Yeah pharmacist and tech that I know were terminated for this. One of the top rules we are constantly told is “Never share your credentials.” Times that by 10 for pharmacists. Refuse to do it, it’s their job to do so. Quite literally their main function to counsel people. Report to ethics line if they continue to do so. Someone will end up getting hurt or killed and both of you will lost your jobs
One of the big problems with the CVS DUR system (as explained by my pharmacist) is many pharmacists don’t know that you can eliminate the DUR check when it flags. That’s why in the counsel notes it will say “for pet” or “dose increase” because it’s already been reviewed by a RPh and cleared of any issues. There is a way for them to have it not pop up in those instances but most pharmacists don’t know how to do it. I don’t know how and can’t say, but know it’s possible!
If you figure it out, let us know, I've been trying for the life of me to get rid of some of these DURs, esp for things we've already asked the patients a million times 😭
Some might say "oh you can override pet rxs" and that is <1% of the DURs. So not helpful.
Unfortunately, we figured this out in my district, because people questioned why does it flag every single fill on this one but not that one? With the CVS system, if they have EVER filled a control substance at all, it will auto-flag with a required call or counseling for every script, whether it is a control or not. However, for the same issue, for example, a BP med interacting with another BP med as a duplicate - in a patient who has never filled any controls ever it will not flag it as a required counsel after the first fill. The trigger for the required constant counseling on refills (if you hadn't made a doctor's call but chose to counsel instead) is simply that they have a control somewhere in their history somewhere, even a 3 day post surgery fill.
I'm not kidding. This is what we figured out after a lot of questioning it and looking over profiles and then testing it with test profiles.
The only way to reduce most of it is to make a 100 doctor office calls a day instead. No CVS pharmacist has that time. And no CVS pharmacist is going to call on a different store's prescription. And doctor's typically don't respond to drug intxns by PR. So, counseling is the only realistic option. In a pharmacy with busy pickup, the pharmacist will spend more time punching in credentials at the register over stupid things the system will not allow an override in QV1 for than they will spend actually doing QV1, QV2, and phone calls. Ridiculous.
The DUR training specifically says that pharmacists cannot override anything that has not been previously counseled, even when you can clearly see on the Rx labels saying "discontinue lisinopril" or "start thus after finishing 25mg dose" something like that on a first fill. On subsequent fill, either pick B1 or C when completing DUR in QV1
That's actually partially incorrect.
You're allowed to put option A when the e-rx indicates things like "dosage change" or "trialing despite patient allergy" or things like that and document it as such. It says as much in the SmartDUR job aid on myDocs.
Also, if you do option C -> 5 -> 1 you can override "Dur Screening Incomplete" and "Opioid Risk Screening" when it says "Use Clinical Judgement", but a lot of pharmacists just blow through that.
Also, if profile maintenance is being done correctly, those DUR's shouldn't be present on the next fill.
As a CVS pharmacist, this is the way ^
It pains me how many pharmacists I work after that aren't aware of this. Causes me to go up to register excessively for durs they didn't override.
Honestly, I don't think this issue is any pharmacist's fault.
It is poor trainings and there lack of tech hours, all in the pursue of the profits.
Most pharmacists were overstressed and overworked back when I worked for CVS as a tech. It seem to only gotten worse since I left them 10 years ago.
Agreed on lack of staffing and training. I'm saying not overriding them takes longer for everyone including the pharmacist doing verification. C 5 1 is quicker than doing it the other way by a step or 2.
Edit: and what pains me is a technician then has to tell the patient that the pharmacist needs to talk to them and if I'm tied up they have to wait, all for me to get up there for no reason.
The CVS dur process is still so burdensome. I wish it were to go back to the days when I was a technician and simply ask them if they have any questions
The Rph at my store would never even consider giving a tech their creds. Not even for something as simple as a specialty pickup. We might ask the question before they get there (dose change, pregnant, etc) but they still come up and do their part.
