A 16-year-old girl came in with her mother with a hand written prescription today for pain killers. She said that they both could not read and to show them where to sign, which I did.
The daughter handed me her prescription from the A&E department of a hospital for "diclofenac 75mg three times a day" and "tramadol 200mg twice a day"; neither had a quantity specified. The diclofenac also did not state whether it was modified release, which you would normally expect for that strength.
Knowing that it was above the licenced 150mg max daily dosage, I questioned the prescription dose but the girl immediately became hostile. I mentioned that due to the dose being as high as it was, I would need to check it with the prescriber for confirmation. The girl started to create a scene shouting that I was wrongfully withholding her medication when she was in great pain (which she showed absolutely no signs of).
Her mother did not seem to understand nor care that I was looking out for her daughter's safety either and went and sat in the car. We tried calling the hospital A&E department and were told that a doctor would call back shortly. I again tried to explain the situation to the girl who remained in the pharmacy but she didn't seem to care for what I was saying.
Since the pharmacy was a little busy with waiting patients, I did not like the situation, as her loud accusations of "you're being difficult", "you are not listening to what the doctor has asked" etc may reflect badly on me, despite my good intentions.
After 10 minutes of waiting for a doctor to call back, she began to make more of a scene. It came to a point where I wished I wasn't a pharmacist so that I could have just told her to get lost.
She said that due to waiting so long she would take the prescription elsewhere so I gratefully tried to hand it back to her, but upon trying to give it back she changed her mind and claimed that she would wait in the pharmacy for however long it took until I gave her what was on the prescription.
I had little faith that someone from the A&E department would actually call me back so it put me in a predicament. Out of curiosity can we even return a script to somebody in such an instance creating a scene in the pharmacy, when they're not physically affecting things and ask them to go elsewhere?
Thankfully the patients that remained in the pharmacy were regulars and could see I was trying my best to help but was getting nowhere. Had they been new patients, I may have been under further pressure to issue what was on the prescription as demanded by the patient.
Thankfully a senior doctor in the A&E department did call back shortly after. He confirmed that the patient had attended the hospital A&E department the previous day but had no record of that dose being prescribed. He asked me to reduce the doses on both, only supply seven days worth and asked me to fax the prescription back to him.
It would have been far too easy to have given in and dispensed what was on the prescription in a situation like this where the patient refuses to leave while causing upset amongst all other patients waiting, but for their sake and your own, definitely check any scripts that you have any doubt about. I know I'll be even more vigilant from now, especially with any handwritten prescriptions.
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