High School Students Filling Prescriptions

[RamboLiberal]

Source: ABC

The country's major drug store chains are increasingly relying on pharmacy technicians, often as young as 16 with little training, to fill prescriptions involving even the most powerful drugs.

Sometimes, there are tragic results.

A high school-aged pharmacy technician at a Walgreens in Lakeland, Fla., made a typing error and dispensed a dose of the blood thinner Coumadin that was 10 times what the doctor had prescribed.

"She was in high school. Her prior job had been cleaning a movie theater and serving popcorn," said Karen Terry, a lawyer representing the patient's family.

The patient, Beth Hippely, suffered a massive stroke after taking the medicine she was incorrectly given, forcing her to stop chemotherapy for a treatable, stage II breast cancer. She died earlier this year.



Read more: http://blogs.abcnews.com/theblotter/2007/03/high_school_stu.html

[skooooo]

1. Grocery store clerks are also...

...processing U.S. Mail. Evidentally the postal service can license stores out to do this. They don't get paid extra for the responsibility, of course.

This country is going to hell in a handbasket!

[MountainLaurel]

8. My town's main PO is in a grocery store

I drove all over looking for one when I first moved here, because the branch office near our house doesn't accept credit cards. Only later did I learn that the post office is in the IGA.

[LiberalFighter]

15. Remember the show Green Acres?

[lanlady]

53. faaaarm living is the life for me

land spreading out so far and wide
Keep Manhattan, just gimme that countryside.

[drm604]

2. K&R

:kick:

[Wickerman]

3. I don't think this is new

When I was in High School I worked in a drug store and they routinely had HS girls working behind the counter filling scripts. The pharmacists checked everything before it left the counting counter.

The problem ain't with the kids doing the filling its with the quality check; with the pharmacist who signs off on what happens in their space.

[1monster]

10. I worked for two different drug stores for a period of ten years from 1981 to 1991. In

no case did anyone but the pharmacist EVER fill a script.

Pharmacy techs are being used more and more these days as a means for big chain stores to keep down costs. However, the pharmacy techs I know of have to get a degree for this work... (My stepdaughter is going to school for this now)

I guess the standard vary from state to state.

[Wickerman]

12. Must be, as you say, a state by state thing

In Iowa and Minnesota it was evidentially ok in the late 70's early 80's. And, the place I worked was no chain - it was a mom and pop place that co-oped with other indies for ads and buying power. Again, the key to safety is the Pharm checking the techs work - a monkey could fill the script for all the end result matters.

[3waygeek]

19. Definitely right about Iowa...

I grew up there, and just after I graduated high school in '81, one of my classmates filled my prescription for antibiotics & pain pills following minor surgery.

[slampoet]

22. I sold liquor at the counter of a drug store when i was 15, but i was NEVER allowed to...

..fill anyone's script. WOW. Yet annother reason to boycott Walgreens.

[Kool Kitty]

37. I was a pharmacy tech for about seven years.

I learned "on the job", no school training. The pharmacist checked EVERYTHING before it was bagged. Seems like the pharmacist should have checked this before it went out.

[rfranklin]

4. Sounds like my neice and nephew...

They also went from the movie tenplex to working behing the counter at a drug chain. They seemed to have not trouble doing the job.

What I have noticed is that they have you sign a slip saying they have counseled you on drug interactions even though they never do any such thing.

[proud2BlibKansan]

26. I sign the side that says yes, I want advice

My pharmacy has 2 columns on their sheet. Almost every customer signs the side that says yes advice was offered but they don't want it. I sign the other column that says yes help was offered and I still want advice. Just last week, the pharm tech asked why I signed there. I told her well if I go home and get sick from the drugs you gave me, I may not be able to sue you if I sign the column refusing advice. From the look on her face, I could tell she had never had a customer tell her that. LOL

[BOSSHOG]

5. This is the sense of proportion that brilliant acamedician

limbaugh shares with his lemmings. More people die from bad prescriptions then in Iraq so what's the big deal? So thousands of people get killed because bush told a little lie. Most of them aren't Americans so its no big deal.

