Somehow I've ended up with too much on my plate. Actually I know how; it was out of fear of being static and unproductive. Concerns about being unaccomplished, unable to contribute, etc. While I'm worried about being stretched thin for time, being able to be involved in this much work is kind of exciting at the same time. Work/uni not so much, but the side projects and position on the society (woo!!!!) has me on the edge of my seat to create and work with people. If only I could have all the energy in the world.
Today was my first day off in two weeks and it was a bit startling. Technically I have work to do but fuck that (for now) because I hadn't been home to eat a proper meal in a week in half. I made the mother of all sandwiches and sent myself to food coma land for a solid 3 hours and napped all afternoon. Bliss. Hoping to be able to better balance the new things and the old things and all the people along the way.
Sunday, 18 May 2014
placement log 5
DAY 5 (1000 days later)
This post is ridiculously delayed and is about my last day of placement at SP Ashy. The day was mostly quiet so it wasn't too stressful but unfortunately there wasn't as much to observe.
One noteworthy thing from the day though, that I can relate to the domains, was the effect of the leader on the attitudes of the staff. J was stuck in a rut organising things with people and something broke the camel's back while I was out on my lunch break because when I got back, the mood was death and I could feel the gloom that suddenly infected everybody's work. Towards the end when he got his things sorted though, he was visibly more relaxed and everybody else lightened up too. Go figure.
And I guess that's it for day 5 folks.
This post is ridiculously delayed and is about my last day of placement at SP Ashy. The day was mostly quiet so it wasn't too stressful but unfortunately there wasn't as much to observe.
One noteworthy thing from the day though, that I can relate to the domains, was the effect of the leader on the attitudes of the staff. J was stuck in a rut organising things with people and something broke the camel's back while I was out on my lunch break because when I got back, the mood was death and I could feel the gloom that suddenly infected everybody's work. Towards the end when he got his things sorted though, he was visibly more relaxed and everybody else lightened up too. Go figure.
And I guess that's it for day 5 folks.
Monday, 28 April 2014
placement log 3-4
Placement day 3 happened last Thursday, so I'm going to have to test my memory with this log. 4 days ago feels like 400 days ago - I've been occupied with something every day and I'm a bit glad that I split the block with a weekend, because at least work meant a change of scenery/pace.
My ambition on Thursday was to improve my counseling technique. I prepared CMIs for learning and summarising, but according to J, the best way to learn the important information is by reading the AMH. That one's going to be a work in progress. At some point during the day, K did try to get me to counsel him on statins. It was a short-lived venture; the day-to-day duties of the dispensary quickly took precedence.
Thursday meant webster shipping which meant a chaotic rush to have everything packed/ready. All that on top of the usual dispensing. It was mostly stressful and now that I try to remember it, I can't. Having V there to help me dispense was very helpful although I felt bad for bossing her around. I learnt about the 21 day safety net - legislation/the healthcare system is pretty interesting to learn about, I feel like it's important to contextualise the profession. I hadn't really focused on the domains over the first 3 days because while I am aware of its importance in underpinning the profession, it felt more like rules. I feel like learning how to procede in accordance to the rules is more engaging and useful than just learning the rules. Same reason why they dont make us memorise/quote specific legislature??
As an aside, I finally met A! We go way back; he was the first person at the pharmacy to receive my papers and pass them to John. It was good to finally meet him again and to see him work. He's a very task-oriented person and although he only drops by once a week apparently, he picks up the work smoothly and efficiently. He also likes to keep the dispensary clean, which makes 2 (bless P).
Anyway that was a long ass day.
3 days off later - 2 x work + 1 x housewifeing - I return with a mild-ish vigour but a rested mind. I am ready to work.
The day peaked quickly and I was swamped with long ass scripts early on. Things of note:
- I had to interrupt a LONG script to rush a 2nd script because the patient returned early. In this situation I should've bugged someone else to do it instead of trying to do it on my own. By the time it was finished with me (yep) I was just totally confused by where I left off on the first script. FOCUS IS KEY.
