Category Archives: General

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Nothing but Hip

I was hesitant to write two music-themed posts in a row, but as much as I would like to isolate myself in a pharmacy bubble some days, real life forces me to look inwards. Trying to make sense of how people affect each other every single day is a lifetime’s work. In whatever vocation you choose, whether you’re the star of the show, the director, or an essential piece behind the scenes; there is always a deeper story under the uniform.

Gord Downie, best known as the lead singer of the Tragically Hip, passed away Oct 17, 2017 at the age of 53 from brain cancer.

His uniform was that of a poet, whose lyrics evoked canadiana. His prose seemed to always leave a sense of mystery as to the true meaning.

Last year in August, I felt compelled to write a post dedicated to the Hip’s final concert. I wrote about  how it brought so many people (11.7M) together for three full hours of magic. The point of the post was to suggest that we give of ourselves as much as we feel comfortable, and help each other live the best lives we can. The risks and rewards are all part of living life to the fullest; taking our own chances and being ready to catch others should they stumble along the way.

To quote Laura from that post:

“So let’s remember what Gord and the Hip did on Aug 20. They gave everything they had left to their fans in one last hurrah. Every Canadian, healthcare professional or not, can stand to give a little more to others, care a little less what people think and get on with living their best life.”

Being a pharmacist in 2017 is more challenging than ever. Check that, being in healthcare in 2017 is more challenging than ever. As costs continue to rise, service delivery is evolving for all health professionals. There is a need for all health professionals to become more efficient in maximizing our scope. Pharmacists in various parts of the country are involved in a multitude of new services: independent therapy initiation, lab requests, layered access to provincial drug files, projects in the realm of genomic testing and subsequent dosing adjustments, naloxone training, and INR monitoring just to name a few. Patient-focused care is the direction in which we’re headed, with drug therapy being only one avenue to improved health. Some of us are more prepared for these changes, but we all have a part to play in making it happen.

“A great song’s greatest attribute is how it hints at more. The Hip has always had a strong curiosity to see what’s around the next corner. To see what more we can do, what more we can say — to each other, primarily. We try and serve the song. If we’re any good at all it’s because we’re together on that.” — Gord Downie, 2009

Replace the word song with just about any source of pride, and it gets to the heart of who we are as people and as a community. For this blog, I choose to replace the word song with the word profession as that’s truly how I feel about where we are headed. “A great profession’s greatest attribute is how it hints at more…”

You’ve inspired a generation, a country, and gone too soon. You are the personification of the tragically hip, and will live on in the annals of music history.

Rest easy Gord, fully completely.

 

 

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 Climb

I’ll wait a moment for you to finish singing the chorus while doing your best Miley Cyrus impression.

Today’s topic has a management slant, due to a number of recent conversations had during our yearly review season. The idea of letting go. It’s something that’s difficult to accept, and even harder to use the philosophy to keep yourself and your teams engaged.

Say you take over a new retail operation as a manager for the first time. As a new manager, chances are you’ve worked on high-functioning teams and learned what to focus on and what NOT to do to get results. The first stage is feeling out the people and the workflow. This period is very blue sky; everything is an opportunity and the urge is there to mix things up.

After a few months, the long-term planning begins. Most of the quick fixes have occurred, and the team has a sense of your style. The schedule may have changed. Certain tasks may be assigned to different roles. New technology may be introduced. Now that the ‘newness’ and shine have worn off somewhat, you’ve settled in and are building your vision for the future.

Then it happens: someone puts in their notice. My immediate reaction used to be: ‘great, in 2 weeks we’ll be short-staffed, I’ll need to take on x, y, and z, plus hire someone, and my best trainer will no longer be here, so we’ll be playing catch up all summer / flu season / Christmas break, etc’. Does this sound familiar? All your best-laid plans are at risk, and you have no idea when you’ll get it back to this happy point right now.

I’ve talked frequently about my satisfaction in watching people learn and grow. I’ve been lucky to work with some of the sharpest minds in my field. They have made me better every step of the way, and I’ve tried my best to pay it forward. My most ambitious employees, the ones I’ve shared experiences, and pushed in new directions, have always left to further their careers. In the moment it’s disappointing, but if I’ve truly prepared them for their next chapter, then they have earned the right to choose what happens next. I will support that decision either way, even if it means letting go.

