RP: responsible pharmacist? Ready and prepared? Rather petrified?
All of the above.
Day one as responsible pharmacist of a retail pharmacy business brought many challenges as well as great professional satisfaction.
Having spent the previous six months working as pre-registration pharmacist at Merck Sharp & Dohme, on the advice of many industrial pharmacist colleagues as well as my desire to maintain a patient facing role, I was keen to locum as soon as possible following registration. Fortunately, my local independent pharmacy needed someone part-time for a few weeks, the manager was very supportive in getting me up-to-speed with how the pharmacy operated. He invited me to be second pharmacist for a day, something I would recommend anyone do before taking on the reins of absolute responsibility.
Having a second pharmacist was mutually beneficial, it gave the manager the chance to catch up on some administrative tasks and be able to dedicate time to completing a number of MURs with patients.
At the end of my first day, I had a strong understanding of how the pharmacy functioned. I knew to expect many OTC consultations (due to the emergency medical centre next door); I was aware of the the distribution of work load (numerous care homes with MDS, a high volume of EPS repeats for delivery and a steady number of walk-in prescriptions); as well as the job roles of the eight support staff; and of course the location of necessities such as the CD register/keys and private prescription book.
Day one as RP arrived, safety-net no more.
It was the Saturday of a bank holiday weekend and I wasn’t sure whether the day would prove hectic or not, but the queue of patients waiting at 9am soon settled this. The first patient through the door wanted to know whether her husband could take Gaviscon alongside his 15 regular medicines. I loaded up his medication record and quickly came across omeprazole, oxytetracycline and a number of MR preparations that I knew could/would interact. After reviewing the rest of his medication, including the timings at which they were to be taken, I recommended she advise her husband to leave a two hour gap between taking the Gaviscon and his other medicines. Given the queue of five patients still waiting for my attention, this query very quickly reminded me of the time pressures faced by community pharmacists.
Despite this pressure, five years of pharmacy training has engendered me with the ethos that patient safety comes first. There is no rush.
The day continued with a continuous stream of prescriptions, including a prescriber who had strangely penned cetirizine 10mg BD; hardly enough to induce liver failure, but enough to make me question their intention. This was followed by a potential propranolol ADR, one which I deemed unlikely following in-depth questioning. The day eventually slowed in pace, enough for me to spend five minutes refuelling with lunch.
All in all, I had a thoroughly enjoyable first day. I enjoyed tackling the unexpected and putting to good use my training from Manchester Pharmacy School and Guy’s and St Thomas’ hospitals. I feel ready and excited for further locum opportunities and the educational experiences they will bring.
Daniel Greenwood is PhD candidate at Manchester Pharmacy School and a locum pharmacist
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