- Endone is kept in the safe, and that HM/SPA are fairly reliant on each other for spare stock. Also Erskine Park. HCP relationships are important, not to mention all the phone calls John keeps making. Medicine swaps and compounding and prescription appropriateness are all topics conversation between the pharmacists.
- Some patients are patient and willing to come back the next day for an order. Some are not. I'm endlessly surprised by people who are willing to come back tomorrow for an order, especially old immobile people. What's stopping them from visiting another pharmacy to buy the medicine?
No specific lesson was taught today but I did talk to J/K about what motivates them and their thoughts on my patent vs royalty theory. I feel like I need to push the first question a bit further. They said money and family, which then got twisted into money anyway. I want a bit more substance. What is money a means for? Family is a wonderful, humbling answer and I have much respect for K for being motivated by his family. I want to know what money is a means for. Wealth? Comfort? Where does patient care come into this? I want to know what is important to a person who is a pharmacist.
Personally I think I want to do good. Simply to do good, and if reading and learning about the system so that I can change it or working with patients who are a part of it means that it will help them in their lives, then I will try my best to do that. Finding out today that I didn't get the position at the pharmacy was a bit soul crushing though; I'm more sad than angry or spiteful... Having spent weeks there, I'd hoped to get a leg up on the job, but in the end I doubt I was even considered. I didn't even get a call for an interview; I didn't get the chance to fight my case in front of F and even be considered. Honestly this is demotivating and it makes me feel like there is no room for me to contribute to this field. It's only an assistant job and as much as they talk it down, it's a step closer to where I want to be. How am I going to get there? I've eaten 3 consolation pancakes.
More notes in the domain booklets.
My ambition on Thursday was to improve my counseling technique. I prepared CMIs for learning and summarising, but according to J, the best way to learn the important information is by reading the AMH. That one's going to be a work in progress. At some point during the day, K did try to get me to counsel him on statins. It was a short-lived venture; the day-to-day duties of the dispensary quickly took precedence.
Thursday meant webster shipping which meant a chaotic rush to have everything packed/ready. All that on top of the usual dispensing. It was mostly stressful and now that I try to remember it, I can't. Having V there to help me dispense was very helpful although I felt bad for bossing her around. I learnt about the 21 day safety net - legislation/the healthcare system is pretty interesting to learn about, I feel like it's important to contextualise the profession. I hadn't really focused on the domains over the first 3 days because while I am aware of its importance in underpinning the profession, it felt more like rules. I feel like learning how to procede in accordance to the rules is more engaging and useful than just learning the rules. Same reason why they dont make us memorise/quote specific legislature??
As an aside, I finally met A! We go way back; he was the first person at the pharmacy to receive my papers and pass them to John. It was good to finally meet him again and to see him work. He's a very task-oriented person and although he only drops by once a week apparently, he picks up the work smoothly and efficiently. He also likes to keep the dispensary clean, which makes 2 (bless P).
Anyway that was a long ass day.
3 days off later - 2 x work + 1 x housewifeing - I return with a mild-ish vigour but a rested mind. I am ready to work.
The day peaked quickly and I was swamped with long ass scripts early on. Things of note:
- I had to interrupt a LONG script to rush a 2nd script because the patient returned early. In this situation I should've bugged someone else to do it instead of trying to do it on my own. By the time it was finished with me (yep) I was just totally confused by where I left off on the first script. FOCUS IS KEY.
- Endone is kept in the safe, and that HM/SPA are fairly reliant on each other for spare stock. Also Erskine Park. HCP relationships are important, not to mention all the phone calls John keeps making. Medicine swaps and compounding and prescription appropriateness are all topics conversation between the pharmacists.
- Some patients are patient and willing to come back the next day for an order. Some are not. I'm endlessly surprised by people who are willing to come back tomorrow for an order, especially old immobile people. What's stopping them from visiting another pharmacy to buy the medicine?