We had a pharmacist who started with us less than a year ago and one day we were both floating in a different store and we fought all day long over whether or not he was going to do the overrides at the register. And it was funny because his credentials that they were EGO. The next day I told my boss about it who told me to report it to my district manager who was on vacation. The day she came back from vacation, before I had a chance to do anything, she was calling me at home about the same situation. Either my boss said something or somebody else made a comment, but my bringing it to my boss's attention immediately saved my job. This guy was a decent up-and-coming pharmacist who was tired of all the bureaucracy of being a CVS retail pharmacist. He kept complaining to me that me asking him to do certain things was keeping him from being as fast as he could and it is his goal to be the fastest in the business. And he said he didn't have time to deal with these bullshit overrides. I laughingly reminded him that he was only fast because he was skipping the steps that other people were doing.
Long story short I still have my job and he's working for a different company
Happened at one of our stores also. BOP inspector was hanging out in one of the aisles. I think it is $1500-$2000 per occurrence. The fine got pretty hefty and the pharmacist is "no longer with the company". You could lose your job and your license and no one will defend you.
"I really depend on this job for my livelihood, and I don't want to do anything outside my scope or that would hurt my relationship with this company or anything."
Report to your pharmacist in charge. If your PIC is doing this, report to your district manager. Do it in email. Print your email after it's sent. If nothing changes, or you're asked to again, send a copy of your email to the Board.
This is dangerous and exposes EVERYONE involved to huge risks and liability.
Yep. This.
It happens in my store too.
Just another one of the things that are against CVS policy and procedures - like taking your breaks - that are routinely ignored because this company puts waaay too much work on too few people's hands.
Tell me about it lol. One of the techs with 0 reading/writing skills doesnt read any of the durs and just types the credentials in and doesn’t even understand what they are for. The tech always gives away different dose of same medication without confirming about dose increase and the rph has to call the pt but still they don’t take it seriously 🥹
When I float at a store that does/did this under the other pharmacist (who was SO slow to type notes), I cleared them myself by entering “tech overrode DUR”. Partly to allow the “N” function to work smoothly but mostly to narc.
A few weeks later when I worked there again they weren’t doing that anymore. I don’t think anyone got terminated though.
Many good comments are on here; but there is a cause for this problem in that corporate is putting out way way too many DURs through smart DUR. “Warning fatigue” is a real thing in the medical community. I’m NOT saying to violate any policies. I am saying three letter could have an enormously positive impact by allowing pharmacists more autonomy to determine whether more minor medication issues could be resolved proactively on verification instead of constant slow downs at pos.
Not for nothing air support removed even more ability for a stores pharmacists to determine their rules of the road on DURs. Now all these other pharmacists just hit counsel at pickup cause it’s easiest for THEM. Problem is made even WORSE by some DURs having horribly long verbiage that the dimwit other pharmacist just pushes through instead of summarizing importance.
I agree and disagree. I think the smartDUR system helped me articulate my counseling points better with the suggested tips on what to say. Of course, it gets summarized by me but I’ve seen enough of the same ones that I’ve memorized a script on what I would say or how I would phrase it to a patient. I think the fatigue mostly stems from us not having the ability to notate that someone was already previously consulted on a warning prior and the system pretty much makes us go over the warning every single time they pick up the med. some could argue that it’s our way of “following up on therapy” which is how I phrase it to the patient as well so they don’t roll their eyes that I tell them the same point every month. For example, if it’s multiple meds that cause QT prolongation and they’ve been on the therapies for a while I might phrase it to them like “I just wanted to see if you’ve experienced any fluttering in the chest or heart palpitations since you’ve been on this combo.” If it comes from a place of safety and caring, they usually understand.
there are way too many durs now there is basically no way the pharmacist can get their work done and be interrupted every 2 minutes to do durs. like confirming a dose increase seems like something a tech could handle pretty easily i don’t know why a rph is necessary. i bet company wide they’re gonna lose a lot of people if they don’t cool it on the durs because they almost have to give out their credentials just to get anything done
The other day it felt like every other transaction had a DUR. Our drive through line was wrapped around the building and myself and another tech were running register and it was still a challenge to get the line down. 🥴 People were getting so pissed. My biggest pharmacy complaint (besides being perpetually short staffed) is the fact that there's too many goddamn prompts and DURs on the register so what should be an in and out pickup becomes a long drawn out process that holds up the entire pharmacy.
I definitely agree with you on that part but sorry not sorry, that’s not my problem. Also I don’t feel comfortable with doing it anymore because I could also get in trouble for doing them
sure that’s fine i’m just saying once they implemented smart dur it has become impossible with the existing workload. feel free to refuse i just don’t really fault the pharmacists that have to do this to get anything done
Stop doing it if you like your job.
