Monthly Archives: October 2014

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Law & Ethics

One of the hats I wear is that of a pharmacy skills-lab demonstrator at Dalhousie University. The fourth-year graduating class is lucky enough (or unlucky, depending on who you ask) to have me stand in as a patient, physician or family member with whom to interact as part of given case scenarios. They are assessed on clinical knowledge but also delivery and style; body language and empathy make up a good portion of the final scoring rubric.

Sometimes I forget just how awkward it is to be a student.

Every year the course evolves, and the content of lab scenarios is tweaked to account for the expanding scope of practice. Prescription adaptations are new within the past two fall semesters, as are injection training modules. A couple of weeks ago, the lab focused on law and ethics, which has always been part of the curriculum, but not always represented in lab scenarios. The written cases were excellent, and would be challenging for seasoned practitioners, let alone mature students.

I have been practicing for over a decade. Although I have first-hand knowledge of some difficult moral and ethical dilemmas that occur in the pharmacy world, most times they have been second or third-hand. Staff members stealing narcotics from the safe, substance abuse in the workplace, and sexual harassment are just a few examples of uncomfortable situations that can arise in a dispensary. None are straight-forward and all require discipline to separate responsibilities under the law and the empathy for the person or persons involved. The law doesn’t care if it was a one-time occurrence or a habitual behaviour, the situation needs to be dealt with as dictated. However the follow-up may have a few more layers. Does the individual have mental health issues that have not been treated? Are they a danger to themselves or others? Is this terrible error in judgement easily corrected?

As preceptors, it’s natural to shield students on rotation from these difficult situations because they have so much on their plates already. So the students in lab were in a bit of a quandary. The scenarios were new and surreal. They had to think fast, interact with a possible offender and gather the information they needed to make a sound decision. The weird thing was that when I had received the case to review, the scenario almost exactly matched an incident I experienced during my first management role. The emotions I felt at that time came flooding back, mostly about how afraid I was to confirm my suspicions that someone was dispensing to themselves. As a new manager at the time, I made the situation about me, and how much trouble I would be in had I been wrong. That said, it was dealt with properly but I completely understand the thought process my students utilized. My answers to their questions were the same as I had received when I went through the situation myself, as was the doubt I tried to create that it was more than a harmless misunderstanding.

The feedback I provided to the students along with their responses identified the two adjoining conclusions: you can uphold the law by reporting and documenting a potential crime or professional misconduct, while at the same time ethically supporting individuals by referring them to a mental health specialist or social worker as needed. For the most part, it is not one over the other.

It amazes me each year the empathy and comfort the students display in their interactions, even awkward ones. There is no doubt that they will all encounter a situation or two that test their knowledge of pharmacy law and blur the lines of the ‘right’ and ‘wrong’ ways toward a resolution. Introducing these new professionals to a few of these possible scenarios should aid their thought processes for when they’re out practicing on their own.

I would say the lab was a resounding success.

 

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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Flu Shot Redux

Oct 19,2014.

The date has been bandied about for the commencement of this year’s flu vaccination season. Although the date may change slightly from this posting, Nova Scotia is ramping up for a robust campaign to exceed last year’s success. Pharmacies in the province provided upwards of 80,000 doses of the seasonal vaccine while physicians provided only about 18,000 doses less than the prior year. Interestingly enough many pharmacies, including my own, were late receiving supply or had only one injection-certified pharmacist on staff for a good portion of the fall/winter months.

Last year, performing injections was new for pharmacists here, but we got pretty good at it. In the time since, I’ve been keeping in practice with travel vaccines and have recently been in demand for the shingles shot as patients become more comfortable dropping in to ask about them. For a service so straightforward and quick (the act, not necessarily the pre- and post-documentation), people genuinely appreciate the convenience and most will happily pay any associated fees to avoid sitting in a clinic waiting room.

I’ll be the first to confess that I’m not that excited about needles; whether I’m giving or receiving a shot, my feeling is quite neutral. I know there are plenty of practitioners who can give and not receive, or have a mental block when it comes to touching a patient. The sight of blood in any amount may not be on your daily agenda but the reality is that pharmacists have proven we can fill a large care gap…a care chasm as it were. An at-risk individual may be stopping in for a blood-pressure medication refill and perhaps receive a shot at the same time. A family of four with two kids under the age of ten come to pick up a few things on the way back from a matinee and now they’re no longer influenza carriers for Christmas dinner with Nan. A pregnant woman’s fears about harming her baby will be allayed.

