Hi all, hospital clinical pharmacist here. After a particularly rough week, I’m sitting at home wondering to myself: why does everyone lack critical thinking skills? Or even taking basic responsibility for doing one’s job?
Many of the comments I’ve read here recently are all things I’ve experience as well.
This is a bit of a rant, but here goes:

1. Pharmacists: what the hell has happened? The people coming out of school are GARBAGE. Embarrassing knowledge gaps, lazy, entitled, can not make a decision, are slow AF at verifying orders or writing a note, and use anxiety as an excuse for everything. Seriously worried about my profession.
   
2. NPs. sigh. There’s a few good ones but basically a needle in a haystack. Some recently highlights -NP insisting active c diff can be treated with probiotics -NP OBSESSED with magnesium. Sepsis? Give magnesium. Headache? Give magnesium. Sinus tach? Give magnesium. Normal magnesium levels? Give magnesium -NPs that can’t extrapolate anything. Not knowing that ampicillin = amoxicillin, tetracycline = doxycycline -NPs that just know it all. DO NOT argue with me about how to dose vanco. If I know anything, it’s vanco.
   
3. PAs -see above
   
4. Nurses Why do y’all think you can just hold any med at anytime of day for any reason and not tell anyone? Good luck when your multitrauma dies from a PE because you didn’t give the lovenox for some unknown reason Warm wishes when dealing with a thrombosed mechanical valve because you determined that an INR of 3.2 warranted holding warfarin.
   
5. Physical therapy Why are you shocked and appalled at being consulted to rehab a bunch of amputees? Isn’t that like the core part of your job when you work at a rehab facility?
   
6. Dietitians For the love of god, stop talking about vitamin D and giving crazy doses. Also, I don’t care that the acute dialysis patient has slightly elevated phosphate. They have bigger issues. Lastly, don’t argue with me over TPN. I know how to adjust electrolytes, thank you.
   
7. Oh almost forgot pharmacy techs. It is in fact your job to refill the Pyxis, so just do it please.
   

not feeling inspired by the current/future workforce!

The Compassion in Healthcare Act of 2022

This is an act to improve access to lifesaving prescriptions.
Whereas, Fremont is taking bold steps to ensure a better life for all of its citizens
THEREFORE, BE IT ENACTED by the General Assembly of Fremont that: Section 1. Title
(A) This bill shall be referred to as the "The Compassion in Healthcare Act of 2022"
Section 2. Funding
In October 2022 the assembly authorized a 20% tax on profits generated by casinos in the state of Fremont, this tax is estimated to generate the state of Fremont $6,500,000,000 annually.
Immediately following the passage of this bill 40% of the Casino Profit Tax ($2,600,000,000) shall be appropriated to fund the Compassion in Healthcare Act, these funds shall be reappropriated on an annual basis, occurring on the same day this legislation is signed into law,
