Moving up the ranks in hospital pharmacy
There are many opportunities and options to move up the hospital career ladder. Alison Worwood describes her journey from being a preregistration trainee to becoming a band 8b hospital pharmacist
Pharmacy is what you make it. From the time you finish your degree you can start to develop the skills you need to get the job you want. Whether it is in the pharmaceutical industry, community or hospital pharmacy, you can use your preregistration year to start building the foundations to your future career.
Road to hospital
I started working for a community pharmacy chain when I was 16. I was working on the till, but soon moved onto the chemist counter and realised that pharmacy might be a career for me. Ideally, I wanted to work with people and in a job where I could wear a nice suit. After choosing my A levels to get into university to do a pharmacy degree, I always assumed that I would work in community pharmacy. I was unsure what hospital pharmacy involved.
After placements at university, I had well and truly caught the hospital bug (and by that I do not mean meticillin-resistant Staphylococcus aureus). The clinical lectures at university, coupled with third- and fourth-year placements, showed me a different side to pharmacy I wanted to explore. The possibility of interacting with the patients and doctors in hospital intrigued me and suggested an exciting and inspiring side to pharmacy I had not yet seen.
I applied for both hospital and community preregistration placements. Unfortunately, I was ill and missed the interviews for the hospital places and the community pharmacy decided that seven years’ service on and off was not worth rewarding. This meant I had to fight harder to get the place I wanted. After some searching, I found and was interviewed for a hospital that had not filled one of its preregistration places. I got the place and have not looked back since.
At the beginning
I was ready to start my preregistration year at St Richards Hospital in Chichester with great enthusiasm. I had enjoyed studying but I was ready to get on with the job. Little did I know how much I had to learn. I passed my registration examination and my first day as a pharmacist arrived.
Going to bed as a preregistration trainee and waking up as a registered pharmacist is quite a transition. The first time you make a decision on your own, sign for something or give some advice without someone watching over your shoulder is a big moment. This is the culmination of five years’ training.
Being a band 6 pharmacist is just as steep a learning curve as being a trainee. But that willingness to learn, and acknowledging your limitations and referring when appropriate are still important in building a good career. If you are lucky you will get to rotate through medicine, surgery and admissions to learn the core basics of the profession. I got to cover some great wards and rotate through aseptics, medicines information and two dispensaries (a main dispensary and a technician-led satellite). I also did my clinical certificate during that first year.
Moving up the band
All of the above set me up for when a band 7 post came along. A rotational 7 at the same hospital meant I got to do a second sweep on the rotations I had already done and expand my knowledge. I was always interested in aseptic dispensing: being a super clean freak it was a natural environment for me. I like the order, the methodical nature and the involvement in making the products for the patients whom I knew from clinics and the wards.
While I was a band 7 pharmacist, the band 8a pharmacist in aseptics left and there was no immediate replacement. I was asked to cover as an 8a for six months. I was not ready for a band 8a post but agreed to act up for six months only to help the service, as long as my band 7 job was still there.
I was dropped in at the deep end but relished the challenge. I was running an aseptic unit, doing my diploma, training a technician to cover aseptic and preparing for a peer review. Sometimes rising to a challenge brings out the best in you and shows you which direction to take your career. I also took on teaching fifth-year medical students.
I stayed in the job six months, and then another six months and then another. Before I knew it, the job was mine and I was involved with more and more. In the time I was in that role, there was the refurbishing of the aseptic unit, building relationships with consultant haematologists, going to multidisciplinary team meetings and weekly ward meetings, writing protocols for the unit and for treatment regimens for chemotherapy, being lead for intrathecal protocols and being involved in training assistants, technicians and junior pharmacists in the unit. I still covered cardiology, which is something I have always enjoyed.
An additional challenge came along when we needed to build a whole new aseptic unit in a new purpose-built cancer centre on site. This meant starting from scratch, thinking about layout, design, materials and involving a lot of the ‘Rules and Guidance for Pharmaceutical Manufacturers and Distributors’ (aka the orange guide).
I learnt so much about this in a short period, such as writing new procedures and meeting with builders and architects. I also had to consider organising the time when the unit was to be closed, finding a company that could make what we needed in the time frame we needed it.
The job changed from one week to the next, all the while keeping a unit running while the new one was built. There were so many things to think about on different levels, such as what was happening day-to-day for the patients and the operational plans for a unit that was not yet built.
If you want to make a job interesting and different you can. Know your strengths and use them but improve on your weaknesses. Do not be afraid of a challenge.
Before the unit was finished I had decided to move county for personal reasons and had to find another job. Unfortunately I became ill before the unit was finished and never got to work in the new unit that was built. After five months off sick, I started my new job at East Kent Hospitals NHS Trust with new colleagues, which was daunting after so much time away and a total change in what I was doing.
My new title is lead medicines management pharmacist and this involved managing a department of people and developing medicines management across the hospital. This is an 8b job and is a world away in some respects to what I had been doing.
I soon managed to find my old management skills and started to develop a role that had been empty for sometime before I took up my post. It felt as though I was developing this from scratch, finding my place in the department.
I have been doing the job just over a year now and the ideas I had before I started and what I have done until now have been different in a lot of ways. Looking at a department with fresh eyes, trying to develop training strategies, clinical strategies and manage the department are all challenging.
Once again, I am on a steep learning curve and I am developing the role as I see fit. I truly believe that all roles in pharmacy are what you make them. It is your career so make it count.
Alison Worwood is lead medicines management pharmacist at East Kent Hospitals NHS Trust
Citation: Tomorrow's Pharmacist URI: 11078891
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