Does fast-pace nature of pharmacy make it risky as a career?

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jjoeirv

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A pharmacist must dispense medications at a fast rate. Generally, mistakes are more likely when one has to work at a fast-pace than a slow-pace. These medications can be harmful or even fatal if any mistakes are made such as dispensing the wrong medication (since many of them have similar-sounding names) or making the wrong dilution. I am trying to look at the pros and cons of whether or not to pursue pharmacy, dentistry, or optometry. Dentistry and optometry are not as fast-paced as pharmacy. I have found the following 3 articles about pharmacy on the internet.

( 1 ) >>>> Massachusetts Family Wins $7.1 Million in Pharmacy Malpractice Case <<<<

March 28, 2002

A jury ordered three former pharmacists at a Massachusetts hospital to pay $7.1 million to the family of a four-year-old boy who received an improper drug dosage months after his birth. Pharmacists at Children's Hospital in Boston failed to dilute the high-blood-pressure drug Enalaprilat in March 1997, mistakenly giving three-month-old Joey Rice 100 times the proper amount.
The infant's parents, Christopher and Kathleen Rice, alleged the overdose caused Joey's severe brain damage that left him mentally ******ed. Defense attorneys argued the boy, who was born prematurely, had already suffered neurological damage before the medication was given.

( 2 ) >>> Pharmacists And Pharmacies Make Prescription Errors That Kill Or Injure <<<


Why Do These Preventable Mistakes Occur?

One potential cause is the similarity between some drug names. For example: Levoxine vs. Lanoxin, Eldepryl vs. enalapril, quinine vs. quinidine. Picture a poorly written prescription for Norvasc (or is that Navane?), or Procanbid vs. probenecid. Another frequent source of confusion is the use of drug suffixes, like SR or XL. In one instance, a prescription for Procardia XL, 30 mg once per day, was filled as Procardia 10 mg, dispense 40 tablets.

In a study of 500 pharmacist malpractice claims conducted by Pharmacists Mutual Insurance Company, the following types of errors were identified: Wrong Drug Dispensed -- 52%, Wrong Strength Dispensed -- 27%, Wrong Directions Given -- 7.4%, for a total of 86.4% of errors that could have been prevented.

What are some of the factors that contribute to these mental lapses?

A Pharmacy Today survey (published December 15, 1996) asked, "What could cause dispensing errors?" Of 187 responses from 171 pharmacists and 16 pharmacy paraprofessionals, insufficient filling time and too many distractions were identified as two of the major areas of concern. Ringing telephones and customer questions unrelated to medication were frequent sources of interruption. Unrealistic workload requirements, inadequate technician assistance, and a nonsupportive system (with no provision for one person to check the work of another) were also identified as factors that can increase the rate of error. In short, many dispensing errors are caused by stress, distraction, or lack of backup.

None of these causes justify the harm that can be caused by a misfilled prescription.

According to the law, pharmacists have a responsibility to the patients who depend on them to practice according to acceptable standards of care for the profession.

When something goes wrong and there is a deviation from the standard of care, an error occurs. Any action or conduct that deviates from the standard of care is negligent, and the pharmacist/pharmacy may be considered liable for the act.

Whether a patient would have a reason to pursue a claim against a pharmacist or pharmacy depends often upon the answer to this question: "What injuries or damages did the patient suffer?" A major injury like a heart attack or stroke, or a patient who is left permanently disabled as a result of the injury is more likely to bring a lawsuit than an individual with minor injuries.

Breach of expressed warranty occurs when a pharmacist makes any expressed claim about a product that the product fails to meet. For example, the pharmacist might dispense a generic form of a drug to a patient and tell that patient, "This is the same thing as the other drug and will work just as well."

( 3 ) >>> Pharmacists sue Wal-Mart over pay
Employees say discounter owes them $200 million <<<<<<<<<

By Louis Aguilar
Denver Post Staff Writer

Monday, August 12, 2002

Trinidad pharmacist Michael Fiorenzi says he had little choice but to work for Wal-Mart when a superstore opened in his tiny southern Colorado town in 1988.

