Is it just me, or is my employer being really messed up?

[Capp]

I find myself really irritated with this recent decision by my employer, and I was curious what other people thought of it. Am I being unreasonable? Or is this messed up?

I work for one of the major health systems* in my area, and us employees are forced into health insurance plans that penalize us for using services outside of the system. They recently made a new rule that employees of the system are no longer allowed to use the outpatient pharmacy at the hospital. Apparently there is a clinic somewhere in a less convenient location that has much more restrictive hours that we are allowed to use.

I work night shift and the hospital pharmacy is the only 24 hour pharmacy, so I will have to forgo sleep if I ever want to pick up a prescription. Alternatively, there may be a 24 hour Rite Aide or something out there, but even if there is the cost will be much higher since it is out-of-system.

Also, apparently my family is also now banned from the hospital pharmacy. My wife was heading from her doctor's office to the hospital to pick up a prescription and they called her while she was en route and basically said, "So where do you want us to send this prescription that just came in, 'cause you're not welcome here anymore."

They didn't give much of a rationale for the change, but seemed to be suggesting that the goal was to reduce wait times. I guess if you deny services to a group of people than your wait times will improve, but it seems to me the same rationale would work equally well to justify discrimination against any group. I think in a way, it would sort of be less unethical for them to deny services to any other random group since we are the one group of people who are forced into insurance plans that penalize us for using out-of-system services.

So, am I being unreasonable?

*I didn't mention the employer by name in case it is against some policy here on Allnurses.

[Capp]

Maybe I gave too many details in my original post, because people are kind of fixating on irrelevant details. I guess I shouldn't have said "the hospital pharmacy" but "the main pharmacy in our system."

Basically we are talking about a group of our patients and how we choose to treat them. This group happens to be employees as well as patients, but my whole point is to ask why does that matter? How is it right to treat a patient crappily just because of who they work for. I personally would think that was wrong whether it was Chic-fil-A employees or healthcare workers from a rival system that were being discriminated against.

Also, I guess I shouldn't have mentioned my own situation as an example because that just stirs up people's natural instinct to make things personal. "Quit whining . . . Get over it. . . Etc." The change technically doesn't impact me personally because I don't have any current prescriptions anyway. I was saying that I personally think all patients deserve to be treated the same regardless of who their employer is. Obviously the consensus is that I am wrong.

Here's another example that doesn't involve me. Say I have a patient who is supposed to discharge in the evening and is supposed to pick up a prescription upon discharge. Normally I would have the patient get their meds sent to the main pharmacy because it is the only one open late. With this new change, if it is an employee, basically they're just screwed. If it's pain medication, for example, they have to be in pain for the next 14 hours or so. CaliOtter would presumably tell the patient to quit whining and that they're stupid for selfishly expecting everything to be open late just for their convenience. I personally don't think that is a fair way to treat a patient. Again, obviously the consensus is against me, so we will have to agree to disagree.

[NurseCard, ADN]

So, am I understanding you correctly...

Even though you have the exact same insurance as your patients who

do NOT work for the hospital... say, Mr Green who works at the

local factory has MDHealthPlus... and you, an employee of the hospital,

also have MDHealthPlus... Even though you have the exact same

insurance.. Mr. Green can pick his prescriptions up at the main

hospital pharmacy but you can NOT, solely because you are a

hospital employee.

That does kinda suck. I would have to agree. But, I'm sure

the hospital has what they feel is a legitimate reason for

doing this. If I'm understanding the situation correctly.

Still, it makes for crappy employer/employee relations,

IMO.

[Guest219794]

Well, that does kind of suck.

It seems to me that it is similar to working for a hospital that has no 24 hour pharmacy. Or even no 24 hour pharmacy. Or living in an area in which there are no 24 hr pharmacies at all.

I think a lot of folks are in this situation.

In your case, it seems to not make much sense. What better way to control costs than to do something in house, and how heavily do employees use this service so that it significantly increases wait times?

[Katillac, RN]

It seems like this is really bothering you. I think it might turn out to be less of a problem than you're thinking. An employee patient could be discharged as late as 8 PM and still make it to a local pharmacy like CVS or Walmart, by their closing time - at least on weekdays. And realistically, how often does that happen? The examples you gave in your OP, your spouse filling prescriptions from her doctor's office and you foregoing sleep, seem like they have work-arounds that are less convenient for you but most people, including commenters here on allnurses, would take it in stride.

However, your language suggests you may be feeling victimized by your employer: forced into plans, penalized for going outside the system, you're not welcome here, discrimination, unethical, treat a patient crappily, if you're an employee you're screwed, etc. With that perspective, I can understand why you may be seeing this change as mistreatment by your employer. I hope you can soon come to terms with it - feeling powerless and victimized is very uncomfortable.

[Alex_RN, BSN]

That really sounds like a hassle. If you are in a union, I would mention it to your union rep.

For ongoing maintenance meds, it is usually worthwhile to go through the hassle of setting up a mail order pharmacy if you have that option. Typically you get more meds for the same copay (3 month supply versus 1 month supply).

