Hospital Placement 2017: Self Assessment

As I completed my hospital placement at Lakeridge Health in Whitby/Oshawa, I gained some valuable experience. I found it significant to learn how hospital pharmacy is run both at a smaller hospital in Whitby, and on a larger scale in Oshawa. In Whitby, two Registered Pharmacy Technicians (RPhTs) were responsible for all aspects of pharmacy, from filling refill lists and orders of traditional stock, to compounding, restocking, computer entry of orders, and restocking MedSelect machines. In Oshawa, there were as many as 20 RPhTs working in the pharmacy, and all had an assigned area with specific tasks to complete that shift. I realized that not every shift at a bigger hospital do you get to be hands on with dispensing meds, or filling the MedSelect machines, however every job that must be completed is an important part of a whole team that works together to provide patients with much needed treatment.

While working at both hospitals, there were many similarities to the theory taught in class at Fleming College. For example, as discussed in class, I saw the use of unit dose packaging, picking stations, and the need for prepackaging meds into smaller quantities. I witnessed the use of automated systems, such as MedSelect, as well as traditional systems, as with refills and orders for stock not carried in MedSelect machines, and the use of ward stock in medication rooms on the hospital floors. I also noticed the use of only generic names in the pharmacy, and not the use of Drug Identification Numbers (DIN) when selecting or checking drugs, which means extra care must be taken when picking a drug to fill a prescription, as some medications have many different strengths, and durations.

I feel that I was able to gain more practice filling prescriptions, as I filled many refill lists and orders for traditional stock items. I also became more familiar with medication names used in hospital pharmacy. I found the use of automated systems fascinating, and I’m pleased to now have the skills to restock MedSelect machines, and become familiar with the use of unit dose packaging. I thoroughly enjoyed observing sterile compounding, especially at the Durham Regional Cancer Centre, and hope to gain more experience in aseptic techniques. I also enjoyed having the chance to do non-sterile compounding, practicing the skills I learned in class.

I am grateful for the experience I had at Lakeridge Health. I found it rewarding to have a hand in patient care for so many people on a daily basis, which in some instances could have been life saving. I am excited to take the next steps to becoming a RPhT, and I see hospital pharmacy as where I would like to pursue my future career.

Hospital Placement 2017: My Last Two Weeks

My last two weeks at Lakeridge Health Oshawa, I completed the following:

Monday

I helped check certain hospital floors for their iv bag stock (NAPRA 4). I replenished drugs for the operating room trays (NAPRA 3). I also processed returns from hospital floors using the computer, and restocked the returns into traditional stock bins, as well as stocked shelves (NAPRA 4).

Tuesday

I worked at the fill counter to fill the traditional order refill lists for specific hospital floors, as well as filled some new traditional orders (NAPRA 3). I took note of sound-alike-look-alike drugs (SALADS), and of the proper handling of hazardous drugs (NAPRA 5; 9). I also saw how to fill leave of absence drugs (LOA), ensuring proper packaging (NAPRA 1; 3; 9). I recognized which drugs were running low in stock in the traditional unit dose bins when filling, so the unit dose packagers could make more, and I restocked returns (NAPRA 4).

Wednesday

I filled refill lists for specific hospital floors (NARPA 3). I barcoded meds for MedSelect machines, and prepackaged vials into smaller packaging (NARPA 3; 4). I helped fill narcotics into a MedSelect in the Durham Regional Cancer Centre wing (NAPRA 3), and signed documentation that I witnessed a discrepancy, as there were more narcotics in the machine than the computer’s inventory stated (NAPRA 1). I also assisted in unpacking a McKesson order (NAPRA 4).

