Is there such thing as a “right” pharmacy school? Going to pharmacy school is the wrong choice, period.
Agree with this. I have been reading to some of the new pharmacists (graduated in the past two years) working with me about how they have expanded the role of nursing practice and the new roles of nurses in value based care and population health and they said this was exactly what they were taught to do in pharmacy school. Then they sigh and say nurses are taking all the jobs. I respond and say it was there job first. You were just trained to help with the nursing shortage and being told it is clinical. I hand them supporting literature. They were trained to do everything this Ohio nursing school is teaching nurses to do except pap smears! I guess nurses are more qualified! Sadly they have 180 to 200 in student loans. Nurses are quitting and pharmacists are desperate to be a nurse just to have a job! I have new pharmacy technicians talking about going to pharmacy school because they can see themselves doing what we do in the pharmacy. I tell them they are not going to be doing what we are doing and hand them a stack of literature. They read it and quickly change their mind. I never tell them not to do it, just provide literature and let them decide for themselves. Some are considering nursing and pharmacy and I say it is the same job so do whatever one will be the cheapest education without putting you into massive debt. Achieving better outcomes at lower cost is the motto!
Interesting enough the USA is behind other countries on these models of care. I will share UK examples because I think these are the best.
Reading some health system editions of pharmacy times makes it seem like they do not want to keep pharmacist in the system at all due to costs. If a nurse can do the same job for cheap why use a pharmacist?
Bottom line: Elevating the pharmacist profession to be equal to a registered nurse or clinical nurse specialist is not a upgrade in my opinion.
VALUE BASED, PATIENT CENTERED, WHOLE PERSON CARE, POPULATION HEALTH has killed off the pharmacist. Getting paid for value and not volume leaves the pharmacist without a way to be paid except the same billing codes as a nurse in a ACO or PCMH. Incident to billing or billing Medicaid for MTM.
Redesigning nursing education to support patients in primary care
by Wendy Bowles, Margaret Graham and Portia Zaire The COVID-19 pandemic has exposed both the importance of and deficiencies in our healthcare system, including our primary care infrastructure. And beyond a shadow of a doubt, it has spotlighted the need for registered nurses to play a larger...
nursing.osu.edu
Highlight from this website: Law and regulation for RN practice need to be evaluated in each state to ensure the RN is practicing at the top of their scope. Regulatory prohibitions of RNs using “patient diagnoses,” sometimes referred to as “medical diagnoses,” must be changed in Ohio and other states to maximize the RN’s participation on the healthcare team. In addition, the joint regulatory statement by the Ohio Boards of Pharmacy, Medicine and Nursing regarding the
Use of Protocols to Initiate or Adjust Medications must be amended to allow RNs to work closely with the healthcare team in the management of patients with chronic disease. This will dramatically increase the number of educated professionals who can support patients with
chronic disease and enhance access to care.
RN Role in Primary Care
Primary care is the foundation of healthcare. It provides a way to access an interprofessional team of healthcare providers who address personal and integrated healthcare needs while partnering with patients in the community. Those who receive an RN in Primary Care certificate will be prepared...
nursing.osu.edu
Highlight from site:
What are the skills of the RN in primary care?
- The following list provides examples of a vast range of skills required for this role, but it is not exhaustive:
- Motivational interviewing
- Health guidance
- Coordinating care
- Chronic disease management
- Telehealth
- Managing transitions between levels of care
- Team development
- Team leadership
- Patient education
- Physical assessment
- Medication administration
- Vaccine management
- Injections
- Specific office-based procedures based on policies and procedures (IV hydration, EKG, ultrasound, pap smear, eye and ear exam, diabetic foot exam, phlebotomy, point of care testing, screenings and assessments)
Registered Nurses in Primary Care Certificate
- Registered Nurses in Primary Care Certificate
The Vital Role of Nurses in Delivering Transformative Primary Care
The Vital Role of Nurses in Delivering Transformative Primary Care
Highlight: Depending on their level of education and experience, the BMC Health Service Research Article observes, nurses can independently "
provide a broad range of patient services, including preventative screening, health education and promotion, chronic disease management, acute episodic care, and a wide variety of therapeutic interventions."
Highlight: These organizations had "practice-wide standing orders" that directed nurses to "independently conduct preventative visits, manage minor acute illnesses, and provide significant chronic illness care and management" to the patient panels.
Value-Based Care Elevates the Role of the Registered Nurse in Primary Care
One way primary care practices can improve their likelihood of success in value-based care initiatives is by streamlining their practices with the help of their registered nurses.
www.hfma.org
Highlight: For example, a patient may need to see only the nurse and nurse assistant for one scheduled visit but on another visit needs to be examined by the physician and provided training by the nurse.
