Editorial
Welcome to the March edition of i2P – Information to Pharmacists.
You may have noiticed if you receive i2P by email, that we have simplified our mail out presentation.
This was because the code in our earlier version appeared to be too unstable to maintain, hence the simpler presentation.
Columns
Rollo Manning: Pharma-Goss
John Dunlop: Inside NZ
Loretta Marron BSc: Health Watch
Barry Urquhart: Marketing Focus
Harvey Mackay: Strategic Thinking
Mark Neuenschwander: I`ve been thinking about...Recent Comments
Past Editions
Volume 1 Number 1
Volume 1 Number 2
Volume 1 Number 3
Volume 1 Number 4
Volume 1 Number 5
Volume 1 Number 6
Volume 1 Number 7
Volume 2 Number 1
Volume 2 Number 2
Pharma News
Staff Writer: SIGMA Pharmaceuticals suspends share trading before release of revised earnings outlookHospital News
Health Politics
Pat Gallagher: Health Informatics - The State of the Nation
Peter Sayers: The Three-Ring Circus
Dr David More: e-Health IdentifiersEPublications
Has the horse bolted?
Printer-friendly version
Send to friend
PDF version | Ken Stafford |
A Consultant Pharmacist Perspective | |
Some twenty years ago uneasy tremors were running through hospital pharmacy here in Perth. Hospital management had suggested to one of my fellow Chief Pharmacists that the hospital needed a total parenteral and intravenous additive service (IVAS) .
When it was pointed out that this would be very labour intensive and the pharmacy did not have sufficient staff to provide it, the comment was that “nurses would be happy to run such a service”.
As you might imagine this went down rather like a lead balloon – who did these nurses think they were, trying to do a pharmacist’s job? If they want to act like pharmacists let them go to university and do the study! Sounds familiar doesn’t it? All this took place about the time nurse training moved from being hospital based to being a university degree course and nurses were looking to spread their wings. As it turned out the service was established, by pharmacists, within the pharmacy department with no input from the nursing division but battle lines were drawn. Nurses were moving out from being the doctors’ handmaidens to a brave new world where they would become recognised as health professionals in their own right.
“What does this have to do with pharmacy” you might ask but it came to mind when I read Warren Plunkett’s article in the June 2009 Australian Journal of Pharmacy. In this Warren claims the “profession needs a model of pharmacy that better utilises the skills of modern pharmacists”. This is exactly what the nursing profession had set out to do over 20 years ago. They had sufficient confidence in themselves to be willing to take on something totally outside the experience of the average nurse. An IVAS is not a service one would associate with nurses, it had long been the domain of pharmacists, but the group in my colleague’s hospital were confident enough to say “We’ll have a go”. The newly graduating pharmacists of today now indicate they do not want to carry out the usual supply function “beloved” by older generations – they demand the right to use their unique skills and be remunerated on this basis.
I really can’t blame the latest crop of pharmacists for wanting a new paradigm in pharmacy. Returns from the Pharmaceutical Benefits Scheme (PBS) are continually coming under pressure from government attempts to restrain burgeoning drug costs, community pharmacy ownership is not only moving far beyond the ability of young graduates buts appears under threat from the major supermarket chains and only hospital pharmacy offers any type of career pathway. Given all these constraints is it any wonder that there is a growing push to change how pharmacy operates?
My major concern is that this may be becoming a case of “closing the stable door after the horse has bolted”. Pharmacists seem to have been left behind in the area of prescribing, they are rarely considered by governments making health policy decisions and may even be under threat (see Matthew Eton’s editorial in the June AJP “Can pharmacy lump it?) and are frequently excluded from taking part in healthcare initiatives. Compare this to nursing, no minister or health department bureaucrat would dare to set up a policy developing committee without including nurses. Chronic disease management programs, an obvious area for pharmacists to take the lead, are almost invariably managed by nurses who may, or may not, have good working relations with clinical pharmacists. Many of these programs include a medication review component to patient care but I have not heard that there has been an overwhelming push to refer patients to accredited pharmacists. Another missed opportunity perhaps?
Twenty years ago the nursing profession made the decision that their newly acquired university degrees meant they could set their own goals, reach out to new horizons and become masters of their own destiny. They have succeeded in spectacular fashion. My hope is that pharmacy can to a great extent emulate this success. I must admit to a vested interest as both of my children are pharmacists trying in their own way to extend the scope of professional pharmacy, primarily by utilising the expertise of accredited consultant pharmacists and I am about to take part in a study whereby palliative care patients will be targeted for medication reviews to improve care in this group. Small steps such as these and similar activities by many consultant pharmacists will, I hope, possibly overcome the problem of a bolted horse and closed stable door.
Return to home
Dr Andrew Byrne & Associates: Fatal torsade tachycardia due to methadone either rare or non-existent finds Norwegian study
Neil Retallick: A time of pivotal change will require new ways of thinking about community pharmacy
Neil Johnston: Dispensing errors and criminality
Post new comment