Thursday

I was able to assist in the area responsible for sterile preparations. I helped gather completed iv bags to fill the refill list for specific hospital floors (NAPRA 3). I also helped prepare for sterile compounding by gathering drugs and appropriate iv bags, and creating a batch number and labelling bags (NAPRA 3). Later, I was able to properly wash and garb with the appropriate personal protective equipment (PPE), and enter the clean room to observe sterile compounding in a Laminar Airflow Hood (NAPRA 1; 3; 5; 9). Then, I unpacked a Baxter order of iv bags, barcoded them, packaged them into groups of 20, and put tamper proof foil on the ports of the narcotic iv bags (NAPRA 1; 4).

Friday

I experienced an evening shift, which began with checking the inventory of non-sterile compounded products (NAPRA 4), and then making a suspension (NARPA 3). The rest of the evening there was a Code Grey, which is loss of infrastructure, as Lakeridge Health was hit with a computer virus which ended up affecting nearly 100 countries. As a result, the evening was spent visiting hospital floors to see which MedSelect machines were not operating, and aiding nurses to find the inventory sheet of their MedSelect machines so they could manually open them with keys found behind an emergency kick plate, and locate the meds they would need (NAPRA 1, 6, 7, 8).

Monday

I had the opportunity to spend the morning in the Durham Regional Cancer Centre wing of the hospital. There, I garbed in the appropriate PPE, and entered the clean room to observe sterile compounding with cancer drugs (NAPRA 1; 3; 5; 9). I witnessed the use of a Class II Biological Safety Cabinet; the PhaSeal system used to create a closed system to withdraw drugs from a vial, and inject drugs into an iv bag; and pass through windows to deliver drugs to the adjoining cancer clinic and keep the clean room sterile (NAPRA 1; 3; 5; 9). I learned how the cancer centre takes place in many clinical trial, and how they assist patients with obtaining non Ontario Drug Benefit (ODB) drugs through various programs such as Trillium, the Exceptional Access Program (EAP), or the Compassionate Drug Program (NAPRA 1; 2; 5; 6; 8). Later, back at the pharmacy, I filled refill lists and traditional orders (NAPRA 3).

Tuesday

I barcoded sterile drugs for MedSelect machines (NARPA 4). I filled refill lists and traditional orders (NAPRA 3), including a LOA, ensuring proper packaging (NAPRA 1; 3; 9). I checked the expiry of meds in anesthesia trays, and replenished meds in the trays (NAPRA 3; 4; 9). I also helped stock shelves (NAPRA 4).

Wednesday

I filled refill lists and traditional orders for specific hospital floors (NAPRA 3). I checked the expiry of meds in emergency room crash cart trays, and replenished meds in the trays, and sealed trays in special bags (NAPRA 3; 4; 9). I also processed returns from hospital floors using the computer, and restocked the returns into traditional stock bins (NAPRA 4).

Thursday

I witnessed how to refill the list for the night cupboard, with the appropriate packaging and documentation, as well as how to open and restock the night cupboard (NAPRA 3; 4). I filled refill lists and traditional orders for specific hospital floors (NAPRA 3). I also restocked returns into traditional stock bins (NAPRA 4).

Friday

I filled refill lists and traditional orders for specific hospital floors (NAPRA 3). I restocked returns into traditional stock bins (NAPRA 4). I unpacked a Baxter order of iv bags, barcoded them and packaged them into groups of 20 (NAPRA 4). Also, I stocked meds on shelves (NAPRA 4).

 

Hospital Placement 2017: My First Two Weeks

I have now completed two weeks on hospital placement, one week at Lakeridge Health Whitby, and the second week at Lakeridge Health Oshawa.

Lakeridge Health Whitby is a smaller hospital, that provides continuing care, Geriatric Assessment and Rehabilitation (GARU), a regional dialysis unit, home hemodialysis and an ambulatory rehabilitation centre. During my first week, I completed the following:

Monday

I was introduced to filling MedSelect machines on hospital floors, and witnessed stocking MedSelect with narcotics by two Registered Pharmacy Technicians (RPhTs) so there is a double count (NAPRA 1). I stocked patient specific bins on hospital floors with traditional stock drugs (NAPRA 3). I witnessed compounding of drugs, order entry, and tech-check-tech of orders entered (NAPRA 3), and completed runs to the hospital floors throughout the day to check for orders and deliver additional traditional stock items (NAPRA 3).