The point here is that I see the value in providing the service to those that want it. Many members of the public are against flu vaccination. That is their right, and I have no interest in putting anyone on the defensive. I DO however want to be available to anyone who is eager to protect themselves and will pass the word that we’re ready and willing to provide for their family and friends if they are so inclined. Waiting on our first lot of vaccine is making for suspenseful week with the multitude of phone calls we’ve been fielding, so the demand is there. Signs are up and clinics are being planned. It appears we’re going to be receiving Agriflu, which is pre-filled 0.5mL of convenient, time-saving goodness. To be sustainable, our approach will be to treat any request for a vaccination no different than an acute medication for a patient; wait times may vary depending on the time of day and the volume we’re processing. These are duties we will carry out as best we can with the flow of the day.

You can bet that as long as the flu vaccine supply lasts, pharmacies will be instrumental in finding deltoids to receive it. When the season passes, we’ll be ready for the travel rush of winter.

Emergency kits inspected? Supplies ordered? Forms printed? Staff primed on intake? This year, it looks like we’re all ready to rock.

Just remember to save a shot for yourself.

 

 

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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Engagement of One

There are things in this world about which I hold strong opinions. Most often these are in the realms of personal development and group change. There needs to be an inherent trust between members of a team. It doesn’t matter how big the team is; two people in a partnership, or a global brand spread across continents all require a level of engagement to truly be effective at executing strategy. There has to be an emotional attachment to the mission and a shared satisfaction to reach a goal.

The most successful organizations understand that their greatest strength is their people. Taking that one step further, it’s the development of those people that set them apart. I could use a collection of cliched buzzwords here that have a tendency to say everything and nothing at the same time, but the gist is this: it’s one thing to have quality people in leadership roles to succeed today, but it’s another to have those same people prepared and inspired to take on tomorrow.

I am confident and proud to work for an employer that takes engagement seriously from the top down. They recognize the differences in learning styles between generations, and have an evaluation process that focuses on behaviors that contribute to the business, trusting that desired results will follow. I currently feel that I’m valued, and have mentors looking out for my best interests personally and professionally.

So how does one engage another person or group for a common goal? Job satisfaction means different things to different people, so one approach is to try and understand what motivates and rewards different groups.

A quick Google search brought me to this document discussing staff development from none other than the United Nations.

The link is a fairly easy read, but the content is nevertheless fascinating. The title is: ‘What Matters and How They Learn’ and breaks down the generation gaps in the workplace. I’ll let you have a skim and then we’ll continue the post. I’ll wait for you here…

(Interlude music)

So the groupings themselves: Baby Boomers, Gen X, and Gen Y comprise the vast majority of the current workforce. There are some Traditionalists, but their number is declining into retirement. By grouping generations in this way, commonalities emerge around the fault lines. For example, I fall near the tail end of the Gen X timeline, meaning that I may share a similar value set as a 50-year-old colleague with respect to being goal-oriented and self-reliant. At the same time, there are flickers of the Gen Y group that I recognize as well; when it comes to sociability and collective action, I completely embrace that culture in the workplace.

[As an aside, one of the distinctions between Gen X and Y as written in the document of Techno-literal vs. Tech-savvy. One needs step-by-step instructions and the other finds technology intuitive. If I was able to start a blog, but have no idea of any advanced features, does that make me advanced-techno-literal?]

So, we know the workplace is comprised of blended learning styles. Training should therefore contain elements that appeal to most workers. Gen X apparently respond well to graphics/design and brevity of training materials. Gen Y wants to learn when and where is comfortable, and being connected online is very important to them. The key is knowing the audience, and it takes a significant investment of time to learn how to relate to the individuals. Once that emotional attachment is established, you begin getting back more than you put in. You challenge one another and learn together. On a personal note, the occasions that I am wrong tend to be the most rewarding experiences in the end.

One final point I’d like to make is that there are many tools or devices being used for engagement, be it team-building exercises, group dinners or retreats, in-house competitions, monetary rewards, surveys or even one-on-one meetings. What tends to get missed is that engagement starts with people and ends with people; the tools are not the answer by themselves, nor do they have an endpoint. When used by someone who is already engaged, any strategy has a chance to reach others who may in turn, pay it forward by seeking to engage their other colleagues.

If you’re like me and truly engaged, that passion will keep you coming back for more, and you’ll have confidence that someone will always be waiting for you to challenge, learn and grow. Take advantage of that feeling and the opportunities that will present, just be ready to create those same feelings and opportunities for others when the time comes.

 

 

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.