Monthly Archives: March 2014

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One Year in the Blink of an Eye

It’s a wee bit stormy out here on the east coast. Spring has decided to pack up and go to Florida to avoid 30cm of blizzard leftovers.

I’m in awe that 1) it has been a full year since I published my first post on PharmAspire titled ‘Inspiration‘ and 2) as my gender is not always known for remembering certain occasions, I have earned my gold star on this day.

It has been a banner year for personal and professional growth. Even from post #1 the tone and feel of the blog is exactly how I had originally envisioned it: a place to explore all of the positives in our lives as pharmacists in the words of those living it. Other places may serve to spotlight all of the crazy/annoying/mundane aspects of our profession and it’s often a good laugh, but at the end of the day, it keeps the mind trapped in all the things we dislike about what we do. At the very least, what can we take from those examples to illustrate what we have control over to improve the situation for the next time?

It was never meant to be all about me, and consequently, many of the experiences I’ve had over the past year have been shared with or inspired by others. A couple of other author-friends have taken a turn writing their own pieces, and they are certainly worth a read.

Reviewing some of the topics covered, we have delved into job satisfaction and handling ‘no-win’ situations. We have taken on mental health in numerous posts, including mobile outreach, community group participation and addiction. There have been heavy topics (suicidal ideation) that have balanced with lighter fare (Odds & Ends). Current events in Nova Scotia include the journey towards technician regulation and our first foray into administering injections. Quite a mixed bag, wouldn’t you say? All posts may be found in the archives if you’d like to check them out.

All in all, and I repeat myself often in saying that it’s been extremely satisfying to watch this blog idea grow. It has reached more people than I could have expected in such a short time. To top the year off, the blog is being featured in the March 2014 issue of Pharmacy Practice +. I am both honored and humbled by the support I’ve received.

A sincere thank you goes out to Laura M, who has been my blog editor since day 1. My ideas are sometimes convoluted and my metaphors don’t always make sense. I’m so glad she has stuck with me and pushes me to be a better writer.

So what’s in store for year #2?

A lot has happened in the pharmacy world and continues to happen. As I wade through my own experiences with expanded scope and collaborative practice, I hope to share as much of the highlights as I can. Plans are in the works to continue mental health outreach with the More Than Meds project (http://morethanmeds.com). Other upcoming features include further follow-up on my smoking-cessation sessions, a deeper look into palliative care, and a profile on a new provincial initiative (http://polypharmacy.ca).

Stay tuned!

 

Twitter: @PharmAspire

Facebook: https://www.facebook.com/pharmaspire.ca

email: dcovey@pharmaspire.ca

 

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.

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Pharmacy Lawn Care

***This post was originally created March 3rd and may be found as a static page on the left sidebar under ‘About PharmAspire’. It was inspired by the editor of Pharmacy Practice +. Thank you Vicki 🙂

Recently I was asked to write a blurb to introduce myself and expand on the creation of PharmAspire. Over the past year, I’ve tried to share pieces of me through my thoughts and experiences, but haven’t really given any background to the ‘who I am’ and ‘why I created a blog’ questions. I guess that would be a good place to start.

I have been a community pharmacist since graduating from Dalhousie in 2001. Since then, I have been involved in many aspects of community pharmacy. This includes exposure to pharmacy management, marketing, human resources, professional development, corporate direction and process analysis. I’ve met many great leaders and have several mentors within the profession. I’ve had moments of burgeoning job satisfaction and also some periods with an empty, ‘is-this-for-me?’ feeling inside.

I have been fortunate that my career has had been mostly ups with only a sprinkling of downs. Here are a few of the highlights that capture my journey as a practitioner. Firstly, in 2005, I was asked to manage a dedicated long-term care site. This role required me to not only provide medications to nursing homes, but also use consulting hours each week specifically to support facility initiatives. I was able to be part of a collaborative team along with the administrative staff, the nursing staff, the medical director, and a recently added nurse practitioner. I was invited to chair pharmacy and therapeutics meetings, help draft policies and procedures, perform training sessions, and take part in facility events for the residents.

My second example is from my time at corporate office. I had always enjoyed the professional development side of human resources, and was fortunate enough to have a hand in preparing and delivering numerous events for staff. There was quite a variety, ranging from orientation of new pharmacists, to managers-only sessions, to training events for the entire pharmacy staff across multiple provinces.

The single largest change in my career was in July, 2012. Changes to legislation had begun to severely impact the life of a community pharmacist. Our new expanded scope of practice required that changes to practice be integrated on an accelerated schedule to counter drastic changes to the existing economic model. I was leading a team through these transitions, but realized that I was struggling with my readiness to change my own practice. I made the personal decision to step back and rediscover what drove me to pharmacy in the first place. PharmAspire began as a way for me to channel my thoughts and observations to focus on the positive.