Tuesday

I picked drugs off the shelf for traditional orders to be filled (NAPRA 3). I helped fill MedSelect machines on hospital floors (NAPRA 3; 4). I witnessed the process of signing in narcotics to the narcotic safe on the hospital floors, with the need for a nurse to sign as a witness that she received the narcotics (NAPRA 1). I practiced deciphering orders (NAPRA 3). As well, I completed runs to the hospital floors throughout the day to check for orders and deliver additional traditional stock items (NAPRA 3).

Wednesday

I selected drugs off the shelf to be packaged for the traditional order refill list (NAPRA 3). I helped fill MedSelect machines on hospital floors (NAPRA 3; 4). I witnessed the process of signing in narcotics to the narcotic safe on the hospital floors, with the need for a nurse to sign as a witness that she received the narcotics (NAPRA 1). I helped return unused unit dose drugs to the pharmacy shelves (NAPRA 4). I witnessed how to return narcotics from the hospital floors to the Centrack cart, and how to document narcotics that are to be discarded (NAPRA 1; 4; 5; 9). I helped take inventory of ward stock on the hospital floors, and put away a McKesson order in the pharmacy (NAPRA 4). Again, I completed runs to the hospital floors throughout the day to check for orders and deliver additional traditional stock items (NAPRA 3).

Thursday

I filled drugs on the traditional order refill list (NAPRA 3). I observed picking narcotics for the hospital floors from the Centrack cart in the pharmacy (NAPRA 3; 4). I unpacked the order from Lakeridge Health Oshawa of unit dose strips, put them into floor specific bins, and I helped fill MedSelect machines on hospital floors (NAPRA 3; 4). I checked the pharmacy traditional stock on the shelves for expiry dates, and made sure opened bottles of drugs were marked with a one year expiry from the date of being opened, as per Ontario College of Pharmacists (OCP) regulations (NAPRA 1; 4; 9). I made a suspension compound, and double checked the drugs and batch number of the RPhT who pulled the drugs (NAPRA 3). Also, I completed runs to the hospital floors throughout the day to check for orders and deliver additional traditional stock items (NAPRA 3).

Friday

I filled drugs on the traditional order refill list (NAPRA 3). I observed picking narcotics for the hospital floors from the Centrack cart in the pharmacy (NAPRA 3; 4). I unpacked the order from Lakeridge Health Oshawa of unit dose strips, put them into floor specific bins, and I helped fill MedSelect machines on hospital floors (NAPRA 3; 4). I helped return drugs from hospital floors to the pharmacy shelf if they were in sealed unit dose packaging, and discarded the rest into the appropriate container (NAPRA 1; 4; 5; 9). I observed processing returns in the computer to be sent back to Lakeridge Health Oshawa (NAPRA 4). I completed runs to the hospital floors throughout the day to check for orders and deliver additional traditional stock items (NAPRA 3).

My second week was at Lakeridge Health Oshawa, which is a large general hospital. In the pharmacy, each staff member is assigned a specific area and task each shift. My second week, I completed the following:

Monday

I witnessed filling MedSelect machines with narcotics on assigned hospital floors, as well as assisted filling MedSelect machines with non-narcotics (NAPRA 3; 4). I witnessed the process of signing in the narcotic methadone in tang to the narcotic safe on a hospital floor (NAPRA 1), and witnessed my supervisor catch a near miss (NARPA 9), as when signing in the next day’s dose of methadone in tang, she observed that the patient had only received a portion of the current day’s dose as the auxiliary label stating to drink all contents was not read properly. I also witnessed the operation of the unit dose packaging machine, and helped package the rolls of unit dose drugs into parcels for delivery to Lakeridge Health Whitby (NAPRA 3; 4).

