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  • Work done by Hospital pharmacists

    I recently applied for a job at a hospital pharmacy and was astonished to hear about the amount of work that technicians do!
    They seem to do everything!!
    They check if they are ACT's
    They wright up TTO's
    They check all the drug charts on the wards.
    They manufacture everything - non-sterile and aseptic.
    All the pharmacists do is clinically check the charts and then how often is there a problem!!
    I quickly withdrew my application and decided i will carry on with locums for a while.
    It must be really boring being a hospital pharmacist - doing virtually bugger-all all day!

    What are hospital pharmacists views?
    Do you think you will be made redundant one day?
    Just techs - what a disaster!
    Hospital pharmacists i feel have let this happen!

  • #2
    Re: Work done by Hospital pharmacists

    well according to what i learned in my two weeks placement in hospital, a pharmacist main job is to support medics through ward rounds, assessing new patient's medication, sorting out any queries, providing information etc... i.e. doing the job the 4 year degree taught them to do. Dispensing and all the running around is done by technicians who btw are paid quite well for it, the better of them quite similar to what a newly qualified pharmacist gets paid in hospital.

    technicians dont check drug charts for interactions, they make sure all the medicines on the drug chart are e.g. there, in date, working properly in the case of devices (inhalers) etc... this would also be double checked by the pharmacist. Technicians are to pharmacists what nurses are to doctors, and let me assure you the knowledge base alot of nurses have is atleast comparable to most junior doctors.

    and to:
    clinically check the charts and then how often is there a problem
    well let me assure you there are more clinical issues in hospital for a pharmacist to sort out than in community pharmacy.


    What are hospital pharmacists views?
    Do you think you will be made redundant one day
    i can only laugh at this comment, have long have you been a pharmacist, you do realise presence of pharmacist in hospital has shown to increase outrcomes etc... and also pharmacists have a totaly different role in hospital than they have in community, they are more clinically orientated, and are respected and treated like health care professionals should be,

    on the other hand locuming is a lot easier, id be surprised if one encounters more than 1 clinical issue, community pharmacy issues are more to do with quantities, out of stock, manufactueres delays, special orders, etc... which when locuming you dont need to worry about as you (hopefully) wont be there the next day!!!
    We are the music makers, We are the dreamers of dreams and God damn we are that good

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    • #3
      Re: Work done by Hospital pharmacists

      Well done in speaking up for hospital pharmacists Solomon. It annoys me when people compalin that hospital pharmacists do nothing because technicians do so much.

      However please don't disrespect community pharmacy in the way you have here.

      I don't know where you work but one clinical issue a day doesn't seem right. As you are only a pre-reg and haven't actually worked as a pharmacist in your own right I am concerned about the quality of your training. Any community pharmacist who is merely worried about stock levels and out of stock situations hasn't had the full range of training a modern pharmacist should have.

      I am not saying this to disrespect you or your contribution. I hope when you qualify that you find your focus and prosper. But I fear your pre-reg may not be preparing you in the way that you deserve.
      http://uk.youtube.com/watch?v=Hmbyj0XFUhA

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      • #4
        Re: Work done by Hospital pharmacists

        I have been a pharmacist for 18yrs.
        Yes please do not disrespect retail pharmacy.
        Most hospital pharmacists would find it much harder in retail and locuming is harder in retail than hospital because all of the techs can help you out if you find it hard - ah diddums!!
        SolomonQ you haven't had the experience yet to appreciate fully what i have said but you will in time when all the techs are clinically checking as well!!
        The extended extended role of the technician!!
        Then there will be no pharmacists in hospital at all and then you will say 'Oh yes he was right after all'
        I saw this thing start to happen when i was a pre-reg in hospital and another pre-reg said 'yes i totally agree with you' all those years ago and now it is happening!
        When i worked in hospital for the first 3 years of my career i stocked up the ward and clinically checked all of the charts and dispensed the drugs back in the pharmacy - it wasn't hard at all!
        I didnt need a tech in fact they would have been a nuisance!

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        • #5
          Re: Work done by Hospital pharmacists

          You talk just enough sense to stop me from accusing you of 100% unconscionable bollocks.

