Hospital work experience: the dispensary

I spent the afternoon in the dispensary dealing with TTAs (to take aways), outpatient prescriptions, adult crisis centre and one stop (for use on the ward) requests to name but a few.  I noticed that the dispenser often has more freedom than in a community pharmacy, for example, requests often come in without the form of the medication being stipulated leaving the dispenser to select the most appropriate form.  The dispenser can also, in some cases, choose how much of a medicine to supply, for example, with a TTA discharge supply the minimum number of days supply that can be given to a patient on discharge is 14 days and for some medicines this is all that is allowed.  If this is not a requirement it is still expected that no excess is given.I was shown the CD (controlled drug) cupboard in the dispensary which, in fact, consisted of three large cupboards.  As there is plenty of space some non-CD medicines are also stored there.  For example, an anti cancer drug which costs approximately £6000 per box is kept there as they understandably want to keep it under close supervision. Mifepristone, an abortifacient, is also stored in the CD cupboard as it can easily be misused.  Ambulance drivers can each carry ten vials of morphine.  In order to obtain more from the pharmacy they need to show how many they have left and they also keep their own personal CD book. When CDs are collected for a patient on the ward they are booked out by the ward and not by the patient’s name.  It is also vital that the CD books are kept just as safe as the actual CD medicines as they could easily be manipulated.