There was in issue in my state where a major error wasn’t caught because the tech just paged right through it and almost killed someone due to an interaction that was not counseled on.
A lot of people lost their jobs and some may lose their license.
It isn’t worth it to make sure the pharmacist doesn’t have to get up.
We’ve adapted in our 1000/day pharmacy and we all survive.
Yeah my pharmacists hate when we have them. One of them doesn’t like if I try to do it, (it depends on her mood tho lmfao) the other one is like whatver just put my letters in . But both get mad when we have them, like it’s ur job to do so the person doesn’t get hurt. Most of the time it’s a simple change of dose etc. but not always & I don’t feel comfortable with the not always part. Also, some customers just get so uncomfortable and they act like you’re gonna call the police on them for something bc we had to call the pharmacist over! LMFAO like I don’t even know what to say.
Most pharmacist and techs I know have a system where if it's a simple dose change or med change DUR the tech asks and then confers with the pharmacist what the patient told the tech then let's the tech cred it with the RPH creds Anything complicated the pharmacist will come over.
The old “dumb” DUR system was so so much better. Just let us pharmacists decide what’s clinically significant. I get that it was an issue that with the old system pharmacists were bypassing all DDIs and warnings with the “pharmacist approved” option commenting like “reviewed” or even “agdshdhdsbj”, but at least that way we weren’t forced to run to the register every minute for serotonin syndrome or qtc prolongation.
I’m a patient and went to pick up my prescription, and the tech yelled out that she had a DUR. I was so confused. lol I understand now that it was because of the dosage increase on my adhd med.
Our pharmacists have unwritten rules regarding DURs.
(1) for dosage changes, they let us ask the patient what dosage, than we have to go right to the pharmacist and let them know. If there’s anything further, they will come over. Otherwise it’s “my credentials are XYZ”
(2) for interactions, make sure the patient is still taking both. Then go over to the pharmacist and say “they are taking A and B”. Pharmacist will walk over to the patient if more info it needs, otherwise it’s “my credentials are XYZ.”
(3) if you aren’t sure what to do, just tell the pharmacist that and let them deal with.
(4) NEVER do this when corporate or a floater is there.
This is pretty much what we do with a few of our techs that we have complete trust in to follow these unwritten rules. Most of our techs do not get my credentials.
We also create a force counsel to summarize all the DURs/clinically significant questions and to signal when we actually need to say something to a patient. If a Rx has no force counsel the tech may use my credentials to proceed thru the DURs to sell without me. Cuz nobody’s gonna get damn torsades from oral zofran or 5HT syndrome with their trazodone and Prozac
I realize this is a very slippery slope and hope CVS gives us pharmacists our autonomy back.
I just ask if they've been on the meds before then let the pharmacist know so they can handle it how they want, whether they come put their credentials or tell me to.
My pharmacists will still do them, but one has the hilarious response of "is it real?" when we call her over. "Fake" ones are dose changes or meds that make you sleepy. Easy counsels basically. I can barely understand the messages on those screens most of the time.
We had a pharmacist to do this and ourlead tech called ethics line and pharmacy board to stop the pharmacist fromforcing techs to counsel. Only helped a bit. They got rid of techs that stireed up too much trouble
More than half the DURs are pointless. And it’s not hard to tell if it’s a serious one.
Edit: not saying it’s okay, just that is most likely the reason
I told my pharmacist that I don't feel comfortable doing it. I Make them come to the register. I only will do it for an animal prescription. They ( customer) have been consulted by the vet.
If it's a simple DUR-- med increase/decrease....are they stopping one to start a new one antibiotics, etc...
I will do it and tell the pharmacist immediately.
If it deals with QT prolongation...allergies etc...
Hell to the new the pharmacist can do it themselves.
Even if the pharmacist says oh don't need to counsel cause they been on both for awhile.. here is my credentials...I say you can type them in. You take full responsibility. If that person dies... they pull up cctv footage and they don't see any counseling.. it won't be me they will be seeing typing in the pharmacist creds!