          You are talking about 98% unconscionable bollocks.
          http://uk.youtube.com/watch?v=Hmbyj0XFUhA

          Comment


          • #6
            Re: Work done by Hospital pharmacists

            Originally posted by Tony Schofield View Post
            You talk just enough sense to stop me from accusing you of 100% unconscionable bollocks.

            You are talking about 98% unconscionable bollocks.
            For the benefit of the audience, Tony- Who are you addressing this to?
            Ze genuine Article, present & perfect!

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            • #7
              Re: Work done by Hospital pharmacists

              For the benefit of the audience, Tony- Who are you addressing this to?
              abviously not to me (i hope), but just to elaborate my position above and comment regarding my experience, ok maybe ive not had as much experience as people who have been pharmacists for 10-20 years but I can still comment on those people saying hospital pharmacy is becoming redundant sector for pharmacists, well these people will have been living in a cave somewhere far away from UK then, here is a easy observed sector to see where pharmacy is moving towards and what changes are being made, pharmacists can be seen working alongside doctors and nurses aswell as others in multi-dicipline teams sometimes even pharmacist led clinics etc... but some people would still rather do menial work like counting pills and filling shelves.

              also according to the same logic being applied to hospital pharmacy by some, are the same people predicting similar fate for community pharmacy especially with the "responsible pharmacist" becoming more of a reality each day and also with ACTs etc.... atleast they dont appear to be doing that at the moment. Before making points like this please consider things such independent prescribing rights for pharmacists plus the re-orientation of community pharmacy towards clinical issues.

              and like I said pharmacy technicians are to pharmacists what nurses are to doctors. there must be alot of nurses out there who can manage some conditions aswell as a doctor can and so there are many situations where nurses are solely responsible for he care of ceratin paqtients, and similarly pharmacy technicians might well become qualified enough to do clinical checks, but they wouldnt be pharmacists just like the above mentioned nurese are not doctors. and in such situations pharmacists would still be hired by hospitals but maybe to do more, shall i say, useful jobs.

              Regarding low levels of clinical errors in cp, and my experience well it doesnt take more than 8 motnhs to see what kind of errors a pharmacy encounters, and fortunately as a pre-reg im not regarded as just another dispensary staff member as alot of pharmacies like to treat people at my level. and i do keep a look out for any potential issues in the rx im processing or any others (Normally pharmacist goin out to the shop front, then me askin him what was wrong with the Rx later) etc.. with Rx and when i talk about 1 error per day I mean CLINICAL error such as contraindicated medicine or an interaction etc... not things such as unsigned or undated prescriptions or uncomplete Rxs in other ways. however I do not include OTC interventions, the number would be far greater then.

              There are basicly two type of Rx patients, those on repeat prescriptions and those on just the one off, short term say antibiotics. The long term patients on repeat medication hardly ever change therapy however those initiated on long term therapy do take time to stabalise, so very low chance of issues here.

              The short term patients, well shouldnt really call them patients, should call them customers as they treat pharmacy like a shop and like to shop around, one time they go to one pharmacy with their antibiotics next time go to another for their ibuprofen, then go to a third for the omeprazole so how do you check for any clinical issues here? the best intervention i can think of for these sort of patients is if it's a dentist Rx asking them if they're allergic to peniciilin as the dentists dont have patient medical records.

              I have the feeling someones gona get totally the wrong side of the stick about what ive written and make unneccesary comments but hey the best i can do is write a note :

              PLEASE READ ALL OF THE ABOVE (TWICE FOR SOME, THRICE FOR A SMALL MINORITY OF OTHERS)!!! THANKS
              Last edited by SolomonQ; 17, May 2008, 01:21 AM. Reason: me sleep talking
              We are the music makers, We are the dreamers of dreams and God damn we are that good

              Comment


              • #8
                Re: Work done by Hospital pharmacists

                My comment was directed at DRH75.

                I have only read Solomon's post once so won't comment on it until I have had my breakfast. However on first reading he makes many sensible points.

                Before I go I worked in a pharmacy yesterday that did 587 prescriptions. I noted the following:-

                I explained to a patient and then their doctor what Isophane insulin pyr was and the possible consequences of the practice computer not recognising it.

                I assisted a doctor in calculating a dose for tinzaprin

                I explained to a doctor the new formulation of perindropril. The discussion was important as the doctor had no idea how the patenting of medicines and branded generics could impact on her prescribing costs.

