NPSA Leaflet

[lamzee]

yes--someone please put a stop to open plan dispensaries! They make me want to retire (very) early!!!

[Pharmanaut]

Originally Posted by Robatcymraeg

It's been suggested elsewhere that a formal complaint shoul dbe made to Stat Com about the lack of confidentiality in completely open dispensaries.

What does anyone think?

A complaint from a patient would carry more weight.

[SolomonQ]

imagine with an open plan setting:

the pharmacist is busy shifting the workload in the dispensary, many repeat and waiting prescriptions to dispense, nomad/dossette trays to check, queries to make, CD entry to make etc etc... a patient come into the pharmacy and wants to talk to the pharmacist about a chesty cough. normally in such a situation the assistant cud say s/hes busy, but in open plan the patient can see the pharmacist in the dispensary and even though s/he seems to be workin the patient expects the pharmacist to stop workin and come and speak to the patient. Actually in this situation the patient wudnt even ask the assistant and kinda shout out for the pharmacist trying to get eye contact with them, commiting them to talking to the patient. (after eye contact, blanking wudnt really be a polite gesture from the pharmacist).

other issues raused:

-lack of privacy in such settings (e.g. if the pharmacist or other staff are less than pleased they cannot express their disgust because they are in full view of patients, these situations are needed when e.g. the doctor fails to comply to a decent request)

-further degradation of the reputation of pharmacists (people tend to put low value on things they can get to easily e.g. when patients go to see the doctor they wait outside a room with closed door, they might be made to wait longer than expected but dare not complain because the doctor might not treat them properly, thats why doctors are valued but with pharmacists if made to wait for longer than a few mins they can jus go to another pharmacy next time or ask for their RX back)

-patient brings in Rx and wants to wait, Rx passed to dispensary, although there is no one else waiting in the pharmacy, no one is able to attend to it straight away because of other ongoing activities. dispenser cud be in the middle of a large repeat script, and the pharmacist cud b checking a dossette box, what wud the patient's reaction be to this in an open plan setting.

-etc etc...

[Jeff]

Originally Posted by SolomonQ

imagine with an open plan setting:

the pharmacist is busy shifting the workload in the dispensary, many repeat and waiting prescriptions to dispense, nomad/dossette trays to check, queries to make, CD entry to make etc etc... a patient come into the pharmacy and wants to talk to the pharmacist about a chesty cough. normally in such a situation the assistant cud say s/hes busy, but in open plan the patient can see the pharmacist in the dispensary and even though s/he seems to be workin the patient expects the pharmacist to stop workin and come and speak to the patient. Actually in this situation the patient wudnt even ask the assistant and kinda shout out for the pharmacist trying to get eye contact with them, commiting them to talking to the patient. (after eye contact, blanking wudnt really be a polite gesture from the pharmacist).

So an accuracy check is a higher priority than talking to a patient?
Suitably trained technicians can do the accuracy check - the clinical check and ability to communicate with patents is our strength.

-lack of privacy in such settings (e.g. if the pharmacist or other staff are less than pleased they cannot express their disgust because they are in full view of patients, these situations are needed when e.g. the doctor fails to comply to a decent request)

It's called self control - and consider using a cordless phone in private area.

-further degradation of the reputation of pharmacists (people tend to put low value on things they can get to easily e.g. when patients go to see the doctor they wait outside a room with closed door, they might be made to wait longer than expected but dare not complain because the doctor might not treat them properly, thats why doctors are valued but with pharmacists if made to wait for longer than a few mins they can jus go to another pharmacy next time or ask for their RX back)

And you are a part of a positive feedback loop that implies that the prescription which needs your attention is more important than a patient consultation that can wait - preferably out of sight.

patient brings in Rx and wants to wait, Rx passed to dispensary, although there is no one else waiting in the pharmacy, no one is able to attend to it straight away because of other ongoing activities. dispenser cud be in the middle of a large repeat script, and the pharmacist cud b checking a dossette box, what wud the patient's reaction be to this in an open plan setting.

It gives you the opportunity to explain to the patient - while holding up a yard of labels - that you are in the middle of a long script and that being a mere male are unable to multitask safely - so her prescription will unfortunately be a few minutes.

Are you really so scared of talking to patients? It's talking to them that creates loyalty.

Jeff - who prefers patients to prescriptions.

[SolomonQ]

I hope I do assume rightly that most pharmacies dont have the dispensary support that they should have, as Jeff assumes,

Relating to the different points and scenarios:

-I think Jeff underestimates workload of most pharmacists, checkign is an exercise the pharmacist needs to perform most of the time aswell as the clinical check, not all dispensarys are laden with ACTs.