“Sometimes being a friend means mastering the art of timing. There is a time for silence. A time to let go and allow people to hurl themselves into their own destiny. And a time to prepare to pick up the pieces when it’s all over.”
—Octavia Butler

Succession planning isn’t just about looking at a roster of names and picking the best-suited. Succession planning is paying it forward. If someone has taken the time to grow you, then you take the time to grow the folks that you lead. Those goals we set every year? They represent your plan, and the path you both take to get there. If you have an assistant manager, you will be sharing financial information and business plans for the next 6 months. A people supervisor? They will need to evaluate and challenge their staff to learn new tasks and perfect old ones. The hope is that they learn from your examples, and add their own flavour to the process, which should include being an example for their own trainees. The best way to mitigate the loss of a team member is to treat it as an opportunity for another to step into the role.

So I’ve chosen to manage people as if they are on the side of a mountain with me; we’re all trying to reach the top, and everyone has their own footholds and paths to get there. If we encounter each other, my goal will be to lift you as far as I can go, knowing that it may slow me down for a bit, knowing that you may very well pass me on your journey. The end result will be that together, we will be further up the slope, both looking down occasionally to see who may benefit from our help and experience.

It’s never goodbye, only farewell. We’ll see each other again on the climb.

 

 

 

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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Blow Me Down

To all of my readers native to the lovely province of Newfoundland, the title is exactly the reference you have in your head at the moment.

To the uninitiated, Blow Me Down is the name of a provincial park on the west coast of Newfoundland on a peninsula between Lark and York Harbours. Therefore, it’s also found in the names of various trails, land forms, and businesses. My favourite, and really the seed of this post, was stumbling across this retirement centre about 50 km from Corner Brook.

The title is also referring to my reaction on this, the 4th anniversary of PharmAspire. 

So why was I in Newfoundland? Pharmacy of course. Due to the tragedy that befell a dear colleague just before Christmas, the region he supported has been emotionally adrift. Like all of us, when answers are lacking we try out our brave faces in an attempt to carry on as normal. The onset of winter was the darkest I can remember, and three months later, the pall carries us into the spring. It’s familiar now, so reminiscing about fond memories tends to bring about smiles a bit more often, and those touched by Dave’s spirit share a strong, common bond. I’m here to finish some audit work he started, and that thought alone has made the last week rather surreal.

Being the city slicker I am, anything outdoorsy is met with reluctance. If I’m goaded enough, I will absolutely enjoy building snowmen, sliding, skating, 4-wheeling, swimming, canoeing, but never from my own ambition; someone who knows the ropes needs to bring over the plate of excitement for me to sample. The west coast of NF is still quite wintery at the end of March, and I have never seen so many snowmobiles taking residence in the hotel parking lot. Deer Lake is my hub, my command centre. Just off the Transcanada and about 5 minutes to an airport that would fit comfortably in the new Ikea being built in Dartmouth, I’ll do my traveling 90 minutes northeast and about 30+ minutes down the coast.

A few observations that struck me driving through this beautiful part of the country: 1) there isn’t much to look at between townships (or exits for that matter), 2) sidewalks are rare, as are pavement markings, so dodging pedestrians on snow-covered roads can be a bit unnerving, and 3) through the light flurries just before Corner Brook, I’ve found myself looking directly at the side of a mountain that has angled streaks reminiscent of a marbled steak. It was pretty neat to be driving through Humber valley with walls of rock and ice on either side.

After a week of meeting new people, coaching, discussing procedure, assessing dispensary layouts and staffing mix, I am reminded of the quality of pharmacy services you find anywhere. The styles and personalities may be a bit different, but they fit well in the communities they serve. I learned something new every day that I will carry with me to others. Dave brought these pharmacists, these technicians, these assistants together. They are leaning on each other for support and healing together despite their differences and relative distance.

