Preparation for starting band 6

[pharmacist_interrupted]

Hi everyone,

I've managed to secure a band 6 position which I'm thrilled about but I'm now also a bit worried after doing community for so long! Just wondering if anyone can offer any advice on any preparation I should do before I start so I'm not going in completely clueless. I'm not starting for another couple of months.

Thanks to anyone who replies.

[Asterix]

It won't be easy and it will be a big step up. I would focus on reading around biochemical factors such as urea, sodium, potassium, creatinine as there is a lot of emphasis on this during patients being admitted and and during stay. What is your IV drugs knowledge like, in hospital you will come across a lot of these, I can direct you to a few sources if you want. T

There are also a range of articles around drugs such as warfarin I would advice you to read. Also get your head around anticoagulants and LWMH, trademark drugs in hospital.

[Nik]

Biochemistry is a quite an important aspect of ward work. However to start off with there will be a lot of SOP reading and getting to grips with the dispensary, understanding the computer software and screening prescriptions when they come in, rather than checking off assembled prescriptions as it were in community. Any help just PM me.

[pharmacist_interrupted]

Thank you both for the advice. My IV drug knowledge isn't great so any sources on that and warfarin would be useful. I've seen a lot more LWMH going out in community recently so have got a bit more familiar with them but I'll definitely look into it more.

Nik, yeah I was thinking there'd be a lot of SOPs to read initially and getting to grips with the other stuff you mentioned. I may be PM'ing you soon!

[Asterix]

Thank you both for the advice. My IV drug knowledge isn't great so any sources on that and warfarin would be useful. I've seen a lot more LWMH going out in community recently so have got a bit more familiar with them but I'll definitely look into it more.

Nik, yeah I was thinking there'd be a lot of SOPs to read initially and getting to grips with the other stuff you mentioned. I may be PM'ing you soon!

I will pm you some information to help you up the speed into IV's.

Most pts at hospital get put onto some form of LMWH for DVT/PE prophylaxis and hence it's important to get your head round this and the doses that accompany it.

[crit care]

you will be fine as they will gradually introduce you to the work and you will have mini validation tests before they let you loose on the wards.....just be up to date on your clinical knowledge...go back to uni notes and text books....basic clinical pharmacy...drug monitoring, common interactions, antibiotics,

i'm sure you will be fine...they wouoldn't have given you the job if they didn't think you would be good at it!

[bobbin]

It won't be easy and it will be a big step up

I think it will be different rather than a big step up. In community, pharmacists often have to make decisions on their own, as the sole responsible pharmacist. Patients come in with difficult problems, often when the surgery is shut and there is no one to ask for help. There is no support network, it all boils down to *you* - in some cases you will have good support staff, in other cases you won't. Clients with incomplete methadone prescriptions may very well turn up near closing time on Saturday afternoon and start kicking off.... or whatever

As far as I know, Band 6 is the basic grade hospital pharmacist and so you will not be expected to know everything about everything from day 1. There will be other pharmacists to ask for help when you need it. Although community pharmacy has had more of a clinical emphasis lately, we do not normally see patients blood results or anything like that. Also, the range of products used is quite different to hospital. Hospitals have a formulary and so the range is restricted, there are many products dispensed in community which will not be on the formularly. On the other hand, hospitals dispense a large range of injectables, cytotoxics and TPN which are rarely, if ever, seen in community pharmacy. You will have plenty of reference sources available if you need to make checks on dosages and other clinical issues.

I think it would be useful to look at the BNF every day. Each day, look at a different group of drugs which are used in hospital but not in the community.

[Nik]

And of course there's a nice relationship between the two sectors as well. I have had to contact community p'cists regarding pt's coming on dosettes and organising a supply on discharge (if needed), confirming drug histories on the odd occasion and informing them when methadone pt's get admitted.

[bobbin]

go back to uni notes

Only if they're very recent, which I suspect that are not. Clinical pharmacology and therapeutics has been subject to a lot of change in recent years. I suggest looking at the most recent medical and pharmacy reference sources available.

[Nik]

Much of the basic therapeutic principles will be unchanged, and updating this kind of knowledge is a good thing to put drug therapy in to context. However with things like drug choice it's good to keep up to date with national and local guidance.