| Wasted medicines. |
[Jan. 30th, 2007|07:24 pm] |
| [ | mood |
| |  aggravated | ] |
It was a fairly quiet day at work today, so I took the opportunity to catch up on some of my odd jobs. One of these was clearing out a load of returned medicines that various people had brought back over the last few days.
It's one of the jobs I hate, not because it's tedious, or time consuming (although it's both of those), but because it's such a waste. It's not so bad when it's a half used box that someone isn't taking any more... but when you have a bag of several boxes of medicines that haven't even been opened, and are still in date - I can get quite grumpy at having to throw them away.
We often get given bags of medicine when someone's died and the relatives have had a clear out, and the amount of stuff like painkillers there tends to be - boxes and boxes of various dates, most likely ordered "just in case" - is mind-boggling. (No less boggling are the occasions when we get given a bag that includes tablets that expired ten or fifteen years ago - I think the oldest one I've seen so far was 1970-something!)
As far as I can tell, a lot of people don't seem to realise that we can't reuse anything that's been taken outside the shop. Several times I've had an elderly lady come into the shop with a box of tablets that she "didn't realise was in the bag" and thought she'd bring back to save it going to waste. Trying to explain that since it's been out of the shop, it's just going straight into the bin (well, the pharmaceutical waste tub, to be accurate), can be an exercise in patience. Sometimes I give up.
The NHS spends a lot of money each year on unused medicines - an article I found dated from 2004 had an estimate of £30-£90 million each year, with a note that this was probably a large underestimation. I hate to think how much the sum has increased in the past three years. This is money that could be used for operations, equipment, all sorts of things... and instead, it gets spent on medicines that the NHS then has to spend even more money to incinerate and dispose of safely. |
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| Bank Holidays... |
[Aug. 27th, 2006|12:12 pm] |
I really hate working on the Friday/Saturday of a bank holiday (or the Thursday, if it's Easter).
On the Friday, I'm rushed off my feet because it's the last day that the doctors' surgeries are open, and so there's all the prescriptions people are bringing in "just to make sure they don't run out of tablets over the weekend". Fair enough, although I have to say that those people who aren't due to be out of their medicines for another week, are probably being just a trifle over-cautious.
Then there's the people coming in to order their repeat prescriptions because they're completely out of tablets and forgot to order before this. After the third or fourth one of these, I'm ready to start banging my head against the wall. Especially when they ask if it can be delivered "this afternoon". Ah, in a word, no. Repeat prescriptions generally take about 2 days, and that's before we even dispense them. You could go and ask the receptionists if they can do you up an emergency prescription. That sometimes works.
On the Saturday, there at least isn't a massive pile of prescriptions to worry about, other than the ones that didn't get done on the Friday. Instead, I get the people coming in who forgot to order their medication and are (guess what?) out of their medication. Or the ones who ordered their prescriptions right at the start of the week and decided to wait until Saturday to pick it up... when all the doctors' surgeries are closed and so I can't phone up to find out why their prescription hasn't come back. The Saturday staff don't have any idea either, as often they don't work during the week.
In either case I generally end up giving emergency supplies of medication (5 days worth is the legal maximum, although you don't have to give that much) to last them until the surgeries are open again. In theory I could charge whatever I wanted to for these transactions, but in practice if it's a regular patient we won't make a charge and will just take the same amount out of their next prescription.
Out of town visitors and persistent repeat users of the system generally get charged a fee (often the private prescription cost of the medication). Out of town visitors won't be able to bring a prescription in, and with repeated requests it's simpler to do it strictly by the book. Having the supplies as completely separate transactions to the prescriptions instead of keeping track of which supplies have been repaid and which haven't is much easier. (Besides, it's amazing how people start ordering repeats in time once their wallet is affected.)
Once having given an emergency supply, it then has to be written up in the prescription register (otherwise used for private prescriptions). All of this takes time. Time that I could have used doing the prescriptions for the line of people waiting patiently (and not so patiently) out in the shop. I can get a little frazzled sometimes... |
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| One, two, four, oops. |
[Aug. 11th, 2006|11:22 am] |
Recently, while spending one day working in a shop, I caught around ten errors relating to the quantity of tablets in a box not matching the quantity that it was supposed to contain. Sometimes it was a couple of extra (a box of thirty labelled up as 28, for example) or sometimes there was an entire strip (which can be as much as half the box's contents) missing.
Admittedly this was more than I normally find in one day, but I still tend to find quite a few. Which is why it worries me that quite a number of my colleagues don't always open the box to confirm the quantity when they're performing the final check. Yes, it slows you down, which makes customers grumble, but isn't that better than making a mistake? |
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| Easing the load |
[Aug. 9th, 2006|08:15 pm] |
| [ | mood |
| |  bemused | ] |
I read a letter in the Pharmaceutical journal a while back (can't remember exactly when, or who wrote it) which I agreed with whole heartedly. The gist of it was, there's frequent articles in the Journal about new initiatives for pharmacists, where they can ease the workload of GPs, nurses, and various other health professionals by taking on new roles such as prescribing, medication reviews, minor ailment schemes, various types of diagnostic testing, and flu vaccinations.