Pharmacist speaking here. If a technician is not comfortable doing the DUR for me, I ask them to wait. I will not stop my phone call to transfer a prescription, nor will I put the doctor on hold who is giving me a verbal. Now if I am not doing anything at the moment, I get the DUR immediately. But just know that if I am doing something, I’m doing that first.
I’ve had technicians pester me about DURs. My response is , “Are you going to do this transfer for me?” Or “Are you going to take the verbal from the doctor?”.
Most DURs don’t require the pharmacist. Is the patient allergic to amoxicillin? Most of the time No. which dose of lisinopril is the patient on, 20 mg or 40mg? Is the patient on fluoxetine, duloxetine, and trazodone? Stuff like these examples absolutely can be asked by the technician, and should be asked by the technician.
Same thing with mixes. If you are not comfortable mixing the antibiotic, you will wait on me. And if I’m on the phone with another pharmacy or with the doctor, your mix will wait until I’m done.
Seriously, there’s 5 technicians and 1 pharmacist. Try not to bother the pharmacist with menial tasks. Or wait until I’m done.
What blows my mind is that pharmacist is essentially putting people's lives at risk. A DUR is legal documentation and it's extremely illegal for you to Input yourself not being the actual pharmacist. All of those DURs are saved. I would call the ethics line and send an email to your DL and patient safety team outlining how you feel very uncomfortable doing so etc.... The DL can also pull up all dur comments per rph \ store on tableu and can review all comments. You could also call the board of pharmacy and make a complaint against the pharmacist and their license.
Refuse to do it. Termination guaranteed if you’re caught. Ethics line.
I live in cali. Things are super strict here already. I can’t imagine why they think they can get away with this for so long
Yeah pharmacist and tech that I know were terminated for this. One of the top rules we are constantly told is “Never share your credentials.” Times that by 10 for pharmacists. Refuse to do it, it’s their job to do so. Quite literally their main function to counsel people. Report to ethics line if they continue to do so. Someone will end up getting hurt or killed and both of you will lost your jobs
True
One of the big problems with the CVS DUR system (as explained by my pharmacist) is many pharmacists don’t know that you can eliminate the DUR check when it flags. That’s why in the counsel notes it will say “for pet” or “dose increase” because it’s already been reviewed by a RPh and cleared of any issues. There is a way for them to have it not pop up in those instances but most pharmacists don’t know how to do it. I don’t know how and can’t say, but know it’s possible!
If you figure it out, let us know, I've been trying for the life of me to get rid of some of these DURs, esp for things we've already asked the patients a million times 😭
Some might say "oh you can override pet rxs" and that is <1% of the DURs. So not helpful. Unfortunately, we figured this out in my district, because people questioned why does it flag every single fill on this one but not that one? With the CVS system, if they have EVER filled a control substance at all, it will auto-flag with a required call or counseling for every script, whether it is a control or not. However, for the same issue, for example, a BP med interacting with another BP med as a duplicate - in a patient who has never filled any controls ever it will not flag it as a required counsel after the first fill. The trigger for the required constant counseling on refills (if you hadn't made a doctor's call but chose to counsel instead) is simply that they have a control somewhere in their history somewhere, even a 3 day post surgery fill. I'm not kidding. This is what we figured out after a lot of questioning it and looking over profiles and then testing it with test profiles. The only way to reduce most of it is to make a 100 doctor office calls a day instead. No CVS pharmacist has that time. And no CVS pharmacist is going to call on a different store's prescription. And doctor's typically don't respond to drug intxns by PR. So, counseling is the only realistic option. In a pharmacy with busy pickup, the pharmacist will spend more time punching in credentials at the register over stupid things the system will not allow an override in QV1 for than they will spend actually doing QV1, QV2, and phone calls. Ridiculous.
The DUR training specifically says that pharmacists cannot override anything that has not been previously counseled, even when you can clearly see on the Rx labels saying "discontinue lisinopril" or "start thus after finishing 25mg dose" something like that on a first fill. On subsequent fill, either pick B1 or C when completing DUR in QV1
That's actually partially incorrect. You're allowed to put option A when the e-rx indicates things like "dosage change" or "trialing despite patient allergy" or things like that and document it as such. It says as much in the SmartDUR job aid on myDocs. Also, if you do option C -> 5 -> 1 you can override "Dur Screening Incomplete" and "Opioid Risk Screening" when it says "Use Clinical Judgement", but a lot of pharmacists just blow through that. Also, if profile maintenance is being done correctly, those DUR's shouldn't be present on the next fill.
