Monday, January 14, 2008

Another Stupid Question

(Phone Rings)

Me: Hi, __________ Pharmacy. How can I help you?

lady: Can I speak to a pharmacist?

Me: I'm a pharmacist, can I help you?

lady: I'm trying to become an LPN, and I just had a pharmacology test, and I was wondering if you could help me with one of the questions I couldn't answer.

Me: (Thinking that this might actually be interesting) Sure. What was the question?

lady: (Reading the question) The order is for Synthroid 150 micrograms once daily. The only dose available is Synthroid 0.05 milligrams. How many tablets do you have to give to complete the order?

Me: (Trying to educate) You see, there are 1,000 micrograms in 1 milligram. Therefore, 150mcg would equal 0.15 milligrams.

lady: (complete silence for a few seconds)... So, what's the answer? I couldn't even guess on it. I just left it blank and moved on.

Me: 3. The answer is 3 tablets.

lady: Thank you! (hangs up)

Wow... The funniest thing of all is that she felt that ONLY a pharmacist would know the answer to this question. Hell, she probably could have found some random 12 year old that could have figured that one out. Moreover, she distinctly stated that this question was on a pharmacology exam. Apparently, pharmacology for aspiring LPNs is idiot's math with a drug name thrown in.


The Ole' Apothecary said...

It's like a learner's permit test, or, to get close to home, it's like you and me getting through one of those appetizing continuing-education question sets in Drug Topics so we can renew our licenses.

On the other hand, nurses call me to check their math when they have to administer a dose of medication. I always respond cheefully and cooperatively, because this is serious business.The calculation may be simple, but there is no recalling an I.V. push. When in a hurry, we like to double check our calculations. Many a simple but profound error has been made in haste.

At my hospital, as in many hospitals, all chemotherapy orders MUST be checked by TWO pharmacists, as does the preparation of each chemotherapy dose.

There is one issue,though, that always enters in here: the metric system and decimal measurement, particularly with Synthroid doses. We can read "$0.05" right from the page as five cents, but we in the U.S. have not yet been trained to read "0.05 mg" literally as 50 micrograms. Even so, there is a rule, called the "rule of 1000," that requires quantities less than 1000 subunits to be written as such, and not as decimal submultiples of a larger unit. Synthroid dosing is the perfect example of this in pharmacy. Digoxin is another. In fact, many digoxin tablet products are labeled in hundreds of micrograms instead of tenths of milligrams.

Finally, be GLAD they see you as the high priest of calculations! We want our healthcare colleagues to rely on us for "unique services." That they haven't figured out that others can do this is fine with me. Also, consider that calling the pharmacist is a convenient choice, even a logical one. Sure, anybody with mathematical ability can reckon the right number of micrograms, but we're used to doing it, and it IS a drug question, however hokey it may sound.

Yes,OK, I admit, I often take the humor out of these blogs with my serious approach, but you guys often beg serious questions. Sorry about that (grin).

Pharmacy Mike said...

Not that I wasn't happy to answer the question...

I guess the thing that got me is that she had no interest in learning how I arrived at the correct answer. She just wanted the answer.

Intern Jason said...

I've had nurses from doctor offices call me and yell at me for giving the wrong generic statin before. I check the prescription and say you called in lovastatin right. Nurse says yes thats right so why didn't you give the generic simvastatin. I had to fight from laughing. I say now they are both generics and simvastatin in generic zocor and lovastatin is generic mevacor. Well she didn't believe me b/c i'm not a pharmacist yet (in my 4th year) so I hand the phone to my pharmacist to says the exact same thing and hangs up.

Un-PC RPh said...

Oh man.. I am even more afraid to go to the doctor or hospital now... and I am a pharmacist, what about the poor fella who cannot even read his script to make sure its what he was supposed to get?

Ariadne said...

I've worked with LPN's. Smart ones are the exception, rather than the rule. Most LPN's are nothing more than glorified ass-wipers who dole out meds in nursing homes. Yeah, I'm prolly going to upset some LPN's with that last statement, but you know what? If they were smart they'd be RN's if not more.
So, I think I just proved my point.