Love that Jonathan is the only person who does med rec correctly (and that I can tell it's Jonathan even though it's just a picture and ALL OF THE CHARACTERS ARE PLAYED BY THE SAME GUY).
It was bad enough one night I went to every floor and made each nurse come look with me. The only med not where it was supposed to be had been randomly tossed aside by another nurse who didn't need that one.
I laughed when Jonathan wins the Perfect Med Rec Award. I assume he doesn't speak and the pharmacist just assumes that he is making the correct med recs all the time
As a hospital pharmacist, I can confirm this is 💯 accurate. I recently was reviewing a med rec and it said the patient was taking 800 tablets of vitamin d per day. Just went ahead and changed that to 800 units.
@@bob8mybobbob How many meals a day are you eating?! Or.... do you consider the cereal bowl of vitamin D a meal and put yourself in an infinite loop? >.>;
Amazing how the pharmacist manages to maintain the same chipper, assertive-yet-not-condescending tone and demeanor with every call that comes his way. I dare say he's near the level of a Johnathan.
@@TheRayfield77 I don't imagine that real pharmacists are all like this all the time. I was mostly talking about the character that Dr. G plays. But I will say most of the pharmacists I meet are quite courteous and cool-headed despite how busy they are, and it is something to be appreciated. But it's not like nobody is allowed to have a bad day.
Honestly I love the ones that are so egregious that I get to be a little rude. “You continued the patient’s home potassium when their K is 7.4. Are you going to fix that?”
As a doctor, I'll tell you there are times we deserve to be hit on the head with the entire Pyxis. Go ahead and be as "straightforward" as you need to be.
@@Makermook I work in veterinary medicine and have had some pretty bad encounters with vets. One time a vet demanded to know what vet school I went to and then made me repeat back that I will not question her dosing again. 😵💫 there are a lot of lovely ones too but you never know what you’re gunna get 🤦🏻♀️
Yeah no sometimes a doc deserves to be bashed upside the head just a little bit for a stupid med rec, my dad had a pharmacist directly call his doctor and go are you absolutely sure you want this man to take this medication... He's on warfarin remember (the medication in question thinned blood which warfarin also does(technically warfarin is an anti coagulant but potato potatoh similar function and you don't really want to mix the two willy nilly)) the doctor quickly rescinded the prescription and changed it to something else
Context for some of the less obvious screw-ups for any non-medical peeps - - Creatinine is a measure of kidney function, this patient has a kidney injury and NSAID's like ketorolac can cause/worsen kidney injuries - Hydralazine is for blood pressure, hydroxyzine is for itching (everyone gets these confused at some point) - Warfarin is kind of an old school blood thinner (but still pretty common) that can be a pain to manage/keep at appropriate levels because it requires regular follow-up visits and lab checks. So docs who don't typically see patients long-term or deal with a lot of chronic conditions would not be the best choice to manage it, to put it mildly
@@livewithmeterandnomeasureb1679 I had to look up hydralazine, but while watching the video my immediate reaction was "That sounds like they meant to order hydroxyzine, but didn't." For somebody in IT, maybe I know too much about meds.
As a hospital pharmacist, I appreciate every time you shed light on what we deal with. People already don’t really know what community pharmacists do and certainly don’t know what hospital pharmacists do
Pharmacists saved my dad's life post- back surgery. They knew what the prescribed medications would or would not do and my dad always consulted them after that.
Please call pharmacy if you aren't sure or need us. As a hospital pharmacist I can tell you we would rather you call then have errors found later. We have so many people calling for so many different reasons. At least with the hospitals I have worked at we are taught that doctor calls are the priority.
I swear pharmacists pay more attention than the prescribing physicians do. I had a psychiatrist once prescribe me a med that's contraindicated for people with epilepsy, and my pharmacist caught it when I was picking it up. What was less fun was that the psychiatrist refused to prescribe a new med until my appointment a month later, which I also had to pay for, just to tell them that yeah, I didn't take any of the med that was dangerous for me and I have no updates, please just write me a new prescription. Grateful for that pharmacist, tho.
The part when the pharmacist recommended the generic brand reminded me of the first time I bought my own prescription. I was in college and it was going to cost more than I had in my bank account. That Walmart pharmacist was the real MVP for making that call to my doctor and getting the prescription fixed to the $15 generic brand
Is this a state-by-state thing? I’m in Oregon, and I think the pharmacists just automatically substitute the generic unless the doc specifically says it has to be the brand name. There are signs about it in every pharmacy. Maybe I’m missing something behind the scenes… or maybe it depends on the medicine.
@@LexAnnalyn I'm pretty sure it's state by state. It's the same here in Massachusetts, its automatically switched to generic unless the doctor specifically writes not to do so. It ought to be every state!
Retail pharmacist here, likely scenario is the doc wrote for a brand only medication when there is a perfectly acceptable generic in the same family that is much cheaper and preferred by insurance
@@bronwynhl They can do that here in the US as long as the doctor doesn't specifically write the prescription "dispense as written" - which most don't unless there's a good reason. And a good pharmacist doesn't even have to be asked, you get the cheapest generic. That said, I've used DAW prescriptions to my advantage before, DAW + a copay discount card can burn through your out of pocket maximum REALLY quickly without you having to actually pay out of pocket. I know, not an issue in Australia, but healthcare is stupidly expensive here.
@@Soprano91396 I’m honestly happy no other place I’ve worked at but CVS has decided the phone needs to announce “ X Pharmacy calls “ every couple rings 😭
We have about 6 nurses who call CONSTANTLY and when their vocera shows up on caller ID, we all grimace before we paste on our customer service voice and answer. My least favorite is when nursing gives patient's family members our number...
I’m a hospitalist who worked in internal medicine for quite some time. I actually said “OH GOD” out loud when I heard it was ortho managing the warfarin. 😂
You would not believe how often the pharmacy gets called about a med and it turns out it's just sitting in the tube. Once in a while you go down there yourself to get it out of the tube for them haha
I love that Jonathan is getting the recognition he deserves for his excellent care and service. Also, he was the employee of the year before and after 2022. Meaning the Pharmacist just made his job easier by putting pictures up in advance. He knows no one will ever beat Jonathan!
