Working at a late-night pharmacy
Laura Elli Sharp had the opportunity to work night shifts at a late-night community pharmacy during her summer placement. Here, she writes about her experience
Working at a late-night pharmacy is a rollercoaster from one night to the next. People often drive past late night pharmacies and see few customers in the shop and assume we can get their prescription done in a flash because nobody else is waiting. Often we can, but at least once a night there will be an emergency or difficult case.
After two years of learning the ropes at a small village pharmacy, I was ready for a challenge and asked the summer placement co-ordinator for a busier store. So I was put in a town centre pharmacy and, after my first day, I wondered if I had made the right choice.
I was constantly run off my feet, as were the other staff. I was based in the dispensary doing the usual jobs, such as picking and labelling medicines. At first, I struggled to find products and medicines in the dispensary and shop and felt a bit lost. However, that feeling soon ended. The dispensers were friendly, helpful and fast, and I soon caught on and was part of the team.
During my placement, I was able to do a few night shifts. The pharmacy is open until 10pm every day, and those last few hours were the best. The patients and the situations were out of the ordinary and nothing you could learn in a lecture or a book could prepare you for them.
After 6pm, instead of a continuous push of prescriptions in and out of the pharmacy, it all goes quiet. Normally, this would be the perfect time to catch up on duties such as filing prescriptions and tidying shelves. After all, there is never nothing to do in a pharmacy. As time wears on, one or two prescriptions will arrive.
The prescriptions presented to us are often from out-of-hours doctor surgeries. Sometimes there are prescribing errors or queries with these prescriptions so extra care needs to be taken when dispensing them.
An incident I will never forget
At about 8pm one Friday night, the shop was busy. We had a waiting time of about 40 minutes for prescriptions. We were going at full speed when a man walked in and asked: “Can you check you have this. I’ve tried everywhere.” A member of staff said: “Sure, we’ve got that.” So the man joined the end of the queue.
I got to his prescription after about 15 minutes. The prescription was for codeine syrup 25mg/5ml but we only had codeine linctus 15mg/5ml. I took the prescription out to the man in the shop and told him the problem but he was now angry that he had had to wait for nothing.
He explained that the prescription was for his son who was going into a hospice in the morning. The medicine was to help ease his suffering tonight. He said he had criss-crossed town and was sent from one pharmacy to another. We were his last hope.
In light of this, I rang all the local pharmacies that were still open and none of them had any in stock. It was what the pharmacist had suspected but he wanted me to double check. It is not a commonly prescribed medicine so not many pharmacies stocked it.
I made a list of alternatives and wrote down the calculation for the dose conversion from the syrup to the linctus and rang the doctor to see if we could get a new prescription faxed over for the linctus so the patient could at least have something tonight.
It took a while for the doctor to get his head around what I was saying to him and, on the third attempt, he agreed. However, the man waiting for the prescription stood up and said “don’t bother”. His son had died.
That man had spent the last few hours of his son’s life running around shops, rather than being with him and I felt terrible. In my opinion, the man should not have been turned away from the first pharmacy he entered. I will never forget this experience and the principle of patient care. I hope in the future I will never fail a patient.
Sometimes, things are out to try you
There are other times when you really cannot help a patient no matter how hard you try. For example, we had received a prescription for a Controlled Drug but the doctor spelt something wrong, did not put a quantity and had not written the patient’s name. We held the prescription in store and sent the patient back to the doctor to obtain a new one.
The doctor generated a new prescription and this time forgot to sign it. We again had to refuse to dispense the prescription and the patient was livid. Although it was not our fault, we are the gatekeeper to what patients see as their medicines and it is often hard to explain to them that we have to follow the law and cannot just give things out.
Overall, I think patients and the public are lovely. They just want a chat and often respect the advice you give. But there are times when you wish you could hide behind the counter until they are gone.
I remember one patient spitting in a staff member’s face because she would not sell her something. Others shout at you over the telephone and some have had a bad time at the surgery so it becomes “your fault”, especially if you do not have their medicine in stock or give long waiting times.
My advice for those doing a summer placement is get stuck in straight away. Do not be scared to ask a pharmacist or member of staff for help. If you do not agree or do not understand something, make sure you ask them to explain. How else are you going to learn?
My summer placement experience has helped with university work, especially with the dispensing module. Experiencing situations first-hand ensures you are better equipped to deal with similar problems in the future when you are a preregistration trainee or newly registered pharmacist.
Having been there through the tears, tantrums and not to mention the occasional 999 call, I believe I am so much more equipped to deal with the real world of pharmacy. So start applying. Spaces for placements fill up quickly.
Laura Elli Sharp is a fourth-year pharmacy student at the University of Nottingham
Citation: Tomorrow's Pharmacist URI: 11054854
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