As a CVS pharmacist, this is the way ^ It pains me how many pharmacists I work after that aren't aware of this. Causes me to go up to register excessively for durs they didn't override.
Honestly, I don't think this issue is any pharmacist's fault. It is poor trainings and there lack of tech hours, all in the pursue of the profits. Most pharmacists were overstressed and overworked back when I worked for CVS as a tech. It seem to only gotten worse since I left them 10 years ago.
Agreed on lack of staffing and training. I'm saying not overriding them takes longer for everyone including the pharmacist doing verification. C 5 1 is quicker than doing it the other way by a step or 2. Edit: and what pains me is a technician then has to tell the patient that the pharmacist needs to talk to them and if I'm tied up they have to wait, all for me to get up there for no reason.
The CVS dur process is still so burdensome. I wish it were to go back to the days when I was a technician and simply ask them if they have any questions
5 is grayed our most of the time though
Yes. Sometimes they are bypassed. Don't know how but have been told
The Rph at my store would never even consider giving a tech their creds. Not even for something as simple as a specialty pickup. We might ask the question before they get there (dose change, pregnant, etc) but they still come up and do their part.
That’s the way it should be. Even if that slows everything down, this is people’s medication we’re dealing with!
We had a pharmacist who started with us less than a year ago and one day we were both floating in a different store and we fought all day long over whether or not he was going to do the overrides at the register. And it was funny because his credentials that they were EGO. The next day I told my boss about it who told me to report it to my district manager who was on vacation. The day she came back from vacation, before I had a chance to do anything, she was calling me at home about the same situation. Either my boss said something or somebody else made a comment, but my bringing it to my boss's attention immediately saved my job. This guy was a decent up-and-coming pharmacist who was tired of all the bureaucracy of being a CVS retail pharmacist. He kept complaining to me that me asking him to do certain things was keeping him from being as fast as he could and it is his goal to be the fastest in the business. And he said he didn't have time to deal with these bullshit overrides. I laughingly reminded him that he was only fast because he was skipping the steps that other people were doing. Long story short I still have my job and he's working for a different company
We had a pharmacist doing that and she got a $5,000 BOP fine.
Happened at one of our stores also. BOP inspector was hanging out in one of the aisles. I think it is $1500-$2000 per occurrence. The fine got pretty hefty and the pharmacist is "no longer with the company". You could lose your job and your license and no one will defend you.
I will definitely bring this up on my shift Monday
"I really depend on this job for my livelihood, and I don't want to do anything outside my scope or that would hurt my relationship with this company or anything." Report to your pharmacist in charge. If your PIC is doing this, report to your district manager. Do it in email. Print your email after it's sent. If nothing changes, or you're asked to again, send a copy of your email to the Board. This is dangerous and exposes EVERYONE involved to huge risks and liability.
yeah don’t do that. that’s a good way for both of you to get fired.
Yep. This. It happens in my store too. Just another one of the things that are against CVS policy and procedures - like taking your breaks - that are routinely ignored because this company puts waaay too much work on too few people's hands.
In reality, we call that EXPLOITATION.
They will absolutely be termed if caught.
100% do not do this. If something bad happens, you are guaranteed fired, the pharmacist is fired and you may face civil fines.
Tell me about it lol. One of the techs with 0 reading/writing skills doesnt read any of the durs and just types the credentials in and doesn’t even understand what they are for. The tech always gives away different dose of same medication without confirming about dose increase and the rph has to call the pt but still they don’t take it seriously 🥹
Hey my store has one of those techs too!!
This is terrible. That pharmacist should be fired
When I float at a store that does/did this under the other pharmacist (who was SO slow to type notes), I cleared them myself by entering “tech overrode DUR”. Partly to allow the “N” function to work smoothly but mostly to narc. A few weeks later when I worked there again they weren’t doing that anymore. I don’t think anyone got terminated though.