As a hospital pharmacist I think of Jerry McGuire when I see crazy orders "Help me, Help you?". I will give the doctor most things they want but it needs to make sense. We can decipher a lot but you would be surprised how often orders come through that make no sense what so ever. I had a doctor order Aspirin rectally every 4hours scheduled, when I asked him he blames Epic and said he basically just punched at the keys. 😂
Thank you, as a pharmacy technician, I think you may be one of the only nurses that don't blame pharmacy for when you can't immediately find you neds! You are right, we are all on the same team!!! 👏👏👏
@@scgirl9310 nah Every nurse I know and myself too love pharmacy We’re short sometimes I think because by the time we’re talking to you we’ve been dealing with an issue for a while and it’s holding us back from doing our other work.
Hospital pharmacist here: It’s true, all of it and more. We’ve finally semi-beaten the current crop of residents into submission, just in time for another batch to show up and make all the classic errors 😂
Thank God for the Pharmacy! I was dog tired after an night of call, eight admissions, and, since it was a weekend, I had to write the hyper-al orders for the patients on my service before I could hand off. I had about ten orders to write and was rushed because they HAD to be in the pharmacy before 1:00 PM. I had just finished and was wrapping up to go home when the Pharmacy called. Damn it! “Hey, Wayne, Pharmacy. Did you mean to write for one unit of Norcuron per cc on the HAL for pt, ____?” “What? No, of course not. The patient is on the floor and unintubated. I did want a unit of heparin per cc in the solution, though.” “Thought so, but I wanted to let you know. I’ll make the changes” Holy crap! Saved my patient’s life and my career, all in one phone call! For the non-medical: 1) Norcuron is a paralytic agent that will make the patient stop breathing. 2) Norcuron isn’t measured in units.
100% accurate. One time I had to call a doc who meant to order Thorazine (brand name for an anti-nausea/vomiting med), but instead ordered thioridazine (used exclusively for schizophrenia). Dr. G out here being a great advocate for hospital pharmacists.
Thorazine is brand name chlorpromazine, a typical (first gen) antipsychotic. It's primarily used as a sedative antipsychotic that also has potent antiemetic effects. Thioridazine is also a typical antipsychotic.
@@lindseybrown1683 probably not. They’re both “psych meds”, but some like Thorazine and Compazine are often used for big time nausea/vomiting. Whereas thioridazine is effectively used exclusively for psychiatric indications.
I'm a pharmacist and every time I watch your videos I keep thinking that it would be nice to have a vid about hospital pharmacy. Thank you so much and this is accurate!
Hi Big Fan from Thailand, This is my first time to watch your video before it hit 10,000 views. As a former hospital pharmacist, now studying medicine, I laugh out loud. LITERALLY. Your mocking skill about our routine jobs is ANOTHER level. It is so real, especially the pharmacist-to-dose things. Great job as always sir. !!
@@ConstantineIII Thank ! To be honest, it's not a bed of roses. The only thing I know is meds LOL. I need to re-learn almost everything about human body.
As a hospital pharmacist this was hilarious to watch but also so true. I wish more people understood what we do, most still think pharmacists just "count pills". I joke that 90% of my job is keeping doctors from making mistakes that will hurt patients but honestly it's true. It's kinda like doctors are writing a book and we pharmacist are the editors who come through and make sure the book makes sense.
Welp, my step mom was taking some rheumatoid arthritis drug Xeljanz. Had a stroke. Still kept her on it. Had kidney failure. Getting dialysis. They were still giving to to her up until I arrived (retired nurse) and demanded it get d/c'd. It eventually killed her. All she had to do was stop eating nightshades. The last 3 months of her life, i didnt feed her nightshades and all she needed for pain was tylenol. The medical field is useless sometimes.
Dr. Bill, I wish we could give our full attention to you but... phones. We appreciate the visit. Trying to answer all the phones, multi-tasking, trying to track down where x went. Resending a third of the meds we filled... Did you check the tube? The fridge? Bottom of the tube station? Underneath the pile? Med room? "I'm not trying to do your job for you, but you did write "pharmacy to dose on the order." I'm crying. All of this is so accurate it hurts.🤣 This is why you all get put on hold.
I've added onto my spiel to these mostly travel RNs that plague my hospital, "have you checked in with every single one of your coworkers on the floor to confirm that they may have taken it from the tube station and not told you?" It works magic because they seem so afraid to ask.
@Jagaroth They very well could be. I've met travel nurses who have met nothing but contempt from other nurses from places they went. Or just weren't helpful. So I always made it a point to introduce myself. It's nice to have at least one friendly face.
Knowing the many questions our antimicrobial stewardship pharmacist has to negotiate every day, plus the ones I pose to the rest of our amazing PharnDs, this brings me pure joy.
As a hospital pharmacist, this is so real (I got twitchy just hearing the phone ring). It's killing me a little bit that he never heard or answered Bill's question though - now he has to make a note and come back to it later.
as a nurse, the pharmacist does even more than what they show here. Here they just showed dealings with the doctor but I often have my own stuff they need to help me with. Kings and Queens I tell you
Yep and that doesn't include making IV meds, Chemo meds, and checking all orders to be loaded into the pyxis machines. Oh and medication timing! So much of our job is involved in medication timing. So often the doctor just enters the medication in and we have to call the nurse to double check when the last dose was given and is timed appropriately.
I really appreciate nurses so much. Especially when they call us to run things by before they talk to the doctor. I don't know how many times I have had nurses say they felt more comfortable calling a doctor after talking to pharmacy. Basically they feel like they can say they are concerned about something and they have already talked to pharmacy. All of a sudden they have more power in what they say since we backed up their concerns. I thank the nurses every time because honestly nurses catch so many problems.
Hysterical... especially the last scenario! I ran an anticoagulation clinic for years and managed warfarin for lots of surgeons during the perioperative period. Like Ortho Bro they just wanted to operate and were happy to let me watch the bleeding and clotting risks. Actually, I really enjoyed our interactions and felt privileged to be part of the team.
