Tag Archives: Nova Scotia

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The Odyssey, Part 1 – The Intro

Having some extra time this summer to ponder next steps in my career has come with a helping of spontaneity as a welcome side effect. One of those moments led to another, that became one of the most enjoyable road-trip adventures I’ve ever experienced. As a pharmacist on hiatus, much of the trip was divorced from my professional side, although it crept through here and there. If you would indulge me, the desire to recount this story has stoked a small fire within me to begin writing again. I will do my best to refrain from wandering off on too many tangents, jumping down rabbit holes, or hopping off tangent holes.

It began back in the spring when I was finding my way back to old hobbies and discovering new ones. It was a commitment to learning a new routine and involved connecting with friends on a whole new level. I help mom and dad out in the yard, or grab coffee with a friend in a neighbouring town. Running errands during non-peak retail hours is an added bonus! On a random Thursday, I asked Dad if he had any plans and we took a drive to Lunenburg for lunch. In the course of sampling some craft beers and deep-dish donair pizza, the topic changed to planning summer trips. Last summer we had flown to Toronto to do some sight-seeing and take in a weekend of Blue Jays games at the newly renovated Rogers Centre. It was a great time as we were in an AirBnB across the street from the stadium.

Suggesting we could do another weekend of baseball, it was met with an underwhelming response, mostly due to the air travel and the congestion in the city. Quickly, the discussion pivoted to bucket lists. I wondered if he had one. To be honest, I wasn’t expecting a firm answer; through the years, I couldn’t identify any single place or attraction that would elicit excitement. His answer rather surprised me: “I had always wanted to see the Fallingwater house”.

I will pause for a moment in case some of you are deciding whether or not you should know what that may be. My bet is that the vast majority will not. I certainly couldn’t recall anything by that name coming up in previous conversation. As an aside (one tangent isn’t too many…), Dad had taken architecture in university and had therefore studied some of the greats, including the esteemed Frank Lloyd Wright (1867-1959). Known for pioneering architectural moments in the early twentieth century, he influenced countless architects and apprentices over a 70-year career. One of his philosophies was to let the environment dictate the design of a structure. If it was pastural, forested, hillside, or urban, the look and feel of the structure would complement the surroundings. His crown jewel was Fallingwater, a ‘summer house’ built from 1935-1937 in a small locale called Mill Run in southwestern Pennsylvania.

Now that we had a destination, we began plotting our route with a few guidelines:

  • Keep the bulk of travel to main highways and interstates.
  • Whenever possible, avoid more than five hours of driving on any given day.
  • Stay in towns outside of large downtown cores. We wanted to avoid excess traffic and keep lodging costs down.
  • All four occupants in the car, mom, dad, myself and my fiancee, each needed to suggest destinations or attractions for us to map out along the way. Although we had an endpoint, this was a trip with experiences we all would share.
  • All food, accommodations, gas, consumables (ahem…wine with dinner?), etc. would all be split 50/50.

So on August 11, to celebrate my parents 51st wedding anniversary, we emptied the car of any contraband (joke 🙂 and set off to enjoy half the fun of getting there!

Tantallon, NS (Canada) –> Wells, ME (US of A)

The drive wasn’t notable, with a handful of stops for gas and bio breaks. The border was weird, as it always seems to be. Trying to remember the last time I had set foot in the US was harder than it should have been. With the pandemic in the rearview, I usually just add three years to whatever time period I ‘think’ makes sense. Thankfully it was wasn’t more than ten; in that case, border agents start asking more pointed questions about past convictions and reasons why you haven’t visited such a fabulous country in such a long time.

By Sunday night, after my calculations, we already had experienced 1/6th of the fun! We had an unflashy new currency, a brand, spanking new time zone, and shrinking distances to drive (silly metric conversion)! We settled into our AirBnB off the main drag and fought with the smart TV until bedtime.

Stay tuned for Part 2, where the adventure really begins!

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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Changes and Choices

Change. It is both inevitable and unstoppable, inspirational and heartbreaking. It is both emotive and stoic, superficial and intensely personal.

This past 6 weeks have no doubt reminded me of the power of change as my place in the pharmacy world has been upended. After 25 years in the profession, a restructuring has suddenly left me on the outside looking in.

Initially, this came as a surprise; every role comes with ups and downs but usually even out over the long term. The idea of letting go of a work routine and the network of people that go along with it was always a possibility, but not something I had strongly considered. I am proud of what my teams have accomplished over the years and did my best to prepare them for their next chapters. I just know that they will continue to thrive, though I shall dearly miss being along for the journey.