Should the costs of the Compassion in Healthcare Act exceed $2,600,000,000 in any given year it is the sole responsibility of the assembly and the governor to pass a bill approving additional funding for that year. Section 3. Provisions An agency called “The Fremont Department of Healthcare” shall be created to oversee and coordinate the provisions of this legislation, The Fremont Department of Health shall oversee these programs until The Fremont Department of Healthcare is established. All citizens shall be issued a unique health insurance card, called a “Fre-Care Card”, by the state of Fremont, that may be used in conjunction with a primary health insurance plan for the coverage of the select prescriptions outlined in Section C. Of this bill, Uninsured citizens may use the Fre-Care card to cover these select prescriptions, so long as they are ineligible for state Medicaid and they have contacted the Fremont Department of Healthcare to inform them that they are uninsured
(1a) It is the responsibility of the Fremont Department of Healthcare to accurately determine whether or not a citizen is truly uninsured and whether or not that citizen is eligible for state Medicaid
(2a) If a citizen is eligible for state Medicaid it is the responsibility of the Fremont Department of Health to help that citizen enroll
In cases where an individual has dual insurance coverage that is already ran at a pharmacy via Coordination of Benefits, a Submit Direct Link Coordination of Benefits shall be ran to coordinate their state issued Fre-Care card
In cases where an individual has insurance coverage and a manufacturer savings card that is already ran at a pharmacy via Coordination of Benefits, a Submit Direct Link Coordination of Benefits shall be ran to coordinate their state issued Fre-Care card
All Fre-Care Cards issued by the Fremont Department of Healthcare must include a Member ID, a BIN #, a PCN, a Group #, and a Person Code of 01 printed on it
All holders of a Fre-Care Card shall be entitled to receive the following or any combination of the following medications outlined below at a $0 Copay, route of administration shall not matter unless explicitly mentioned, the State Government shall pick up the cost of any remaining copays after primary insurance(s) and or manufacturer coupons have been properly billed for these medications:
Albuterol Naloxone Epinephrine Insulin glargine Insulin degludec Insulin detemir Insulin lispro Insulin isophane Insulin Insulin aspart Any Brand Glucose Test Strips Insulin aspart protamine Insulin lispro protamine Insulin glulisine Atorvastatin Rosuvastatin Simvastatin Levothyroxine Lisinopril Metformin Amoxicillin Azithromycin Doxycycline Benzonatate Prednisone Prednisolone Fluticasone HFA Fluticasone Latanoprost Fluticasone furoate Hydroxyurea Methylprednisolone Estradiol Norethindrone Norgestimate Drospirenone Ethinylestradiol Levonorgestrel Medroxyprogesterone Clindamycin Clobetasol Valacyclovir Cefdinir Buprenorphine Escitalopram Sertraline Bupropion Fluoxetine Lamotrigine Venlafaxine Trazodone Amitriptyline Acyclovir Quetiapine Naltrexone Citalopram Duloxetine Desvenlafaxine Paroxetine Propranolol Metoprolol Fluconazole Eliquis Xarelto Warfarin Rectal Diazepam Levalbuterol Losartan Valsartan Olmesartan Umeclidinium bromide Vilanterol Any Brand Glucose Meter Any Brand Glucose Lancets Glucagon Penicillin Nitroglycerin Nifedipine Ampicillin Metronidazole Dexamethasone Betamethasone Hydralazine Gentamicin Oseltamivir Paxlovid Covid-19 Vaccine Influenza Vaccine Hepatitis B Vaccine Hepatitis A Vaccine Monkeypox Vaccine Human Papillomavirus Vaccine Pneumococcal Vaccine Shingles Vaccine TDAP Vaccine Polio Vaccine Chicken Pox Vaccine Rabies Vaccine MMR Vaccine