-about the privacy, so Jeff suggest when the fitters for the open plan come we should also ask them to install a cordless phone for us, so we can talk in private, i wonder where this privacy would be achieved as most pharmacies are not as big as he assumes

-about self-control, people get agitated and distress on purpose dont they and they can see it coming so they can exercise self control, atleast Jeff thinks so, the rest of us are human

- about being part of the so called positive feedback loop, the pateitn sees you putting stickers on a pack of tablets, im not sure how much experience Jeff has had with how patients treat the packaging and especially the labelling on the medicines, just to make it simple they dont really think they're important and everyone thinks about themselves anyway

- about the explaining, well how many times are you going to waste (literally) time by telling patients this. nothing to do with being scared to talk to people. Im still at the stage in my career where im eager to talk to the patient.

I prefer patients to prescriptions too but you should never forget a pharmacist's main link to a patient is through their prescription (atleast in the community setting).

If the pharmacist spends his time talking to such patients, what happens to the patient whose prescription needs to be dispensed. and lets not forget what pharmacy contractors employ pharmacists for, to make profits for them, talking to patients doesnt make them profits (atleast in the short-term), diespensing prescriptions does.

[SolomonQ]

continuing from above, im not saying a pharmacist should not provide counselling or information to people who walk in with queries, just that with an open plan pharmacy it would be harder for the pharmacist to manage such queries with the workload they already have in the form of prescriptions, queries with prescribers, processing of compliance aids for use by present regular/loyal customers/patients etc etc..

Peace Out!!!

[Jeff]

Originally Posted by SolomonQ

I hope I do assume rightly that most pharmacies dont have the dispensary support that they should have, as Jeff assumes,

Many don't have the support they should have - The problem is one of lack of support and not one of patients wanting to see you

Relating to the different points and scenarios:

I think Jeff underestimates workload of most pharmacists,

I'll admit that I'm fairly choosy about where I accept work.

checking is an exercise the pharmacist needs to perform most of the time as well as the clinical check, not all dispensarys are laden with ACTs.

Can we agree then that the problem is a lack of support i.e. poor management.

-about the privacy, so Jeff suggest when the fitters for the open plan come we should also ask them to install a cordless phone for us, so we can talk in private,

Nip down to a supermarket and buy one - they are easy to fit.

i wonder where this privacy would be achieved as most pharmacies are not as big as he assumes

Consulting room, loo, - if the pharmacy offers no privacy it fails in its duty of confidentiality - does it not?

about self-control, people get agitated and distress on purpose dont they and they can see it coming so they can exercise self control, atleast Jeff thinks so, the rest of us are human

No - it's usually down to bad management. (at a variety of levels)

- about being part of the so called positive feedback loop, the pateitn sees you putting stickers on a pack of tablets, im not sure how much experience Jeff has had with how patients treat the packaging and especially the labelling on the medicines, just to make it simple they dont really think they're important and everyone thinks about themselves anyway

Why do YOU need to be the one putting labels on boxes? Oh yes - lack of support - it's a management issue.

- about the explaining, well how many times are you going to waste (literally) time by telling patients this.

That it will be longer than expected because they are in a queue behind a giant script? Not as long as it takes to type. People will put up with all sorts provided that you communicate with them and let them no what's going on. It's being ignored while they are waiting that gets up their nose.

I prefer patients to prescriptions too but you should never forget a pharmacist's main link to a patient is through their prescription (atleast in the community setting).

No - that's just a way in - the relationship develops - it's about their family, their life, - the signposting role offers many opportunities to both network with other professions and to help your customers.

If the pharmacist spends his time talking to such patients, what happens to the patient whose prescription needs to be dispensed.

Most prescriptions are repeats - if the clinical check was OK last month and the month before and the script hasn't changed then it's OK this month too.
With sufficient confidence in the support staff why do I need to be involved in the majority of the dispensing process?

and lets not forget what pharmacy contractors employ pharmacists for, to make profits for them, talking to patients doesnt make them profits (atleast in the short-term), diespensing prescriptions does.

I'm not suggesting that you stop dispensing prescriptions - just that much of the process can be delegated to suitably trained staff leaving the pharmacist available to spend more time with patients and less time with green bits of paper.

Regards

Jeff

[SolomonQ]

so i guess the management would hire an extra assistant in the dispensary to support the pharmacist, maybe even an ACT. why is it hard for you to believe that they will do no such thing, they will redesign the pharmacy layout, but also makesure they can sqeeze the most that they can out of a pharmacist employee or locum.

and Jeff what are you doing awake at 4:19am in the morning?? im worried for you now!!

Peace out, A-Town!!!

[Jeff]

Originally Posted by SolomonQ

and Jeff what are you doing awake at 4:19am in the morning??

Investestment research - better to do with no interuptions.

Jeff

[Pharmanaut]

Think about what would P*ss you off as a patient.

You feel grotty, have been to the doctors having waited ages.

Of you go to the pharmacy and you find...

All the staff industriously working to do prescriptions and getting on with it.
OR
All the staff working on prescriptions and getting on with it while chatting and joking.

Waiting to hand a prescription in but being ignored
OR
Someone says "Morning/Afternoon, I'll be with you in a minute".

The scripts are getting done just as quickly but the second one creates the wrong impression.

Take a moment to see ourselves from the customer point of view.