Rates of Pay For Locums

[admin]

Originally Posted by Linnear

My missus always said that before she met me she thought that all pharmacists were nutters. Now she's sure of it!

I think the real problem is that part of our trainign has always been to be afraid of the Stat Com, the drugs squad, basically everybody.


Make sure you do this or it's illegal and you'll be done etc.etc. etc.

Then there's the older pahrmacists who were trained and worked when pharmacists were respected and feel that they shoudl do everything for everyone. The problem is that the world is a very different place today and if you delivered every single Rx that you received all you;d get is complaints because you left someone's gate open or knocked their begonias as you walked up the path!

I think I agree with you. That statt comm axe hanging over your head makes you scared to do anything really, doesn't it.

[Jeff]

Originally Posted by Linnear

Then there's the older pahrmacists who were trained and worked when pharmacists were respected and feel that they shoudl do everything for everyone. The problem is that the world is a very different place today and if you delivered every single Rx that you received all you;d get is complaints because you left someone's gate open or knocked their begonias as you walked up the path!

I don't think it's the training or a different time - just a case of getting older, and the realisation that the point of pharmacy isn't the prescription, the medicine or the head office target but the patient.
That having someone tell you to naff off is a failure - and the conversion of the more challenging patient is probably one of our more important interventions.

Jeff (who rarely has a problem with a patient)

[admin]

Originally Posted by Jeff

I don't think it's the training or a different time - just a case of getting older, and the realisation that the point of pharmacy isn't the prescription, the medicine or the head office target but the patient.
That having someone tell you to naff off is a failure - and the conversion of the more challenging patient is probably one of our more important interventions.

Jeff (who rarely has a problem with a patient)

Jeff

She wasn't a "challenging patient" she was a nasty drug abusing woman. I smiled nicely to her, explained all the reasons why the drug was not corect for her son, and she shoutd f**k you at me. Can you explain to me, exactly where I failed with this challenging patient? The only way to avoid what happened would have been to bow to her wishes, and sell a drug that was not appropriate for the patient. Is that what I did wrong? Should I have sold it anyway?

If you have rarely had problems with a patient, then to be honest I either don't believe you, or you must work in quiet little village pharmacies. Try working at my friends place (he's after locums) with over 150 addicts. I'll put my mortgage on it that at least 5 of them will say exactly the same to you in just one day.

Are you doing locums now Jeff? If you are, try a few inner city pharmacies. See how you manage with a drugged up shop lifter, when all the staff escape to the back of the shop, because he's known for always having a knife on him. See how far your diplomacy skills go then.

I always put the patient first, and do my best for them, but you cannot please all the people all the time.

[Linnear]

Jeff - we're going to have to agree to differ old mate.

Someone swearing at me doesn't strike me as my failing, it strikes me as a failing on their part and why should I lose any sleep over them.

I find the point of pharmacy is to get those people that really need their drugs and can organise that in a civilised manner to having their drugs.

I don't see that being treated as a doormat aids our profession all it aids is our current climate of the consumer can have whatever they damn well want and they can have it whenever they like.

[admin]

Originally Posted by Linnear

Jeff - we're going to have to agree to differ old mate.

Someone swearing at me doesn't strike me as my failing, it strikes me as a failing on their part and why should I lose any sleep over them.

I find the point of pharmacy is to get those people that really need their drugs and can organise that in a civilised manner to having their drugs.

I don't see that being treated as a doormat aids our profession all it aids is our current climate of the consumer can have whatever they damn well want and they can have it whenever they like.

Obviously I agree with you Linnear, but I wonder where people like Jeff work? Jeff doesn't seem the doormat type, but every single pharmacist I know has problems with the public in one form or another. My old mate Geoff has even had a knife held to his throat, and he's the nicest guy you could meet!

[Jeff]

Originally Posted by admin

Obviously I agree with you Linnear, but I wonder where people like Jeff work? Jeff doesn't seem the doormat type, but every single pharmacist I know has problems with the public in one form or another. My old mate Geoff has even had a knife held to his throat, and he's the nicest guy you could meet!

For the last 3 or 4 years a quiet pharmacy - maybe up to 20 misuse patients.
Enough time to get to know the patients.
Yes I've banned a couple for shop-lifting - but that doesn't mean that I don't still get on with them. I ask how they're getting on when they pass by - and other members of their family come in.