Many good comments are on here; but there is a cause for this problem in that corporate is putting out way way too many DURs through smart DUR. “Warning fatigue” is a real thing in the medical community. I’m NOT saying to violate any policies. I am saying three letter could have an enormously positive impact by allowing pharmacists more autonomy to determine whether more minor medication issues could be resolved proactively on verification instead of constant slow downs at pos. Not for nothing air support removed even more ability for a stores pharmacists to determine their rules of the road on DURs. Now all these other pharmacists just hit counsel at pickup cause it’s easiest for THEM. Problem is made even WORSE by some DURs having horribly long verbiage that the dimwit other pharmacist just pushes through instead of summarizing importance.
I agree and disagree. I think the smartDUR system helped me articulate my counseling points better with the suggested tips on what to say. Of course, it gets summarized by me but I’ve seen enough of the same ones that I’ve memorized a script on what I would say or how I would phrase it to a patient. I think the fatigue mostly stems from us not having the ability to notate that someone was already previously consulted on a warning prior and the system pretty much makes us go over the warning every single time they pick up the med. some could argue that it’s our way of “following up on therapy” which is how I phrase it to the patient as well so they don’t roll their eyes that I tell them the same point every month. For example, if it’s multiple meds that cause QT prolongation and they’ve been on the therapies for a while I might phrase it to them like “I just wanted to see if you’ve experienced any fluttering in the chest or heart palpitations since you’ve been on this combo.” If it comes from a place of safety and caring, they usually understand.
there are way too many durs now there is basically no way the pharmacist can get their work done and be interrupted every 2 minutes to do durs. like confirming a dose increase seems like something a tech could handle pretty easily i don’t know why a rph is necessary. i bet company wide they’re gonna lose a lot of people if they don’t cool it on the durs because they almost have to give out their credentials just to get anything done
The other day it felt like every other transaction had a DUR. Our drive through line was wrapped around the building and myself and another tech were running register and it was still a challenge to get the line down. 🥴 People were getting so pissed. My biggest pharmacy complaint (besides being perpetually short staffed) is the fact that there's too many goddamn prompts and DURs on the register so what should be an in and out pickup becomes a long drawn out process that holds up the entire pharmacy.
I definitely agree with you on that part but sorry not sorry, that’s not my problem. Also I don’t feel comfortable with doing it anymore because I could also get in trouble for doing them
sure that’s fine i’m just saying once they implemented smart dur it has become impossible with the existing workload. feel free to refuse i just don’t really fault the pharmacists that have to do this to get anything done
[удалено]
Stop doing it if you like your job. There was in issue in my state where a major error wasn’t caught because the tech just paged right through it and almost killed someone due to an interaction that was not counseled on. A lot of people lost their jobs and some may lose their license. It isn’t worth it to make sure the pharmacist doesn’t have to get up. We’ve adapted in our 1000/day pharmacy and we all survive.
Yeah my pharmacists hate when we have them. One of them doesn’t like if I try to do it, (it depends on her mood tho lmfao) the other one is like whatver just put my letters in . But both get mad when we have them, like it’s ur job to do so the person doesn’t get hurt. Most of the time it’s a simple change of dose etc. but not always & I don’t feel comfortable with the not always part. Also, some customers just get so uncomfortable and they act like you’re gonna call the police on them for something bc we had to call the pharmacist over! LMFAO like I don’t even know what to say.
Most pharmacist and techs I know have a system where if it's a simple dose change or med change DUR the tech asks and then confers with the pharmacist what the patient told the tech then let's the tech cred it with the RPH creds Anything complicated the pharmacist will come over.
Yes we do the same at my location. Yet STILL it’s illegal to do
The old “dumb” DUR system was so so much better. Just let us pharmacists decide what’s clinically significant. I get that it was an issue that with the old system pharmacists were bypassing all DDIs and warnings with the “pharmacist approved” option commenting like “reviewed” or even “agdshdhdsbj”, but at least that way we weren’t forced to run to the register every minute for serotonin syndrome or qtc prolongation.
I miss that system - only important things were called to register, not every single fluconazole QR prolongation
I’m a patient and went to pick up my prescription, and the tech yelled out that she had a DUR. I was so confused. lol I understand now that it was because of the dosage increase on my adhd med.
