Really enjoyed my shift today so I thought I’d share my thoughts. Amidst all the negativity in community pharmacy, sometimes it can be very rewarding if things work as they were intended to.
I was the Locum pharmacist in a well-staffed store today – two staff members permanently on the counter, two with me in the dispensary and one tech preparing nomads. Safe to say I achieved a lot despite the store being extremely busy.
Stopped a patient from taking a drug that could have potentially killed her- patient thought GP had switched her from gabapentin to amlodipine for neuropathic pain but I told her that was not possible unless it was off-label and proceeded to call the GP who confirmed the prescription was sent in error. Luckily, the patient hadn’t left the pharmacy.
Conducted more MURs than I was asked to just because I had a solid team and there were lots of patients who needed it. Helped the new manager by doing some NSAID audits for the quality payments as well.
Spoke to a gentleman who had been placed on 4 cardiovascular medicines at once after a heart attack 5 months ago and hadn’t been reviewed by anybody since leaving the hospital. Found 2 issues that needed addressing and referred him to his GP urgently.
Discovered during an MUR that a lady was not even aware she had COPD (I was quite shocked myself), she knew she had been prescribed inhalers but could not tell me what they were for. I was able to deduce her condition based on the type of inhalers she had. She was also terribly non-compliant with her medication. It was almost as if she didn’t care. Wasn’t sure if it was early dementia, as she was not on any medication for it. Signed her up for our EPS service, went through all her medication with her and wrote down brief summaries of what they were for in case she forgot. Contacted her surgery so they could handle things on their end and was basically told by a snotty receptionist that it was not my business and she had never had a pharmacist request such information to be passed on to the GP. I stood my ground and explained that as a healthcare professional, I must do my best to ensure the well being of patients and asked her to write everything down immediately. Threatened that I had done my due diligence and the negligence would fall on her if she did not pass it on to the GP. Of course, she did not want the responsibility.
Being a pharmacist is great! I only wish there was a way to integrate primary care in such a way that there would be a system whereby community pharmacists could directly refer patients requiring urgent care to GPs. Telling patients to see their pharmacist first only for us to tell them to go book an appointment doesn’t make sense. If it’s not urgent then fine, but if I feel like it’s an emergency, I want to make sure I have done my best by following it through. Only being able to tell them to book an appointment happens to be a slight glitch in the seamless care we should ideally be providing. But that’s just my opinion.
Also, do not get me started on remote supervision. Unless techs will be trained to know that amlodipine and gabapentin do not have similar indications, then in my opinion, not having an available pharmacist on site will not be in the interest of the patient. Period.
Author: Ora Ibanibo