futuredruggist said:
sdn1977 - I am curious as to the setting in which you practice pharmacy? I only have experience as a pharmacy clerk in the retail setting. I do not have a good understanding of how much opportunity there is for pharmacists to apply the understanding of drugs that you described in your posts. Can you describe how often you get to apply professional knowledge in the settings you are familiar with, and examples of specific situations?
I explain drugs everyday & I mean lterally every day! When I work...I work in two places - ambulatory care - so I can relate to all your insurance issues, patient impatience, formaulary changes, etc.. When work acute - I'm in ICU/ step down & OR. Occassionally I have to cover the main pharmacy which is everything else - we don't have peds/neonates in my hsopital (thankfully!) but we do have a locked mental health unit & a SNF.
I also have a husband who is a dentist & my daughter visiting who is in medical school. Currently, I'm on vacation, so I'm only fielding family questions. She pimps me with what ifs & whys. My husband asks me if the pt drug history is enough to influence his call & to call the PMD. I mostly have him call the PMD if he has any questions! Otherwise, he will ask me if a particular symptom he sees is a symtom of a drug or a disease (within HIPPA rules!!!)
However, when I'm in ambulatory care...I often have the ability to interact with pts & explain what they are feeling & why. Sometimes I offer to interact with their physician to help them dimish their side effects. Other times I'll initiate contact to try to decrease they finanacial outlay.
Patients often don't understand the term hypotension when its applied to an antihypertensive we dispense. So, when I dispense a new one...I take the time to tell them that when they get up from a chair or more importantly, when they get up to go to the bathroom at night (which most older folks will do) they need to stand by the bed for a minute before they take that first step - just to be sure they have their balance. A HUGE fear of older folks is falling down - not just because they break hips which they & we know have a greater mortality, but they don't know how to get themselves up. We can go on and on into many different examples all day long.
One thing which I might do differently than others on here - I don't ask if they want counseling on a new rx. I don't allow my tech to ask. They get my counseling. If the pt is on a cell phone, I just walk away until they are free. I have the drug & they get me. It goes hand in hand. Now..there might be times the new drug status is only a change in current therapy - its a fast consult & very friendly....remember you take this twice a day now...and how is that new grandbaby? Or...you have another 3 months of Trinessa - when do you go back to school?
In the hospital, it is different. Patients are inundated with information. I've been on both sides - patient & pharmacist. They don't remember what you've said. Provide simple, easy to read materials. Numbers they can call - WHICH WILL BE ANSWERED BY SOMEONE WHO CAN GIVE THEM AN ANSWER! And...give them reassurance they can always call you back with any drug information question.
Most of the information I give in the acute setting is to prrescribers & nurses - sometimes RT too. But...I'm happy to talk to the janitor about how hard it is for him to control his blood sugars while I have coffee & he eats his donut & OJ. Baby steps....you might make a difference slowly
Don't get me wrong - I have to look up lots of informaton! But..I leaned a long time ago...your best friend as a pharmacists is your references. Don't pretend you know it all - you don't & won't. Some prescribers will know far more than you ever will. When you are asked for information...don't take 3 days to get it (like a university drug informatin center). Find early on what your good reliable resources are and use them. When you don't know - say I DON'T KNOW. However, if you've had a good basis in understnding pharmacochemistry, pharmcodynaamics & kinetics, you can make an educated guess. That is the art that goes with the science - secundum artem.
PM me if you want more info...good luck to all!