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Pre-registration training: a week in the life part 1.

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Any attempt I make to describe aweek in the life of a hospital pre-reg promotes the conclusion that there is no‘typical’ day.  However, over the nextcouple of months, I intend to blog through a few weeks of my working life as apre-registration pharmacist. Maybe this will give students an insight intofuture opportunities for hospital training, strike up a chord of solidarity withfellow trainees and give others both inside and outside of the profession abetter idea of what the daily life of a pre-registration trainee involves.

Last week was a mash-up of my second‘core’ clinical week, and the first of two ‘self-directed’ weeks. Pre-registrationtrainees at my Trust, alongside varied clinical rotations, are given theopportunity to return to the same ward throughout the year, on five separateoccasions (for a week at a time). Accompanied by the same senior pharmacistthroughout, the aim is to track our development and to provide, gradually, moreopportunities to make independent interventions. I know that my clinicalknowledge still leaves much to be desired, but I am certainly more confidenthandling drug charts, constructing medicines histories, orderingmedication  and reviewing TTOs fordischarge than I once was.

On Monday, my tutor asked me to studysome of the patients on her cardiology ward in more detail – a privilege I’mnot sure time often allows for ‘grown up’ qualified pharmacists!  The experience was made extra-interesting by apatient whose pacemaker had, quite literally, fallen out of a hole in her chest!My cardiac surgery expertise is limited but surely this is not normal! Withlots of support and supervision from my tutor I’m gradually (slowly butsurely!) gaining the confidence and skills needed to manage patients on my own.Sometimes it feels easy (or at least my colleagues make it look easy!) andsometimes (and I have to be honest) it feels like an uphill struggle. SometimesI love it, and sometimes I don’t – I’ve come to expect nothing less!

As of Tuesday, I’m hopeful to haveone more GPhC performance standard in the bag. More importantly, however, I’m now a competent first aider ready for anycrisis scenario (well, almost). The training we received through the regionaltraining programme was practical and fun, led by expert pharmacist first-aiderswho helped put everything (epipiens and all!) into context.

On Wednesday, I finally finished mydispensing validation assessment. It was monumental. Having made every known error at least once, and taken holdof dispensary time in every area in the hospital (to complete the required 50labelled and dispensed items, 50 paediatric items, 25 medical/surgical itemsand 25 outpatient items including HFP10s) whilst keeping up with a hectictimetable – I thank God for helping me over the first hurdle! Of course, I’m aware now thatduring pre-reg training, the completion of one validation marks little morethan the beginning of another, but as President Obama reminded us last week‘progress will come in fits and starts’.

As well as the pacemaker saga, thisweek has seen the beginnings of a fruitful audit project. On Thursday andFriday, I had the pleasure of visiting every ward  in the hospital (which may, according toWikipedia, be the largest hospital in the UK!) to investigate how well we arefollowing procedures for the disposal of waste medicines .It was hard work,good exercise and good fun visiting every clinical area to inspect bins andtalk to nurses. There won’t be any audit spoilers here, but all I’m saying is this: Chloramphenical eye drops belong in the cyto-sharp bin...who knew?Watch this space for audit developments.

This week, I’ve begun my mentalhealth rotation which can so far be summarised by locked doors, lengthy drugcharts and loads of Clozapine. Someone even gave me a purple pen – now I know I’m really going to make it.

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