New Year, New Challenges

As I rang in the New Year with a few close friends, it really started to sink in. Everything had been a blur the previous week and it was finally starting to catch up.

And no, I’m not talking about rum and eggnog.

On December 30, I accepted a new position to manage a dedicated long-term care site. You can never predict when opportunities like this come along, and although hesitant to leave the most stable position I’ve held in a long time, the application was sent. At this stage in my career, my only real fear is stagnation; I’ve felt that sensation before and have no desire to dance with complacency. Thankfully, that stage has not yet arrived but could have appeared on the horizon at any moment. It’s best for me to be thinking ahead.

I have done this kind of work in the past and had always hoped to make it back, but this time it feels different. My first foray was helter-skelter; long hours, rushed chaos, problem-solving emergency calls after closing time, and staff watching me learn as I muddled along. To this day, I thank them for their patience. Amid all of that, it was also my first real exposure to institutional pharmacy. Under the guise of a semi-retail operation, we provided medications solely to nursing homes, with a few supplies and/or convenience items the facilities needed. As primary consultant, I can speak fondly of my interactions with nursing staff, administrators, the medical director and a Nurse Practitioner with whom I have been working to promote polypharmacy.ca.

Nowadays I feel I have grown in a myriad of ways professionally. I’ve worked on some amazing teams and helmed some progressive projects. I have worked with student pharmacists and 30-year veterans. There has been pharmacy-related exposure to academia, government, hospital and most recently, journalism. Although I feel ready for the role ahead, suffice it to say there is still a long way to go. It’s a bigger team in a site with larger growth ambitions but the structure is sound so we can hit the ground running. Everyone is pointed in the right direction and I need to find a way to feed that positive energy.

Oftentimes when I have entered new environments, they have been in need of stability. The desire to be proactive is usurped by the need to be reactive, at least at the beginning. Ensuring policies and procedures are being followed to cut down on incidents, being detail-oriented with communication so everyone knows how to handle situations serve as a good place to start. The key is promoting consistency, which sometimes challenges current habits. The squeaky wheel often gets the grease, but sometimes the reverse is also true: your most patient customers / colleagues / support figures give you more rope when the going gets tough. It’s much appreciated, sure, but must not be taken for granted. It’s a nice change to begin where most of that coaching has already taken place.

I am excited to meet my new team and to see if I can fit in without upsetting the chemistry they’ve developed. My learning curve will be steep, but manageable. Respect is not an entitlement; I must earn it from every person I work with and for. After receiving a debrief from upper management, I can already feel the synapses firing on projects we can undertake and roles we can expand.

So as I bid farewell to my current team over breakfast this weekend, the gratitude will spill over like the Horseshoe Falls. We shall celebrate how far we’ve come and how close we’ve grown, almost as a family. I have friends for life (or as long as they’ll have me) and they deserve the best in the next phase. I’m not an emotional sort, but I couldn’t be more proud of the pharmacy and the grocery store proper. You’ve helped me grow and learn even more about myself. You’ve prepared me for this next challenge and I promise to not let you down. You’re welcome to check in anytime; I will be doing the same.

Onward and upward…

 

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.

The Bloom Program

Before you all jump on me for using another lawn/garden reference, please know that this is purely coincidental (though it does go tidily with the growth of our profession).

On these pages, I have written about my experience with the More Than Meds program. Its philosophy is entirely patient-centric. It uses a pharmacist’s medication expertise and accessibility to promote early intervention at the community level. Networking with my local mental health and addiction service centres has been eye-opening. for someone who prides themselves on having a good understanding the pharmacy side of things, gaining a first-hand perspective from those living with mental illness has made me realize just how deep stigma can run. Patients will send family members to pick up prescriptions because they feel judged at the counter. They may feel is distrust of the ‘system’ and feel no satisfaction due to treatment failures or embarrassing side effects. I was missing tools on how to listen properly instead of simply force-feeding advice. I stopped assuming that what I wanted to tell someone about their new therapy was what they wanted to hear. My line of questioning became much more open-ended.

So fast-forward to the current day. The next iteration of this mental-health community outreach project has become the Bloom Program. In partnership with the NS government, this demonstration project (a study to demonstrate value of an intervention) has been funded to build on the positive feedback generated. It is starting out small with only select sites approved to enroll patients. In doing this, promotion has been fairly under the radar with sites being responsible for making contacts within the mental health community where they are located. My chance was early December when I was invited to a nearby hospital to briefly introduce the program.

I was nervous. Unsure of who would be in the audience, I went over in my head the history of the program and the philosophy of the approach. Those involved with Bloom believe strongly that early intervention in mental health illness, in terms of recognizing potential problems and building a support network, can mean the difference in the lives of individuals and their families. As front-line practitioners, pharmacists are often the first point of contact for those unfamiliar with available services in the area, but not all pharmacists will know themselves where to turn or how to refer. To meet that challenge, a resource called ‘The Navigator’ was put together. Broken up by health district, the Navigator attempts to capture as many of those services in the form of ‘helping trees’. For any query, be it crisis-management, sexual assault, suicide, legal aid, continuing care, social services, etc, a list of groups and their phone numbers are available in one place. This has proved invaluable on a number of occasions to give people options to try. Sometimes I find myself calling on someone’s behalf to gather information on intake procedures or meeting times for various support groups.

That said, I’ve been guilty of harboring a sense of intimidation when the word ‘specialist’ arises. I have a feeling that many practitioners, from both the pharmacy and medical sides prefer not to challenge drug therapy regimens due to the relative complexity of the symptoms being treated and the associated adverse effects being managed. Sometimes it gets lost that many folks diagnosed with a mental illness often have smoking habits, poor sleep, or family history of diabetes and hypertension. These conditions need a similar amount of attention and may indeed be exacerbating the highs and lows.

In some ways, it was better that I didn’t know to whom I was speaking. There were about a dozen in the room and at least two specialists. Nurse managers from different departments (outreach, addictions) were in attendance and curious as to how I would be looking to work with them. Hopefully, they went away with a bit of inspiration to have a deeper collaboration with community pharmacy. I just need to be ready when they do.

 

 

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.