 (D) The assembly recognizes that public health is an ever changing landscape that requires due diligence and proactive efforts to ensure it is maintained, for that reason the assembly acknowledges that the list of drugs in section C may not always be considered essential and that more drugs may become available in the future that may become essential to maintain public health, as such the assembly now holds that during times of crisis the Governor may issue a Fremont Public Health Decree declaring a particular medication or medications to be free under this legislation until the Fremont Public Health Decree expires: 

Fremont Public Health Decrees shall last for 1 year, unless terminated early by the governor or the assembly A governor may renew a Fremont Public Health Decree a total of 4 times in 1 term The assembly reserves the right to override a Fremont Public Health Decree via legislative action There must be a legitimate public health emergency justifying the Fremont Public Health Decree Section 4. Enactment
(A) This act shall go into effect immediately after it is signed into law.
(B) If any portion of this act is struck down, the rest of the act shall still be in effect.
This piece of legislation was authored by KushGator (R) & MichaelDGrant (R)

The Compassion in Healthcare Act of 2022

This is an act to improve access to lifesaving prescriptions.
Whereas, Fremont is taking bold steps to ensure a better life for all of its citizens
THEREFORE, BE IT ENACTED by the General Assembly of Fremont that: Section 1. Title
(A) This bill shall be referred to as the "The Compassion in Healthcare Act of 2022"
Section 2. Funding
In October 2022 the assembly authorized a 20% tax on profits generated by casinos in the state of Fremont, this tax is estimated to generate the state of Fremont $6,500,000,000 annually.
Immediately following the passage of this bill 40% of the Casino Profit Tax ($2,600,000,000) shall be appropriated to fund the Compassion in Healthcare Act, these funds shall be reappropriated on an annual basis, occurring on the same day this legislation is signed into law,
Should the costs of the Compassion in Healthcare Act exceed $2,600,000,000 in any given year it is the sole responsibility of the assembly and the governor to pass a bill approving additional funding for that year. Section 3. Provisions An agency called “The Fremont Department of Healthcare” shall be created to oversee and coordinate the provisions of this legislation, The Fremont Department of Health shall oversee these programs until The Fremont Department of Healthcare is established. All citizens shall be issued a unique health insurance card, called a “Fre-Care Card”, by the state of Fremont, that may be used in conjunction with a primary health insurance plan for the coverage of the select prescriptions outlined in Section C. Of this bill, Uninsured citizens may use the Fre-Care card to cover these select prescriptions, so long as they are ineligible for state Medicaid and they have contacted the Fremont Department of Healthcare to inform them that they are uninsured
(1a) It is the responsibility of the Fremont Department of Healthcare to accurately determine whether or not a citizen is truly uninsured and whether or not that citizen is eligible for state Medicaid
(2a) If a citizen is eligible for state Medicaid it is the responsibility of the Fremont Department of Health to help that citizen enroll
In cases where an individual has dual insurance coverage that is already ran at a pharmacy via Coordination of Benefits, a Submit Direct Link Coordination of Benefits shall be ran to coordinate their state issued Fre-Care card
In cases where an individual has insurance coverage and a manufacturer savings card that is already ran at a pharmacy via Coordination of Benefits, a Submit Direct Link Coordination of Benefits shall be ran to coordinate their state issued Fre-Care card
All Fre-Care Cards issued by the Fremont Department of Healthcare must include a Member ID, a BIN #, a PCN, a Group #, and a Person Code of 01 printed on it
All holders of a Fre-Care Card shall be entitled to receive the following or any combination of the following medications outlined below at a $0 Copay, route of administration shall not matter unless explicitly mentioned, the State Government shall pick up the cost of any remaining copays after primary insurance(s) and or manufacturer coupons have been properly billed for these medications:
Albuterol Naloxone Epinephrine Insulin glargine Insulin degludec Insulin detemir Insulin lispro Insulin isophane Insulin Insulin aspart Any Brand Glucose Test Strips Insulin aspart protamine Insulin lispro protamine Insulin glulisine Atorvastatin Rosuvastatin Simvastatin Levothyroxine Lisinopril Metformin Amoxicillin Azithromycin Doxycycline Benzonatate Prednisone Prednisolone Fluticasone HFA Fluticasone Latanoprost Fluticasone furoate Hydroxyurea Methylprednisolone Estradiol Norethindrone Norgestimate Drospirenone Ethinylestradiol Levonorgestrel Medroxyprogesterone Clindamycin Clobetasol Valacyclovir Cefdinir Buprenorphine Escitalopram Sertraline Bupropion Fluoxetine Lamotrigine Venlafaxine Trazodone Amitriptyline Acyclovir Quetiapine Naltrexone Citalopram Duloxetine Desvenlafaxine Paroxetine Propranolol Metoprolol Fluconazole Eliquis Xarelto Warfarin Rectal Diazepam Levalbuterol Losartan Valsartan Olmesartan Umeclidinium bromide Vilanterol Any Brand Glucose Meter Any Brand Glucose Lancets Glucagon Penicillin Nitroglycerin Nifedipine Ampicillin Metronidazole Dexamethasone Betamethasone Hydralazine Gentamicin Oseltamivir Paxlovid Covid-19 Vaccine Influenza Vaccine Hepatitis B Vaccine Hepatitis A Vaccine Monkeypox Vaccine Human Papillomavirus Vaccine Pneumococcal Vaccine Shingles Vaccine TDAP Vaccine Polio Vaccine Chicken Pox Vaccine Rabies Vaccine MMR Vaccine

 (D) The assembly recognizes that public health is an ever changing landscape that requires due diligence and proactive efforts to ensure it is maintained, for that reason the assembly acknowledges that the list of drugs in section C may not always be considered essential and that more drugs may become available in the future that may become essential to maintain public health, as such the assembly now holds that during times of crisis the Governor may issue a Fremont Public Health Decree declaring a particular medication or medications to be free under this legislation until the Fremont Public Health Decree expires: 

Fremont Public Health Decrees shall last for 1 year, unless terminated early by the governor or the assembly A governor may renew a Fremont Public Health Decree a total of 4 times in 1 term The assembly reserves the right to override a Fremont Public Health Decree via legislative action There must be a legitimate public health emergency justifying the Fremont Public Health Decree Section 4. Enactment
(A) This act shall go into effect immediately after it is signed into law.
(B) If any portion of this act is struck down, the rest of the act shall still be in effect.
This piece of legislation was authored by KushGator (R) & MichaelDGrant (R)