This blog was created to help share experiences and positivity with others. Ever the optimist, Dave’s outlook on life was to accept every day as a gift; enjoy the people, never panic, give your best, and end the day celebrating any improvement, no matter how small.

I don’t know when or if I’ll be back, but for a week I felt welcome and accepted. Those folks carry a piece of Dave with every memory and recalled conversation. Each time I met someone new, inevitably they would smile and tell a story worth a few chuckles. In some small way, it felt like I was saying hello to him once again. Pair that with an anniversary of my first dabble into the writing forum, and it’s overwhelming.

Like the strong winds that constantly whip over the Murray Mountains, it’s enough to knock me off my feet.

Blow me down…

 

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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A Few Numbers

My LinkedIn feed chimed in the other day to notify that the 4th anniversary of PharmAspire is fast approaching. Four years. A full election cycle. A round of Olympic Games has come and gone. Pharmacy? I would say we’ve had plenty of evolution during that time, much of it chronicled on these pages. Thank you so much for reading and joining in the movement to practice on our terms…in our terms.

The topic today centres around my fascination with numbers. As long as I can remember, the logic and the consistency that numbers provide has ruled my behavior and my approach to problems. They are universal in meaning, and exist in all languages. In a digital age, information may be stored as never before. Numbers are broadcasted and converted to sound-waves, they are used to form images that we share with one another. They help explain this vast three-dimensional world we live in, and through theoretical physics, suggest dimensions beyond our own.

Nowadays, the numbers that pharmacists care most about are about the evidence. How treat-able is a disease? What monitoring parameters do we need for drug therapy? To which demographic slice does this guideline pertain?

A quick look at the Statscan homepage shows some interesting nuggets. Did you know that in 2014, the percentage of the population that were current smokers (18.1%), was virtually identical with the WHO classification for heavy drinkers (17.9%) and both were slightly higher than those previously diagnosed with high blood pressure (17.7%)?

The page also points out that over half (54%) of adults and almost 1 in 4 (23.7%) of youth were classified as overweight or obese. I find that amazing. How are we doing in the realm of mental health?

Perceived mental health by age group and sex
(Very good or excellent (%))
2011 2012 2013 2014
%
Very good or excellent
Both sexes 72.6 71.7 71.1 71.1
Males 73.5 72.7 71.9 72.1
Females 71.7 70.7 70.3 70.1

These numbers represent about 20 million people, meaning that 9-10 million do not report having very good or excellent mental health. The alarming thing is that these percentages are declining at 0.5% a year (~150000 people), with the largest fall coming from women aged 20-34:

20 to 34 years 75.3 73.8 74.0 72.3
Males 74.7 75.1 74.6 74.9
Females 76.0 72.4 73.5 69.7

Here are a few more  observations from Laura:

57- The average number of times Devin must remind Laura to please look at and edit his post so he can put it up (for the love of God)!

2- the number of cups of coffee needed by the editor to survive the day.

2- the number of cups of coffee needed by the editor so all other pharmacy staff and customers survive the day.

200mg- the number of morphine equivalents allowed to be prescribed in chronic non-cancer pain in NS right now.

50mg- the number of morphine equivalents that will be allowed to be prescribed in chronic non-cancer pain in NS in the next year or so.  Will funding for addiction services increase to account for this drastic decrease? We sure hope so.

It’s an important question given the stagnating economy and the illicit drug crises occurring in major Canadian centres like Vancouver and Toronto. It’s one thing to restrict access to contraband. It’s quite another to restrict prescribing of legitimate therapy without offering alternative counseling support or treatment options.

Before we paint by numbers, and generalize too much, we need to remember that each case is different. Poor mental health is pervasive and affects so many of us living with or without any co-morbidities. As front-line healthcare providers, pharmacists may be in position to intervene earlier with a frank discussion or a recommendation to a physician.

At the outset, I mentioned that numbers help explain the world around us. No one wants to feel like ‘just a number’, lost in the system with little cause for hope. Each one of those ‘numbers’ has a story to tell. Are we ready to listen?

 

 

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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WWDD?

What would Dave Do?

I was working on a couple of other posts just now and needed to stop. This grief is nothing I’ve ever felt before and coming to terms with it has been difficult.