Although disconcerting, the weeks that followed were full of well-wishers offering support and guidance. What could have been a much darker experience was helped immensely by a stable home life and a passion for the arts; after performing with an amazing cast in Jesus Christ Superstar last June, I am equally chuffed to be back onstage with http://stageprophets.ca for a 2-weekend run of Music Man that takes place in mid-May. It’s a grueling process, but storytelling at it’s finest!

What I have recently found embedded in this cacophony of change is a tiny, exuberant voice that grows louder with each passing day. The message is simple: be thankful for new choices and new opportunities.

“The secret of change is to focus all of your energy not on fighting the old, but on building the new” -Socrates

Leave it to a 2,500-year-old Greek philosopher to challenge the status quo by being curious and asking the experts questions on topic definitions that he did not fully understand: https://en.wikipedia.org/wiki/Socratic_method. My first choice is to adopt the above strategy and be open-minded to the growth opportunities I have today and to those that present in the future. I have looked at some graduate courses, but also have interest in other segments of the pharmacy profession outside of retail, including industry and government. There are so many directions to explore and learn, many of which I am assuredly unaware as of this writing.

“Change will not come if we wait for some other person or some other time. We are the ones we’ve been waiting for. We are the change that we seek.” -Barack Obama

This quote from Barack resonates deeply. We all strive to make our marks wherever we dabble. I feel there are so many more contributions I can make to a profession that has given me a rewarding career to date. The thought of once again being that catalyst for change certainly excites me. I want to immerse myself into the next work environment with a renewed fervor, pushing my own creative limits and trying to make better those around me.

“Every day the clock resets. Your wins don’t matter. Your failures don’t matter. Don’t stress on what was, fight for what could be. “ -Sean Higgins

A quick web search on ‘Sean Higgins’ directs to a Wikipedia page for a former NBA basketball player turned Chairman/CEO of an investment company. Admittedly, I did not research this to any extent, but I keep picturing a resetting 24-second shot clock that is used on the court. It seems to fit.

I actually wanted to end on this one because frankly, I don’t agree with the second or third sentences. My wins did matter. My failures did matter. At least they mattered to me. They all helped to mold and create the person I am today. Those experiences will allow me to make the best choices when embracing the inevitable, unstoppable change. The latter part of the quote makes sense. Although I value the past, it will not define me. The time has come to move forward with wide-eyed exhilaration.

“Choices are the hinges of destiny.” – Edwin Markham

Quotes courtesy of https://blog.hubspot.com/sales/quotes-about-change

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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Welcome to Canada

By now, everyone has heard of the Syrian refugee crisis. The Syrian people, having witnessed unspeakable tragedy and horror, are fleeing their home country in the hopes of finding a new, safer, more prosperous life elsewhere.

The Government of Canada has committed to resettling 25,000 Syrians here in Canada. It may have been naive of me but I didn’t think many of them would be coming to our humble little province. I assumed they would be heading west, to Ontario, or Quebec or even further west. How very wrong I was.

I should have known that Nova Scotians would step up to the need. Mosques, church groups and government agencies have sponsored families. They are supporting them as they enter their new lives and helping them with things we all take for granted. As of February 5 of this year, over 500 refugees have arrived in our wonderful little province and I have had the pleasure of meeting a few of them in my capacity as their new pharmacist.

My first meeting came when a gentleman and his interpreter arrived at our store asking for help with itchy skin. He didn’t have his paper that would allow him to go to the doctor, and as myself, my manager and my student all worked to find out how to get him his paper and if he could see a doctor, his interpreter kept telling us that he was saying over and over “Canada is the best country in the world.” At the end of our interaction, we all welcomed him to Nova Scotia and wished him well. We felt we did very little for him – a Google search, a phone call. But to both men, it seemed this little act of kindness was huge and brightened their day. It certainly brightened ours.

The next time I met a refugee was when a gentleman and his son arrived at the pharmacy with the proper papers in tow but not a single syllable of English. Through mime and drawings, we were able to convey to him that his son was to take his amoxicillin three times daily until they were finished. Once they finally understood, they smiled and said thank you. Apparently, in a super Canadian fashion, thank you was the one phrase they had learned.

