Quality vs quantity

[stawberry]

I was qualified recently and just started to work in a pharmacy which deals with care homes. I admitted I am a bit slow in checking at the moment because I have been looking up the BNF and the scripts frequently and I am quite cautious. I was on my own for couple of days this week and I could not finish checking and meet the deadlines set by the ACT last week. Reason being that things not turn up it should be in the morning when it was short staffed and 3/4 staffs were stuck with store operations and could not concentrate on doing homes. I pushed them and told them I can't finish checking if too many people worked on the same stuff. I was stuck at the front in afternoon and I can't finish checking. When the ACT came in the very next day I let her know what's happened. She did not blame me and we both knew that it needs to go out today. However still, I have been looking up BNF for doses, interactions and checking patient's history cautiously. I might have been over cautious and I had few queries on scripts because the fact that patients had taken for a few medications for long term did not seem to satisfy me or stop me from putting in query. I used my judgment and I did not put in queries every single time. I might be too quick to ring the surgery and put in my query straight away and the ACT started to get concern and spoke to my manager straight away. My manager came to the back and started to look at the script I was enquiring and said that the doctors have been visiting patient every year. It gave me a message that I need to check quickly and there is no need to check doses that have been on for ages. My ACT then said if I query on every prescription she will get worried that the home cannot go out as it set. If I have any queries I should go to the manager first before I ring up and then she confirmed with my manager that I can do that. It sounds like I am trying to slow up the process every other time I have a query. I wasn't very happy and I spoke to my manager personally that I was aware of what's happened and I can see why the ACT was worried. I then spoke to my ACT and asked her to speak to me directly in the future if there is any concern about me and she asked me why would I put in the query to the surgery directly without asking the manager and she needs to make the manager aware because the manager is the boss. She was defensive and wasn't very happy about what I told her so I apologised because I did not want to create bad atmosphere in the pharmacy. Am I too cautious about less important or less significant interactions? Is quantity more important than quality especially when I am checking the homes?

Sorry my words are too long.

[johnep]

Are you an absolute beginner, an 'accuracy checker', dispenser' ACT or a pharmacist? What qualification do you have? NVQ. BTech or M.Phm?

johnep

[LeftArm]

Am I too cautious about less important or less significant interactions? Is quantity more important than quality especially when I am checking the homes?

For the first question you will find a balance with experience. It is always a good idea to note interaction checks on PMR so that the same interaction is not queried every month but many pharmacies do not do this. If a patient has had something long term it is usually the case that it has been checked and confirmed but this is also a way that long term errors occur.
For the second patient safety is the most important.

[stawberry]

Mpharm. Thanks for people replying this thread. I am aware of my roles. My confidence just got knocked down because I am thinking do I need to go through every query with my pharmacy manager each time I have one query. It is a common thing that people will trust someone that has been working with them for years and need some time to build the trust towards new people. However, do I need to go through every single query with experienced people even though I am a pharmacist? I was attacked for putting in a query and I don't see the point when I am acting for patient's safety and I am aware of the deadlines too.

[Defblade]

Is your manager a pharmacist?

If not, then they really have no relevance or input over how you work professionally.

You probably are over-cautious at the moment; however this is 100% normal for newly-qualifieds. This should have been taken into account in deciding where and when you would work; that is, how much to do and how short a deadline.

Knowing what can go through on-the-nod and what needs a closer look will come with time... you get a sixth-sense. On the whole, regular tray meds for homes are fairly low on the risk list - GPs will be frequent visitors to the home, there are (or should be!) trained staff, doses should be taken regularly, the home should be receiving advice from pharmacy and possibly medicines management at PCT level. Have you offered to MUR all the residents?



BUT having said all that, there are times (or more likely, branches) where you can find little confidence in what is done there - a long series of errors and queries - and at those you must take all the time you need!



"Newly qualified" or "old-timer", you're still a Pharmacist like us all, and when you're in charge, you work how you want to work - you ARE in charge!

[andrew paxton]

Nice to see a proper pharmacist