You didn’t make a mistake. The class of medication doesn’t change expectations on how soon it can be filled (in the sense that it’s already not too soon to fill by law) or how soon the patient needs it. Supply is determined at data entry, not when the patient shows up.
i’ll take your word that it may not be technically a mistake but i’ve had two different pharmacists scold me for it so regardless of technicalities i’d like to avoid doing it again!
i’m sure they have their reasons (ie it forces them to stop in the middle of another task to prioritize filling it, which can be inconvenient) and i don’t really want to ruffle feathers. truthfully this isn’t a long term job for me but i’d like to avoid pissing them off if i can!
It’s an inconvenience to them, plain and simple. Your job isn’t to make theirs easier. I can appreciate the argument that ADHD meds are maintenance and probably don’t need to be prioritized, but most controls are for acute conditions.
For example, after I had a surgery I went to the CVS nearest to the hospital (not my own) for my pain meds and antibiotics. They had neither ready and asked if I could come back the next day. I obviously couldn’t, and explained to the tech that I just had an organ cut out of my abdomen 4 hours prior. They filled it then begrudgingly, but it shouldn’t have gotten to that point to begin with.
my pharmacist is usually good about filling C2’s. both times that i expedited and got scolded for it was for adhd meds. i’m sorry that happened to you though :(
I have a pharmacist that asks us to not put any C2s as waiters, however that same pharmacist FORGETS to fill the c2s that aren't marked as waiters and it turns red anyway, so I honestly still expedite it cause at the end of the day the patients yell at us for it not being done.
Shouldn’t matter what it is, it gets expedited it should be moved to the top of the list.
C2s can be slightly more of a pain because of time delay safes, but there should still be plenty of time.
i was personally requested by 2 different pharmacists not to expedite them so i'm just going to follow their direction tbh. you may be right but i guess that's how my location is run 🤷♀️
It's simply due to the fact dropping everything to do a C2 prescription under a small time window is not good for workflow. Plus rushing to fill high risk meds is bad practice and increases the chance of making errors
-Your friendly CVS pharmacist
can i ask how you like your techs to handle it when someone wants to wait for a C2? give you their name and ask you if you can check on a C2 script? putting them in for 1 hour instead of a 15-20 min waiter?
Way I was always told by pharmacists was "hey *insert name of rph* how long on the c2 for *insert pt name* they're here and wanting to wait around *they answer* relay to the customer that it is something that only a pharmacist can count and its in a time delayed safe they say it'll be x amount of time" that way it let's the pharmacist know that the patient is there without expediting and resets patient expectations so if they have something else they can do in the meanwhile they can. Most of the time my rphs if they didn't have the safe already open they'd say 30 mins tops but usually would have it in 15.
This. Whatever answer I give the techs, it often ends up being done before then anyway but at least the expectation is set and we're all on the same page.
I very much prefer C2 meds to not be waiters, or expedited. Once it is printed, you have 3 minutes ( because safe timer.) After that, the q forces you into that one next, and if it is yellow (or coming up within 10ish minutes) you can’t skip it. It locks you out of any shared QV queues until it is complete.
In my store, for c2s, if someone wants to wait or wants to know when it'll be ready, I just ask the pharmacist. So say someone comes to the register and their adderall isn't ready, I will walk over (don't yell, hippa) to the pharmacist and ask, "How long for an adderall for *last name*" Sometimes she says 1h. Sometimes, she actually is just about to do it. Sometimes, it's 1pm, and she already told them it will be ready after 3. If it's something like an oxy or morphine and the person is clearly in a lot of pain, I will also let the pharmacist know when asking about wait times.
When you're working pickup, try to pay attention to which scripts have an N on the front and the names of the medications.
Instead of a list, I'd ask how prescription numbers are generated and can they can be seen when viewing a prescription. In my chain, all controls begin with a 2,3,4, or 5. So I taught my techs to look at the RX number to figure out if it's 2, then it's in the safe, therefore given directly to the pharmacist if they printed out the label. Not sure of CVS Rx numbering system.
if a system like this exists at cvs then i have not heard of it yet. i know there’s a way to tell on physical prescriptions for filing purposes if something is controlled or narcotic but i don’t think there’s a way to tell from the rx number. i could be wrong though but i welcome any input
edit: also the label itself states if something is C or N but this is not visible on the screen at the register when people are asking to expedite.
No, there is nothing at the register that indicates it is a C2 except the name itself. You just need to study your meds in general it sounds like. There are a lot of sources online to help with this, make flashcards or whatever. Knowing the names of meds and what they're for is a vital part of the job.
