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  • Independent nurse prescribing

    Is anyone else slightly worried about nurses being allowed to prescribe any licensed medicines, including certain CDs (including morphine and oxycodone)?

    And how stupid is it that independent pharmacist prescribers will not be able to prescribe any CDs (including Sch5). So unless the regulations are changed before the first pharmacists qualify as prescribers, there will be the ridiculous situation where they can sell co-codamol 8/500 but not prescribe it!

  • #2
    Nurse Prescribing

    Steve

    I have worked in two hospitals, and virtually all nurses I have met believe they know all about drugs. I don't know why, they just do. I was once having a conversation about hypertension with one. I mentioned the autonomic nervous system, and she had never even heard of it. My friend who's a nurse, tells me they do no pharmacology on their course. The question is therefore why are nurses getting these powers and we are not.

    This obviously has nothing to do with education or knowledge. The same friend did I think 5 GCSE's and a two year course, and she's a staff nurse. We all know how difficult a pharmacy degree is to do.

    So the only conclusion I can come up with is that are better represented then us. When you read articles in say the BMJ, about supplementary prescribing, they always put nurse/pharmacist together, as if we had the same qualifications. Maybe they think we do, I don't know. All my experience tells me is that we are very low down the health worker chain, if not at the bottom, in people's eyes.

    "And how stupid is it that independent pharmacist prescribers will not be able to prescribe any CDs (including Sch5). So unless the regulations are changed before the first pharmacists qualify as prescribers, there will be the ridiculous situation where they can sell co-codamol 8/500 but not prescribe it!"

    Very stoopid, that's obvious. All I can say, is don't ever get your hopes up as a pharmacist, because you'll only get disappointed. I never expect anything to go our way, and that way I am never disappointed. If something does go good for us, it's a bonus.

    In practice I think nurses will only prescribe what they feel confident and knowledgeable about. I can't see in practice them starting someone on morphine etc, without checking it with the patient's GP first.
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    • #3
      Qualifications

      Was asked by one of my younger customers who was just leaving school. "How many O'lvels do you need to be a Pharmacist. I told them about needing A' levels and a degree. They could not believe it.
      Advised them to go and be an Optician or Dentist.

      For the record I have only got 5 0'levels as that's all we did in 1975.
      47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
      2018 AD : Modern Man : I shopped, I clicked, I collected.
      How times change.

      If you find you have read something that has upset or offended you an anyway please unread it at once.

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      • #4
        Education

        Pharmanaut

        Do you think we are over qualified for the job? Before I went to do my pharmacy degree, I did a HNC in chemistry (part time). If I had only studied for an HND in pharmacy (two years full time) I'd feel quite happy with my salary/job etc. I personally feel I only ever use about 5% of what I have learned to do the job. I couldn't believe it when they turned pharmacy into a four year course, and feel sorry for the kids of today.
        Lively debate is encouraged but please respect the opinions and feelings of others.
        Please help keep the forum vibrant by spreading the work to friends and colleagues via word of mouth or social media.
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        • #5
          education

          Think of it the other way around: of the skills you use every day in your job, what percentage did you learn at uni? I certainly never had courses on people skills, diplomacy, health & safety, marketing, employment law, accountancy, baby nutrition, cosmetology, photography,...
          I think the most important thing I learnt at Uni was HOW TO LEARN!
          Ze genuine Article, present & perfect!

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          • #6
            Re: Education

            Originally posted by admin
            Pharmanaut

            Do you think we are over qualified for the job? Before I went to do my pharmacy degree, I did a HNC in chemistry (part time). If I had only studied for an HND in pharmacy (two years full time) I'd feel quite happy with my salary/job etc. I personally feel I only ever use about 5% of what I have learned to do the job. I couldn't believe it when they turned pharmacy into a four year course, and feel sorry for the kids of today.
            The course I did in 1977-1980 was scientifically very interesting. As someone who loves sciences (and still does) was happy with the course. I'm not sure what the MPharm course is like, but one could be suspicious that the first year is now spent getting up to the same level, whereas this was once the focus of the first term.

            I think the main thing that hits people when they get into the 'community field' is the long hours and the need to maintain a very high level of concentration for extended periods of time. This is mental skill that you can develop and will help you throughout life in whatever else you do. Physically it is easy to neglect your own simple needs such as the need to eat and drink etc.
            47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
            2018 AD : Modern Man : I shopped, I clicked, I collected.
            How times change.

            If you find you have read something that has upset or offended you an anyway please unread it at once.

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            • #7
              Zo

              I can see your point about all the things that we don't learn at university, but wouldn't we have learned them anyway? I just can't see the point of learning lots of things that seem to me, to be just for the sake of it. Why do you need a degree to be a pharmacist? If the course was split into say a two year course for community pharmacy, and a three or four year for hospital, wouldn't that be better for community pharmacists?