No specific lesson was taught today but I did talk to J/K about what motivates them and their thoughts on my patent vs royalty theory. I feel like I need to push the first question a bit further. They said money and family, which then got twisted into money anyway. I want a bit more substance. What is money a means for? Family is a wonderful, humbling answer and I have much respect for K for being motivated by his family. I want to know what money is a means for. Wealth? Comfort? Where does patient care come into this? I want to know what is important to a person who is a pharmacist.
Personally I think I want to do good. Simply to do good, and if reading and learning about the system so that I can change it or working with patients who are a part of it means that it will help them in their lives, then I will try my best to do that. Finding out today that I didn't get the position at the pharmacy was a bit soul crushing though; I'm more sad than angry or spiteful... Having spent weeks there, I'd hoped to get a leg up on the job, but in the end I doubt I was even considered. I didn't even get a call for an interview; I didn't get the chance to fight my case in front of F and even be considered. Honestly this is demotivating and it makes me feel like there is no room for me to contribute to this field. It's only an assistant job and as much as they talk it down, it's a step closer to where I want to be. How am I going to get there? I've eaten 3 consolation pancakes.
More notes in the domain booklets.
Wednesday, 23 April 2014
placement log day 1 + 2
For a week I am having placement at my local pharmacy to become acquainted with the nature of community pharmacy. I've started dispensing and (VERY BRIEF) counselling and this is a log of my activities for future reflection.
Yesterday I was able to learn the software to dispense from start to end. I found that once I was able to understand the work flow, dispensing became much easier. The data input wasn't always intuitive and I made plenty of mistakes, which brought to my attention all the possible ways a dispensing could go wrong (there are so many). After much hair pulling and stressing, I decided it was time to understand the different types of scripts - pharm+patient copy vs duplicates vs medicare copies vs repeats - and patient claims - C/G/AC/AUG etc. We were flat out busy but the pharmacist found time in between scripts to explain to me the different categorising of patients under medicare, and the safety net for PBS drugs. It's a big picture but he was patient and now that there is some kind of context for the scripts, I feel that it's easier to power through the process.
So yesterday's emphasis was on the dispensing work flow.
I felt uncomfortable being unable to counsel patients on their medications and it doesn't look like there's an easy way into it; I've just got to learn the CMIs I suppose... Oh fun times ahead. It's hard not to notice the disparity between the quality of counselling expected by the university vs the quality of actual counselling IRL. Scenario/hypothetical patients have way more time and patience than real life patients and during busy times, it feels almost impossible to counsel; at my level, anyway. If I could gun through a couple of questions that would probably be enough, but as I mentioned earlier I would have to be able to jump into counselling the medication by heart. So, it looks like I've got some CMIs to read.
I've also got the Competency Standards Framework (PSA) to learn but for now I am tired and the practical learning is much more appealing.
Other things I observed during day 1 included:
DAY 1
At this stage I'd already had several 2hr weekly placements. The advantage of full day placements is that you see a wider spectrum work. Not much happens in 2 hours; if it's a busy hour maybe several scripts come through and you see a mad rush. Maybe 1 or 2 interesting things happen but it's not enough to get a good scope on what the full responsibilities and tasks of a pharmacist entail.Yesterday I was able to learn the software to dispense from start to end. I found that once I was able to understand the work flow, dispensing became much easier. The data input wasn't always intuitive and I made plenty of mistakes, which brought to my attention all the possible ways a dispensing could go wrong (there are so many). After much hair pulling and stressing, I decided it was time to understand the different types of scripts - pharm+patient copy vs duplicates vs medicare copies vs repeats - and patient claims - C/G/AC/AUG etc. We were flat out busy but the pharmacist found time in between scripts to explain to me the different categorising of patients under medicare, and the safety net for PBS drugs. It's a big picture but he was patient and now that there is some kind of context for the scripts, I feel that it's easier to power through the process.
So yesterday's emphasis was on the dispensing work flow.
I felt uncomfortable being unable to counsel patients on their medications and it doesn't look like there's an easy way into it; I've just got to learn the CMIs I suppose... Oh fun times ahead. It's hard not to notice the disparity between the quality of counselling expected by the university vs the quality of actual counselling IRL. Scenario/hypothetical patients have way more time and patience than real life patients and during busy times, it feels almost impossible to counsel; at my level, anyway. If I could gun through a couple of questions that would probably be enough, but as I mentioned earlier I would have to be able to jump into counselling the medication by heart. So, it looks like I've got some CMIs to read.