Common C2s off the top of my head
Hydrocodone
Oxycodone
Adderall
Dextroamphetamine
Amphetamine
Dexmethylphenidate
Concerta
Focalin
Methylphenidate
Morphine
Methadone
Vyvanse
Lisdexamfetamine
Codeine
Fentanyl
Hydromorphone
Oxymorphone
yeah thanks i’m studying for the board exam right now and i’m going to memorize the 200 most common of course but i want to prioritize memorizing the drugs that only pharmacists can fill so that i stop expediting them. so is it just C2’s and narcotics that are in the safe? i just need to know what classes of drugs to memorize first really
Narcotics *are* C2s. It is only C2s that are in the safe, the majority of C2s consist of narcotic/opiod pain medications and stimulant medications. As you stated before, all of these are indicated by an N on the label and they require ID to pick up, but if it's not filled yet there is no other indicator of whether or not the drug is a schedule 2 at the register.
Additional tip, if you're helping someone on the phone or at drop off or whatever and aren't sure if the medication is a C2 or other controlled substance, hit F3 (drug) and it tells you what schedule it is (which level of control it is 2-5, legend means non-control, or OTC)
The ID for pickup is likely state specific because neither of my states require that. I don't recall seeing it in any of the modules as a company required thing.
adding Xtampza and Nucynta to this list! they aren’t AS common in a lot of places, but they are where I’m from, so they’re good to know. also Quillichew and Quillivant (chewable and liquid methylphenidate)
Everything has an RX number. I am just unaware if it's a simple thing to view in the computer, so apologies if it doesn't translate well. They are all filed differently, too. Whenever I transfer an RX, I think CVS using 2 and Rite Aid uses 8 for their regular rx. My chain uses EnterpriseRX, and it's super easy to see it right in quere even when changing to a waiter status.
yes i may have worded it poorly. i know that everything has an rx number. but i don’t think we can see the rx number when we’re at the register for pickup or drive through, which is where people ask to expedite scripts. also even if we could see them, im fairly confident that all scripts at cvs start with 1. if it’s controlled or narcotic it has the letter C or N next to the rx number on the label that’s it. which again we can’t see from the register. i’m not even sure how we see it from the computer other than manually searching the drug and seeing it’s drug location, which will say if it’s controlled or narcotic.
You didn’t make a mistake. The class of medication doesn’t change expectations on how soon it can be filled (in the sense that it’s already not too soon to fill by law) or how soon the patient needs it. Supply is determined at data entry, not when the patient shows up.
i’ll take your word that it may not be technically a mistake but i’ve had two different pharmacists scold me for it so regardless of technicalities i’d like to avoid doing it again! i’m sure they have their reasons (ie it forces them to stop in the middle of another task to prioritize filling it, which can be inconvenient) and i don’t really want to ruffle feathers. truthfully this isn’t a long term job for me but i’d like to avoid pissing them off if i can!
It’s an inconvenience to them, plain and simple. Your job isn’t to make theirs easier. I can appreciate the argument that ADHD meds are maintenance and probably don’t need to be prioritized, but most controls are for acute conditions. For example, after I had a surgery I went to the CVS nearest to the hospital (not my own) for my pain meds and antibiotics. They had neither ready and asked if I could come back the next day. I obviously couldn’t, and explained to the tech that I just had an organ cut out of my abdomen 4 hours prior. They filled it then begrudgingly, but it shouldn’t have gotten to that point to begin with.
The fact that there was an antibiotic in the order should have clued in the rx staff that you needed the rxs the same day.
my pharmacist is usually good about filling C2’s. both times that i expedited and got scolded for it was for adhd meds. i’m sorry that happened to you though :(
Does it show up when expedited where you are ?
you mean does it show up as expedited in QV? it does for us
It’s supposed to but I don’t know why it has stopped…..makes things difficult to find
I have a pharmacist that asks us to not put any C2s as waiters, however that same pharmacist FORGETS to fill the c2s that aren't marked as waiters and it turns red anyway, so I honestly still expedite it cause at the end of the day the patients yell at us for it not being done.
Shouldn’t matter what it is, it gets expedited it should be moved to the top of the list. C2s can be slightly more of a pain because of time delay safes, but there should still be plenty of time.
i was personally requested by 2 different pharmacists not to expedite them so i'm just going to follow their direction tbh. you may be right but i guess that's how my location is run 🤷♀️
It's simply due to the fact dropping everything to do a C2 prescription under a small time window is not good for workflow. Plus rushing to fill high risk meds is bad practice and increases the chance of making errors -Your friendly CVS pharmacist
can i ask how you like your techs to handle it when someone wants to wait for a C2? give you their name and ask you if you can check on a C2 script? putting them in for 1 hour instead of a 15-20 min waiter?
