In the morning when we get to the pharmacy ...

(1) Cart Fill List - we prepared all the medications in the upcoming 24 hours for the patients.  The medications were placed in the bin, and they will be taken at 2 pm daily.

(2) Ex-temp List - a list where we prepared all the oral suspensions and intravenous medications for the patients.

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The drama started when Mattie (the techinician) forget to "do the final run list" on Friday.   

On Saturday morning, we found out that the cart fill list did not automatically print.  Therefore, I called the HELP desk at the hospital.. to resolve the problem.   If the computer programs run correctly, the cart fill list will be CORRECT.  It took the whole morning for the "IT guy" to fix the problems.. and he was clueless.  FINALLY, I have to call the pharmacy administrative person ON CALL.... it was the director of pharmacy, Tad.

.... Finally, the cart fill list was printed .......  BUT, I spotted checked some of the patient bins, and found out that there were medications which were incorrect.   It was very frustrating ...........  (I was working with the PGY 1 pharmacy resident, Amber).   As the senior person for that shift, I told the resident that she continued to verify orders, and check medications, blah.  

In order to make sure that I sent the correct medications for the patient, I decided to MANUALLY opened each patient's profile, match the medications inside each bins.   It took me over an hour to check, and I found a handful of medications which were discontinued, changed dosage, frequency, etc !!! 

We called Tad again............................... and informed him that the IT person needed to fix the problem, because we did not anticipate this issue would HAPPEN again on Sunday !!

SUNDAY

This morning, the EX-TEMP list went wrong.   What ??????

I found out that the labels "beyond use date" were all in the near future.   Technically speaking, if we drew an oral medication for the patient, it was ONLY good for 24 hours !!   The correct LABEL should be written as "DO NOT USE BEYOND DATE: 11/09/09 23:59" !

Many labels were ALL in the date of 11/10/09 and 11/11/09 !!  These labels kinda implied to me that the computer program was set to the WRONG DATE !!! So all the labels were messed up, and dated wrong !!

I manually corrected all the labels, and changed the expiration date to 11/09/09.  GUESS WHAT ? 

The technician QUESTIONED me and SAID: "I  have been working here for years, and none of the pharmacist changed the expiration date on the labels, and I don't understand why you are changing them !"

I wa like ............  the date was WRONG, and it should be 11/09/09.... !!!  I am not going to take the responsibility and sign my NAME on all these medications when I knew that they are ONLY good for 24 hours !!!   She is clueless.... and I am speakless !!!  I did whatever things which I think it is RIGHT, and I am IN CHARGE !!  I don't care what others people said about me, I only care about the sick kids !!! 

FINALLY, I called JIM.  I knew that he is kinda upset for calling him on a sunday morning (And he is NOT the ON-CALL person).  I think that he should know what was going on with the children's pharmacy deptartment for the whole weekend because HE IS THE PHARMACY MANAGER !!  He is MY BOSS !!!    I simply wanted to give him a HEAD UP... to let him know the problem first before he goes to work on MONDAY.  

PHONE CALL FROM JIM on FRIDAY -  Apparently, Jim worried that if Philllip worked with me this weekend, it would be a big problem (since Phillip never work at the children pharmacy).   Jim was kind enough and called the PGY1 pharmacy resident to switch with Phillip...... Therefore, Phillip worked at the main pharmacy, and Amber worked at the children pharmacy. 

Sometimes, I cannot tolerate his temper.  Sometimes, he is soooooo nice, and sooooo sweet.  Sometimes, he is a 100% JERK !!  He has a strong passion of work, but sometimes, he lies about stuff !! 

I am not sure ... how long I can stay here, and how much I can tolerate this work !! 

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Suddenly, I think of the book called "Who moved my cheese?"

When problems happen, I will react and solve the problem first.  

Just like one of the mice in the story, the mice will look for a new place for cheese instead of staying at the same spot finding out WHY the cheese is gone !

..... I still don't understand WHAT went wrong with the entire working shift !!!  But at least, I did my job, and I am hoping that things went well !!  We had 2 BIG medication errors last week !!!  So I am praying that .......... there will be NONE !!

...... I like being a PEDIATRIC PHARMACIST !!!!.........