              At my uni they told us you needed a degree because it gave you respect from other health care professionals. I don't think any of them even know we do one, never mind how hard it is.

              I was once very ill with an abscess, and was in bed at home, needing a GP to visit me. He knew I was a pharmacist as I had seen him in some meetings I used to attend, and I re-introduced myself to him when he came in my room. I was being prescribed Kapake for the pain (2 QDS), but it was so bad I was awake all night in pain. When I told him this, he said he would prescribe me 30mg codeine tabs, and I could take two QDS along with 2 paracetamol. I told him this was the same as I was taking, and he said no it isn't, to me like I was a 3 year old, and the paracetamol would be cheaper if I bought it! He thought I didn't even know the price of a packet of paracetamol. I told him I wanted some extra codeine, but he refused this, yet asked if I wanted some Zimovane. I said no, I'd just be all dopey and still in pain. In the end I said to my husband "please get this f*****g idiot out of my bedroom!". Ok maybe he was the idiot, but that's the kind of level of education I find most people think we have.

              I guess I just feel that I wasted a lot of time and energy studying things I don't need to know, and I don't like that feeling. Life is short as it is, so why spend two extra years at uni you don't really need to. It all comes off the bill at the end!

              To Pharmanaut, you say we develop the ability to concentrate for long hours. So do snooker players! I have met quite a lot of new pre-regs that have done the four year course now, and their depth of knowledge is extremely high. Imagine how they feel three months into the job, as that knowledge is starting to slip away, bit by bit, because they never actually use it. I see that same feeling creep up on them, that I had, that tells you you've just spent years training to do a job that isn't really that was sold to you. A couple of years in, and most of the science they learned is a faded memory, as we all know you lose it if you don't use it.

              I just think we should be trained for the actual job, and not for the sake of it.

              Just my opinion, that's all. Never forget: -

              "It's nice to be important, but it's more important to be nice"

              Admin
              Lively debate is encouraged but please respect the opinions and feelings of others.
              Please help keep the forum vibrant by spreading the work to friends and colleagues via word of mouth or social media.
              Thank you for contributing to this site.

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              • #8
                Admin is spot on, once again...

                "It's nice to be important, but it's more important to be nice"
                Now why does that instantly make me think of my area manager?!?
                Ze genuine Article, present & perfect!

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                • #9
                  Zo

                  That was a quote that I nicked from watching the world snooker championship these last couple of weeks. It was said by Ken Doherty ex world champion. I don't think he's your area manager, but if he is will you ask him if he'd give me a game, and a few tips!

                  Ok. I admit it's a bit sickly, but I thought it sounded good!

                  Lively debate is encouraged but please respect the opinions and feelings of others.
                  Please help keep the forum vibrant by spreading the work to friends and colleagues via word of mouth or social media.
                  Thank you for contributing to this site.

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                  • #10
                    Bits of the course not relevant?!!! What do you mean!

                    ... so this 4th year assignment i have in tomorrow analysing the mass spec, H1 NMR, UV spectra, and IV spectra of a drug (many of you come across diazoxide?) won't help me to be a better pharmacist! ;-)

                    The make or break of my degree will be my project - its on stabilising liposomes using PEG. Its not the most interesting, but I'm cracking on with it...

                    ... my point is that my tutor for this project, and for a lot of the background science of the course move into teaching modules of pharmacy from another science degree eg. Biochemistry. They can teach their subject area superbly, but it rarely leaves me any wiser on how it'll help make me a better pharmacist.

                    I'm looking forward to next year when learning on the job will mean the skills i learn will be skills i use.

                    PS: Here at manchester, we do now have token communications modules, althoguh they really are no substitutute for getting some experience

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                    • #11
                      Alex

                      All the analytical techniques might help you in industry, but you won't come across it much in retail. I did a project like yours, i.e. a practical one not a survey one etc and I found it interesting. It does give you skills in things like how to conduct basic research, how to present work properly, things of that nature. I guess it all adds to your general communication skills, written and verbal (we had to do an oral presentation of ours) which is useful. Having said that, we were always doing oral presentations at uni, which I like everyone else hated, and yet I've never done one since.

                      Are you going to work in retail when you are finished? You could maybe do your pre-reg in hospital and see if you like that side of the job. You can always get a job in retail later on, if you don't like hospital work.

                      You are right that there really is no substitute for doing the job. Do you learn in communications things like people management, conflict management, difficult customers, shop lifters and the law, potential violent situations, leadership/motivation, patient councelling or anything like that? I once went on a self defence course and found that useful.

                      Do you do any role-playing of the situations you can find yourself in? If you do it would be interesting to know what the current course covers.

                      Thanks
                      Lively debate is encouraged but please respect the opinions and feelings of others.
                      Please help keep the forum vibrant by spreading the work to friends and colleagues via word of mouth or social media.
                      Thank you for contributing to this site.