As an independent pharmacist, he could not compete with a retail operation the size of three football fields.

He said he found his Wal-Mart experience enjoyable for several years. But as the store gained in popularity, Fiorenzi contends - as do thousands of other former and current Wal-Mart pharmacists - he could not keep pace with the growing workload.

Fiorenzi said he often filled 200 prescriptions daily, working 10-hour shifts. Then, he had to go home and fill out paperwork for up to three hours a night, he said.

Wal-Mart continued to pay him for 45 hours of work. When he began to complain to management that he was working more than 45 hours, he was fired on the charge of misfilling a prescription. Fiorenzi disputes that charge. He now drives 85 miles one way to work at a hospital pharmacy.
 
I am currently a fifth year student going on to my rotations in 2 weeks. All pharmacy students basically know how hetic a pharmacy can be. It is up to us as future pharmacist to take control of the situation. Regardless of where I work a medication is not leaving the pharmacy unless I am sure if it's the correct medication. If that patient has to wait, than the patient waits. I am not going to risk seriously harming anyone just because the doctor won't call back, or the wait time is 20 minutes instead of 15 minutes. It's up to the pharmacist to make a difference in the work place. If the employeer wants to have a policy that allow patients to be injured, I will work somewhere else. Hope that helps.
 
Try searching for some positive articles regarding the profession or pharmacy instead of just the negative ones. I think that "pharmacist" was recently rated as one of the top professions in a major news magazine, and it would be difficult to think of a profession with better job security. Optometry is cool and optometrists make some good money, but I would never ever want to be a dentist. I couldn't go through my entire day with my hands in somone's disgusting mouth with bloody tooth fragments flying everywhere. Yeech. They might have good hours and make some excelent money, but I personally couldn't do it. There is also more to pharmacy than the fast-paced aspects, and I've worked with countless pharmacists and never run into a single one who was sued or caused any harm to his patients/customers. More oftern than not, I see pharmacists (and even techs) catch errors on the doctor's written prescription and save the patient from potential harm.

Jd
 
I agree with rutpharm. Life is a risk. Take your time and do the job right and you won't have too many problems.

However, no matter how good you are, you will make mistakes. The important thing is to catch them before they get out, i.e. to the patient. Also, if you make a mistake and it does get out...always be honest and straightforward about it. If you try to cover-up or b.s. the patient, they will not respect you and will be more likely to sue you.
 
The failure to detect the "non-dilution" of intravenous Vasotec is negligence on quite a number of levels. Unlike a retail pharmacy, there are more checks and balances in most (though not all) hospital pharmacies. But also, unlike retail, meds come in all dosage forms including parenterals, intravenous medications, which may have to be compounded by an IV room tech. At the hospital where I work, a pharmacist checks and enters medication orders. The med order is "filled" by an IV room technician who will write out the calculation on the label of the bag, and will show his IV admixture, his added volume calculation, the diluent used, and the original vial of medication for a final verification by a charge pharmacist before the IVPB heads out to the floors. The pharmacists I work with will not let themselves be rushed. I think that's key in ANY pharmacy practice.

As for retail, bear in mind that the current drug distribution system may very well undergo dramatic changes in the next decade because of 1) rapidly growing population of elderly patients who will be on medications to control their disease state(s), and 2) rapidly growing number of pharmaceuticals on the market to control those said disease states. How these two factors change the practice of retail pharmacy remains to be seen, but given the inefficiencies of the current situation, changes are in order.

The practices of pharmacy, medicine, and even dentistry are frought with risks....risks that are only mitigated by the expertise of their respective practitioners; and even then, things can and do go wrong. If anything, I'd say pharmacists (especially hospital pharmacists) are undercompensated for the amount of risk they assume in caring for patients.
 
that is very true unfortunately. most pharmacists have to work very quickly in (relatively) stressfull conditions, so if you're not too crazy about that, that's something to consider.
statistically speaking though, bad mistakes dont happen all that often.
as you're deciding on your future career , i'd chuck this in the "minus" column for pharmacy.
 
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