If I understand Texas board regs and your position, you are actually required to constantly supervised by a licensed pharmacist. I would argue with you that pharmacists can't do anything to change the trajectory of our profession.
Well in most situations I would say you're pretty correct, but there are some areas where the laws and rules do change. I can't site them because I've never cared enough to read the rules, but I can say that the TSBP has visited our two technician pharmacies multiple times and I've learned about the rules regarding them from their mouths.
To give you some context, we have two satellite pharmacies that are technician run, one of them is the main OR in the hospital and the other is a day surgery/minor procedure center that is in a building adjacent to our main hospital. Until the most recent visit by the TSBP the day surgery center was staffed by a single technician that distributed medications to the providers directly, the main OR was the same setup (except with more technicians) and with a staffed pharmacist, who was also the PIC of the day surgery center, available M-F. The most recent visit by the TSBP said that because of the classifications of the the types of surgery centers we had, day surgery and main OR, that a technician could not hand out medications at the day surgery center, but could in the main OR. The hospital then moved our main OR pharmacist that is only here M-F to the day surgery center and the technician is now in the main OR, with no pharmacist in the direct vicinity of the technicians. The TSBP verified this was legal and acceptable to them and their policies, and they said the main factor of the day surgery center was when the technicians are distributing medications to the providers, the technician cannot make the drug selection themself and hand it to the provider, but if we had for example a platter of different medications then the provider could grab the medication directly making their own selection of the medication. This was the issue that the TSBP took issue with and said was acceptable in one place and not another because of how the two surgery centers are classified according to the state.
To give you even more context, I myself am the technician that works Friday through Sunday. I am the only person, a technician, present in the main OR pharmacy. I do not compound anything directly, and refuse to when asked because I don't have a pharmacist, and surgeons have asked me to make things, especially right now with many of the the locals unavailable currently, like 0.25% bupiv w/epi 1:200,000. We have medication trays that are made up with all the medications most commonly needed, and I exchange and remake those trays between cases, during the week we have two technicians sign off on the trays, but at nights and weekends only one of us is here to sign them so we check them ourselves. I also hand out narcotics to the anesthesia providers for each case, record waste, and reconcile waste versus dose charted to maintain a complete and accurate narcotic log. I make myself available to the providers as well if they're in the middle of a case and need something then I will get them what they want and bring it directly to them in their OR room so they don't have leave or send someone to us. We do have compounded items that we use like dexmedetomidine 4mcg/mL in a 5mL syringe that is compounded by us, in bulk and under supervision in the IV room, and if there is an order that needs to be compounded and we don't have immediately available, then our job is to facilitate that process and ensure it goes smoothly. For example I would call our ICU pharmacist to verify the order, they would send the label down to the IV room, and I would call the pharmacist in the IV room to let them know it's a STAT OR order and I'll be down to either pick it up or have them tube it to me. The rest of my job just involves simple stuff like inventory management and expired med checks.
And before anyone says anything else I will tell you upfront too that the answer is yes, I am well aware that most hospitals have only omnicell/pyxis machines in their ORs and not a staffed pharmacy, and yes, my job is incredibly easy and especially with my Sat/Sun shifts which involve only urgent or emergent cases and not elective surgeries. I am however thankful and blessed to be in this role because it has been one the greatest, most interesting career experiences I've had. I've learned so much about the anesthesia medications, the job roles of the surgeons, anesthesiologists, anesthesia techs, surgical techs, OR nurses, and other support staff, and seeing everything come together has been an awesome experience. I also get quite a bit of downtime to study and work on homework which has been invaluable too.
Sorry for the wall of text, just thought you (everyone) might be curious of what goes on in one type of technician run pharmacy.