[psu_213, BSN, RN]

I don't really understand the hospital's rationale. I'm guessing it is financially motivated, and that stinks. The hospital group for which is works provides not the greatest insurance, at least in terms of how much we pay, coinsurance, etc.; and I think it is shameful the way in which hospitals don't seems to really care about, or pay lip service to, the health of their employees.

I must say, however, in the litany of issues that I have, this one (not being able to use the hospital's outpatient pharmacy) is pretty low on the list. Yes, it's annoying; it's inconvenient; etc. I don't know the exact geographic situation of the OP's hospital, but I still don't see how difficult it is to make it to some other retail pharmacy...either after a night shift for the OP or for the discharged pt/employee. As I said, it stinks that the hospital is enacting this policy, but, in a practice sense, I really don't find it to be a major issue.

[Capp]

I hope you can soon come to terms with it - feeling powerless and victimized is very uncomfortable.

I think of all the passive-aggressive attacks poorly disguised as well-meaning attempts at psychoanalysis from a stranger on the internet that I've seen, this was by far the funniest. I think the last sentence really ties it together. If you were writing this as a satirical commentary on people who make those kinds of attacks you would be a comical genius.

I also love how in your first paragraph you are criticising me for my example of a patient put in a very unfair position (a situation which is 100% inevitable based on the new policy) on the grounds that "realistically, how often does that happen?" So the number of patients that happens to probably is rather small, so who cares? Then, at the end of your second paragraph you conclude that you have so much empathy for this poor, random person on the internet that you've never met that you genuinely hope I somehow manage to overcome my clearly deeply pathological obsession with this imagined "injustice," for otherwise I will surely die a lonely, bitter old man.

I've been thinking from the beginning of this conversation that it is interesting the way that people use words like "inconvenience," apparently to try to trivialize things to set up attempts at making me look petty. I don't think it really matters to me if we choose to use a word like that. Even just inconveniencing patients without good reason isn't right if you ask me. It also isn't a question of magnitude, as some people have implied. Yes, there are bigger injustices in the world; ISIS is worse than this policy. Yes, there are greater struggles that an individual may be forced to cope with in life. Yes, the patient in my example might be able to get to Walmart before they close and in so doing avoid the 14 hours of unnecessary pain. But it will cost them more than if they had gotten the prescription at an in-system pharmacy. And it will "inconvenience" them. I personally think that is enough to conclude that it isn't right.

Side Note: Repliers who said things like, "I agree this is messed-up, but it isn't the end of the world," please don't think any of my rhetorical ripostes are directed towards you. We are, I think, in exact agreement. My original question was, "Is this messed-up?"

[Kooky Korky, BSN, RN]

I know my facility has a very narrow network but if we do want to go out of network, we pay a little more for those services. For example, if the co- pay in network is $10 then out of network for same service $25. Most places I have worked have similar plans. The physician I see used to be in network but this year is no longer in network but I choose to keep my doctor and willingly will pay a little more. Plus I can literally walk or just ride my bike to his office.

$15 more per prescription is a lot of money, especially if a person takes several meds.

OP's health plan made the classic mistake of not giving a single thought to those members who work other than M-F 9-5.

OP - let the decision-makers know about the problem they have created. Is there mail order delivery available to you? Could night shifters still be allowed to use the hospital pharmacy?

[Kooky Korky, BSN, RN]

It seems like this is really bothering you. I think it might turn out to be less of a problem than you're thinking. An employee patient could be discharged as late as 8 PM and still make it to a local pharmacy like CVS or Walmart, by their closing time - at least on weekdays. And realistically, how often does that happen? The examples you gave in your OP, your spouse filling prescriptions from her doctor's office and you foregoing sleep, seem like they have work-arounds that are less convenient for you but most people, including commenters here on allnurses, would take it in stride.

However, your language suggests you may be feeling victimized by your employer: forced into plans, penalized for going outside the system, you're not welcome here, discrimination, unethical, treat a patient crappily, if you're an employee you're screwed, etc. With that perspective, I can understand why you may be seeing this change as mistreatment by your employer. I hope you can soon come to terms with it - feeling powerless and victimized is very uncomfortable.

Take it in stride? Just like having to take another patient, on top of the 400 you already have. And having your schedule changed at the last minute, and like many other examples you can think of.

No night shifter should have to forego sleep to fill a danged prescription or come to a required meeting at work, or anything else.

Taking everything in stride is why nursing is in the state it's in.

Get your back up, friend, and be part of the solution.

[Kooky Korky, BSN, RN]

Your argument about night shift inconvenience does not fly. Any person who chooses to work night shift puts up with the inconvenience related to their choice. Life occurs after night shift. I only get concerned with finding an all night pharmacy when there is an after hours need for meds. Nothing at all to do with the convenience of when I go to pick up a prescription.

Night shift isn't always exactly a choice. Sometimes it's about survival or being new.

[klone, MSN, RN]

Mail Order Pharmacy

[caliotter3]

Night shift isn't always exactly a choice. Sometimes it's about survival or being new.

Notwithstanding the need to be nitpicky, that does not change the fact that people who work night shift contend with a dayshift world, the premise behind the remarks on this thread. And for that matter, needing to survive does not change the fact that when I seek night shift work for my own reasons, employers usually can't accommodate me. They are not concerned with my survival.