Tuesday

I shadowed a RPhT who completed Medication Reconciliations in the emergency department for patients being admitted. I witnessed the process of using additional sources of medication history, such as Ontario Drug Benefit files and community pharmacy medication history, before interviewing the patient to obtain a Best Possible Medication History (BPMH) (NAPRA 2; 6; 7).

Wednesday

I worked in the unit dose packaging room, and helped organize rolls of unit dose packaged drugs from the machine into hospital floor specific bins, as well as added additional needed drugs from picking bins (NAPRA 3; 4). I saw how to replace unit dose paper into the machine when it ran out, and how to add drugs to the machine when they were low (NAPRA 4). I packaged narcotics with the table top unit dose machine, and I packaged blisters of drugs for the picking bins (NAPRA 3; 4). I helped stock unit dose drugs into the bins that were low in the traditional stock filling area (NAPRA 4). I attended a meeting on a new Pharmacy Order Verification Process that will soon be implemented, to eliminate the process of matching order hard copies with printed labels to be checked, as it will become computerized (NAPRA 4; 7).

Thursday

I observed the process of matching order hard copies with printed labels, and passing those orders to be either double checked against the printed labels, or filled if any traditional stock needed to be dispensed (NAPRA 3). I helped fill some traditional orders (NAPRA 3). I observed the use of the tube station to send orders to specific hospital floors (NAPRA 4). I helped stock MedSelect machines on certain hospital floors (NAPRA 3; 4). I attended a Pharmacy Technician meeting for staff addressing any problems or concerns and ideas on how to keep workflow at its best (NAPRA 7; 8).

Friday

I worked in the stock room, and helped pick drugs to add to hospital floor specific bins, to be put into the MedSelect machines (NAPRA 3; 4). I helped check ward stock expiry dates and inventory on specific hospital floors, and gathered drugs needed for ward stock from the pharmacy (NAPRA 1; 4; 9). I added barcode stickers to iv bags (NAPRA 4). Unit dose drugs that were returned to the pharmacy from the emergency department were processed, and I restocked those drugs into traditional stock drug bins (NAPRA 4). I also did a run to specific hospital floors for orders, and delivered some traditional orders (NAPRA 3).

My Final Reflection on Community Placement

I have now come to the end of 4 weeks of a full-time placement at Loblaw Pharmacy. The pharmacy team, and especially my supervisor, have been great to accommodate having me there, asking many questions, and learning new skills. Loblaw Pharmacy is extremely busy, and I got to witness how a pharmacy truly has to work together as a team. This opportunity has taught me that everyone in the pharmacy must do what is needed at that moment, and not just do their assigned roles, as it’s easy to have overwhelming days, and a lot of customers to satisfy.

I have had time to practice processing prescriptions, from entering, to packaging and labelling. I also got quite comfortable with making blister packs, and have come to realize how important they are as many patients require them. I have learned a lot more about what certain medications are used for, which are most commonly used, and I am better at recognizing drug names, and generic versus brand name. I’ve learned the importance to become familiar not just with medication names, but with how medication looks, as I have overheard many patients wanting their medication refill, but all they know is what it looks like, and not the name.

I saw the theory taught in class put into practice, especially with regards to the many legal requirements for running a pharmacy, such as the rules for receiving narcotic orders, storing narcotics, transferring narcotics, and filing narcotic prescription hardcopies. I also saw or heard of situations taught in class, such as when to seek the pharmacist for a recommendation, when to fax the doctor over refills or discrepancies, and how to properly dispose of old medication returned by patients. As well, I had more real life experience with Kroll, and saw how third party billing works.

My 4 weeks of community placement at Loblaw Pharmacy definitely taught me what working in a retail pharmacy is like, all the various duties to be done everyday, and how fast-paced a busy pharmacy can be. It has helped me expand the skills I was taught in the classroom. I appreciate the time spent with the Loblaw Pharmacy team, and the guidance of their Registered Pharmacy Technician, who gave me a glimpse into my future career.