You have outdone yourself Doc! I was laughing hysterically at the Vancomycin bit 🤣🤣 I am so grateful for all the pharmacists managing Vanco troughs, and INRs behind the scenes! Signed, a PGY12
I find he's really impressive about that, the jokes never seem to be at the patient's expense either. I totally get medical professionals need to blow off steam complaining about patients to each other, but when you share it with the world it can make people who really should come in even more scared.
As a former hospital pharmacist now outpatient clinic pharmacist, everything about this is spot on. The phone never stops ringing, and every few minutes there's always an intervention that needs doing. To the point where, as a low social energy person I want zero human interaction after clocking out from work.
The ortho warfarin thing gives me deja vu. When I was a junior resident rotating through ortho I asked the boss what to do about the warfarin for his preop patient and he was like I don't know why don't you ask someone smarter than me who know. The trainee said try haematology... patient had a mech valve 😂
hahahhaa this is genius. please incorporate more sad trombone sounds/sound bytes. just wanted to say thank you to all hospital pharmacists out there. you are truly appreciated and i always seem to learn more from you than any other hospital staff. we have vancomycin per pharmacy order set because of all the shenanigans that we have to go through lol
I'm about to cry laughing. My parents were both pharmacy managers and I spent my childhood hanging out in the floor of the pharmacy reading pill bottles. The perfect smooth "Pharmacy" with the smile is uncanny. The exact movement and facial expressions my parents made 🥰🤣🤣
I audit medical records for preventive care and one of the things we look for is proper medication reconciliation after a hospitalization. It's sadly true how many of these are done poorly and it is often due to multiple providers not sharing one record or a non-prescribing care giver (like an RN, LPN, or MA) doing the med rec without the doctor signing off that they checked it, too. In most industries, it's best to have someone double checking your work. We're only human. Thank you to the pharmacists and their software that make it clear and easy to see when a med rec was completed!
I work in a tier 4 retail pharmacy, but the phone comments hit deep 🤣 I really do just start answering the phone at random intervals to get out of other things lol
I watch my pharmacist when I pick up a prescription. The phone has about a 20' cord on it so he can walk to every station in the pharmacy. He continues talking as he gathers meds to fill prescriptions. I'm starting to think the phone is actually attached to his ear. ☎️🤕 I used to work at a call center and obviously spent the entire day on the phone!🗣️ By the end of the day we would have 'cauliflower ear'! The pharmacist is the unsung hero and saves lives every day! They're the best source for information about any meds!💊 ⚖️ Who else in medicine can talk on the phone, carry on a conversation with the assistant and quote instructions to a customer all at the same time?!? 🤓
OMG the Vancomycin Phone! The hospital pharmacist was the absolute BEST when Infectious Disease ordered a continuation of vancomycin because they "couldn't be sure it was the vancomycin" that caused the adverse reaction after surgery. Bug Bro got his second dose, but the hospital pharmacist made sure that the nurses knew an allergic reaction was coming so they could prepare accordingly.
@@nooneyouknow4829 Yes, I know that. Thank you. Back when I started as a nurse, during the paper charting days and no EPIC, docs wrote orders on paper and “pharmacy to dose” or manage was commonplace. I do appreciate you trying to correct me though ☺️
BAHAHAHAHAHA! Pharmacist here! Truer words were never spoken!! I’m retired now but a ringing phone is definitely a trigger for me to this day! Text me FFS!! 😂😂😂😂
Not totally true - I’m an RN and can tell you that AT LEAST 75% of the time when I call the pharmacist suddenly “finds” the dose they”already sent” OR seconds after I call the tube containing my missing dose suddenly drops into the station…LOL
@@cynthiayarger9757 I guess our experiences vary based off the hospital. Where I work, there is a high turnover for nurses. A lot of nurses here neglect to check patient specific, most don't know how to recover storage for pyxis, a lot of them don't even bother to check the tube station before calling, and most don't even check the medication fridge for refrigerated patient specific meds.
As someone who used to work at a stool bank, I'm glad there's someone to tell doctors to stop prescribing Vancomycin. Uuuugh the horror stories... And also my grandmother, may she rest in peace, thanks you for the Warfarin emergency alarm.
@@nancylindsay4255 FMT baby, at the time you couldn't get it until you'd undergone a few rounds of vancomycin. And after the vancomycin hasn't worked for a few rounds you're in really rough shape.
I'm a pediatrician who is always asking question to a pharmacist about medical dosage, taste of the medicine, and so on. I really appreciate it!!! From Japan
Don't forget the phone calls 30 seconds after the order is placed for X, Y, and Z, that you are in the middle of verifying but have to pick up the phone from said RN calling about said order like you aren't chained to you computer trying to prevent the phone from ringing!
This is gold. I have heard stories from my pharmacist sister-in-law (works at a hospital, maybe moved up the chain just enough to deal with other headaches). The warfarin bit also was priceless. I know enough about it from my dad being on it, but he is also a doctor and heard a story that makes me think it applies to ALL surgeons. (In short, he knew of someone who needed a surgery through a mutual friend, and the surgery team was wise enough not to operate with him on it, but did not realize that the chances of a clot forming from not taking it for a few days are small and in his case, worth the risk.)
Retired community pharmacist but was on a Medical Center campus. There were many times I had two phones in my hands juggling Drs and insurance companies. As others waited on hold , the walk in customers would be staring at me with a death glare because I was just “chatting on the phone” instead of doing my job. 🙄
I worked in an automotive dealership service department many years ago and still have 'ringing phone ptsd' and remember the baffled looks of customers being greeted by me with a phone to each ear. Argh.
Working in pharmacy this is true there’s always someone to talk to! I used to do med Recs specifically all day and redoing the residents med recs was always a challenge. Thank you for including pharmacy I love it!
10000% accurate as a hospital pharmacist. Those nonstop phone calls literally made me experience a short bout of PTSD just now. Did you get your examples from my pharmacy by chance?
My favorite part if these videos used to be other than the impressive world building of the Glauckomverse is looking at the comments and seeing "I am x kind of doctor. This is completely accurate"
My wife is a hospital pharmacist. All she could manage after watching was saying, "It's all true"
Did she say that while answering the phone?
