Why I Built RxShift

I'm Susie Monahan-West. I like to joke that I'm a pharmacist first, not a software founder. However, it turns out I've become both. With over 25 years in pharmacy practice, most of my focus has been on medication management and patient safety. I'm board-certified in geriatric pharmacy, but none of that quite prepared me for the often unspoken part of this job: creating a compliant staffing schedule by hand every week and ensuring the math is correct each time.

Right now, I'm establishing a new specialty pharmacy for Optum here in Las Vegas, and I'm the Pharmacist in Charge. This means the schedule is fully my responsibility. It must be not just "close enough," but provably right, because Nevada's Board of Pharmacy insists that a pharmacy must be ready to demonstrate proper staffing if questioned.

Here's what actually goes into getting it right. Under Nevada's current rule (NAC 639.250), a pharmacist in a non-hospital pharmacy can supervise up to three pharmacy technicians at once. This sounds straightforward until you're knee-deep in a real week's schedule, while dealing with last-minute call-outs and trading days.

Our pharmacy used to manage all this on a spreadsheet. Every week, we recalculated the ratio by hand for each shift, checked the math, and hoped no errors lingered, unnoticed. I looked for a scheduling tool designed for this purpose and found none. General scheduling software doesn't comprehend the pharmacist-to-technician ratio. It will naively schedule you into non-compliance because it simply doesn't know any better.

So, I put the ratio math together myself, capturing the true logic a pharmacist uses to verify a schedule by hand. My husband, who’s spent his career building software companies, helped turn it into something that could run on its own. That's how RxShift was born.

RxShift applies Nevada's ratio rules to every shift you schedule because the regulation demands that distinction. Generic schedulers can't acknowledge what they don't recognize. It keeps a record of how staffing actually played out, so if anyone asks, you're not reconstructing a month from memory and old spreadsheets.

I'm building this pharmacy the same way I'd build any pharmacy: carefully, and by the rules. RxShift is what I developed to make that process manageable, rather than a constant manual chore.

I'll be sharing more here about what I'm learning, pharmacy compliance, staffing, and what Nevada's rulemaking process really entails for those managing pharmacies daily. If you're currently tracking your ratios by hand and wondering if something's slipping through the cracks, I’m eager to hear how you're handling it.