On Monday, Dec 19, I received a call to inform me that Dave Collins, esteemed member of the Pharmacy Association of NL and my work teammate for the better part of nine years, lost his life under tragic circumstances the night before.

As this is being written, it’s been 26 hours since the phone call ended. Nearly every thought has been about his family, his interests, his ever-positive attitude, and his unbending support for all of us.

Those who knew him best are all trapped somewhere in the 5-stages of grief. Me? The Denial flipped to anger early yesterday afternoon as news outlets reported additional details. Today, I believe it’s falling in the Bargaining / Depression bucket. Thankfully, our team is quite close, so having folks to talk to and remember positive memories has really helped. The last stage is acceptance, which seems will never happen. It will of course, but not for a long while. Life goes on, but time moves incredibly slow when emptiness consumes you.

If there is any silver lining to find, I know his memory will make me better. Dave had a way of looking at any situation, no matter how bleak or stressful, and taking the worries away. Quoting lines from Dylan and Neil Young, he didn’t frazzle or get even mildly annoyed. He treated everyone with the utmost respect and expected the same. He came from a large family and wanted every interaction to be meaningful and personal. He gave his all into every endeavour. As an example, he had recently started beekeeping, which is just so Dave:

These pics will always make me smile.

So in dealing with his loss, I’m now thinking WWDD? He wouldn’t want us to wallow in self-pity. He certainly wouldn’t want us stop doing what we enjoy, or be fearful of what could be around the corner. He would want us to celebrate his life, thrive in our work and home-lives, and carry on.

Rest In Peace my friend. We will meet again someday on the other side, share a cold brew and listen to some Lennon. Save me a seat, I’ll be there when it’s my turn.

http://www.cauls.ca/mobile/obituaries-details.cfm?o_id=4043859&fh_id=14293&forcelayout=mobile#obituaries

 

 

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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Hip For a Night

How often do you feel part of something too big to explain in words alone? It’s a sensation; a point in time where everyone casts an eye, bends an ear, and opens a mind to an emotional spectacle only experienced a handful of times a generation.

The Tragically Hip bid farewell to the masses in their home town of Kingston, Ontario and an estimated 11.7M viewers across Canada via an uncut CBC live feed on August 20. I certainly won’t find the right words, but I’ll gladly take a lunge at it.

Lead singer Gord Downie was recently diagnosed with glioblastoma, a terminal brain cancer that grows aggressively and offers minimal chance at long-term survival. He decided to do the opposite of what you might expect; instead of becoming reclusive, accepting what remaining quality-of-life measures were available, and letting us mourn in advance of the inevitable, he organized a final tour to share himself with the fans one last time.

 

“Courage…It couldn’t come at a worse time.” – Gord Downie, Courage

However ravaged his body appeared after a craniotomy and six weeks of chemo and radiation, the energy from all pockets of the country seemed to fuel his voice after every introductory riff. Each of the three encore sets reached a fever pitch, and without interruption, we could hang on every solo, every iconic lyric, each instance of a certain signature, tumbling cadence to cap the vocal line.

That night I wasn’t a pharmacist. I was a Canadian…and a damned proud one at that.

The next morning, Laura and I were chatting about the significance of the concert. This exchange captured what many of the articles and pundits had been reporting:

Me: Any way I can tie in the Hip concert into a pharmacy blog post?

Laura: Oh God, I cried through the whole concert last night. Their bravery and COURAGE was unbelievable.

Me: I know. Read an article about Gord burning out onstage for everyone. Pretty amazing stuff.

Laura: They played for three hours.

Me: After the first few songs, I felt he was straining hard, but he kept going.

Laura: Yeah, and a lot of classics later on he sounded amazing. Imagine spending that much time and energy with four other guys for thirty years. They know exactly what they’re all going to do. Remarkable really.

Me: Can’t imagine. They deserve the adulation. If you’re going to hero-worship anything, this feels right.

Laura: Canadian pride and caring less about what others think is a surefire way to a happier life. Tonight the ENTIRE COUNTRY stopped to watch a concert. Would that happen anywhere else in the world? 