@@chua95 There no after call there is only call
@Winson Chuanardi the only way I could talk to her was to call her even though she is off and we are in the same room
@@DarkLento😅
Ortho managing Coumadin lol. What’s the definition of a double blinded study? Two orthopods trying to read an EKG.
Love that Jonathan is the only person who does med rec correctly (and that I can tell it's Jonathan even though it's just a picture and ALL OF THE CHARACTERS ARE PLAYED BY THE SAME GUY).
Of course it's Jonathan. We'd know that look of serenity anywhere.
🤣🤣🤣
And I did the nod without even thinking when I saw Jonathan.
Oh nonono, *most* correctly
*most correctly
If I had a nickel for every time a "missing dose" was sitting at the tube station, I'd actually be receiving fair pay for my work.
It was bad enough one night I went to every floor and made each nurse come look with me. The only med not where it was supposed to be had been randomly tossed aside by another nurse who didn't need that one.
Are you from Brazil?
You forget check the med fridge.
Or the fridge... or they tubed the octreotide or alteplase... 🤦🏼♀️ would you believe nursing has tubed Dapto back to us?
Nickel O.D.'in? :P
I laughed when Jonathan wins the Perfect Med Rec Award. I assume he doesn't speak and the pharmacist just assumes that he is making the correct med recs all the time
You don't need to talk to document in the notes.
Jonathan can speak, he just don't need to
How dare you slander Jonathan like that?
He also can communicate just with his mind, the way he activate this power is with head nods and facial expressions.
That's why he wins every year lol
As a hospital pharmacist, I can confirm this is 💯 accurate. I recently was reviewing a med rec and it said the patient was taking 800 tablets of vitamin d per day. Just went ahead and changed that to 800 units.
Or when they send suppository instead of suspension and order to take orally
Are you telling me I should stop having a cereal bowl of vitamin D tablets after every meal?
@@bob8mybobbob How many meals a day are you eating?! Or.... do you consider the cereal bowl of vitamin D a meal and put yourself in an infinite loop? >.>;
Is true that too much vitamin D can cause liver problems?
@@rebecaanderson1935 too much of anything will cause liver problems
I once tried to say “Alexa stop the timer” and instead “Pharmacy, this is Ellen” came out of my mouth
Well, with the complexity of a lot of the calls, Alexa could probably answer them just as easily. =P
My mom called me recently and I answered "This is Tomás, I'll be your Spanish interpreter today"
I've literally answered my cell phone like that before
Old habits do die hard after all!
i’d be glad to stop the timer, but i don’t know where it is, really i don’t. 🫤
- oh, wait! you mean the Alexa computer thingy. whew! :) 🖱️🖥️🌷🌱
Amazing how the pharmacist manages to maintain the same chipper, assertive-yet-not-condescending tone and demeanor with every call that comes his way. I dare say he's near the level of a Johnathan.
We aspire to Jonathan levels of zen
@@Autismgirl75 *nods*
Ah, yes... we maintain that demeanor at all times... yes...
Umm... yeah we might not all keep our cool like that. Just a heads up.
@@TheRayfield77 I don't imagine that real pharmacists are all like this all the time. I was mostly talking about the character that Dr. G plays. But I will say most of the pharmacists I meet are quite courteous and cool-headed despite how busy they are, and it is something to be appreciated. But it's not like nobody is allowed to have a bad day.
It’s a fine line that I walk as a pharmacist knowing something is wrong and trying to clarify without coming across as rude or degrading lol
Honestly I love the ones that are so egregious that I get to be a little rude. “You continued the patient’s home potassium when their K is 7.4. Are you going to fix that?”
As a doctor, I'll tell you there are times we deserve to be hit on the head with the entire Pyxis. Go ahead and be as "straightforward" as you need to be.
@@Makermook I work in veterinary medicine and have had some pretty bad encounters with vets. One time a vet demanded to know what vet school I went to and then made me repeat back that I will not question her dosing again. 😵💫 there are a lot of lovely ones too but you never know what you’re gunna get 🤦🏻♀️
Yeah no sometimes a doc deserves to be bashed upside the head just a little bit for a stupid med rec, my dad had a pharmacist directly call his doctor and go are you absolutely sure you want this man to take this medication... He's on warfarin remember (the medication in question thinned blood which warfarin also does(technically warfarin is an anti coagulant but potato potatoh similar function and you don't really want to mix the two willy nilly)) the doctor quickly rescinded the prescription and changed it to something else
@@Makermook your name reminds me of the bad boys film
Context for some of the less obvious screw-ups for any non-medical peeps -
- Creatinine is a measure of kidney function, this patient has a kidney injury and NSAID's like ketorolac can cause/worsen kidney injuries
- Hydralazine is for blood pressure, hydroxyzine is for itching (everyone gets these confused at some point)
- Warfarin is kind of an old school blood thinner (but still pretty common) that can be a pain to manage/keep at appropriate levels because it requires regular follow-up visits and lab checks. So docs who don't typically see patients long-term or deal with a lot of chronic conditions would not be the best choice to manage it, to put it mildly
You’re the real mvp for clarifying this!
Shit i even read the other med as hydroxyzine. I was like wait that sounds right. Must have read it wrong.
I once heard a story about a patient who mistook 1/4 of a tablet for 4 tablets, next visit his INR was unmeasurable. PS INR should be within 2-3
@@livewithmeterandnomeasureb1679 I had to look up hydralazine, but while watching the video my immediate reaction was "That sounds like they meant to order hydroxyzine, but didn't." For somebody in IT, maybe I know too much about meds.
Ive been on ketrolac before for my back. For some reason it messes with my stomach less when ive been on it (IV) in the hospital.
As a hospital pharmacist, I appreciate every time you shed light on what we deal with. People already don’t really know what community pharmacists do and certainly don’t know what hospital pharmacists do
Pharmacists saved my dad's life post- back surgery. They knew what the prescribed medications would or would not do and my dad always consulted them after that.
