8.00am – The pharmacy opens at 9am, but I came in early today to catch up on things from yesterday. It was a hectic day with all the prescriptions coming through! 

9am – I have three dispensers and one member of staff in the shop today. It a full house. The shutters go up and we’re ready for any challenges the day might bring. By 9.15am there’s already a queue forming from the GP early morning clinic. I’ve got a load of prescriptions to clinically check and accuracy check whilst patients wait.  I’ve got to make sure the prescription is appropriate for the patient, and make sure my dispensers have picked the right product from the shelf. Amongst all that I’m checking prescriptions for any patients who might come in to collect their monthly medication. I’ve got lots to check!

9.45am – I’m on the last prescription from the morning rush – I still have a lot of prescriptions to check for patients who’ll be coming in later.

10am – A lady brings in a prescription for her son. He has an ear infection that just isn’t getting better.  The GP has prescribed Flucloxacillin – an antibiotic. We get the medicine ready and I go to hand it out – a quick conversation reveals her son is allergic to penicillin. The last time he had it, he ended up in hospital with a life threatening allergic reaction.  Looking at the prescription, I know the GP who signed it, so I asked for a few minutes to call the GP. It’s still early, so the phone is busy at the surgery. Eventually I get through and explain the situation – they pass me through to the GP and its a quick call. Within 15 minutes I’ve had a new prescription sent to the pharmacy for another (safer) antibiotic. Once that’s cleared up I continue checking the monthly repeat prescriptions that have come through.

12pm – An elderly gentleman comes into the store and asks to speak to me. I invite him into our private consultation room.  He tells me he’s been feeling really dizzy for a few days and unable to get a GP appointment. He doesn’t know what to do and doesn’t want to go to hospital.  He tells me he lives with his wife, but she worries a lot so he doesn’t want her to know. Further questioning reveals that he’s been off his food for a few days too and he’s also had a fever, though this has cleared now. I’m looking for any ‘red-flag’ symptoms that might need an urgent referral, but he doesn’t seem to have any.  I notice that he walks with a stick, so now I’m worried he might have a fall and end up in hospital. I check his blood pressure which is a little low, but not enough for me to worry about. I ask him about how he is in the bathroom and he admits it hurts when he goes for a wee sometimes but other than that he’s fine. Working my way around all the possible conditions in my head, I decided he’s likely to have an urine infection – which needs a trip to the GP. I give him a slip with our pharmacy details on, and send him to his GP.  He’s seen the same day.

1pm – lunch time! Although I’m working through my lunch, it’s a bit quieter in the shop and I get the chance to get ready for the couple we have coming who want flu jabs. I get everything ready and have 5 minutes to sit down for a cup of tea.

2pm – A customer comes in to collect her monthly medication. Her prescription bag has a red sticker on it that says ‘MUR’ – she’s eligible for a free medicines review with me. I ask her if she’d like one and she tells me she just had her annual GP review. I explain that a MUR is different and that we aim to make sure you know the basics about your medicines – why you take them, how to take them, when to take them etc – it’s also an opportunity to raise any concerns you might have that we will be able to sort out.  She politely declines.

2.30pm – The gentleman with the suspected urine infection is back. He’s been to the GP who confirmed the diagnosis and has given him some antibiotics. The man is really grateful and relieved that it’s an easily treated problem.

3pm – I’m still working my way through the monthly prescriptions when I overhear the member of staff in the shop talking to a patient. The patient has had pain in the foot for weeks. She is struggling to walk now. She gets asked all the relevant questions by the healthcare assistant and then I get asked to have a look.  She’s tried a lot of different pain relief products and is currently taking Ibuprofen. I ask her about her other medication and immediately realise she should not be taking Ibuprofen as she also takes naproxen which is from the same family of non-steroidal anti-inflammatory drugs (NSAID) so this would increase the side effects of Ibuprofen. I tell her to stop the ibuprofen and refer her to the podiatrist. I think she has plantar fasciitis, which means she needs better support in the soles of her shoes for her feet. She’ll need a gait assessment.

4pm – I spend the last two hours of the day catching up on paperwork for headoffice. My two flu jab patients arrive and its a quick and easy process for both. 15 minutes in the pharmacy and both are vaccinated.

6pm – Finally, its closing time! What a day.  I’ve got a bunch of notes I’ve made through the day for queries on prescriptions – wrong doses, wrong quantities, wrong strengths. I lock up the shop and head off to the surgery – I pass the slips to the receptionists who’ll get them all corrected and back to me within 24 hours. The aim is to make the process of picking up medicines as seamless as possible – most patients are completely unaware of the errors I’ve identified in their prescriptions – they just come and pick up. It’s usually a thankless task but that’s what we do. We make sure every single patient is on the right medication, at the right dosage; we diagnose and treat minor ailments; we refer patients to the right specialists; we look for signs of serious illness.  We stand at the vanguard of the NHS for appointment free healthcare advice.

 

We’re not doctors or pretend doctors.  We are Pharmacists.

 

Author: Wajeeha Mir MPharm

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