The CAPS are unedited, and proper emphasis is where it belonged 🙂

 

“No one’s interested in something you didn’t do.” – Gord Downie, Wheat Kings

I could take a fatalistic approach in saying that many cases of malpractice litigation definitely hinge on things that weren’t done, but I digress…

In all seriousness, wiser words have not been spoken as a mantra to living all phases of life. As pharmacists, how many minor ailments have we failed to offer? How many open-ended questions have we failed to ask? How many turf wars do we concede to other health professions? How many courses have we failed to take? How many trips have we failed to plan? How many opportunities have we failed to grasp? None of these examples are malicious or vindictive, just oftentimes we remain passive because of the emotional investment and unknown consequences.

Laura really drove the point home for me:

“So let’s remember what Gord and the Hip did on Aug 20. They gave everything they had left to their fans in one last hurrah. Every Canadian, healthcare professional or not, can stand to give a little more to others, care a little less what people think and get on with living their best life.”

 

“No dress-rehearsal…this is our life.” – Gord Downie, Ahead By  a Century

Everyone’s watching. Work, play, practice..LIVE on your own terms. 

#InGordWeTrust

 

 

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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R&R? Part 1

I really tried to resist the urge to write a post about vacation. It’s been a while since my last commentary on being in exotic places and marveling at the contrast in pharmacy services (or lack thereof) in many resort countries and cruise ports. This time around, I still have a few observations to make on that topic, but will intersperse them with more of a general narrative on trying to free the mind of real life, at least for a week or two.

This cruise was planned in celebration of a best friend’s 40th. The thinking went that the kids are getting to the ages where the term ‘family vacation’ may start to become taboo. Maybe it’s that we’re closing in on two decades in our chosen profession, or perhaps watching your generation stepping perilously close to the chasm of middle age is enough to appreciate times when you are absolved of things like responsibility, routine, and maturity. Starting in February when part of my birthday gift was an eye patch for each of the four adult travelers, our adventure on the high seas featured plenty of entertainment. Much of this was not from the on-board shows, but rather the sight of us bouncing around for a week like a pair of giddy goofballs.

Now for the uninitiated, a few observations about cruising:

  • When you’re floating in the middle of the sea, hundreds of miles from land with flat, blue horizon all around, it makes you feel extremely small and insignificant. Paradoxically, it can also be quite a claustrophobic experience; if you follow the routine during sea days, every shop, attraction, buffet, restaurant and bar resembles rows of army ants inching forward in line.
  • Walking preteens through the casino and then having to explain the difference between the slot machines and the games in the arcade upstairs is harder to do than you would think. Essentially the bright lights and colors of the machines just entice you to blow $20 in about 15 minutes and call it ‘fun’.
  • The experience is amazingly multi-cultural. Not just the ports, mind you, but the employees on all parts of the ship have name tags highlighting their native country. We decided to unfurl a world map in our stateroom and have geography lessons with our girls every time we returned from an outing. We met an attendant from Indonesia that works 8 months straight of 12-hour days, 6-days a week. He Skypes home to his young family when the ship is in port and high-speed wi-fi is available. Another one of our waiters hailing from the Philippines jumped up with the house band and performed an admirable rendition of Celine Dion’s ‘Because You Loved Me’.
  • There is this thing called the unlimited drink package. On first blush, it seems to be quite popular for mysterious reasons….hmmmm. Ah, those bars. Perfectly distanced so that you’re never more than 30 paces from a restroom, accessible from the inside and outer deck of the ship, and each seemingly equipped with their own gravity; drawing you close to peruse their unique menu of concoctions.

In part 2, I’ll have some pictures to share and thoughts on pharmacy overseas mixed in with other random observations.

Vacation is always welcome, but it’s good to be back!

 

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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Difficult Conversations

That feeling is back.

There in the pit of your stomach, a queasy, uneven terror takes hold. Even the butterflies are frozen in fear. The thought of confrontation can be a paralytic.