My Last Two Weeks on Community Placement

My last two weeks on placement at Loblaw Pharmacy have been busy. I continued to gain experience entering prescriptions into Kroll, verifying the data of entered prescriptions, billing and packaging prescriptions, and creating blister packs (NAPRA 3.1; 3.2; 3.5.1). One of the prescriptions that I entered was for another pharmacy needing to purchase a medication from us (NAPRA 1.1.1; 8.1.1). I was able to prepare a vacation supply of blister packs for a husband and wife, which required me to make a total of 44 blisters for them (NAPRA 3.1; 3.2; 3.4; 3.5.1). I also practiced mock independent double checks on prescriptions, both on blister packs and on packaged prescriptions in baskets (NAPRA 1.1; 1.2; 3.4). The pharmacy uses PharmaClick, so I was shown how it works, and how Kroll can communicate with it to place orders on low inventory (NAPRA 4.2.1; 4.2.2). The pharmacy team was also treated to pizza for meeting the flu shot quota which was a very nice surprise!

While on placement I witnessed the pharmacy ordering a narcotic from another pharmacy for an emergency supply for a blister pack I was creating (NAPRA 1.1.1; 4.2.3). I saw the pharmacist need to fax a doctor to clarify if there was a dosing error on a patient’s medication (NAPRA 1.2; 9.1.1; 9.2.2; 9.2.3). I heard a lot of patients requesting vacation supplies of their medications as it’s the time of year for many to travel. I heard the pharmacist explain to a patient that certain prescriptions expire so they can’t authorize refills without a visit to the doctor (NAPRA 1.1.1). There were a couple of patients who returned sharps to the pharmacy in special sharps containers as well (NAPRA 5.3; 9.1.1; 9.4.4). Also, patients continued to come in for flu shots from the pharmacists (NAPRA 5.2.2).

Overall, I kept very busy in the pharmacy, continued to learn and refine my skills (NAPRA 1.4.1; 1.4.2; 1.4.4; 1.4.5), seek guidance (NAPRA 1.4.3), and had the chance to see much of the theory taught in class come to life. I have gained some valuable experience!

My First Two Weeks on Community Placement

As a Pharmacy Technician student at Fleming College, I have now completed my first two weeks of placement at Loblaw Pharmacy, the busiest pharmacy in my hometown of Lindsay. The staff which consists of many pharmacy assistants, a Registered Pharmacy Technician (RPhT), who is also my supervisor, and several pharmacists, all work together to keep up with the busy demand of the pharmacy and to serve patients (NAPRA 8.1, 8.2, 8.3).

I have been able to witness the role of a pharmacist, through examples such as therapeutic counseling for patients picking up medications they haven’t used before, giving recommendations for over-the-counter products (NAPRA 8.4.1; 6.1.1), and adjusting a dose which seemed too high for a child’s weight (NAPRA 1.2; 9.2.2, 9.2.3). As well, the pharmacists at Loblaw Pharmacy have embraced their expanded scope of practice and are trained to administer flu shots (NAPRA 5.2.2). I have also seen the role of a RPhT, through my supervisor, who has been an excellent teacher to show me the various aspects of retail pharmacy. She juggles her responsibility of technically checking the many blister packs made each day, with teaching me, handling customers, filling prescriptions and blisters, and problem solving (NAPRA 8).

