to be hospital pharmacist 20

Your first few days of dispensary work will make you very tired –
especially your feet! This is why dispensary staff place great importance on
tea breaks; if you are working hard in the dispensary, you definitely need to
take all your allocated breaks. Be sure to take them on time too, because you
may delay other people’s breaks if you are late going on yours – and people do
not thank you for this.

At first, you will be asked to perform the more technical aspects of
dispensing. This allows you to get used to the process of dispensing drugs,
and the steps that need to be completed correctly. In the beginning you will
probably struggle with the most basic of tasks, such as where to physically
stick the label on the medicine container. The first time that you are asked to
produce a label on the computer system may also cause you some stress and
you won’t have a clue as to how the labelling system works, let alone think
about short codes!

Remember that a range of dispensary staff operate in the dispensary,
not just pharmacists, and that each staff member has an important role to
play within the dispensary. Do not be surprised if the person in charge of the
dispensary is not a pharmacist. These days, it is highly likely that the dispensary
manager is a technician. Whether the dispensary manager is a pharmacist
or a technician is not important. What IS important is that this person is
the one in charge and so you should be directed by him or her in the work that
you do.

There will be many different policies, procedures systems that you
need to follow while in the dispensary, and at first what you need to do is
confusing. There are many, many folders filled with standard operating
procedures that you need to follow, and different pieces of paper that need
to be filled in depending on whether the dispensed medicine is on the
hospital formulary, non-formulary, unlicensed, part of a clinical trial or a
specially manufactured item. It takes time to untangle all the requirements
that working in a busy hospital demands, but don’t worry, with practice
and your familiarisation with how the systems work, things eventually
become clear and you don’t feel stupid having to ask somebody what to
do next a million times a day.

You may find that, when the dispensary is busy, you are called in from
other rotations to help. Although this may be perfectly reasonable, you
should question why the dispensary takes precedence over other areas, especially
if you may be the only member of staff holding the fort in your
particular rotation. The dispensary is undoubtedly important, but the work
that you are doing in another section is equally important, and you have to
weigh up whether or not you can be spared to go into the dispensary.
Remember that you, as the pre-reg, have the obligation to learn about all

the different sections of your pharmacy department and you need to become
competent in all of these areas, not just the dispensary.

As part of your dispensary training you are required to dispense, label,
screen and check a certain number of items before dispensary staff deem that
you can do any of these processes correctly. You will be given paperwork to
fill in as evidence that you have achieved your set goals. As there are multiple
points in the dispensing process where errors can be picked up, it is hoped
that any errors that you make will be identified and rectified before the item
leaves the dispensary. These errors are massive learning points, because they
may expose areas of your dispensing and checking process that need to be
more systematic. It is useful at first to devise and write down a self-checking
procedure and adhere to this. 

Every member of pharmacy staff has their own
internal checklist that they go through; it does not matter in what order you
check your work, only that, at the end, everything that needs to be checked
has been covered. You will find that most dispensaries have some logs or
paperwork for you to complete that is based on the paperwork for accredited
checking technicians (ACTs). ACTs undergo a thorough training programme
before they are allowed to check prescriptions that they have not dispensed,
and have to be regularly revalidated by passing a dispensary test. On most
occasions, once you have completed your pre-reg training, you may never be
assessed, or revalidated, again for your dispensing – in your whole career!

It is likely, however, that you will make mistakes. Although experienced
pharmacy staff are generally able to bear the responsibility of what
they are doing and therefore accept the fact that they make errors every now
and again, the first error that you make may come with some emotion,
especially if a patient has subsequently taken the wrong medication as a
result of your error.

The first time that you have to query a prescription with a doctor will
be a daunting one, especially if you are working on outpatients and the
patient is waiting patiently for the medication. The stress comes from not
knowing how the doctor will respond to your request and also how assertive
you can be, especially if you feel that you do not have the whole picture of the 

patient’s condition. 

Although you can never totally predict what will happen,
you CAN be prepared for the interaction by thinking through what the
doctor might subsequently ask you. For example, if you are going to speak
to the doctor to say that you cannot provide a particular medicine for whatever
reason, it would not be unreasonable for the doctor to then ask ‘what
alternative do you suggest?’ – so it would obviously be wise to think of this
before even picking up the phone.