After both of these scenarios, I was able to go home to my warm house, snuggle my fluffy cat and make a nice meal for myself. I was able to call my friends and family and ask how their days were, read a good book have a cup of tea and go to bed. As I went through the motions of my day, I was struck by how brave these people truly are. I tried to imagine myself in a country in which I didn’t understand the language. I imagined trying to navigate a doctor’s visit, a trip to the grocery store, a walk down the street. I couldn’t imagine what it would be like to have to do all of those things that I take for granted in a totally new country after having fled a war zone. And these folks are doing it with a smile on their faces! They’re so glad to be out of the war zone and starting fresh. They will have lots of healing to do, and lots of learning to do. And so will we. We have to learn how to help these people. How do we communicate effectively? How can we make them feel welcome? How can we tell them where the nearest grocery store is? These are all things that we will learn as they learn to adjust to this new, snowy place.

Despite the fact that their English was broken at best, at the end of both of my interactions with the above mentioned folks, I left them with a sentence they understood right away. As soon as I said it, either alone or through an interpreter, their faces split into some of the brightest smiles I’ve ever seen- Welcome to Canada!

For more information on refugees and what we as health professionals can do, visit www.isans.ca or your pharmacy college website!

 

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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Broaching Breaches

The expectation of privacy in today’s world is becoming increasingly difficult. Everything is becoming electronic; online banking, online shopping, email lists and profiles built on computer system are common in every business nowadays. Pharmacy is no different. With the advent of the Personal Information Protection and Electronic Documents Act (PIPEDA), ground rules are in place for private sector businesses to collect, maintain and disclose any type of personal information contained in a database. Obtaining consent is essentially the gateway to collection;  if we are not able to collect, maintain and use the information for the purpose of filling prescriptions, it’s very difficult to  provide service, if at all. Having accurate allergies and diagnoses can definitely impact the appropriateness of a new therapy or dose change.

The issue of consent can be a minefield. For instance, the Personal Health Information Act (PHIA) in Nova Scotia doesn’t specify an age of consent. The individual must have the capacity to provide informed consent, that is to say that when given all of the pros and cons of allowing personal information to be used in a given situation, they  have a choice to provide that authority, limit the scope, or revoke their previous permissions. In 2008, the criminal code of Canada raised the age of consent in sexual matters to 16, with exemptions down to 14 and in some cases if two minors are involved, even as low as 12. This is important because pharmacists need to determine whether a protective parent should be included within a young patient’s circle of care. As an example, a new birth control prescription is presented by a teen, but her mom picks it up. It’s not always straightforward. The same thing goes for those suffering from mental illness or cognitive decline. A spouse or other family member may be a more reliable source of information when making clinical decisions, but the patient has every right to keep information from being shared with them.

Even with safeguards in place, breaches have happened and will happen from time to time. Faxes sometimes end up at the wrong office or two people with similar names pick up each other’s prescriptions. Nobody intends for these incidents to happen, but the reality is that systems can fail. Perhaps an address wasn’t confirmed or was misheard at pickup. Maybe a large order accidentally included someone else’s bottle during the bagging process. As mentioned above, a counsel session could be initiated with someone who is not within the patient’s circle of care. With expanded scope of services, pharmacists have a heavier burden to communicate any injections or prescribing activities to the primary care-provider. We may not necessarily have longstanding relationships with everyone that receives a flu shot, so while faxing is more convenient than calling an office, we are relying on the patient to specify their family doctor and the potential for error is real. It happens in the other direction as well. Our site has received patient profile requisitions from hospital units intended for other locations, or transfers intended for other pharmacies.

I believe we do an admirable job at upholding these responsibilities. Use of personal information is appropriate to properly advise and advocate for patient care and we’re about to receive more of it in the form of the Nova Scotia Drug Information System (DIS). Other provinces are in various stages of integration; examples include H-Link in Alberta, the Pharmacy Network in Newfoundland and Labrador, PharmaNet in British Columbia and Health PEI. They all currently feed data from institutional and community settings into a central database. While this endeavour is aiming to provide a comprehensive patient profile of all provided health services, it also poses challenges to maintaining privacy. More information will be available to more people in real-time. Applications for this information will be new to many users and perhaps mistakes will be made with security permissions and protocols. Perhaps a look-up with a misspelled name results in accessing the incorrect profile, and adding a care note that doesn’t pertain to that individual. Lab values may be routed to the wrong ‘Dr. Smith’ and communications end up at the wrong office as a result.