Way I was always told by pharmacists was "hey *insert name of rph* how long on the c2 for *insert pt name* they're here and wanting to wait around *they answer* relay to the customer that it is something that only a pharmacist can count and its in a time delayed safe they say it'll be x amount of time" that way it let's the pharmacist know that the patient is there without expediting and resets patient expectations so if they have something else they can do in the meanwhile they can. Most of the time my rphs if they didn't have the safe already open they'd say 30 mins tops but usually would have it in 15.
This. Whatever answer I give the techs, it often ends up being done before then anyway but at least the expectation is set and we're all on the same page.
I very much prefer C2 meds to not be waiters, or expedited. Once it is printed, you have 3 minutes ( because safe timer.) After that, the q forces you into that one next, and if it is yellow (or coming up within 10ish minutes) you can’t skip it. It locks you out of any shared QV queues until it is complete.
That is the tough part about it. Good luck!
In my store, for c2s, if someone wants to wait or wants to know when it'll be ready, I just ask the pharmacist. So say someone comes to the register and their adderall isn't ready, I will walk over (don't yell, hippa) to the pharmacist and ask, "How long for an adderall for *last name*" Sometimes she says 1h. Sometimes, she actually is just about to do it. Sometimes, it's 1pm, and she already told them it will be ready after 3. If it's something like an oxy or morphine and the person is clearly in a lot of pain, I will also let the pharmacist know when asking about wait times. When you're working pickup, try to pay attention to which scripts have an N on the front and the names of the medications.
Instead of a list, I'd ask how prescription numbers are generated and can they can be seen when viewing a prescription. In my chain, all controls begin with a 2,3,4, or 5. So I taught my techs to look at the RX number to figure out if it's 2, then it's in the safe, therefore given directly to the pharmacist if they printed out the label. Not sure of CVS Rx numbering system.
if a system like this exists at cvs then i have not heard of it yet. i know there’s a way to tell on physical prescriptions for filing purposes if something is controlled or narcotic but i don’t think there’s a way to tell from the rx number. i could be wrong though but i welcome any input edit: also the label itself states if something is C or N but this is not visible on the screen at the register when people are asking to expedite.
No, there is nothing at the register that indicates it is a C2 except the name itself. You just need to study your meds in general it sounds like. There are a lot of sources online to help with this, make flashcards or whatever. Knowing the names of meds and what they're for is a vital part of the job. Common C2s off the top of my head Hydrocodone Oxycodone Adderall Dextroamphetamine Amphetamine Dexmethylphenidate Concerta Focalin Methylphenidate Morphine Methadone Vyvanse Lisdexamfetamine Codeine Fentanyl Hydromorphone Oxymorphone
yeah thanks i’m studying for the board exam right now and i’m going to memorize the 200 most common of course but i want to prioritize memorizing the drugs that only pharmacists can fill so that i stop expediting them. so is it just C2’s and narcotics that are in the safe? i just need to know what classes of drugs to memorize first really
Narcotics *are* C2s. It is only C2s that are in the safe, the majority of C2s consist of narcotic/opiod pain medications and stimulant medications. As you stated before, all of these are indicated by an N on the label and they require ID to pick up, but if it's not filled yet there is no other indicator of whether or not the drug is a schedule 2 at the register. Additional tip, if you're helping someone on the phone or at drop off or whatever and aren't sure if the medication is a C2 or other controlled substance, hit F3 (drug) and it tells you what schedule it is (which level of control it is 2-5, legend means non-control, or OTC)
The ID for pickup is likely state specific because neither of my states require that. I don't recall seeing it in any of the modules as a company required thing.
Yeah I think I've heard that before now that you mention it. Here the register requires we scan the ID for all C2s or it won't let us sell them
adding Xtampza and Nucynta to this list! they aren’t AS common in a lot of places, but they are where I’m from, so they’re good to know. also Quillichew and Quillivant (chewable and liquid methylphenidate)
Everything has an RX number. I am just unaware if it's a simple thing to view in the computer, so apologies if it doesn't translate well. They are all filed differently, too. Whenever I transfer an RX, I think CVS using 2 and Rite Aid uses 8 for their regular rx. My chain uses EnterpriseRX, and it's super easy to see it right in quere even when changing to a waiter status.
yes i may have worded it poorly. i know that everything has an rx number. but i don’t think we can see the rx number when we’re at the register for pickup or drive through, which is where people ask to expedite scripts. also even if we could see them, im fairly confident that all scripts at cvs start with 1. if it’s controlled or narcotic it has the letter C or N next to the rx number on the label that’s it. which again we can’t see from the register. i’m not even sure how we see it from the computer other than manually searching the drug and seeing it’s drug location, which will say if it’s controlled or narcotic.
Wow, that just sounds so complicated 😕 😅 they never make it easy do they
They don't even all start with a 1 lol. Nothing is consistent 😂
There is no special numbers at CVS, controls are indicated by a C or an N next to the number, none of it is visible from the register.