Tag Archives: pharmacist

Pharmacy Night before Christmas

‘twas the night before Christmas, when all through the pharmacy.

Not a dispenser was stirring, not even Tracy.

The Activa stockings had been ordered with care,

in the hope that the driver soon would be there.

Mrs Jones had already rang 6 times to ask where her stocking was. Frank Dispenser and the rest of the pharmacy team were shattered. It was 5.45pm and it had only just quietened down. Frank hadn’t even had time for lunch. He was working his way through the celebrations tin that the area manager had left.

They had got lots of biscuits and chocolates from patients too. Some were not out of date which was a bonus. Mrs Smith had baked one of her special cakes for them. Frank had been initially dubious about selling citric acid to Mrs Smith. He had asked her what the w/w% of citric acid there would be in the final cake. Mrs Smith didn’t know but said that she would bring in some of the cake for Frank. He accepted as he was a reasonable man. Carol the dispenser was singing in the staffroom. She always sang at Christmas.

Mrs Smith and Mr Smith could not have been more different. Couples who order their repeat meds together, stay together longer. This didn’t apply to the Smiths. Mrs Smith used our repeat prescription order scheme. Mr Smith did not. It was then that he burst through the door. A feeling of dread came over Frank. Mr Smith was a large man in his seventies and always dressed in red for some reason. ‘Here is my list of medicines that I want’ he bellowed as he handed over his prescription.

Mr Smith was holding a sack. Susan the technician wondered if it contained biscuits for the pharmacy team. Susan was unfortunately mistaken. Mr Smith had been naughty, not nice.

‘I don’t want these tablets anymore’ he said.

Susan sighed. ‘As well as safely disposing of unwanted medicines, we also dispose of uneaten, in-date chocolates, cakes and biscuits, you know?’

Mr Smith looked confused.

 ‘We don’t have all your tablets’ said Frank.

 ‘Why the hell not?’ Mr Smith replied.

‘Well it is 5.45pm on Christmas eve’.

‘I’ll come back tomorrow then’ said Mr Smith.

‘You can come back but we are shut for the next two days’ Frank sarcastically replied. One day Frank would get a punch because of his sarcasm.

‘SHUT FOR TWO DAYS!!! WHY DIDN’T YOU TELL ME BEFORE?’

‘We told you last year too….’ 

Keep It Simple Stupid

Sometimes, the more you explain something, the less enticing it becomes.

Me: Hi, Mr Smith. Can I do a MUR on you please?

Mr Smith: You what?

Me: Medicines use review

Mr Smith: What the hell are you on about, boy?!?

Me: Just want a quick chat about your medicines.

Mr Smith: Why, what’s wrong?

Me: Nothing hopefully

Mr Smith: I speak to my GP about my medicines

Me: Yes, I know. I would like to speak to you too about them.

Mr Smith: Are you saying I can’t trust him?

Me: Noooo! I just want to see how you are doing with them.

Mr Smith: Doing fine

Me: I want to see if you know what they are all for.

Mr Smith: You calling me stupid?!?

Me: Um…ah.. No. Its just a quick check to see if you are taking them as prescribed

Mr Smith: I am

Me: It really will just take a few mins….

Mr Smith: I’m parked in the disabled spot so have no time. Bye.

Pharmacy Fail

I was speaking to a pharmacy student on twitter the other day, who had a exam resit rapidly approaching. I had a resit at university and remember it well. It clearly is a stressful time.

 

Looking back now, it was nothing to worry about. Nobody is perfect. You can’t be good at everything. In order to try and make the student feel better, I asked pharmacists to tweet about the exams that they failed at university. I had many responses.

 

The best thing to do is to work as hard as you can and avoid failing. However, we all make mistakes down the line, but if you work hard, you will end up where you deserve to be.

 

I got 25% in Dosage Form Design at Bradford University and only just passed the resit.

 

Are you willing to share your pharmacy fail?

The Other Guys

I am not going to poke fun of GPs any more. I want to concentrate on nurses, dentists and hospital doctors. These three groups of health professionals make GPs seem competent at prescribing.

Nurses

Many people think are experts in dressings, sadly, they have been mistaken. It is extremely annoying to get a dressing prescription only to later find out they have written an incorrect size and doubly annoying when you have to send said prescription to NWOS. It is triply annoying when they don’t answer their phone!

A nurse prescription for Dihydrocodeine 30mg tablets Four QDS naturally brought out the detective in me, feeling concerned I rang the nurse and it turned out that she had only prescribed the item because a patient had verbally told her a consultant had recommended that dose.

Back to the topic of dressings, nurses, yes nurses are legally unable to prescribe a box of dressing, meaning any quantity more than three comes out of their back pockets.  I also plead for patients not to believe a district nurse who says “I will order a prescription for you”.

Dentists

These are professionals with a love for prescribing strange doses and out of bound drugs. I have seen Amoxicillin QDS, Amoxicillin tablets and co-codamol on a dental script. I have had many phone calls trying to explain the rules to them. Prescriptions regularly come through not stamped.

Dentists are also lazy. Take this for example; they write the dose but then get the receptionist to write the name and address on the prescription. They very lazy ones have stamps with the drug and dose on, so no handwriting involved no need for any extra pressure on those precious little fingers.

A couple of months ago, a nice dentist prescribed two Temazepam 10mg tablets for an anxious patient prior to her dental procedure. He unfortunately increased her anxiety by forgetting to add ‘For dental treatment only’!