As someone in EMS: do you purposefully give us the rarely-used medication vials scheduled to expire next week?
as a resident my greatest fear is having to call pharmacy for dosing info. Luckily I have been able to avoid it for 19 months now
Please call pharmacy if you aren't sure or need us. As a hospital pharmacist I can tell you we would rather you call then have errors found later. We have so many people calling for so many different reasons. At least with the hospitals I have worked at we are taught that doctor calls are the priority.
I swear pharmacists pay more attention than the prescribing physicians do. I had a psychiatrist once prescribe me a med that's contraindicated for people with epilepsy, and my pharmacist caught it when I was picking it up. What was less fun was that the psychiatrist refused to prescribe a new med until my appointment a month later, which I also had to pay for, just to tell them that yeah, I didn't take any of the med that was dangerous for me and I have no updates, please just write me a new prescription. Grateful for that pharmacist, tho.
The part when the pharmacist recommended the generic brand reminded me of the first time I bought my own prescription. I was in college and it was going to cost more than I had in my bank account. That Walmart pharmacist was the real MVP for making that call to my doctor and getting the prescription fixed to the $15 generic brand
Is this a state-by-state thing? I’m in Oregon, and I think the pharmacists just automatically substitute the generic unless the doc specifically says it has to be the brand name. There are signs about it in every pharmacy. Maybe I’m missing something behind the scenes… or maybe it depends on the medicine.
@@LexAnnalyn I'm pretty sure it's state by state. It's the same here in Massachusetts, its automatically switched to generic unless the doctor specifically writes not to do so. It ought to be every state!
Retail pharmacist here, likely scenario is the doc wrote for a brand only medication when there is a perfectly acceptable generic in the same family that is much cheaper and preferred by insurance
@@LexAnnalyn yeah i was surprised by it too. in Australia its pretty common to just tell the pharmacist 'give me the cheapest one' and they can do so.
@@bronwynhl They can do that here in the US as long as the doctor doesn't specifically write the prescription "dispense as written" - which most don't unless there's a good reason. And a good pharmacist doesn't even have to be asked, you get the cheapest generic.
That said, I've used DAW prescriptions to my advantage before, DAW + a copay discount card can burn through your out of pocket maximum REALLY quickly without you having to actually pay out of pocket. I know, not an issue in Australia, but healthcare is stupidly expensive here.
Inpatient pharmacist here. You absolutely nailed it. The phone never stops ringing. It's not an exaggeration.
Retired outpatient pharmacist here -- same thing in that setting. To this day, I still won't answer our land line when it rings.
@@Soprano91396 I’m honestly happy no other place I’ve worked at but CVS has decided the phone needs to announce “ X Pharmacy calls “ every couple rings 😭
We have about 6 nurses who call CONSTANTLY and when their vocera shows up on caller ID, we all grimace before we paste on our customer service voice and answer. My least favorite is when nursing gives patient's family members our number...
@@gooseazul Nurses call the pharmacist?
@@trailrider7046 Depending on the state or locality, many nurses have prescribing authority.
Vanc line and sad trombone pharmacy emergency warning. These are genuinely needed in any modern hospital…love it ! 🤣😎
Vanc line.... omg I'm dying, thanks for that unintended (?) pun, it cheered me up!
Have never had a good day when Ortho took a wild swing at warfarin dosing…
@@withakay5371 what's a little bleed out? Lol
As someone who is allergic to Vancomycin, I fully support the existence of that phone line. XD
I’m a hospitalist who worked in internal medicine for quite some time. I actually said “OH GOD” out loud when I heard it was ortho managing the warfarin. 😂
Sorry, I'm not medical anything but that typo just seemed perfect
Naturally Jonathan would do a perfect med rec. He is the perfect medical practitioner.
for a sec I wasn't sure but then that creepy smile...yeah it's Jonathan.
I think I have a Glaucomflecken problem by the fact that I instantly recognized that look and knew who the character was...
But he doesn't! He does them /most/ correctly. Shocking to see such a humanization of Jonathan's character.
Any paperwork Jonathan is 30 years experienced in and will get it done
*nod!*
Honestly thought this would end up with Bill calling the pharmacist, while still being in front of him.
That would too have been a good punchline
That would've been a good twist ending!
So what I'm getting from this is that "check the tube station" for pharmacists is basically "try turning it off and on again" for IT people.
We need to tell them that too with the pyxis machines.
You would not believe how often the pharmacy gets called about a med and it turns out it's just sitting in the tube. Once in a while you go down there yourself to get it out of the tube for them haha
@@SBRS47 once in awhile? How about several times a day ;)
Or "check the fridge again"
OMG I get it - I kept picturing the pharmacists at a train station 🤦🏼♀️
I love that Jonathan is getting the recognition he deserves for his excellent care and service. Also, he was the employee of the year before and after 2022. Meaning the Pharmacist just made his job easier by putting pictures up in advance. He knows no one will ever beat Jonathan!
Ha, I didn't notice he already had Jonathan's picture up for the future year until I saw your comment. Hilarious. Thank you.
Tfw ortho started to mess with a patient's anticoagulants together with IV fluids because he once again used up all of his "admit to IM" card punches.
Tfw you're in too deep in the Dr. G universe that you immediately understand and love this comment 🤣 Ortho Bro just wants to fix the bones!
😂and omg it's Jonathan!
Lmao
Are you THE Jonathan...or just one of them?!
I'm in tears, he nailed it! This skit deserves an award for authenticity. Hospital pharmacist-approved!
Hello 🖐️ friend
How to prescribe medication in a hospital: You throw various prescription orders at the pharmacy and see what sticks.
😂😂😂
As a hospital pharmacist I think of Jerry McGuire when I see crazy orders "Help me, Help you?". I will give the doctor most things they want but it needs to make sense.
We can decipher a lot but you would be surprised how often orders come through that make no sense what so ever. I had a doctor order Aspirin rectally every 4hours scheduled, when I asked him he blames Epic and said he basically just punched at the keys. 😂
As a pharmacist, I see you and I thank you.
I love that Jonathan’s photo is already there for next year too
Hahahaha thanks, I didn't catch that! 😅 😂 🤣
“I just randomly pick up the phone every few minutes. There’s always someone to talk to.” 🤣
As an RN I am so thankful for the pharmacists that correct med errors that the doctors make. We are a team.