I record contact numbers for daily patients so that at about 5:30 I'll call them if they haven't collected. I've warned all about the risk methadone poses to children and dispense in separate containers for each dose so as to reduce risk of spillage.
I rearrange appointments at the drugs unit if they miss them and get authorisation for early supply if they know that they are going to miss a day (e.g. due in court - working away from home)
Biggest problem was getting drug unit to allow unsupervised and collection by named relative - when patient gets a job. Required going past the keyworker and to doctor to remind them of the objectives of treatment.
One patient did swear at me - but his/her HRT script hadn't arrived and it was the testosterone speaking - apologies next day - they'd got home to a message on the answerphone that I'd left earlier - saying that even though the surgery hadn't yet signed the script I'd lend them enough to last till they did so.

Here's a nice one for you - what would you sell/recommend to a patient who wanted to home detox and give up heroin?

Jeff

[admin]

Originally Posted by Jeff

For the last 3 or 4 years a quiet pharmacy - maybe up to 20 misuse patients.
Enough time to get to know the patients.
Yes I've banned a couple for shop-lifting - but that doesn't mean that I don't still get on with them. I ask how they're getting on when they pass by - and other members of their family come in.

I record contact numbers for daily patients so that at about 5:30 I'll call them if they haven't collected. I've warned all about the risk methadone poses to children and dispense in separate containers for each dose so as to reduce risk of spillage.
I rearrange appointments at the drugs unit if they miss them and get authorisation for early supply if they know that they are going to miss a day (e.g. due in court - working away from home)
Biggest problem was getting drug unit to allow unsupervised and collection by named relative - when patient gets a job. Required going past the keyworker and to doctor to remind them of the objectives of treatment.
One patient did swear at me - but his/her HRT script hadn't arrived and it was the testosterone speaking - apologies next day - they'd got home to a message on the answerphone that I'd left earlier - saying that even though the surgery hadn't yet signed the script I'd lend them enough to last till they did so.

Here's a nice one for you - what would you sell/recommend to a patient who wanted to home detox and give up heroin?

Jeff

I do most of the above, but don't make appointments for people if they missed it because they were due in court etc. I simply don't have time for that, and in my opinion that's going too far. Why can't they re-arrange their own appointment?

You "lend" medication - don't you mean you do an emergency supply?

As to your question I wouldn't sell them anything. I'd recommend they do it properly through the various channels that are open to them. I am not in a position, and nor is it within my remit, to treat heroin addiction. I would help in the way a pharmacist does, within the system, but not act alone.

I cannot see how you can do either, because you cannot attempt to substitute any OTC product (surely they are un-licenced for this), and you can't advise them to keep buying street heroin, gradually reducing the dose, as they never know how pure it is.

What do you do?

[Jeff]

Originally Posted by admin

I do most of the above, but don't make appointments for people if they missed it because they were due in court etc. I simply don't have time for that, and in my opinion that's going too far. Why can't they re-arrange their own appointment?

Local drugs agency rules on appointments - if you miss you have to wait 2 weeks.

You "lend" medication - don't you mean you do an emergency supply?

No an "emergency supply" supply requires paperwork - "lend" is an option on most PMR systems.

As to your question I wouldn't sell them anything. I'd recommend they do it properly through the various channels that are open to them.

And these various channels are?

I am not in a position, and nor is it within my remit, to treat heroin addiction. I would help in the way a pharmacist does, within the system, but not act alone.

OK so you'd signpost the patient BUT to where?

I cannot see how you can do either, because you cannot attempt to substitute any OTC product (surely they are un-licenced for this), and you can't advise them to keep buying street heroin, gradually reducing the dose, as they never know how pure it is.

What do you do?

CDP ;-)

Jeff

[Linnear]

Originally Posted by Jeff

No an "emergency supply" supply requires paperwork - "lend" is an option on most PMR systems.

Jeff

It may be on most systems doesn't mean the stat comm won't kick your arse if your caught doing it!

[Amba]

Come on Jeff. What you are doing is bad news for all pharmacists. It's like selling yourself short and the profession. The moment we start doing services for free (like collection and delivery) we undermine our profession. The attitude becomes why should we pay you for this service when you do it for free anyway? Do you honestly think that you are particularly qualified to monitor and supervise a step-down strategy for a heroine or drug addiction client? Nobody is under the impression that you are a knight in shining armour for taking on these quite dangerous activities under your own volition. It is not thinking out of the box or showing initiative, it is illegal. Are you prepared to go to jail or lose your registration for this type of unwarranted work? Think carefully, my friend, you are just setting yourself up for a huge fall from grace with the RPSGB (oh no now i have mentioned that name i have to say five Hail Mary's).