treat ADHD.

One article I found stated, “Another danger of lavender in particular is it can be harmful to skin. The doTERRA blogger suggests rubbing some on the forehead to cure watery eyes from allergies. A quick search in PubMed tells me this is a really bad idea. In vitro tests show lavender oil is harmful to skin cells, with a proposed mechanism of membrane damage. If left exposed to air, lavender oil oxidizes, forming chemicals very irritating to the skin – with the study both identifying the oxidized components causing the irritation as well as showing irritation on patches of skin on test patients. Sounds like a bad idea for your skin.” I know of another family where an ear infection was treated with essential oils and the child ended up with a more complicated infection affecting much more than just her ear.

Though the FDA has asked these companies to not proclaim the treatment of disease, their sellers continue to do so both in blog posts, pinterest pins and home parties. There is hardly any science behind essential oil use. Yes, Vanderbilt is using essential oils to reduce workplace stress, but the claims to treat illnesses, especially infection is concerning with no studies to back anything up.