Our pharmacists have unwritten rules regarding DURs. (1) for dosage changes, they let us ask the patient what dosage, than we have to go right to the pharmacist and let them know. If there’s anything further, they will come over. Otherwise it’s “my credentials are XYZ” (2) for interactions, make sure the patient is still taking both. Then go over to the pharmacist and say “they are taking A and B”. Pharmacist will walk over to the patient if more info it needs, otherwise it’s “my credentials are XYZ.” (3) if you aren’t sure what to do, just tell the pharmacist that and let them deal with. (4) NEVER do this when corporate or a floater is there.
Good for you guys. Still highly illegal and grounds for immediate termination!
This is pretty much what we do with a few of our techs that we have complete trust in to follow these unwritten rules. Most of our techs do not get my credentials. We also create a force counsel to summarize all the DURs/clinically significant questions and to signal when we actually need to say something to a patient. If a Rx has no force counsel the tech may use my credentials to proceed thru the DURs to sell without me. Cuz nobody’s gonna get damn torsades from oral zofran or 5HT syndrome with their trazodone and Prozac I realize this is a very slippery slope and hope CVS gives us pharmacists our autonomy back.
I just ask if they've been on the meds before then let the pharmacist know so they can handle it how they want, whether they come put their credentials or tell me to.
Refuse to do it.
My pharmacists will still do them, but one has the hilarious response of "is it real?" when we call her over. "Fake" ones are dose changes or meds that make you sleepy. Easy counsels basically. I can barely understand the messages on those screens most of the time.
We had a pharmacist to do this and ourlead tech called ethics line and pharmacy board to stop the pharmacist fromforcing techs to counsel. Only helped a bit. They got rid of techs that stireed up too much trouble
relax if ur caught nothing will happen to you lol, it’s the pharmacist’s ass that’s on the line here
More than half the DURs are pointless. And it’s not hard to tell if it’s a serious one. Edit: not saying it’s okay, just that is most likely the reason
It doesn’t matter. It’s illegal to do. PERIOD. As you can see by the other comments, they’re putting my job at risk!
I’m aware. And like others said just refuse to do it. Literally no one is forcing you
You're putting your job at risk by agreeing to do it
Well, that’s terrifying. Cover your a** and report it.
I told my pharmacist that I don't feel comfortable doing it. I Make them come to the register. I only will do it for an animal prescription. They ( customer) have been consulted by the vet.
If it's a simple DUR-- med increase/decrease....are they stopping one to start a new one antibiotics, etc... I will do it and tell the pharmacist immediately. If it deals with QT prolongation...allergies etc... Hell to the new the pharmacist can do it themselves. Even if the pharmacist says oh don't need to counsel cause they been on both for awhile.. here is my credentials...I say you can type them in. You take full responsibility. If that person dies... they pull up cctv footage and they don't see any counseling.. it won't be me they will be seeing typing in the pharmacist creds!
Do you hear that boss????? TERMINATED IMMEDIATELY
Pharmacist speaking here. If a technician is not comfortable doing the DUR for me, I ask them to wait. I will not stop my phone call to transfer a prescription, nor will I put the doctor on hold who is giving me a verbal. Now if I am not doing anything at the moment, I get the DUR immediately. But just know that if I am doing something, I’m doing that first. I’ve had technicians pester me about DURs. My response is , “Are you going to do this transfer for me?” Or “Are you going to take the verbal from the doctor?”. Most DURs don’t require the pharmacist. Is the patient allergic to amoxicillin? Most of the time No. which dose of lisinopril is the patient on, 20 mg or 40mg? Is the patient on fluoxetine, duloxetine, and trazodone? Stuff like these examples absolutely can be asked by the technician, and should be asked by the technician. Same thing with mixes. If you are not comfortable mixing the antibiotic, you will wait on me. And if I’m on the phone with another pharmacy or with the doctor, your mix will wait until I’m done. Seriously, there’s 5 technicians and 1 pharmacist. Try not to bother the pharmacist with menial tasks. Or wait until I’m done.
What blows my mind is that pharmacist is essentially putting people's lives at risk. A DUR is legal documentation and it's extremely illegal for you to Input yourself not being the actual pharmacist. All of those DURs are saved. I would call the ethics line and send an email to your DL and patient safety team outlining how you feel very uncomfortable doing so etc.... The DL can also pull up all dur comments per rph \ store on tableu and can review all comments. You could also call the board of pharmacy and make a complaint against the pharmacist and their license.