Sunday, September 4, 2011

Out in the community

Posted by Nina Cimino at Sunday, September 04, 2011

A new month, a new rotation! I am no longer in inpatient oncology, and have now moved on to my community rotation. I am at chain retail pharmacy in a "big box" store. The pharmacy is pretty busy (they fill about 300 prescriptions per day!) but so far, I have been happy to see how much counseling and patient interaction still occurs.

During my first week on rotation, one of the things that stood out most me was the layout of the pharmacy. At this pharmacy, the pharmacist's work station is right next to the pick-up window. Increasing the visibility of the pharmacist to patients seems to encourage more patients to ask questions or ask to receive counseling. Also, because the pharmacist can keep an eye on interactions between the technicians and patients at the pick-up window, they are able to step in if necessary (for example, if they hear a patient asking a technician to ring up a bottle of aspirin with their warfarin...a big drug interaction). I have been very impressed with how the layout of the pharmacy seems to be designed to facilitate interactions between pharmacists and patients, rather than keeping the pharmacist back behind a counter and much less accessible. Even though the pharmacy is busy, many the pharmacists know many of the patients by name. I definitely believe that being in a position to interact with each patient helps to establish a trusting relationship!

Another thing that has struck me about community pharmacy is the huge variety in patient interactions I have had. I have worked in various community pharmacy settings for 10 years now, and I was still surprised! While I have been working in community pharmacy for a long time, it has been a while since I have been there all day, every day, and I forgot how hugely different the range of patient encounters can be! All within my first week, I have had patients: hug me because my advice relieved a big worry, tell me the pharmacy staff should be fired for incompetence, thank me for helpful advice about vitamins, and tell me they wanted to speak to someone else because they don't like the sound of my voice. While being able to help patients with their medication questions is very rewarding, being yelled at or talked down to is tough (and something I had gotten used to not dealing with in an inpatient environment). One thing I definitely will learn this rotation is how to just let some things roll of my back.

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