Pharmacists thrive in many sectors of the healthcare system. When significant changes come about, there are almost always negative aspects associated with the transition. The old cliche, ‘the grass is always greener on the other side’ starts to resonate and folks look for new pastures, and new challenges. However, many of us have roots in the sector in which we work, and if our experience can influence how the changes are implemented, it can only help to sand down the rough patches. My goal with the blog is to inspire and motivate pharmacists. Wherever you may be, grab a bag of fertilizer and make your own grass greener. Strengthen those roots and get excited about sharing new experiences.

So what kind of pharmacist do you aspire to be? The tagline is, ‘The Practice of Pharmacy On Your Terms…In Your Terms.’ and those ideas can spring from anywhere at anytime. The act of describing in our own terms the barriers we’ve overcome and the rewards we reap, will help the entire pharmacy community to evolve our practice to meet the needs of the healthcare system, on our own terms.

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.

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The Unexpected Experience of Mental Health Outreach

Since May, I’ve been a proud member of the More Than Meds team (@morethanmeds, http://morethanmeds.com). I’ve been led off the beaten path of conventional community pharmacy and have begun to test my own beliefs about mental health and stigma that goes with it. I’ve certainly had my eyes opened, and many doors and opportunities too. I think it is fair to say that being a part of this program has really helped me to better understand what patients and their families go through on a daily basis – the hope, exasperation, set backs, isolation, support, and progress. This understanding didn’t happen by remaining in the dispensary.

About four weeks ago, I was invited to attend a meeting with family members of patients struggling with psychotic and schizo-affective disorders. This group has been meeting monthly for about 10 years now. From what I observed, they have grown into a big supportive family. Mostly there were couples, but some single parents attended. Each would provide insight and support to the others in the group by sharing their own experiences with mental health services, inpatient stays, the multitude of care providers, challenges with housing, and of course, the medications. While I am very familiar with the commonly used psychotropic medications, I am far out of my comfort zone when it comes to addressing the non-pharmacological issues of mental health care. While I knew it on some level, being at the support group really crystallized for me the importance of being much more than meds (see what I did there?). Educator, navigator, collaborator, and advocate (definitely advocate) roles make much more sense now, whereas before I didn’t really ‘get’ how to fit them into my practice. Quite frankly, I was overwhelmed by how much information I had to offer. Information that they needed, information that brought the members of the group understanding and clarity and/or new therapeutic paths to follow. Their appreciation was more than humbling.

During a round-table discussion, a member of the group touched on something that I can’t seem to shake, and I paraphrase:

“Our son lives with schizophrenia. He’s been doing well of late. His meds are stable. He is living independently. When he was a teen, he was a gifted athlete and musician. Now mostly he plays video games. We actually get concerned that he has stopped his medications when he gets back to playing music…and he’s really really good!”

This comment really struck me, flooding me with all sorts of thoughts and mixed emotions. This illness, especially the negative symptoms, is so frustrating to families, and to me. What can we do to help? Are his medications stifling his creativity? The concept of blunted affect has been written about extensively (http://en.wikipedia.org/wiki/Blunted_affect, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632232/). Would suggesting a change in his pharmacotherapy be a good idea? Does it keep hope alive or set up false expectations? How do we say in so many words, “things could get better. Would you like to try (x)”? Simply by saying it we are, in fact, pointing out that the current situation is somehow unsatisfactory, but who are we to judge? This may be counterproductive as it may only serve to cause the family frustration rather than hope. As pharmacists, we may struggle to determine our role in these situations. We do not title ourselves as mental health care specialists but we do contribute to mental health services. In a broad sense, we contribute every time we speak with someone about their sleep, their mood, their worries, and the medications that affect those things.

That said, I am glad that I chose to accept the invitation to speak. Even just to be a part of  a community searching for help and support. On the topic of medication regimens: sure, they help the families and caregivers cope. They can also provide stability, the lack of which could otherwise prevent the return to work or leading to the loss of yet another relationship. However, not everyone likes the medication experience. It’s been said that the cost of stability may be a little less color in one’s world. For that evening, I may not have had all the answers to their many questions. I may not have been able to recite the most relevant head-to-head trials or know all the rare side effects for each medication, but I learned that my imperfect knowledge and my experience allowed me to give so much in the way of support, information, and encouragement.

After a couple of sessions with families and patients, I don’t consider myself an expert but I certainly feel that my awareness has changed for the better. I hope to participate in more evenings like the one mentioned above.  I know my daytime patient care activities will benefit from it.

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.