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                      • #12
                        Communications involved one session/week , for about 10 weeks, role playing being the pharmacist "Good afternoon, have you had the medicine before/ do you know how to use it correctly/ then asking their address and bidding them farewell".

                        It was ok. Some of the more hands on, practical sessions were excellent, where we got to practice with things (epipens/different kinds of inhalers etc).
                        Its all very well learning loads of theory - but it doesn't half bring you down to earth when working in a community pharmacy after that, you aren't well enough equipped to deal with simple things.

                        Less than a month left at uni now, i'm really looking forward to pre-reg.

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                        • #13
                          pharmacist training

                          why are you guys knocking pharmacy,of course there are a lot of irrelevant courses in pharmacy but I am sure this will apply to many other degree courses.I have worked in community pharmacy for over 10 years, and although I do not use all my knowledge ,I am glad I studied some of those irrelevant pharmacy courses.If you guys feel that way about pharmacy education write a petition to the RPSGB asking them to down grade it to an NVQ level 2 or 3 ,and let your dispensers and medicines counter assistants take over your shops.Pharmacy is what you make it...there are below average pharmacists,bog- standard pharmacists,good pharmacists and excellent pharmacists....you need to pitch your level of knowledge against the pharmacist you would like to be or are....pharmacology and clinical pharmacy play a significant role in our daily work life
                          I 've seen so many prescriptions dispensed which shouldn't have.
                          Below or bog standard pharmacists will happily dispense two PPIs and an H2- antagonist on the same prescription,amiodarone 200mg bd long term,warfarin 3mg tds,thyroxine 50mcg bd,tildiem 200mg LA tds, celecoxib and Ibuprofen on the same script for a 75 year old and so much more,because they are just dispensing and not clinically checking a prescription,we all need to wake up and smell the coffee,we need to continue learning and applying and making sure we can hold intellegent conversations with other healthcare professionals..Do you think a HND or NVQ will prepare you for NICE guidelines,BTS guidelines etc.I speak to GPs and customers on a professional level everyday and they welcome my advice and input.PLEASE DON'T PUT PHARMACY DOWN BE PROUD OF IT,YOU NEED MORE THAN A HND/NVQ TO BE A GOOD/EXCELLENT PHARMACIST,EVEN A COMMUNITY PHARMACIST.ANYBODY CAN DISPENSE,BUT GOOD COMPREHENSIVE PHARMACEUTICAL CARE CAN ONLY BE PROVIDED BY A PHARMACIST,pharmacists are the last port of call after a patient sees a medic,so we are safety nets,lets not take this responsibility lightly,clinical pharmacy checks protect the public,....... :shock:

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                          • #14
                            Dear Alchemist,

                            you do make some good points. The problem is a lot of the time we're just expected to be dispensing machines and when we are given roles that might tax our intellects a little all we get is aggro because the Rxs have been piling up and Mrs Miggins is missing Richard and Judy because of her long wait.

                            I used to enjoy extemp preps on a Saturday afternoon but hated them on a Monday morning. The same goes for extended roles. PGDs etc.

                            But the main problem is the general public see us as little more than dispensign machines too. Everyone with internet access and Daily Mail readers think they're all Drs.

                            I had a woman today who had had diarrhoea for four days, been taking Kaolin and Morph and had just got back from India! I sent her immediately to Dr who wrote her a RX for Loperamide. When she came back with said Rx she ranted and raved because that was all she wanted to buy anyway!

                            After crap like that it's hard to remain positive. :twisted:
                            Linnear MRPharmS

                            Foetal Alcohol Spectrum Disorder: The biggest cause of brain damage and 100% preventable.

                            In pregnancy: 1 fag is not safe, 1 x-ray is not safe and 1 drink is not safe.



                            For handy pharmacy links try
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                            If you like my posts or letters in the journal try my books!
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                            • #15
                              Hi

                              I have to agree with Linnear on this one. Nobody wants a pharmacist who is good at clinical checks etc. They want one who can happily check 800 scripts and deal with 75 methadone patients and run a needle exchange excheme at the same time, with minimal staff and no complaining.

                              I used to tell people like area managers when I had done a good intervention, and they looked at me as if I was mad. I still do this of course, but just write it down and keep it to myself for CPD entries etc.

                              All I'm saying is that if a HND contained the relevant course content, it would be more then adequate training to work in retail. I just hate to see the look of disappointment of pre-reg youngsters when they have worked in a store for a month, and wonder what they have spent the last 4 years training for.

                              Just my opinion.
                              Lively debate is encouraged but please respect the opinions and feelings of others.
                              Please help keep the forum vibrant by spreading the work to friends and colleagues via word of mouth or social media.
                              Thank you for contributing to this site.

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