At the end of the day, we will continue to apply due diligence in all cases to protect and maintain the integrity and security of the database. The additional information will be available so we can make better, well-rounded clinical decisions for our shared patients. Connecting healthcare providers in community and institutional settings is a huge positive. We can speak the same language based on the same complete profiles. Frankly, many patients seem to assume we already have this access when caring for them, so when we finally do, let’s make the most of it shall we?

 

 

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 Technician Regulation and My Journey To Become Licensed in Nova Scotia

Greetings pharmacy community! I am a pharmacy assistant in Nova Scotia and was asked by Devin (ages ago – sorry Devin!) to write a bit about the adventure I have been on to become a regulated pharmacy technician, and how I feel about the process.

When I began as a pharmacy assistant in 2007, regulation wasn’t even a thought in Nova Scotia. I was hired as a “pharmacy technician.” I was told to “listen to the pharmacist and do everything they ask you to do – they are your direct supervisor on shift, and you are there to support them and the work they do.” So I was trained on the job and became what my pharmacist needed me to be.

I loved my new job! I enjoyed helping my patients, and taking phone calls (even if I was confused as to which “little white pill” my elderly patients were looking to have refilled), filling scripts, and learning everything I could from my pharmacist. For the first time I felt like I had found purpose in what I was doing, and I was quite satisfied with my work. Yes, there were challenging times and tough questions, but there were funny moments as well.

To condense my tale, I ended up working at a very busy retail pharmacy that had a lot of unique things going for it.  As I was away from home, family and friends, I started looking at pharmacy websites and reading about the pharmacy technician regulation process that was happening in Ontario and Alberta.  I decided that this was the next step I wanted to take in my pharmacy career. To do this, I felt I  that needed a bit more knowledge of pharmacy laws, pharmacology, etc. In the summer of 2009, I purchased a few text books, and began to study the NAPRA, PANS, and NSCP websites in anticipation of writing the PEBC Evaluation Exam. I wrote the Evaluation exam in Halifax in April of 2010, with a room full of other hopeful candidates.

And then the waiting game began. As everything was new and nothing was in the Pharmacy Act, I, along with countless other assistants in Nova Scotia, could go no further. In 2011 we finally heard word that we could begin taking the four Pharmacy Technician Bridging Programs being offered through various colleges online (now only being offered by Selkirk College). I completed the final course through Humber College in the spring of 2012, and wrote the PEBC Qualifying Exam (MCQ and OSPE) in March of this year. It was a terrifying experience – so much rested on my abilities and knowledge, and at times I felt like I was failing miserably. I questioned whether I could ever be successful as a pharmacy technician. However, in May I received word that I passed the PEBC!

And then more waiting. Was the new Pharmacy Act ever going to get passed? No one was sure. I didn’t think that I would stick around Nova Scotia much longer, and so in July I started looking into the process to move to Ontario and pursue licensure through their process. Thank goodness that I didn’t! At the end of July we found out that the new Nova Scotia Pharmacy Act would be passed and in effect on the 6th of August! A bit more waiting as many changes were made in the Act (including the ability for pharmacists to give injections to their patients -go and get your flu shots!). Then news came that the NSCP would be offering jurisprudence exams for hopeful pharmacy technicians. I didn’t do much preparation as I used to spend hours on the website, but I did bring a binder stuffed to the hinges with everything I could think of to print. After all, you don’t necessarily need to know 100% of everything for pharmacy – but you do need to know where to find the information you need and how to interpret what you find. The exam was offered last week, and so now I am waiting on the results.

The final step is the Pharmacy Technician Assessment (PTA) which is being offered sometime after December, and once I am successful with this aspect, I should be ready to register as a pharmacy technician!

And so I return to Devin’s original request when he asked me to write for PharmAspire and talk about how the whole regulations process has been. I’d be lying if I said it was an entirely awesome, stress-free experience. Tears have been shed, and drinks have been consumed after exams. There has been so much preparation and anticipation; anxiety and agitation, but also excitement and that feeling of pride once another step in this five year process was achieved successfully.  I can say that I have learned so much through and from the process that I feel I can take on anything! My understanding of pharmacology is so much better (“Your little white pill? You have two on file. Were you looking for the one for your blood pressure or for your diabetes?”) and I feel like I am able to assist my patients more effectively and efficiently.  I am already putting to good use the knowledge that I have gained, and only hope that I can be utilized further once I am licensed to do so.

And so that’s been my journey thus far!

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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.