The author of the letter found himself wondering just who was going to lighten the load on pharmacists, and I have to agree. We tend to be busy enough as it is (unless working in a really quiet store) and all these new schemes take up time. I know of at least one independent pharmacist who chose to withdraw from a minor ailments scheme (where patients with minor illnesses are referred from the doctor's reception to the pharmacy to be assessed and given medicines at prescription prices if appropriate) because it was taking up so much of his time that he wasn't able to carry out his core duties (ie dispensing prescriptions etc).
It all seems rather crazy and mixed up to me. |
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| Flu vaccinations.. |
[Aug. 2nd, 2006|07:13 pm] |
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The government wants to train pharmacists to give flu vaccinations, because they're easily accessible, etc etc. Fair enough, although it's yet another extra job to take on. It makes me wonder, though... if accessibility is such an issue, wouldn't they be better served by attempting to make doctor's surgeries more accessible? |
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| Pharmacists’ lunch-breaks |
[Sep. 10th, 2005|11:43 pm] |
| [ | mood |
| |  thoughtful | ] |
In a recent issue of the Pharmaceutical Journal, two letters concerning the subject of adequate lunch breaks for pharmacists caught my attention. As was pointed out, there are guidelines in place to ensure proper breaks – the problem is in implementing them.
Having a lunch break at work is something that all my friends seem to take for granted. They go into work, have a break around about midday where they can eat a meal and go do their own thing, and then they go back to work for the rest of the day.
Unfortunately, it isn’t quite that simple for community pharmacists. A pharmacy cannot hand out completed prescriptions or sell medicines without a pharmacist being on the premises, and if the pharmacist is gone too long, the shop needs to shut entirely. Obviously, employers don’t want to have this happen – not being able to sell medicines is going to put something of a crimp in their profits. So, either they must pay for a second pharmacist to come in and cover for the duration of the lunch break (assuming they can find a pharmacist to do this in the first place) or they must arrange for the main pharmacist to remain on the premises during their lunch break.
Not such a problem, you might think. Being paid to sit in the staff room and do nothing for half an hour or an hour isn’t so bad, is it? And on the face of it, it isn’t. In practice, however…
Well, during one recent lunch break, I checked off three prescriptions for customers who had returned to pick up their medicines and weren’t prepared to come back a second time (and certainly weren’t happy that their medicines weren’t already ready for collection), gave advice to two rather persistent customers, and answered a query on the telephone.
In some pharmacies I’ve worked in, the shop has been so small that there isn’t a staff room, and I’ve had to eat my lunch in the dispensary. Quite apart from this not being good working practice, it has the disadvantage that customers can see that I’m there, even as they’re being told by the staff that they have to wait an hour for their prescription because the pharmacist is on lunch.
Many customers really aren’t pleased to hear that. When they hand in a prescription, they want it back as soon as possible – which is perfectly understandable and reasonable. Preferably, they’d like it back within the next ten minutes or so, no matter that there’s a whole stack of prescriptions to be done first, or that the pharmacist is taking what will most likely be their only break of the day. They want their prescription promptly, and if they don’t get it then you aren’t doing your job properly.
Not all customers are like that, of course. Many are quite happy to leave it and call back in an hour or two, and others are the most patient souls possible – even if there’s a problem that means they don’t get their medicines for several days.
The impatient ones, though, put a lot of pressure on the pharmacist. Certainly I’ve cut my lunch break short before now, when I’ve been working in a busy pharmacy. Sometimes the knowledge that annoyed customers are throwing their weight around because their prescriptions aren’t ready overweighs the need to have a decent length break, even though cutting short the lunch break just leaves you less rested and more likely to make a mistake.
Sometimes I think the only way a pharmacist is going to get a proper lunch break in a busy pharmacy is to either shut the shop, change the attitude of customers so that everyone is prepared to wait patiently (or if not patiently, at least without giving the staff grief), or to put in a second pharmacist. The first costs money and customers, the second would probably require a miracle, and the last both costs money and depends on a supply of spare pharmacists that as far as I’m aware just doesn’t exist.
Possibly this is an excessively jaded and pessimistic view of the world, and I certainly hope that will prove to be the case. In the mean time I’ll continue to fight my tendency to cut my lunch short in busy pharmacies, and treasure my lunch breaks in quieter shops. |
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| So begins a new project |
[Sep. 10th, 2005|11:29 pm] |
Greetings, anyone who may be reading this. I honestly don't know if anyone will read this, but does it really matter? ^_^
This is a place for me to write down my thoughts about pharmacy, both comments on incidents that happen to me and musings on the job in general. If anyone else reads it and finds it interesting, that's just an added bonus. If it helps anyone gain a better understanding of pharmacy, then that will be an excellent bonus - not to mention quite an ego boost for me.
I have no idea how often I'll be updating, or even how long I'll keep going. We'll see how it goes. |
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