Upon my introduction to Loblaw Pharmacy, I was familiarized with how the drugs are organized by helping put away an order from McKesson (NAPRA 4.1.1), which also helped refresh my memory on drug names learned in my first year in the Pharmacy Technician program. I was able to see how some drugs are very similar in name which reminded me of sound-alike-look-alike drugs (SALADS) (NAPRA 9.2.2), and I became familiar with drugs that are placed on a fast-movers shelf near the filling work station for easy retrieval, both which were taught in class (NAPRA 4.1.1). I also put away drugs that arrived in coolers and needed to be refrigerated, as part of the cold chain (NAPRA 1.1;9.3.2). With the arrival of narcotics and controlled substances, I was able to see how they are shipped in a separately marked parcel with their own purchase order which must be carefully checked to see if all the ordered drugs were received (NAPRA 9.3.2;9.3.3). I was able to put narcotics away in the safe, and separately file the purchase order for them (NAPRA 4.3). Later, I further saw more laws practiced in regards to narcotics, such as narcotic prescription hardcopies being filed separately from regular prescription hardcopies, narcotics needing a double count and being filed with the Narcotics Monitoring System when being filled, and a customer being informed why they couldn’t transfer narcotics to the pharmacy (NAPRA 1.1).

I was able to select drugs and fill prescriptions using Kroll, however was introduced to a slightly different and updated version of Kroll than used in class, which uses barcode technology to scan in the drug selected before filling, to minimize errors in selecting the wrong drug (NAPRA 4.1.3). By filling prescriptions, I practiced verifying data (NAPRA 3.1.1; 3.1.5), selecting drugs off of the shelf (NAPRA 3.2.3), counting medications (NAPRA 3.2.4), owing patients, splitting labels, and selecting the right sized vial and snap caps if necessary (NAPRA 3.2.5; 3.2.6; 3.2.7). I also was introduced to a scale that barcode scans the drug selected, and determines how many pills are being weighed so there’s no need to count large quantities of pills (NAPRA 3.2.4). I was able to see how billing works (NAPRA 3.1.7), and the use of various drug plans including Ontario Drug Benefit (ODB).

I got to practice entering prescriptions (3.1.1; 3.1.2; 3.1.6), scanning hardcopies (NAPRA 4.3), choosing the generic in stock (NAPRA 3.2.1; 3.2.2), typing in the appropriate days supply with refills (NAPRA 3.1.5), and typing in the correct sig. I got to see that many prescriptions are faxed in (NAPRA 1.5.3), and how difficult some hand written ones can be to decipher (3.1.4).

Another important service Loblaw Pharmacy offers is blister packs, and I was taught how to make them, from selection of appropriate drugs to finished, packaged product to be checked, and I gained an appreciation for the time and effort that goes into meticulously creating blister packs for patients (NAPRA 3.2.).

Overall, I had a great first two weeks on placement, and have gotten to know a friendly pharmacy team who have accepted me and are open to teaching me and answering my questions so I can learn how to have a successful future career in pharmacy.

Importance of Additional Pharmacy Services

Pharmacies are not only a place to have your prescription filled, but they also offer many valuable services that can be beneficial to patients. Some of these services include patients meeting with a pharmacist to have a MedsCheck, and discuss medication regimes, and any medication or health concerns they may have; receiving flu shots from a pharmacist instead of waiting at a doctor’s office; or attending various health clinics. Pharmacies offer many different health clinics, whether it be to help a patient manage a disease such as with a diabetes clinic, or offer advice and products on quitting smoking with a smoking cessation clinic, or provide information about how to have a healthy vacation at a travel health clinic, to name a few.

Travel health clinics are useful to inform patients of any health risks, vaccination needs, and how to manage current medications while away on international travel. At travel health clinics, patients receive counselling with a pharmacist on the recommended and required vacations for traveling abroad, to prevent illnesses such as cholera, European tick-born encephalitis, hepatitis, influenza, Japanese encephalitis, meningitis, rabies, typhoid, and yellow fever. Patients learn about the prevention and treatment of insect borne diseases, such as malaria, as well as other common travel associated ailments like traveler’s diarrhea, airplane sickness, dealing with extreme temperatures, sunburns, and being aware of food and water precautions. Patients who are currently on medications and will be traveling may also have a MedsCheck at a travel health clinic. This allows patients to receive a full list of their medications in case of emergencies, or for documentation at customs. They can also to be shown how to modify their medication schedule for different time zones, and avoid drug interactions with any over-the-counter products they may be bringing on their vacation. Travel health clinics can also provide information about traveling while pregnant, and discuss the importance of travel insurance. Some pharmacies may include a travel checklist at their travel health clinic, listing recommended over-the-counter products (ie: anti-motion sickness or anti-diarrheal medications, sunscreen, bug spray) to ensure patients have a safe and healthy vacation.

