One of Those Days

A patient of mine was just discharged from a nursing home. Her daughter asked that I contact her doctor for new prescriptions of what she had been taking now that she is home. One of the prescriptions she was on in the nursing home was lisinopril 20mg. Prior to the nursing home, she had been taking Altace 10mg.

I requested new prescriptions for her latest medications - thus, lisinopril instead of Altace. The nurse called me back today, annoyed.

Nurse: “Doesn’t she have refills on her old prescription for Altace on file?”

pharmacy girl: “Why yes, she does. But since she has been taking lisinopril in the nursing home and her daughter said it had been working just fine, I thought we would save her insurance company more than $50 a month and use the lisinopril instead of Altace.”

Nurse: “Well, the doctor wants Altace.”

pharmacy girl: “Are you aware that the lisinopril would cost her insurance about $5 and the Altace costs her insurance about $65? They are in the same family of medications: they are both ACE inhibitors, and work the exact same way. Altace is the only ACE inhibitor that is still available as the brand name only.”

Nurse: “Fill the Altace.”

pharmacy girl: “Fine.”

Click

Sometimes I don’t know why I even try.

Another lovely incident today: We sent a new prescription request for amoxicillin for a patient. The prescription was supposed to be called in yesterday, but it wasn’t. So I sent a nice little fax to the office. The fax is a fill-in-the-blank sort of operation, not too tricky.

For example:

Patient ________________________
DOB __________________________
Drug: Amoxicillin ______________mg
Sig ____________________________
Quantity _______________________
Signature ______________________

They filled it in and faxed it back right away, bless their hearts. They even managed to include a quantity. The nurse practitioner or whatever signed her name twice, though. Once in the place for “sig” and once in the place for “signature.”

Honest mistake, we thought. We faxed it back and wrote “Need sig, please” in magic marker on top of the fax. The office faxed it right back, only having circled her signature on the line that reads “sig.”

For a lay person, this might be confusing. But I have to assume that a nurse practioner has been a nurse before the practioner part.

And should know her medical shorthand.

“sig” is an abbreviation for “signa”, which in Latin means “write on label.”

I think I learned that one my very first day working in a pharmacy.