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Team on-call

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I officially joined Team On-Call recently as it was the first on-call and late night week of my pharmacy career. If I had to summarise the experience in one word, it would be “enlightening-but-also-quite-terrifying”!. Hopefully the next few blogs will give people a valuable, real-life insight into the role of an on-call pharmacist.

The pharmacy department at the Royal Bolton Hospital is open from 9am to 8pm from Monday to Friday. Nearly all staff work the normal hours of 9am to 5.30pm and, after this time, the late night team take over – this includes the on-call pharmacist and usually a dispenser and a technician. During the week, the on-call period lasts from 8pm until 9am the next morning. Our department allows the on-call pharmacist to work from 12pm (we get a bit of a lie in) to 8pm on the day following the night they’ve been on-call in order to accommodate the late shift.

Come the Monday, I took the on-call case home at 5.30pm and had time to rummage through it before I started on-call at 8pm – the on-call pharmacist from the weekend would have covered the Monday late shift from 12pm to 8pm. The case contains a laptop, mobile phone and the on-call pager, as well as various reference books and a folder full of useful information.

From 8.01pm, I was practically on tenterhooks, half willing the pager to sound in order to show me it was actually working and half willing it to stay silent. Eventually, I managed to fall asleep and was awoken by the shrill tune of the pager. It sounded way too merry for the fear it had suddenly instilled in me. It was light outside so it couldn’t be too crazy a time, I thought. It was just gone 8.30am! Yes, someone had very kindly decided that they couldn’t wait another half an hour for the pharmacy department to open.

My first on-call query was one I couldn’t answer because, simply put, a pharmacist wasn’t the right person to ask. The caller was a doctor wanting to know what an appropriate intra-operative pain relief option was for a patient due to undergo a hysterectomy and who took 16mg of buprenorphine a day. Naturally, I was dumbfounded. How on Earth was I to know? I immediately thought to call the senior surgical pharmacist as she’d be better placed than me to answer it.

However, if there’s one thing I’ve learned from pharmacy it’s that you can’t expect to be spoon fed. By all means, ask a senior for advice. But ensure you have at least a vague idea of the answer to put forward for discussion. Having worked by this ethos ever since I started my job at the Royal Bolton Hospital, I did a bit of research first. Martindale proved to be the best source for this one but I still didn’t really know how to manage the query. After 9am I called the senior surgical pharmacist, who said she’d take the query now that I technically wasn’t on-call anymore and that she would call the acute pain team. In the end, the patient was set up on a high-dose morphine PCA.

So, the first night wasn’t too bad – apart from not being able to go back to sleep… The NEXT night, however… *shudders*

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