Monthly Archives: September 2014

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Resolution Follow-up

For the first time ever, I have accompanied my morning coffee with an ample bowl of Lucky Charms. Hey, when you’re on the go you need to eat some kind of breakfast in the morning. If you can’t get excited about sugary marshmallows with the consistency of dense styrofoam floating in your cereal, then I guess that makes you older than six. It just so happens to be the perfect combo of sugar and caffeine to get the writing juices flowing.

It’s a bit overdue, but with the new school year upon us it seems like a good time to revisit my New Years Resolution Post. Eight months is a good yardstick to see if I’m making progress, albeit a completely arbitrary mid-point.

So first off: gym. I’ve been steady at getting there twice a week between shift-work and evenings at home with the kids. Sometimes it’s not the most energetic session, but my cardio is decent and remains fairly stable.

#2) Guitar – Ah yes, my muse. ‘I know chords’ is a sure fire way to let people know you own a guitar and mess around with it on occasion. A small update on that front: since January, a few friends and I have started a garage cover band and I’ve discovered the bass. So to anyone who is interested in how that’s going, ‘I know chords’.

#3) Getting the house in order – There is always stuff to do around the house. By my standards, I’ve been rather slack. My father and I were successful at tearing down the rotten deck on the back of the house. Landscapers have since put in a french drain and flagstone patio. I’ll take that as a win.

Finally, the practice resolutions:

#4) Letting go – I couldn’t be more proud of how my team has developed over the past year, both in cohesiveness and as a visible presence in the grocery store where we work. I made a key hire in November 2013 for an assistant supervisor and even though I had high expectations, she is well on her way to exceeding most of them in less than a year. This has allowed me to delegate many of my dispensary manager duties. Functions including evaluating and hiring assistants, payroll, accounts receivable, team communication, scheduling, budget reviews, and department meetings are all shared between us. I’ve had more time to focus on promotion, special projects, succession planning, and most importantly spending the time I need with patients (occasionally I get an idea for writing as well). It has been a pleasure to watch her grow into the role and flourish.

5) Inviting a prolonged patient interaction – believe it or not, this is still not as instinctive as I once thought. We still have daily pressures that can make conditions for such an interaction difficult. That said, my relationship with many of our patients gets stronger every day. I enjoy seeing them visit and they will ask for me. I recently had an extremely positive interaction with a patient frustrated with his diabetes control. The doctor appreciated my recommendations and now we have a baseline from which to work. Another gentleman with chronic pain shook my hand the other day to thank me for ‘being good to (him)’. One more off the top of my head is a man who underwent surgery for cancer and is doing well. Through a miscommunication with his wife, they accidentally transferred out, then immediately transferred back and apologized profusely.

Overall, have I met my targets? Not all of them, but I’m not beating myself up over it. There are so many positives I can point to that make the exercise worthwhile. We’re positioned better than ever to provide injections through the flu season, we’re providing medication review services to a larger number of patients, and my team is still growing and improving. The biggest winner in all of this is me; they make me better, and I resolve to ride this wave as long as I can.

 

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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Thoughts on Technician Regulation

Guess what? There are some marked differences between hospital and community pharmacy.

As the blueprint for pharmacy practice transitions across the country, these two working environments really serve to highlight those differences, especially from a training and orientation standpoint. My personal experience in hospitals over the past decade is pretty much non-existent. I have be on some site visits, and have marveled at how the dispensaries were run. My curiosity led me to question how such large teams can become so consistent in their discipline to complete tasks. Like cogs in an assembly line, if one piece gets shifted or removed, another is prepared to repair or replace without missing a beat. Through my observations and discussions, it has got me thinking: in many ways, hospitals are holding back technician regulation because they’ve been too effective in their integration of current assistants to roles requiring more training and responsibility.

Let’s back up a bit…

Here in Nova Scotia, hospitals operate under different regulations than community-based practice. I’m sure this is true in many jurisdictions. Health professions can collaborate freely within the confines of the hospital and have some flexibility to re-define roles in response to new service demands. Tech-check-tech processes were introduced in the hospital long before it was being used in long-term care or community settings. Specialized technical roles had non-pharmacists in charge of sterile preparations, stat-box management and unit-dose dispensing. Dispensary managers are often former technicians that are now administrators, developing and enforcing policy and procedure, while overseeing site-specific training modules that may require upwards of 6 months to complete.

This has allowed pharmacists to spend more and more time in clinical, collaborative practice and minimal time in the actual dispensary. Many full-time positions are entirely clinical in nature, opening the door to take full advantage of approved expanded scope services (i.e. – lab test requisition).

Therein lies the rub: technician roles have been leveraged so well that regulation doesn’t appear to have the same dramatic impact on hospital technicians as it would in a community setting.

As a community pharmacist in both retail and previous long-term care environments, I can see the potential in the investment towards tech regulation to free up pharmacist time. The main difference is that we need the regulation in place to take advantage of some of the opportunities before us, where pharmacists aren’t the ones who primarily verify a completed prescription or compliance packaging, and instead can spend more time injecting, reviewing medications, and documenting interactions with patients. Hospitals were able to integrate those functions without the formal regulations in place, and are thriving as a result.

In closing, although it’s taken a long time, regulation is finally here. There are excellent people in pharmacy assistant positions that are stepping up to support the pharmacy profession. The glass ceiling is cracking and is primed to shatter. A new profession, with new leaders being recognized as the professionals they are, will push us to the next level.

 

 

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.