Highlight:To be successful in such value-based initiatives, healthcare organizations must ensure nurses are working at the top of their license. Progressive providers have increased patient access by conducting new nurse-only patient visits during which registered nurses document patient histories, order lab and other diagnostic tests, and determine patient acuity.
Highlight:By implementing newly defined standardized procedures, clinics are increasing the registered nurse’s scope of clinical decision making including medication refills and anticoagulant and chronic care management. Nurses also are conducting physical examinations, providing triage, and subsequently presenting patient cases to practitioners—activities that significantly improve overall workflow and efficiency. Moreover, evidence shows nurse-led chronic, complex, and transitional care management results in decreased hospital days and emergency department (ED) admissions.
UK examples of pharmacist scope creeping on nurses below:
Tension as practice pharmacists ‘encroach’ on nurse duties
Hospital hires newly qualified pharmacists for wards amid nurse shortage
Pharmacists to take on “unique” clinical and caring role in response to problems recruiting nursing staff.
pharmaceutical-journal.com
USA example of pharmacist scope creep on nurses:
Pharmacists as Essential Team Members Support Patient Care at Rochester Regional Health
Evolution of Health System Specialty Pharmacy to Health System Comprehensive Pharmacy Care
This comprehensive approach is what all stakeholders, especially patients and families, need and deserve from their health care system.
www.pharmacytimes.com
Highlights:
We have to convince our provider communities that pharmacy care should be treated like any other referral for care, and that it should matter where their patients are receiving that care in order to improve outcomes and value-based performance. Also, we have to demonstrate to payers and employers that the integrated delivery for patient-centered pharmacy care translates to better drug-related outcomes and lower overall cost of care. Additionally, we must create what I often refer to as the pharmacy easy button. Providers, clinics, patients, and families should have a single point of contact for all pharmacy-related patient needs. Behind the scenes, a comprehensive pharmacy plan should be implemented, including specialty pharmacy, non-specialty pharmacy, home infusion, alternative nutrition support, and durable medical equipment depending on patient-specific needs. This team would have access to all necessary information to handle benefit investigations, prior authorizations, billing, patient assistance programs, charity care, and other administrative details as needed without the provider clinic having to deal with 5 different vendors.
This comprehensive approach is what all stakeholders, especially patients and families, need and deserve from their health care system. Health system pharmacy leaders must figure out how we achieve these goals and document our success in a much more resource-depleted environment than HSSPs represent as a single component of this comprehensive need. High-quality, patient-centered pharmacy care in all environments of care is our responsibility.
Disruption Is Ongoing and Inevitable
But pharmacists can implement medication use systems and collaborate with other health care professionals.
www.pharmacytimes.com
Highlights:
Pharmacists have 2 choices: do nothing and watch the rapid evolution of the disruption of the medication use system in the community or disrupt the medication use system for patients. Pharmacists must leverage the fact that they have the data, patients, and providers. Pharmacists can implement a medication use system that is highly patient centered and relational vs transactional. They can become integrated into patient care teams, working with care managers, nurses, providers, and social workers to address the many challenges of delivering effective drug therapy. No other potential vendors can do that. To be successful, pharmacists must harness technology, have a digital presence, and incorporate other nontraditional models to deliver highly efficient care that is not dependent on brick-and-mortar pharmacies on every corner. Pharmacists must efficiently shift resources from prescription counters to clinics to develop those patient and provider team relationships and fuse clinical care and medication use systems.
Pharmacists must convince providers that pharmacy care is just as important to keep in system as any other referral for care, as most interventions for chronic diseases concern drug therapies. The team should care where patients receive their pharmacy care. This will be challenging to implement, given reimbursement models, but it can be done using efficient systems and leveraging value-based performance metrics. Pharmacists probably have 3 to 5 years to disrupt the model, so time is of the essence. If they can align the clinical accountability with the financial incentives, health-system pharmacies can have a huge impact on improving medication-related outcomes. It is up to all of us.
Empowering Pharmacist-Physician Collaboration
As a pharmacist, embedding yourself in a primary care practice can have positive outcomes for both patients and your business.
www.drugtopics.com
Highlight:
But even if Moose is successful with this pitch and delivers on the value promised to the practice, he knows his pharmacists must continue to deliver value or he risks the practice choosing to hire a nurse to take on the same work at 70% of the cost.
Moose’s advice? “You have to be valuable...and help generate income.”
Add on:
These models look like NHS models for nurses..... hmmmmm sure looks similar. Holistic whole person patient-centered care.
General Practice nurse England job description:
www.nhsprofessionals.nhs.uk
Kavitha is a general practice nurse that enjoys what she does. She works in a multi-disciplinary team to help patients make choices that promote a healthy lifestyle.
www.healthcareers.nhs.uk
Is Pharmacy School Still Worth It? Dave Ramsey Caller
pharmacyforme.org