I'm incredibly paranoid about any drugs. I just watch the TV commercials for them. Two-thirds of the time is used telling you about side effects. Probably some evil government regulation forcing them to tell us about side effects.

[ryanmuegge]

40. Yeah, same here. I never take anything unless it's absolutely necessary.

I'm even weary of cough syrup and shit like that.

[LiberalFighter]

6. That is totally wrong. Technicians at that age should not dispense ANY drugs.

[BadgerKid]

13. So, they can dispense drugs but not handle alcohol @ checkout? WTF? n/t

[LiberalFighter]

14. You want stupid?? Try Indiana..

Clerks can be under 21 but if there is tobacco or alcohol sale they must call someone of age to ring it up.

[donco6]

20. Same in Colorado, except we don't sell alcohol in grocery.

Have to go to a liquor store for that. They have some 3.2 beer in the store, but that's all.

[LiberalFighter]

23. Last I knew can't sell liquor in grocery stores in Wisconsin either.

A major local grocery store tried to have it in the same building but state said they had to have separate entrances. Had to leave the building to go into the other.

[B3Nut]

63. They do now...

it's in a separate area, but there's no separate outside entrance for the liquor department. Some stores still have it, others don't, some that don't have separate entrances have a separate register in the liquor area, but one of the mom'n'pop stores I do POS tech work for has all purchases including hard booze coming through the main registers. (I do IT for a grocery warehouse/wholesaler.)

Todd in Cheesecurdistan

[Xithras]

57. No beer in grocery stores??!?!?

Madness! The next thing you know, you'll be telling me that you can't buy alcohol in your gas stations either!

<3 Cali

[proud2BlibKansan]

28. Same deal in Kansas

[Divernan]

7. "Stock boys and photoshop workers. . also pressed into service.

From now on, anytime I pick up a prescription, I'm calling the pharmacist to the pickup desk to verify that the pills in the bottle are the same as those prescribed by my Doc AND that the instructions/amount are correct. One of my friend's teenage kids works in a local Giant Eagle pharmacy - he's often in an stressed out state because of his born-again girl friend, and especially so when her pastor shows up at the pharmacy counter to preach at him about converting. A different friend of mine was a pharmacist for Walgreen's in the Chicago area for some 30 years, and he also functioned as the store manager for his shift. Easy to understand how lethal mistakes can be made.

And I'm getting this article to my doctor also.
More snips from the OP's link:

"Testimony in the Hippely case also revealed that stock boys and photo shop workers were also pressed into service behind the pharmacy counter when the store became very busy.

"They know mis-fills and errors are bound to occur because they're giving huge responsibility and important responsibility to people that aren't trained to perform those duties," said Terry.

"This is an intentional, system drive for profits, for money. If it wasn't about that, they would hire more pharmacists," the lawyer said.

Walgreens is the country's biggest pharmacy and recently reported record profits."

[brentspeak]

17. Same thing at CVS

The stores deliberately understaff to get as small a payroll as possible. One store near me never has a cashier waiting behind the counter; customers have to ring a bell, to alert the teenage employees who are always doing double duty stocking the shelves.

[yellowcanine]

9. That is the pharmacist's fault. I don't care who does the leg work, the prescription that goes out

has to be checked by the pharmacist. Of course they should be using people with more training as well.

[mcscajun]

50. Exactly right, and in this case, it was a pharmacist's lapse

"Under Walgreens policy, prescriptions filled by pharmacy technicians are supposed to be double-checked by registered pharmacists. In the Hippely case, the registered pharmacist failed to catch the high school student's error."

[don954]

11. this happens all the time even with experanced techs

I used to work pharm support for a major chain, these occurrences are not anymore present among younger workers than average. In fact, i saw many more errors with older workers than younger ones, as their eyesight and dexterity are not as good.

[susanna]

35. So the pharmacist doesn't approve the dispensation of meds anymore? n/t

[don954]

46. the pharm "approves" it but rarely does the pharmacist actually look at it..

Many large locations have a 10 to 1 ratio of techs to pharmacists, and often that causes allot of scripts to go out without any review.

