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The life of a hospital pharmacist can oftentimes be a thankless job. One of the main reasons for this may be related to the fact that so often, these members of the interdisciplinary team work behind the scenes, having only limited direct contact with patients. Despite this reality, the role which pharmacists play in assisting patients to reach their maximum health potential is monumental. The following text explores the duties, joys, and stressors which one local pharmacist experiences on a day-to-day basis.
There were a number of items described by the pharmacist which the author had found to be surprising. For instance, the pharmacist reported that her profession is now becoming more recognized as part of the interdisciplinary team. This was a good reminder to the author because it is oftentimes easy to forget about the important role that this particular discipline plays, particularly when a nurse’s only interaction may be in making a quick phone call or sending a fax to the pharmacy. The interviewed individual had a considerable amount to say in regards to the obstacles that she faces when working with Medicare, Medicaid, and private insurance companies. Certain challenges in this regard that she had listed include medications requiring prior authorization, medications which simply are not covered by insurance, and medications which the patient is unable to afford. She reports that these patients with limited income who do not take their medication all too often become ill again and are forced to return to the inpatient setting. Another point which the author had not previously considered related to the fact that oftentimes, providers do not consider cost when prescribing a drug.
The interviewed individual reports having been a pharmacist for 3.5 years. While she reports having not experienced any major changes in her role since the inception of her career, she does point out that her experiences as a resident were drastically different than what her role is today. She describes how there is now a larger push in the state to have pharmacists obtain provider status and she lists this as one of the positive aspects currently present in her profession. In regards to challenges faced by this individual, she lists drug-drug interactions, drug-disease state interactions, orders that have not been appropriately adjusted for renal dysfunction, prescriptions with inappropriate dose or duration, and polypharmacy. In particular, this pharmacist points out that many patients are oftentimes on multiple drugs, without an indication for their use. The interviewed individual lists feelings of contribution and accomplishment as the greatest aspect of her work. She also mentions how pharmacists are generally well-trusted by patients, nurses, and providers and how this rapport further adds to her feeling of self-fulfillment.
As result of conducting this interview, the author realized that while the roles of pharmacist and nurse are very different, they both share many of the same challenges and successes. This notion becomes evidenced when recognizing that the pharmacist had reported being expected to accomplish more work with fewer resources. Indeed, this is likely a problem faced by all members of the interdisciplinary team to a certain degree, particularly when considering items such as budget constraints and staff shortages. The pharmacist lists the additional challenge of clarifying orders with prescribers. She reports that it oftentimes is difficult to challenge an order without making a prescriber defensive. This too is an obstacle faced by nearly all nurses from time-to-time.
One learning experience which the author can incorporate into his own practice relates to the need of forwarding prescriptions as legibly and clearly as possible. The pharmacist had described how problematic to can be when a nurse or other pharmacist misinterprets an order secondary to not utilizing electronic scripts. The author’s place of employment still uses paper for virtually all patient care and orders are always hand-written and subsequently faxed to the pharmacy so this was an important take-away. Finally, the interviewed individual described lack of effort by other disciplines to be yet another challenge of her job. This too is important to remember as a pharmacist’s job is largely contingent on the correspondence with other members of the inter-professional team, thus a collaborative approach and team effort is clearly the most effective way to achieve positive outcomes for the patient.
Not unlike any other healthcare professional, the pharmacist experiences many successes and challenges within the healthcare arena. Pharmacists are oftentimes subject to the less-than-ideal practices of insurance companies, physicians, nurses, and the like. Pharmacists play a terribly important role not only in the dispensing of medication, but also in the provision of education to patients and other members of the interdisciplinary team. These other members would be behooved to recognize the pivotal role that pharmacists play in assisting patients to reach their health and wellness goals.
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