This is not just applicable to the pharmacy world of course. A verbal attack, incident of negligence, or general poor attitude can evoke strong reactions from you, other family members, friends or colleagues. Really, any undesirable behavior(s) that affect others may be lost on an individual if they’re not told about it, or asked to reconsider their actions. So how do you toe the line between a proper response and a potential overreaction? A long-time patient violates your trust and is caught shoplifting. A medication incident occurs and you’re cradling the phone receiver to notify a physician that hasn’t always been the most supportive. Say you back into a friend’s car in the driveway after they left it for a weekend away. Perhaps you suspect a family member has a substance abuse problem and you worry about their mental health.

Regular readers may find that I tend to internalize and reflect often. In fact, most of the words I write are borne from some direct or arms-length experience. As a team leader, it’s taken a lot of work to hold back a raw emotional reaction when it festers. If something or someone offends you, it’s important to remember a few things when a potential confrontation occurs:

  • You are entitled to your reaction – Regardless of another’s intent, or their choice of wording, it may offend, insult, surprise, demoralize, etc. and they can’t control your feelings or the reasons why. They are valid and shouldn’t be dismissed. I will sometimes write draft pieces that have a strong topic or controversial nature and I may not realize it. During the editing phase, it’s brought to my attention that for instance, my perspective on technician regulation has been coloured by my growth opportunities in a long-term care setting. It’s something I really hadn’t considered and was thankful that it was pointed out.
  • The earlier the better – Out of the scenarios above, all require a response of some sort. As mentioned, my approach is to internalize and review all possible scenarios, but if I wait too long with a planned response, there’s a chance not only for the behavior or issue to arise again, but it’s also perceived as permissible by onlookers who may become disillusioned.
  • It’s emotionally exhausting, but worth it – Why are these conversations so difficult? If you hold trust and respect for someone, attempting to single out a flaw of some kind without it feeling like an attack is somewhat of an art. I have close friends who are much more adept at meeting with individuals and getting thanked for providing constructive criticism. Almost every difficult meeting I have, I’m usually needing to own up for my own slights or behaviors that have contributed to the situation. See above: they are also entitled to their reaction to something I’ve done or said. Being vulnerable around close family and friends is hard enough, around acquaintances and other professionals is another thing entirely. It’s no surprise that these meetings often happen at the end of the shift, or day, or week even to allow time to wind down.

If you genuinely care, if you are trying to help someone, let that be the basis for an interaction. If the person respects you and your opinion, they often recognize that they have put you in a position to respond. Offering alternatives for moving forward makes the conversation productive while acknowledging past missteps.

Hindsight is always 20/20, but perhaps we can turn that difficult conversation around into something positive with a clear path forward. We can’t guarantee foresight will be 20/20, but how close can we get?

 

 

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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First Aid

It was time for my renewal for standard first aid (SFA) and Cardiopulmonary Resuscitation (CPR) so I registered for the 2-day course and completed my certification last week. This is a requirement to perform injections, but also an expectation as a health professional in the field. Every workplace location should have a trained individual on site at all times.

Is it just me, or does the training seem to change every year?

My first foray into first aid was to earn a badge as a cub scout. One of our group leaders was a trainer with St. John Ambulance and I recall it took place at someone’s house. There were about a dozen of us around the age of 8-10. I only retained a few items from that session: the constant warning of the graphic videos they could have shown us, how to tie a tourniquet, and just how scared to death I was to be confronted with a true first aid situation.

There was so much to remember. During the demonstrations where someone would have to take charge, we all looked at each other with eyes as wide as dinner plates. Almost everyone forgot at least one aspect of the primary survey (introducing yourself as a first-aider, determining multiple casualties, removing hazards, etc.). When manipulating limbs for splints and bandaging, the wrong hand placement led to drops or contortions that would probably do more harm than good. For the CPR component, we would disagree on timing of breaths or whether to do chest compressions first. This was well before the Good Samaritan Act so there was hesitation for fear of doing the wrong thing in the wrong order.