[susanna]

47. Thanks for the info, don954.

I wonder if that is why we have all these commercials about computers cross-checking potential interactions now, so the pharmacist doesn't have to...

[don954]

55. yes, the software does!

At the time (about 10 years ago) I was working with RxPad and PDX software which would display all interactions with the patents purchase history, it was very good software, but, it was easily overridden by the tech...

[susanna]

58. Scary again! n/t

[noonwitch]

16. It all depends on the kid in question, but I did think you had to be 18

I had a friend who worked as a pharmacy assistant when she was 18. She was really good at it-she was good at science and math, and was a good keeper of records.

[3waygeek]

18. Nothing new...

just after I graduated high school back in 1981, I had minor surgery and was prescribed antibiotics & pain meds. When I went to the local pharmacy, one of my classmates filled the prescriptions.

[dysfunctional press]

21. i take methadone for chronic pain...

one time i went to the pharmacy and dropped of the script...when i came back later, there was a different guy working in the pharmacy than when i had dropped it off...i gave him my name, and showed my driver's liscense(this was back when you had to show i.d. for narcotics)- he told me that i didn't need to show an i.d.- i told him that i would, because i was picking up my methadone...he told me that i couldn't get that there- that i'd have to go to the 'clinic'. i told him that yes, they do carry it- in 10mg. tablets- i had dropped it off earlier and i was there now to pick it up. he found the filled precscription, acted kind of surprised, and as he was ringing me up, he whispered to me- "you know, i used to be in the program too..." (i.e. a methadone "program" for getting off heroin)

so- in at least one pharmacy i know of, they hire ex-junkies to work behind the counter with the drugs.

[Zoigal]

25. The wrong medication on

one occasion and an incorrect dosage on another have
convinced me to always check any Rx upon receiving
it from the pharmacy no matter who dispenses it.

[nodehopper]

41. so people who have been through a rehab program

should be discriminated against in terms of employment?

[dysfunctional press]

43. in some professions, yes.

it's just common sense.

[nodehopper]

48. well, I am pretty sure thankfully your point of view is illegal

[Lurking Dem]

49. How is that any different

than not allowing people convicted of child molestation to be a coach or a school bus driver?

[nodehopper]

54. is that a law? I am not familiar with it.

Even if it is, I can think of a few differences. A child molester (in the actual cases where child molestation occurred, and someone isn't labeled a "pedophile" in a scenario where an 18 year old guy has sex with his 16 year old girlfriend and her parents get pissed) is someone who commits a crime against a particularly vulnerable population that can be easily manipulated. I can understand the possible danger of letting a child molester work in close proximity with kids in situations where they are the only supervising adult. But what is someone in a pharmacy going to do? Molest the pills? If a pharmacy employee steals pills or gets high on the pills on the job, that is going to become evident very quickly. Aside form that, I think it is problematic to extrapolate from a specific drug addition to some generalization that because someone used to be addicted to heroin, they are a undifferentiated addict tempted by everything (if that is true for anyone with an addictive personality, then smokers should be banned from these jobs as well), and I think it is problematic to presume that because someone had a problem with a particular substance in the past, they will abuse this position (at least I assume that is what the previous poster's problem with an "ex-junkie" working in a pharmacy was--he never specified what his problem actually was, he just said that some pharmacies hire ex-junkies, as if everyone is supposed to understand WHY that is problematic). If a pharmacy if functioning properly, the pharmacist has to monitor everything the pharmacy techs fill; clearly that process failed in this case. If a pharmacy is worried about employees using drugs in general, they can do drug testing (and most of them do), rather than discriminating against people whose past behavior becomes known to them.

[Doctor Venmkan]

64. Wow, THAT'S some progressive thinking right there!

:sarcasm:

I'd comment further, but do I really NEED to?

[Savannah_H]

62. young kids...

I can always count on the young kids behind the pharmacy counter to make an error with the price. I usually wait til they're working there to pick it up. JK hmm...