Thank you, as a pharmacy technician, I think you may be one of the only nurses that don't blame pharmacy for when you can't immediately find you neds! You are right, we are all on the same team!!! 👏👏👏
@@scgirl9310 nah
Every nurse I know and myself too love pharmacy
We’re short sometimes I think because by the time we’re talking to you we’ve been dealing with an issue for a while and it’s holding us back from doing our other work.
Hospital pharmacist here: It’s true, all of it and more. We’ve finally semi-beaten the current crop of residents into submission, just in time for another batch to show up and make all the classic errors 😂
Thank God for the Pharmacy! I was dog tired after an night of call, eight admissions, and, since it was a weekend, I had to write the hyper-al orders for the patients on my service before I could hand off. I had about ten orders to write and was rushed because they HAD to be in the pharmacy before 1:00 PM.
I had just finished and was wrapping up to go home when the Pharmacy called. Damn it!
“Hey, Wayne, Pharmacy. Did you mean to write for one unit of Norcuron per cc on the HAL for pt, ____?”
“What? No, of course not. The patient is on the floor and unintubated. I did want a unit of heparin per cc in the solution, though.”
“Thought so, but I wanted to let you know. I’ll make the changes”
Holy crap! Saved my patient’s life and my career, all in one phone call!
For the non-medical: 1) Norcuron is a paralytic agent that will make the patient stop breathing. 2) Norcuron isn’t measured in units.
Thank Heavens the Pharmacy caught it.
@@Joy21090 Amen to that!
Thought you were going to say you thought you ordered a once now for when you intubated the patient and accidently ordered it scheduled.
bro the phone thing is giving me PTSD flashbacks to working in pharmacy 🙃
haha it's a nightmare...6 phone lines for 4 employees...yea that will work
100% accurate. One time I had to call a doc who meant to order Thorazine (brand name for an anti-nausea/vomiting med), but instead ordered thioridazine (used exclusively for schizophrenia).
Dr. G out here being a great advocate for hospital pharmacists.
Confused. Thorazine is an antipsychotic. Never heard of it used for nausea.
Actually, Thorazine is the psych med. Doc had it right
Most antipsychotics do help against nausea though. Maybe the patient was just too talkative? :P
Thorazine is brand name chlorpromazine, a typical (first gen) antipsychotic. It's primarily used as a sedative antipsychotic that also has potent antiemetic effects.
Thioridazine is also a typical antipsychotic.
@@lindseybrown1683 probably not. They’re both “psych meds”, but some like Thorazine and Compazine are often used for big time nausea/vomiting. Whereas thioridazine is effectively used exclusively for psychiatric indications.
As a retired hospital pharmacist I can say that this is all true and just the tip of the iceberg. Good Job!
I like that Jonathon is preemptively the winner of the 2023 Perfect Med Rec award.
WE NEED MELATONIN STAT!!
-pushes patient into the sunshine-
Hospital pharmacist for 30 years! Thank you for the perfect parody!!😂❤
I'm a pharmacist and every time I watch your videos I keep thinking that it would be nice to have a vid about hospital pharmacy. Thank you so much and this is accurate!
Have you seen his previous vid "Bill orders Antibiotics." If you haven't, check it out! My Dad's a Pharmacist and he loved it!
Hi Big Fan from Thailand, This is my first time to watch your video before it hit 10,000 views. As a former hospital pharmacist, now studying medicine, I laugh out loud. LITERALLY. Your mocking skill about our routine jobs is ANOTHER level. It is so real, especially the pharmacist-to-dose things. Great job as always sir. !!
Good luck with your studies x
@@janefrost1856 Thank you :)
That is impressive to study to be a pharm then switch to med. Good for you!
@@ConstantineIII Thank ! To be honest, it's not a bed of roses. The only thing I know is meds LOL. I need to re-learn almost everything about human body.
I know your hard work will pay off and you will be successful in your endeavors. I wish you all the best!
As a hospital pharmacist this was hilarious to watch but also so true. I wish more people understood what we do, most still think pharmacists just "count pills".
I joke that 90% of my job is keeping doctors from making mistakes that will hurt patients but honestly it's true. It's kinda like doctors are writing a book and we pharmacist are the editors who come through and make sure the book makes sense.
Welp, my step mom was taking some rheumatoid arthritis drug Xeljanz. Had a stroke. Still kept her on it. Had kidney failure. Getting dialysis. They were still giving to to her up until I arrived (retired nurse) and demanded it get d/c'd. It eventually killed her.
All she had to do was stop eating nightshades.
The last 3 months of her life, i didnt feed her nightshades and all she needed for pain was tylenol.
The medical field is useless sometimes.
@@itsokaytobeclownpilled5937 I'm so sorry for that. I don't know what xeljanz is but it sounds like it's hard on the kidneys.
@@CynthiasTikka It is for rheumatoid arthritis.
I’m a nurse and I don’t think anyone thinks lowly of pharmacists. I see you guys as a valuable resource in pt care and I appreciate you all!!
@@itsokaytobeclownpilled5937 She is lucky she had you there to advocate for her.
Dr. Bill, I wish we could give our full attention to you but... phones. We appreciate the visit.
Trying to answer all the phones, multi-tasking, trying to track down where x went. Resending a third of the meds we filled...
Did you check the tube? The fridge? Bottom of the tube station? Underneath the pile? Med room?
"I'm not trying to do your job for you, but you did write "pharmacy to dose on the order."
I'm crying. All of this is so accurate it hurts.🤣
This is why you all get put on hold.
I've added onto my spiel to these mostly travel RNs that plague my hospital, "have you checked in with every single one of your coworkers on the floor to confirm that they may have taken it from the tube station and not told you?" It works magic because they seem so afraid to ask.
@Jagaroth They very well could be. I've met travel nurses who have met nothing but contempt from other nurses from places they went. Or just weren't helpful.
So I always made it a point to introduce myself. It's nice to have at least one friendly face.
I am a pharmacist, and feel...seen. Thank you Bill, for sharing your experience.
Knowing the many questions our antimicrobial stewardship pharmacist has to negotiate every day, plus the ones I pose to the rest of our amazing PharnDs, this brings me pure joy.