Hospital doctors

These guys change the rules. They place the address labels over the part of the prescription that says that the outpatient prescription can only be dispensed in hospital. They refuse to print their name inside the very box that’s asking for it. They also refuse to sign their name in the signature box. Forcing pharmacists to chase the hospital doctor through a maze of automated options and depressing music.

A hospital prescription for Eurax plus cream showed no results on my computer, google, AAH, Alliance, NPA information department or from the company that produces Eurax. Once the secretary rang me back [Consultants never use the phone], she told me that the consultant had found Eurax plus on the internet and decided to prescribe it….

Let me know if you have any examples like these.

The Book

I have a dream. It’s not quite as powerful as Mr King’s but it’s important to me. I want to write a book about life in pharmacy. There is too much doom and gloom surrounding pharmacy and I want it to make people laugh.

A similar book was published recently. I have not read it but I believe with the help of social media, we could create something special. I need your help.

I want people to send in anecdotes and jokes about pharmacy. I would love to hear from community pharmacists, pre-regs, technicians, dispensers and counter staff. Also hospital, primary care, prison, academics, pharmacy journalists, students, GPs and even GP receptionists. I will add in some of my blogs too. I have no idea how I will publish it but that will be part of the adventure.

You can reply to this blog, via email mrdispenser@hotmail.co.uk, or Twitter @mrdispenser

I look forward to hearing from you and will keep you updated!

Tell your friends too!

GPS and Pharmacists working in partnership? Guest blog by Stephen Riley @pharmaste

The recent GMC study has shown that 5% of prescriptions contain prescribing errors and the DoH backed PINCER study found that Pharmacist-led interventions can substantially reduce common medication errors and are cost-effective. These studies support my own experiences in working with CCGs and GP Practices. I work as an independent provider of medicines management and optimisation services to CCGs and GP practices. One of my key roles is as Lead Pharmacist providing the complete medicines management service to a CCG in the North West who decided to contract out of the PCT in 2010 and commission their own service.

It has provided a great way to build a rapport with GP Practices and staff at all levels (Clinicians, Practice Nurses, Management and reception staff) and has also allowed us to develop partnership working with the GPs. As we are commissioned by the CCG directly we are not bound solely by the PCT agenda and purely cost cutting. Cost-effective prescribing is a factor, but we have also worked with practices to optimise therapies, reduce wasteful prescribing, increase prescribing of licensed therapies, reduce prescribing of unnecessary unlicensed specials, conduct safety audits and conduct face to face medication reviews.

I sit on the executive committee for the PDA union and worked on their Road Map project for Pharmacy. The essence is develop enhance clinical roles for Pharmacists, such as running clinics managing long term conditions (e.g. respiratory, hypertension, etc) or near patient testing (e.g. anticoagulation). These could be delivered via the Community Pharmacy network, by Community Pharmacists. A practice based Pharmacist role could be ideal for Primary Care Pharmacists to move into and work in a complimentary fashion to the essential role of Community Pharmacists.

I am standing for for the EPB in this year’s RPS elections and have joined with some other like minded candidates to work to provide a Bright Future for Pharmacy. Partnership working with GPs and other health professionals is essential If Pharmacy is to have a significant role, high profile impact in the new NHS structure and be effective and properly rewarded as part of the healthcare team. I would urge all RPS members to vote before noon on 01/06/12 and anyone to have a look at our face book group https://www.facebook.com/groups/353602354689304/, we plan to use it as a forum post elections. Together we can work towards a Bright Future for our profession.

OTC addiction (guest post by @zams123)

Guest post by @zams123

I t’s worrying how the majority of people in some areas have a problem with drug abuse and addiction. This problem in community pharmacy however can be very annoying.

For example, how many community pharmacists today are faced with frequent over-the-counter requests for co-codamol products? The same people keep coming in to buy co-codamol, solpadeine plus etc feeding the staff and pharmacist with more or less the same story: ‘I’ve run out of my prescription co-codamol 30/500mg tablets’, ‘its for my back pain, nothing else agrees with me’ or even ‘my doctor recommended it’… It becomes conflicting when we are put in a position to refuse the sale; customers kick off and become rude, complaints arise and go to headoffice department, but the end result is that they are going to buy the co-codamol product from another pharmacy using the same story again.

It can also be annoying that GP’s might not realise what our OTC licensing issues are and recommend patients to buy over the counter as it’s probably cheaper than on prescription.

This problem does not just apply to co-codamol, it’s other products too such as codeine linctus and kaolin and morphine. The frequent requests I had in my pharmacy for kaolin and morphine mixture were atrocious that I had to remove it off the shelf.

In my pharmacy we are recording on paper when we sell these products to suspected drug abusers. Apart from this, how else can we resolve issues with codeine addiction and drug misuse?

What would you do?

Its 9.00pm on a Saturday evening and you are still at work. A patient brings in a prescription for 500g E45 cream and you don’t have the item in stock. You are closed tomorrow.
Do you:
A] Say that you don’t have it in and ask them to try elsewhere
B] Offer to order it in for Monday
C] Ring your competitor across the road and if they have it in, send the patient across
D] Ask patient to ring out of hours doctors to get an alternative prescribed
E] Try [probably in vain] to convince them to buy a small tube of it for over the weekend
F] Other