[Samurai_Writer]

24. Mail Order Pharmacies do the same thing

I worked at Liberty Medical Supply, and they only had maybe two pharmacists to oversee the entire pharmacy. They were responsible for checking each prescription that was going out, but it was pharmacy techs (high school graduates, at best, sometimes not even graduates) that actually worked this huge machine that dispensed the medications.

This has been going on for a LONG time. I don't know why it's all of a sudden in the news.

[proud2BlibKansan]

29. I stopped using the mail order when they called me one day to ask me to count

my pills because they thought they had given me 100 tablets instead of 50. At first I thought great, free meds. Then I realized if they couldn't even count, how do I know they gave me the right pills?

[proud2BlibKansan]

27. Call me naive but this just stuns me that pharmacists don't fill scripts!

Good gawd, why do we have pharmacy schools if we don't expect our scripts to be filled by actual pharmacists?

[alittlelark]

30. How much LOWER can we go?

....never mind - I don't even want to go there.

[okoboji]

31. they allow high school kids to

fill the prescriptions, but if I want a sudifed product, the pharmacist must check my i.d. and I have to sign log ......

how fucked up is that

[Doremus]

32. Wow. I was wondering about this just the other day.

I had to pick up a family member's first-ever diabetes medications and noticed the clerks not only inputting the info into the computer, but actually taking the drugs from the shelves and filling the prescriptions.

I looked at their badges and there were initials after their names (something like RPT or similar), and I thought perhaps it meant they were degreed techs or something.

So much for ASSuming.

[Doctor Venmkan]

61. Sometimes you "ASSume" correctly, or at least get close...

CPhT = nationally Certified Pharmacy Technician.

No "degree" needed, but you have to pass an exam and maintain "continuing education" hours. The same amount as a pharmacist actually, just broken down differently. Techs must get 20 hours in two years, with a minimum number of hours devoted to pharmacy law. Pharmacists must get 10 hours every year, with X number of hours at a live class.

And like I said, some states REQUIRE the certification before you can actually work in a pharmacy. Without being able to get the hands-on experience, a college course is almost mandatory to pass the exam in those states.

Look, like it or not, pharmacies NEED techs in order for a pharmacist to do HIS main jobs - verifying the prescriptions, counsulting with patients with ALL of their questions. Are there pharmacists that are big enough pricks to tell someone who isn't a regular patient to go to pay doctor to answer their questions? Probably, but I have yet to meet one.

You want to blame someone for the stress and workload in pharmacies? Try the INSURANCE COMPANIES. It's a full-time position in my store to be a "go-between" between doctor's office staff, patients, and their insurance companies in order to get their meds covered by the SOBs at the HMOs that are denying coverage for certian drugs....

[rebel with a cause]

33. Flame me but I use Walgreens pharmacy.

It became necessary when I used others, and ran into a problem of needing meds in times when they were not open. With my health problems it is necessary to have the 24 hr service. There are times also that I am unable to get my own meds and they allow my children to do so for me. There have been several times that my scripts have been messed up but it has not been by the pharmacy. Either my doctor or one of their nurses have made a mistake in writing it out. I have come to suspect it is the nurse that I really like that is making the mistake, because they have occurred when she was the one taking down the information.

Two days ago two of my medications were changed without my knowledge. My son picked up my medicine and the pharmacist had written notes on the information sheets and told my son of the changes. The one change was no biggie, but the other one was. It had doubled a medication that had been cut down before because at that dosage it could kill me because my heart rate was below fifty and my blood pressure was so low they could not find it. I was lucky and had a visiting nurse at that time so they found the problem and my doctor (who had not prescribed the original dosage, the specialist had) quickly dropped the amount to half of the original dosage. I do not have the luxury now of having a visiting nurse, so it is up to me to make sure my meds are kept as steady as possible.

Needless to say, I called my doctor and asked them about the changes. I also told them that I would not take twice the dosage that I was taking of the one pill. They (the person I was talking to), of course, said there had been a mistake and would call the pharmacy and have them change the one prescription. I am not dumb enough to take this dosage of the medication, but if I had been then the fault would have been with the clinic and not with the pharmacy. Our scripts are filled by the pharmacist here in Illinois also. I think it is required here, but could not swear to it.