As a hospital pharmacist, this is so real (I got twitchy just hearing the phone ring). It's killing me a little bit that he never heard or answered Bill's question though - now he has to make a note and come back to it later.
I didn’t know the pharmacist had so much in his hands! Kudos to him!
as a nurse, the pharmacist does even more than what they show here. Here they just showed dealings with the doctor but I often have my own stuff they need to help me with. Kings and Queens I tell you
Yep and that doesn't include making IV meds, Chemo meds, and checking all orders to be loaded into the pyxis machines. Oh and medication timing! So much of our job is involved in medication timing. So often the doctor just enters the medication in and we have to call the nurse to double check when the last dose was given and is timed appropriately.
I really appreciate nurses so much. Especially when they call us to run things by before they talk to the doctor. I don't know how many times I have had nurses say they felt more comfortable calling a doctor after talking to pharmacy. Basically they feel like they can say they are concerned about something and they have already talked to pharmacy. All of a sudden they have more power in what they say since we backed up their concerns. I thank the nurses every time because honestly nurses catch so many problems.
Pharmacists, thank you. They perform a complicated and vital job that often goes unnoticed.
I'm a hospital pharmacist. I feel seen. 😂
Hysterical... especially the last scenario! I ran an anticoagulation clinic for years and managed warfarin for lots of surgeons during the perioperative period. Like Ortho Bro they just wanted to operate and were happy to let me watch the bleeding and clotting risks. Actually, I really enjoyed our interactions and felt privileged to be part of the team.
I'm a pharmacist at the hospital and they played this video to start off one of my meetings today 🤣
Wow that was quick
@@DGlaucomflecken it's how they lightened the mood to tell us we aren't getting raises 🤣. Not even joking
You have outdone yourself Doc! I was laughing hysterically at the Vancomycin bit 🤣🤣 I am so grateful for all the pharmacists managing Vanco troughs, and INRs behind the scenes! Signed, a PGY12
A PGY12? O,O That's a lot of extra years. ;)
Dr. G doesn't punch down; a ton of jokes and not one made fun of hospital pharmacists as the butt of the joke. True class.
I find he's really impressive about that, the jokes never seem to be at the patient's expense either. I totally get medical professionals need to blow off steam complaining about patients to each other, but when you share it with the world it can make people who really should come in even more scared.
As a former hospital pharmacist now outpatient clinic pharmacist, everything about this is spot on. The phone never stops ringing, and every few minutes there's always an intervention that needs doing. To the point where, as a low social energy person I want zero human interaction after clocking out from work.
I love how you captured the genuine niceness of all pharmacists..despite how much we doctors keep calling them to save our butts 😂
The ortho warfarin thing gives me deja vu. When I was a junior resident rotating through ortho I asked the boss what to do about the warfarin for his preop patient and he was like I don't know why don't you ask someone smarter than me who know. The trainee said try haematology... patient had a mech valve 😂
They said "I don't know" instead of messing with things randomly? 😲👏👏
🤣🤣🤣🤣🤣🤣🤣🤣😭🤣🤣🤣
Lol!! After working 10+ years as a hospital pharmacist- that summarizes my 10 years except most of what I deal with is chemotherapy! Good job!
I was waiting for Bill to pull out his cell and call the Pharmacist while he was standing there. 🤣😂🤣. It’s what I would have done 😉
hahahhaa this is genius. please incorporate more sad trombone sounds/sound bytes. just wanted to say thank you to all hospital pharmacists out there. you are truly appreciated and i always seem to learn more from you than any other hospital staff. we have vancomycin per pharmacy order set because of all the shenanigans that we have to go through lol
I'm about to cry laughing. My parents were both pharmacy managers and I spent my childhood hanging out in the floor of the pharmacy reading pill bottles. The perfect smooth "Pharmacy" with the smile is uncanny. The exact movement and facial expressions my parents made 🥰🤣🤣
Thank you pharmacists!!! You have saved my license so many times
I audit medical records for preventive care and one of the things we look for is proper medication reconciliation after a hospitalization. It's sadly true how many of these are done poorly and it is often due to multiple providers not sharing one record or a non-prescribing care giver (like an RN, LPN, or MA) doing the med rec without the doctor signing off that they checked it, too. In most industries, it's best to have someone double checking your work. We're only human. Thank you to the pharmacists and their software that make it clear and easy to see when a med rec was completed!
As a pharmacist working in retail. The amount of calls we get is spot on.
I feel like a perfect addition would have had the picture of Jonathan suddenly nod and Bill jumping in fright.
I work in a tier 4 retail pharmacy, but the phone comments hit deep 🤣 I really do just start answering the phone at random intervals to get out of other things lol
I'm a hospital pharmacist, and this describes my day accurately
As a hospital pharmacist I appreciate the truth about all of this! Thank you for highlighting us!!
I watch my pharmacist when I pick up a prescription. The phone has about a 20' cord on it so he can walk to every station in the pharmacy. He continues talking as he gathers meds to fill prescriptions.
I'm starting to think the phone is actually attached to his ear. ☎️🤕
I used to work at a call center and obviously spent the entire day on the phone!🗣️ By the end of the day we would have 'cauliflower ear'!
The pharmacist is the unsung hero and saves lives every day! They're the best source for information about any meds!💊 ⚖️
Who else in medicine can talk on the phone, carry on a conversation with the assistant and quote instructions to a customer all at the same time?!? 🤓
Oh my god I was just contemplating whether I should discontinue vancomycine for my patient 🤣🤣🤣 this made me laugh so hard
This is still true even as an outpatient pharmacist working in a hospital.
OMG the Vancomycin Phone! The hospital pharmacist was the absolute BEST when Infectious Disease ordered a continuation of vancomycin because they "couldn't be sure it was the vancomycin" that caused the adverse reaction after surgery. Bug Bro got his second dose, but the hospital pharmacist made sure that the nurses knew an allergic reaction was coming so they could prepare accordingly.
