Posted by: Brendan Fraser6 SEP 2012
Having had a few fun weeks on the wards, it was time to start my dispensing diary. I knew before I started I wouldn't enjoy it. However this week I've been trying to stay positive, despite some of the rules. I find the 'for pain relief' rule interesting. For example, when dispensing Paracetamol even though it can be used for pyrexia, it requires ‘for pain relief’ as an additional direction at the end of the prescribed direction. This ‘for pain relief’ disappears in under 12s, because adults do not get pyrexia (or so I’m led to believe). Codeine does not require the 'for pain relief' additional direction, nor do NSAIDs. Oramorph 10mg/5ml does require the 'for pain relief’ label. It’s a good job I noted these down… I have problems with this 'for pain relief' label. It makes me very sad. Despite the checkers pointing it out to me (because I’ve made the ‘pain relief’ error a couple of times) I find it slightly undermining because it takes so long to change the label… This is due to the fact I have to stop my mid-dispensing-flow to enter the patient’s details again and correctly print the label (but you must first amend the template and not free type - this is highly important i've been told). So after smiling and apologising for my silly error (despite the prescription not saying 'for pain relief'), I must then spend an additional two minutes, checking and finding where I was up to. The template I mentioned above details the drug information including: name; strength; and frequency. This must be amended if you wish to change a label. As the system appears to be internet based (and the computer hardware/network is sluggish) this can take a short while. I think you have to play around and hit enter a couple of times then. Once you have completed this, you get your label that states 'for pain relief' on it. Yes! Then I walked over to the checker appearing every so happy and apologise for my shocking mistake. I accidently put 'for pain relief' on codeine (before I had it in my notebook) and had to delete it going through this process again. How I miss the computer systems in community... So throughout this learning I may have some QUIPP ideas. One of them includes getting rid of the 'for pain relief’ additional labeling requirement. In my opinion, it's not important and if it's not stated on the script why bother? There is also clearly some form of IT problem, whether it is within the network, the computers or the software. This may require investigation especially when electronic prescribing folds out (this is inevitable in the future). Stock control is also counterproductive. This week we ran out of Paracetamol 500mg both 100 pack and 32, also Prednisolone 5mg E/C, Ferrous Sulphate 200mg, Codeine 30mg and Bisoprolol 10mg. I wouldn't really be bothered but the computer doesn't like me so I can't dispense the last pack. You also have to fill in paper work when there is no stock... How time consuming is that? So I had to waste 3 minutes of my time filling in a form for the sake of 2p worth of Paracetamol (it's probably less). Then someone has to check all this paper work and make sure the Paracetamol 'for pain relief' gets to the correct ward the next day. How is that a lean process? So, all bread and butter generics should be increased to at least double average daily usage (surely this can be monitored with auto-order). That's my final QUIPP scheme up to now.
Despite all this ranting, I'm not mentioning these ideas because I’m a pre-reg and all these procedures have probably been thought to be beneficial at some point -and I’m just being miserable. Ah well, I better adapt or die as they say. Production unit next though, thank goodness!