                I did an MUR in which the patient admitted ordering beclomethasone inhalers to keep the practice happy but wasn't using them.

                I supervised a subutex in which the patient did his best to conceal putting the tablet in his mouth. We had a "mature" exchange of views after which he did as was required of him.



                We also had problems with controlled drug prescriptions which were incorrectly written. MDS prescriptions, a problem with a MAR chart where a carer had incorrectly filled it in, a problem getting Haymine from Unichem who treat the product as a counter item and don't deliver it as quickly as perceived prescription items. These particular queries and more were taken care of by any one of the four technicians assisting me, two of whom are ACTs.

                I clinically assessed each prescription as I hadn't worked there for some considerable time but I didn't do any final schecks unless I had instructed the staff to give the script to me to hand out.

                I don't accept that a pharmacist's clinical knowledge rots because he is working in a community pharmacy. I don't accept that using well trained support staff renders me less useful and possibly redundant in the future.

                The relationship between a pharmacist and staff is not one of power and subjugation. It is one where, as Solomon points out, the developing clinical role of pharmacists will be impossible if more isn't delegated to support staff. That can only be done by educating and empowering support staff.

                Hence my remark about DRH75 where he implies that as hospital technicians do more, hospital pharmacists do less. It is utter, unconscionable bollocks.
                http://uk.youtube.com/watch?v=Hmbyj0XFUhA

                Comment


                • #9
                  Re: Work done by Hospital pharmacists

                  Originally posted by drh785 View Post
                  I recently applied for a job at a hospital pharmacy and was astonished to hear about the amount of work that technicians do!
                  They seem to do everything!!
                  They check if they are ACT's
                  They wright up TTO's
                  They check all the drug charts on the wards.
                  They manufacture everything - non-sterile and aseptic.
                  All the pharmacists do is clinically check the charts and then how often is there a problem!!
                  I quickly withdrew my application and decided i will carry on with locums for a while.
                  It must be really boring being a hospital pharmacist - doing virtually bugger-all all day!

                  What are hospital pharmacists views?
                  Do you think you will be made redundant one day?
                  Just techs - what a disaster!
                  Hospital pharmacists i feel have let this happen!
                  In my hospital, we have three types of technician: Dispensary, Clinical, and Technical Services.

                  Dispensary technicians are pretty much those that you would find in community, with the addition that they tend to be better trained (NVQ3 with BTEC underpinning knowledge). They are able to deal with a much wider range of dosage forms (injections, chemo etc) and also undertake named-patient top-ups, usually on mental health wards. Obviously, they are also ACT's

                  Clinical technicians are usually ward-based. These techs have completed a clinical diloma are are able to undertake a variety of roles on the ward, mostly the basic roles such as: Drug history taking, checking the accuracy of transcribed charts and sorting out the orders. This frees up the pharmacists time to undertake more complicated work, such as concordance issues, clinical checking, TDM and giving advice to medics on prescribing issues, and advice to nurses on administration issues (ie via PEG, NG, JEG tubes).

                  Technical services technicians make sterile and non-sterile items, everything from creams to ready-made chemo. Sounds complicated but is really all down to experience. Pharmacists can therefore concentrate on stability, compatibility and formulation issues - stuff you need the MPharm to understand.

                  Hospitals will only start community pharmacists as band 6 pharmacists - the lowest grade. This is a reflection of the lack of clinical knowledge and training, especially in mental health, oncology, paediatrics, renal pharmacy and surgery. When I do community locums, I feel that half the time I don't need to be there - the techs are more than capable. The clinical issues I pick up should have been spotted by the regular pharmacist a long time ago!(but that is my own experience - I may be covering for a few exceptionally dim pharmacists).

                  Basically, technicians do the jobs in hospitals so that pharmacists can concentrate on harder clinical problems.
                  Band6 is a Band 6 no longer.. now 7/8a

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                  • #10
                    Re: Work done by Hospital pharmacists

                    It is not necessary to repeat your post in so many threads. We all start by clicking on new posts.
                    johnep

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                    • #11
                      Re: Work done by Hospital pharmacists

                      Originally posted by johnep View Post
                      It is not necessary to repeat your post in so many threads. We all start by clicking on new posts.
                      johnep
                      Really?! Heh heh
                      Band6 is a Band 6 no longer.. now 7/8a

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