Pharmacy technicians play an important role to make sure travel health clinics run smoothly. Prior to a clinic, they can aid in letting patients know about upcoming clinic dates, book appointments, and gather patient information to create patient records for the pharmacist. Pharmacy technicians can ensure there is adequate stock of over-the-counter products that patients may be advised to purchase, and also of travel specific prescription medications, such as vaccinations and anti-malarials. They can prepare any information handouts or pamphlets needed for the day of the clinic. During a clinic, pharmacy technicians allow the pharmacist to be uninterrupted during patient appointments by managing pharmacy customers, incoming prescriptions, and taking phone calls and messages. After each appointment, pharmacy technicians can handle the billing and payment for patients, and direct patients to any desired over-the-counter products that the pharmacist recommended.

Travel health clinics are great to assist patients in having a healthy and safe vacation. They are one of many additional ways pharmacies play an important role in patients’ overall health.

The Importance of Patient Centred Care

A person’s health is not only one of the most important aspects of their life, it is also very personal. When a person has any issues with their health, they should feel that they are put first when seeking the advice of a healthcare professional. Patient centred care is important so a patient feels that they understand, as well as have a say in, their own healthcare. To do this, there must be effective communication and shared decision making between patients and healthcare professionals.

For a patient to understand what’s affecting their health, their needs to be effective communication between a patient and their healthcare provider. Not only should a physician, for example, clearly explain a patient’s health issues to them so they are clear about their ailment, they should also be clear about the risks of treatment options so the patient can make an informed decision. It’s also important for the physician to communicate with the patient about their lifestyle, to consider what treatment options are the best fit for the patient’s life. This allows the patient to feel confident that they are making the best decisions about their health, and that the physician also respects the patient, and seeks what will work for them, instead of a one size fits all approach to their health.

Once a patient understands their condition, and has all of the information to make an informed decision about treatment options, a physician (or other healthcare professional) must share in deciding which treatment to pursue. After a physician has presented the patient with information about the illness, the treatment options should be presented with the risks, benefits, and evidence of success to aid the patient in making the right choice. Nothing should be withheld to attempt to coerce the patient towards a particular treatment. The physician must instead respect what the patient chooses to do based on the information presented. In doing so, a physician shows regard for the patient’s values, treatment preferences and goals, which in turn builds a good rapport between the patient and the healthcare professional.

Patient centred care puts a patient first when they are dealing with issues affecting their own health. It is important that a patient can feel confident that they understand what is going on with their body, as well as the reasons for various treatment options, which are tailored to their individual needs, through effective communication with their healthcare provider. It is also important that a healthcare provider helps a patient make an informed decision about treatment, but lets the decision ultimately be the patient’s, and respects the patient’s choice of treatment. Patient centred care not only builds good relationships between patients and healthcare providers, but also helps patients feel they have control over their own well-being.

 

Interprofessional Care and Interprofessional Practice

When healthcare providers practice interprofessional care, they work cohesively together to put the patient first, as well as work with patients and their families, so the patient will have the best treatment possible.

If healthcare providers can agree to come together for a patient’s treatment, the patient will not have the added stress of deciphering through differing opinions on which course of treatment is the best for them. Also, avoiding inconsistencies between healthcare providers’ treatment options could help the patient avoid conflicting treatments, which may put the patient’s safety at risk. As a result, the treatment that is most efficient can be given without delay. The patient will trust the healthcare providers involved with their care if those healthcare providers’ knowledge seems consistent amongst them, and this will build respect for them as well. As healthcare providers work collectively, they also will have better understanding of the benefit of each other’s expertise, and therefore how to refer patients to the appropriate healthcare provider to ensure the best care.