[susanna]

34. Oh God. And I mean that.

Coumadin is a rather intense drug. My mom was on it recently for blood thinning purposes. There are foods you simply MUST NOT EAT when taking it. If you're overdosed on it, I am frightened to imagine the results. It's a lifesaving but potentially fatal drug. I am not surprised this made the news. :-(

on edit: some background

[rebel with a cause]

36. I have been on it for over a year. 5 mg daily

foods not to eat with it just off hand. Cranberries, green leafy vegetables (a little okay), licorice, soybean or canola oil, and no aspirin, An overdose can mean that you bleed internally or under the skin, get a little cut you can bleed to death, etc. It is not something to fool around with. CSI recently had a show where they thought a person suicided on an overdose of it. I am on twelve different prescriptions, three or four different diets, and am sick to death of being sick, but I am doing okay. ;-)

[susanna]

45. Wow, rebel...my hat's off to you.

Mom only took it for a few months but she didn't feel very good on it at all and she missed her salads, of all things. She had a heart arrythmia and they thought it a good precaution to put her on the blood thinner.

That said, my heart goes out to you. I can tell you're hanging in there, though I know being sick is no fun. Take care and all the best to you.

[rebel with a cause]

52. Yeah, I have a heart arrhythmia also.

I hope hers went away. Mine is not going anywhere. But I don't feel to bad as long as I sit with my feet up and do limited activities. In other words, I am living the lazy person's dream. ;-)

My regime of medicine seems to be doing okay as long as I keep my eye on them (the providers and the medicine). Congestion is the thing I have to watch out for, and so far I have been congestion free for one year. MILESTONE!!! HOORAY!!

[susanna]

59. Good for you on your milestone!

That is exciting, I'm sure - it gives you a checkpoint. Those are always pretty good, I'd say!

Actually, my Mom is still affected. She is very limited, activity-wise. Her arrythmia is very random and they do worry about it. She wears a heart monitor X times a year to try and get a handle on it (X meaning I'm not sure how frequently, but to hear her tell it - all the time).

They took her off the Coumadin because of other complications, but I still worry for her every day. They think aspirin alone will be enough with her at this point; the Coumadin thinned her blood too much or something like that? Anyway, I'll always still worry. She's my Mom. :-)

[merwin]

38. I'm pretty sure Walgreens has an actual pharmacist verify the

prescription before it goes out. I'd be willing to bet that there's more to blame than just the technician.

[nodehopper]

42. agreed

[mcscajun]

51. That's the policy, but in this case, there was a lapse.

"Under Walgreens policy, prescriptions filled by pharmacy technicians are supposed to be double-checked by registered pharmacists. In the Hippely case, the registered pharmacist failed to catch the high school student's error."

[woo me with science]

39. sometimes it's good to have a kid around.

i'm just sayin.

[Pavulon]

44. This is great a great job

for a robot. Companies here make them. Robots dont get tired, stoned, or moral hangups. They do their job.

Data comes in, is human checked, robot fills bottle.

[MountainLaurel]

56. This makes me very glad . . .

. . . that the only scrips I'm on come prepackaged from the manufacturer, so that all the pharm tech has to do is take it off the shelf and bag it.

[Doctor Venmkan]

60. Soooooo....where the fuck was the PHARMACIST???

I started working as a pharmacy tech when *I* was in High School.

This was a bit before the company started a "formal" training program.

Therefore, I primarily ran the register until it got slow enough for the pharmacist/senior techs to show me things and for me to practice them.

And now, there are masses of classes to take before you even START working. Some states even say that you must be nationally certified before you START working.

So, don't assume that just because this girl was in high school and had "menial" jobs beforehand that she DIDN'T know what she was doing.

Maybe she didn't. But even if she did, and this won't help you sleep better tonight, SHIT HAPPENS.

Does she share the blame? Yes. Is the pharmacist the one who is primarily responsible? Yes!

Coumadin....Coumadin is THE "be careful, this is some scary shit" drug, at least where I work. Even if she was the best tech in the place, the pharmacist should have actually CHECKED the prescription!