Since then, the training seems to have evolved to be more of a ‘stay calm and collected, assert control, and remember that you’re trying to help the person’. It’s a welcome switch, but watching the scenarios played in the videos are thorough to the point of no longer feeling like an emergency situation. For example, a young girl cuts her hand lengthwise in the kitchen and calls for help. Presumably the father comes in assesses the scene by asking her if anyone else was hurt and check her breathing. He then gloves up and proceeds to check the shoulder all the way down to the arm. The girl does not appear alarmed. By all accounts, this is of course the proper way to perform first aid, but if I was the casualty, I’d wonder why we were spending time doing a head-to-toe assessment. I imagine some folks would be a bit scared and hysterical as well.

CPR is much more simplified. For all cases, a 30:2 compression-to-breath ratio is easy to remember. For choking, the Heimlich Maneouvre (or abdominal thrusts) seemed to have fallen out of favour due to lack of evidence of effectiveness, but is being taught again in combination with back blows. Nose bleeds used to be pinching the nostrils with the head tilted back, but is now angled forward. Shock wasn’t discussed at length like before; if you treat the injury/injuries, then that’s the best way to minimize the effects of shock. Pen devices that administer epinephrine and AEDs are much more direct and straightforward when taught. My biggest disappointment is that tourniquets are no longer in the curriculum; I thought those were pretty cool. Ring pads are out of favour too, as they tend to be unstable on a wound. Pre-fabricated ring pads used to be part of a first aider’s kit. Who knew?

So I should be in good shape for another few years with a re-certification in between. Here’s hoping it’s a set of skills that will be needed infrequently. Should I find myself in a crisis situation, this training may make the difference between a favorable and a catastrophic outcome.

 

 

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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Like Riding a Bike

Recently, after a challenging stretch with my team, I’m reminded of the value of long-term outlooks. As a father, as a pharmacy manager, and as a semi-regular blogger, it’s so important to have clear goals in front of you.

I was out last weekend with my 7-year old in a grocery store parking lot. Having watched me prepare the past few years for the MS Bike Tour (click here for my fundraising page), she decided that this would be the summer to conquer the 2-wheel balancing act. We pumped up the tires and adjusted the seat height. Starting in the driveway, I ran along beside her for a couple of runs before making the 5-minute walk to the lot. I don’t remember details of my own learning experience with a bike, but hearkened back to my driving instructor’s advice from many moons ago: always look to where you want to go, and not the road in front of your wheels.

It took some practice. Being tentative, every time she watched her front wheel start to wobble, her sense of equilibrium followed suit and violent jerks on the handlebars failed to keep her upright. Soon enough, the chin came up, the arms relaxed a bit and she was able to pedal unattended for two seconds at first, then five. She was so excited to show her mother when she got home from work.

She taught me that my experience is no different. In my role, I’m expected to lead people. If I’m always looking at my front wheel, chances are I won’t be leading them very far, and the distance we do travel will be rife with wobbly or uncertain moments. At this point, I have this urge to expand on my meaning. I sense a bullet list coming on…

  • A leader’s vision is enhanced by the relative vision of his/her subordinates – Have you ever watched someone walking with a dog that is seemingly distracted by or reacting to just about everything they pass? Having to circle back and regroup takes time and effort. If there is good communication, and staff are trained to look further down the road themselves, then they may recognize steps to take today that will directly impact how fast they get there. Say, if the goal was to give 1000 flu shots, then finding easier ways to triage patients and pre-populate administrative paperwork will certainly enhance that ability.
  • Everyone has to have a long-term goal – In the same vein as above, the president of a company or the director of a university needs to be focused on long-term planning 95% of the time, to retain viability and competitive advantages. Perhaps middle-management needs to be about 50% focused on long-term and 50% on day-to-day functions. That trickles down to part-time front-line staff. They may fill a specific need 95% of the time, but they still need something to work towards over a 3-6-month period. I like to show these people aspects of inventory management, for instance.
  • Braking and turning are still important to learn – So the vision is communicated and we’re making good progress down the chosen road. What happens if the path needs to veer off (changes in the reimbursement model, etc.), or stop due to a roadblock (Information Technology limitations, etc.)? My daughter still has these aspects to work on, and so does my team. Maintaining that balance and control through the unknown will keep us from hitting a wall or flying into the bushes.

I want to say that managing a team is as easy as riding a bike, but I have a feeling you may have already seen that coming  😉

 

 

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.