Furthermore, when healthcare providers include patients in their own care, patients will feel as if they are in charge of their own health. This will make patients feel less overwhelmed as they understand their treatment, which can also build trust and respect for their healthcare provider, and may help them comply with the treatment regime.

There are many ways healthcare providers can work together and with patients and their families to perform interprofessional practice. When a patient is discharged from a hospital and comes to a pharmacy, the pharmacy staff may have to call the hospital to verify, change or adjust medications and dosages. This could also have to be done with new prescriptions received from family physicians or specialists, if there seems to be any unclarity or concern over the medication prescribed. Also, a pharmacist can work with a patient to perform a medscheck, and during this a pharmacist may refer the services of other healthcare providers and services in the community, such as a meal delivery service. During a medscheck, a pharmacist may have to work with the patient’s doctor to communicate any concerns or advice on current medications. Interprofessional practice also refers to working with colleagues within the same health profession. A pharmacy technician can aid a pharmacist with tasks, such as gathering information from a patient’s phone call to the pharmacy, or inquiry as to what over the counter product to take, before approaching the pharmacist to save a busy pharmacist time. Everyone working in a pharmacy can help each other, and learn from each other with a team approach. Overall, if all health care providers involved with a patient’s care collaborate and perform interprofessional practice, they can each use their knowledge and work together towards the common goal of putting the patient’s best interest first.

Semester One in the Pharmacy Technician Program and Beyond

My first semester in the Pharmacy Technician program (PHM) at Fleming College was challenging at times, as it has been awhile since I have been a full-time student, but I still enjoyed not only Fleming College, but also the Pharmacy Technician program; it has me excited about my future career as a Registered Pharmacy Technician (RPhT). The first semester has laid the foundation for future semesters which will be more hands on. I liked learning about the business aspect of pharmacies, as well as the duties of pharmacists and pharmacy technicians. The first semester has also given me some great insight as to what a career in pharmacy will be like.

I did not realize the expanded scopes of practice for pharmacists before taking the PHM program, nor did I understand how important pharmacy technicians have become due to these expanded scopes. Not only did I gain new insight about pharmacists’ roles in patient care beyond filling prescriptions (such as MedsChecks and other clinics), I came to see how vital RPhTs are to help free up pharmacists’ time for these expanded roles in patient care. I understand how everyone working in a pharmacy is a team, who also work alongside other healthcare professionals as a bigger team, to ultimately provide the best healthcare for a patient. I also did not clearly understand the difference between pharmacy assistants and RPhTs before the program, and I found it interesting that pharmacy technicians can do final technical checks on prescriptions, as well as device demonstrations for patients. The PHM program has made me realize the importance of RPhTs in pharmacies, and therefore why the demand is there for this profession.

Not only are RPhTs useful in pharmacies, but it was motivating to also learn of the career possibilities outside of community pharmacies, and beyond. I am eager to begin my placements in both a community pharmacy, and a hospital pharmacy, in semesters three and four of the PHM program, to understand the differences of working in each kind of pharmacy as a technician. Though I am motivated to gain experience and work in either kind of pharmacy, I hope to pursue a career in a hospital pharmacy, preparing the various medications and IV’s for patients. Additionally, I have a heart for animals and was intrigued to learn that there are veterinary pharmacies. I would be very interested to work in a veterinary pharmacy, or a pharmacy that supplies zoos with animal medication. Furthermore, military bases that have pharmacies which employ civilian RPhTs are appealing to me too. It is fascinating to hear about the opportunities once I become registered.

I hope to continue to work hard and do my best at Fleming College in the PHM program. As a single stay-at-home mom, beginning this program was intimidating at first. However, after completing my first semester and I am no longer intimidated, but rather motivated to keep moving forward towards a promising career, with many possibilities to grow. I cannot wait for what is ahead.