You know what they forget to mention in the 4 years of pharmacy school. That you should always have 911 on speed dial.
I was acutely reminded of this about a week ago when I was working at a nice quiet suburban outlet of McDruggies. Right around 5 in the afternoon I had a young man come in wanting a refill on his ventolin. Of course he'd never been to this particular store, but no big deal...I'll just call his regular pharmacy and get his prescription transferred out. So I call them up and they tell me he doesn't have any refills and that they told him this when he contacted them earlier.
So I go back to him with this info and he completely flips out. Just right off the handle ballistic. (FYI to the non-pharmacists that might be reading this - Hi mom - there's a fair bit of "professional judgment" allowed in the practice of pharmacy, but how much of it a particular pharmacist is willing to use can often depend on your attitude). Since he's being a complete asshole right from the word go, I decide to do this one completely by the book.
In Alberta every pharmacist has been given a limited form of prescribing authority. Basically, we can add a refill to a prescription for an existing patient to give them time to get to their regular doctor. Or we can extend an emergency fill of a regular med to any patient if they can't get to any doctor, are in urgent need, and we can reasonably determine what drug/dose, etc they were taking.
Buddy-boy didn't qualify for part 1, since he wasn't my patient. (There's a little contingency note on that one that allows any pharmacy to do it for people if it would be unreasonably difficult for them to get to their regular pharmacy for that same service.....but the fact that it was 5pm and he had a car and his regular pharmacy is open until midnight and only 20mins away made me read that as a "no" as well)
Part B didn't apply because there is a walk-in clinic right across the street from the store, that is open until 9pm and since he was able to rant, rave and generally make a fool of himself, he obviously wasn't in acute respiratory distress.
Once he stopped ranting enough for me to bother, I presented him with his options, basically...
A) Go back to town and beg at your regular pharmacy
B) Go to the doctor across the road and get a new Rx.
This set him off on another rant. Apparently neither of those options would work for him because he was on his way out of town and he didn't have time to do either of those.
He then presented me with the only options that he deemed available.
1) I give him his damn medication or he was going to have to kick my ass
2) I don't give him his medication and he was going to have an asthma attach and die and then he was going to sue me and kick my ass.
I, of course made him a counter-offer.
1a) I give him his damn medication....but he'd better get his ass in gear cause I'm calling the police and chalking it up as a robbery....oh and by the way, you already gave me your name, address and phone number.
2a) I don't give him his medication, and I take my chances with the ass kicking/lawsuit because I'm calling the cops anyway.
He ended up going with number 2.
I was actually a little disappointed. I've offered "1a" to a couple ornery fucks over the years....and for some reason, visions of having a cellmate named "Bubba" seems to do wonders for their anger management skills.
(PS = Actually offering an angry patient a referral to an anger management counselor generally has the exact opposite effect, but when done correctly can be funny as fuck).
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