Love the pharmacy ones! “Did you mean to order hydralazine for itching?” I’m surprised they didn’t have a heparin drip “pharmacy to dose” order 😂
heparin protocols are a thing, we managed heparin
@@nooneyouknow4829 Yes, I know that. Thank you. Back when I started as a nurse, during the paper charting days and no EPIC, docs wrote orders on paper and “pharmacy to dose” or manage was commonplace. I do appreciate you trying to correct me though ☺️
BAHAHAHAHAHA! Pharmacist here! Truer words were never spoken!! I’m retired now but a ringing phone is definitely a trigger for me to this day! Text me FFS!! 😂😂😂😂
I can imagine the convo with ortho started like this…
Ortho: What up, drug bro?
Ngl as soon as I saw Bill I was like awwww hun, like automatically 😂 also who else is not surprised that Johnathan was the one who won that award 😅
I'm pretty sure Jonathan has won all the awards for best whatever throughout the hospital, lol
absolutely love our pharmacists, nicest people, wealth of knowledge, even when i was a baby intern.
And 80% of phone calls are nurses asking for their meds, but most often it's either in the tube station or already available in the pyxis :)
Not totally true - I’m an RN and can tell you that AT LEAST 75% of the time when I call the pharmacist suddenly “finds” the dose they”already sent” OR seconds after I call the tube containing my missing dose suddenly drops into the station…LOL
@@cynthiayarger9757 I guess our experiences vary based off the hospital. Where I work, there is a high turnover for nurses. A lot of nurses here neglect to check patient specific, most don't know how to recover storage for pyxis, a lot of them don't even bother to check the tube station before calling, and most don't even check the medication fridge for refrigerated patient specific meds.
But even then, the same nurses who did stick around don't seem to learn much from our responses to them...
The creams and ointments one got me hahahaha
7 years pharmacy.... Its all so very true! Loved it.
As someone who used to work at a stool bank, I'm glad there's someone to tell doctors to stop prescribing Vancomycin. Uuuugh the horror stories...
And also my grandmother, may she rest in peace, thanks you for the Warfarin emergency alarm.
You used to work at a stool bank? Good lord. What was your position? I can only imagine the horror stories…
Umm . . . stool bank?
As someone who is allergic to Vancomycin, I fully support the existence of that phone line. XD
@@RachelleBeyer I was in admin but it was a very small organization at the time so I saw a lot of what they were up to in the lab.
@@nancylindsay4255 FMT baby, at the time you couldn't get it until you'd undergone a few rounds of vancomycin. And after the vancomycin hasn't worked for a few rounds you're in really rough shape.
I'm a pediatrician who is always asking question to a pharmacist about medical dosage, taste of the medicine, and so on. I really appreciate it!!! From Japan
Thanks for saving a life, pharmacy.
Of course Jon bro does it perfectly.
Also, poor Bill gets no respect. :(
You made another great one, Doc! Keep it up!
Just brought the pharmacy at our ICU a box of cherries … we Intensivists appreciate you.
Technician here and you have nailed for sure. Would love to see your take on Pharmacy technicians….. the real unsung hero’s
Omgosh! As a hospital pharmacist, I can verify this is entirely accurate, down to the stat melatonin 😂 I literally lol'd
Don't forget the phone calls 30 seconds after the order is placed for X, Y, and Z, that you are in the middle of verifying but have to pick up the phone from said RN calling about said order like you aren't chained to you computer trying to prevent the phone from ringing!
"Ok, I’ll make the change" - very familiar words 😂
This is gold. I have heard stories from my pharmacist sister-in-law (works at a hospital, maybe moved up the chain just enough to deal with other headaches). The warfarin bit also was priceless. I know enough about it from my dad being on it, but he is also a doctor and heard a story that makes me think it applies to ALL surgeons. (In short, he knew of someone who needed a surgery through a mutual friend, and the surgery team was wise enough not to operate with him on it, but did not realize that the chances of a clot forming from not taking it for a few days are small and in his case, worth the risk.)
Bill should have taken the opportunity to take a nap while Pharmacy was on the phone.
Retired community pharmacist but was on a Medical Center campus. There were many times I had two phones in my hands juggling Drs and insurance companies. As others waited on hold , the walk in customers would be staring at me with a death glare because I was just “chatting on the phone” instead of doing my job. 🙄
I worked in an automotive dealership service department many years ago and still have 'ringing phone ptsd' and remember the baffled looks of customers being greeted by me with a phone to each ear. Argh.
I wanna know what Bill's question was! Don't leave me on a cliffhanger like this!
😂😂😂 So true ! This pharmacist applauds you and gives you a standing “O” !
Visceral pain at watching this as a crit care pharmacist. It's perfect, 10/10 please do more.
Hospital pharmacist here. I can't believe how well you've covered all the bases in this sketch, this is amazing!
Same in blood bank. We don't have our platelets! "Did you check the tube station?" haha.
Working in pharmacy this is true there’s always someone to talk to! I used to do med Recs specifically all day and redoing the residents med recs was always a challenge. Thank you for including pharmacy I love it!
As an ex hospital pharmacist and now a doctor (yes, I turned to the dark side!!) I just love this 😂
10000% accurate as a hospital pharmacist. Those nonstop phone calls literally made me experience a short bout of PTSD just now. Did you get your examples from my pharmacy by chance?
I’m a pharmacy tech and the “did you check the tube station” was so true 🤣
The only pharmacist emergency 😂😂😂 Well, if a neurologist tries to deal with Warfarin - almost the same.
Just in time after shift for some good ol Dr. Glaucomflecken
What a coincidence! I'm currently on break!
I recognize you from some damn funny comments... hope your time off is excellent 👍
@@suzbone Awww shucks! Thank you. I'm on break once more!
Never let Ortho manage anything, except maybe Ancef.
I love this channel. It's all the same guy but somehow all characters are different and recognizable with seemingly no effort
ohhhh the jonathan cameo made my lil heart sing. while simultaneously it was breaking for all the hyperextended pharmacists out there.
My favorite part if these videos used to be other than the impressive world building of the Glauckomverse is looking at the comments and seeing "I am x kind of doctor. This is completely accurate"
I’m not trying to tell you how to do your job, but you did literally ask me to do your job 😂