What's wrong with Cedars Sinai Medical Center Department of Pharmacy Services
It claims to be "clinical pharmacy"– with the exception of the specialty shifts (morning ICU, oncology, and pediatrics) most, if not all, floor general medicine/surgery shifts are 70% distribution and 30% clinical. All evening shifts (except maybe oncology and pediatrics, but INCLUDING evening ICU shifts) are 95% distribution and 5% clinical. The claim is that this "decentralized" model puts pharmacists on the floors and allows them to be more clinical. In actuality, it creates a mini "central" pharmacy on each floor and instead of pharmacists being stuck in the basement, they are stuck in the satellites.
Pharmacy computer system (probably developed during the 1970's) – the pharmacy computer system is a joke and is severely inadequate. First the MAR and IV systems are separate, which means if you want to order an IV you have to enter it once on the MAR side and again on the IV side. Second, every time you need to make a change, you must DC the entire order and re-enter it (which increases the chances for errors). And finally, it provides no safeguards against common medication errors. It cannot identify duplicate medication order entries or medication order entries that cross-react with a patient's allergy profile. This causes a major problem and increases the liability for the pharmacists (which shouldn't be a problem in most cases, except for the workload, see next item).
Workload – management believes that the pharmacists' time is free, and therefore they must squeeze every last dime out of the work they do. More work is constantly being added to the daily routine, and nothing is ever taken away. The pharmacists are stretched so thin that they sometimes do not know what they are doing. 12 hours of work are crammed into a 10 hour day (and that's a conservative estimate), which shouldn't really matter except for the pay, see next item.
Pay – usually 3 to 5 dollars less per hour than other clinical pharmacy positions. But who cares, money is not important right? You (the pharmacist) should be happy for whatever the director decides to pay you since Cedars is such a prestigious place to work.
Schedule – constantly flipping back and forth between day shift (7:00AM-5:30PM) and evening shift (1:30PM-12:00AM), sometimes in the SAME WEEK. All pharmacists (except specialists) are required to do a combination of day shifts, evening shifts, and graveyards. This causes the pharmacist to be stuck in a stage of perpetual jet-lag (which also increases liability and decreases productivity). Also, pharmacists who have worked for Cedars for 12 months versus pharmacists who worked for Cedars for 12 years have the same schedule. There is no real benefit for staying at Cedars long term when it comes to the schedule (there might not be any benefit of staying long term at Cedars period, but that's another story). The only "benefit" for the schedule in terms of seniority is the end of graveyard shifts at 10 years.
Management – the department is very "top heavy" and for every one pharmacist staffing and providing patient care on the floors, there is another pharmacist doing projects, managing, and supervising. Why do they need so many project people, managers, and supervisors? Maybe because the director cares more about how those people make the Cedars pharmacy department look (and makes her look since every poster presented, article published, and educational talk given has her name on it) rather than the clinical pharmacists on the floors attending rounds, making recommendations, and making interventions. Maybe if the project people, managers, and supervisors got off their asses, rolled up their sleeves, and pretended to be an actual pharmacist from time to time there might not be such a severe shortage of pharmacists at Cedars. Another note about management is that NOTHING ever gets done. You can request, beg, and plead for things/polices to change but nothing ever happens. Basically, management believes there is nothing wrong with the system (management can do no wrong) and that the pharmacists are just a bunch of crybabies.
Benefits – barely adequate (some may argue inadequate) for an institution of this size.
Extra REQUIRED tasks (MBO's, JCAHO out-dates, on-call weekends) – all done for FREE! That's right; they don't pay you a dime for any of these. So why do them you ask? Because management rules by intimidation. If you want to remain on "good standing" and qualify for your annual 2% raise then you better do them.
Breaks and Lunches – actually the lack thereof. It has gotten better since more shifts are now 10 hour shifts, but I'd still estimate about 25-50% of the staff pharmacists do not take lunches or breaks. This is not due to the fact that they are truly dedicated to Cedars, but because there just isn't time. CA state labor laws mandates an employee take a 15 minute break for every 4 hours worked as well as an unpaid lunch of 30 minutes. Therefore, in a 10 hour shift there should be 9.5 hours of work while being paid for 10 hours. However, since the pharmacists at Cedars do not take lunches or breaks, they work for 10.5 hours and get paid for 10 hours. Good deal!
DISCLAIMER – This "rant" only expresses the opinions of Dr. G (a previous employee) and does NOT reflect how every pharmacist at Cedars Sinai Medical Center pharmacy department feels about his or her position. Inquires about the identity of Dr. G will not be answered.