I've also got the Competency Standards Framework (PSA) to learn but for now I am tired and the practical learning is much more appealing.
Other things I observed during day 1 included:
- S8 dispensing - patient request for oxycodone slow release
- compounding - this was also vastly different from uni compounding. I helped make a salicylic acid cream and a glycerol/emulsifying wax moisturiser. It's kinda gritty and we winged it a bit with the packaging but it worked out. The rules are not rules outside of the institution and you are your own medicine's creator. (there are laws though)
- near theft - somebody tried to steal something????? losing the head pharmacist as he left to follow up sneaky people meant that the dispensary fell to near chaos momentarily before picking up again.
Time goes by quickly in the dispensary and it's not until I finish and I'm on my way home that I realise I am exhausted.
DAY 2
I wanted to really consolidate the dispensing workflow that I started yesterday and the pharmacist was happy to let me romp around and do my thing. Again, more mistakes made, more lessons learnt. From now on for new patients I think I'll request the medicare card. Although repeats have the MC#, it doesn't have the DOB and it just becomes a hassle moving back and forth from the computer to the patient. Not to mention that they wouldn't always be there, and it looks like I don't have my shit together. When that happened though, one of the girls who worked there stepped in and actually called up Medicare to confirm a patients MC#. It was really good to watch and learn from that. I also met another girl in my cohort - small world! It was so pleasant working with the girls, we shared the workload and helped each other collecting and preparing the medications.
I didn't really have time to look at the domains today but I was busy dispensing, placing stock, and I did some webster packing towards the end of the day. I spoke in Mandarin!!? I don't even speak that language but some patients had no English in them so I forced some rubbish out and they were able to make some sense of it. It was such a funny situation! I might consider practising it properly eventually.
When medications are out of stock in the dispensary, we sometimes call up the neighbouring one to borrow their stock. Today I did my own run for some prescription cream but forgot to take the exchange slip... Luckily it's only 2 minutes away and I ran back before anyone else realised my mistake. Honestly I feel like I have to make mistakes for something important to be engrained in my mind... As long as the consequences do no harm to anybody I don't really mind. If anything it puts an emphasis on particular processes and considerations.
There were some mistakes that I wasn't too pleased with making. Towards the end of the day my energy was spent; I hadn't eaten lunch and I was kept busy all day so errors started showing and for one script I hadn't even picked up on the authority number. Some things are more obvious than others, but I knew that the day was going to be done soon, before I made any serious mistakes.
These 2 days have been a good learning experience. There are still things I want to learn about the system - the typical day too, but I want a picture bigger than that. For now I sleep.
Friday, 14 March 2014
Friday, 21 February 2014
holiday, work.
Two months gone so quickly and now uni looms ahead, two weeks away. I feel a mixture of relief and reluctance, having jumped from highly productive to sloth mode countless times this holiday but overall feeling unaccomplished.
Pharmacy work is still nowhere in sight even though I machine gunned out applications early in January, and now I'm in a feeling of disenchantment. How do I keep on trying to enter a field that seems like it, cliche as this sounds, doesn't need me? Is there even any reason to? Apparently it's a numbers game but it feels so much harder than it looks for other people.
Hopelessness. That's a bit of what it feels like. Every letter is a futile attempt and I don't know what's compelling me to keep going anymore. At least when class starts again there'll be a sense of productivity that can make up for the lack of actual work.
Writing continues.
Pharmacy work is still nowhere in sight even though I machine gunned out applications early in January, and now I'm in a feeling of disenchantment. How do I keep on trying to enter a field that seems like it, cliche as this sounds, doesn't need me? Is there even any reason to? Apparently it's a numbers game but it feels so much harder than it looks for other people.
Hopelessness. That's a bit of what it feels like. Every letter is a futile attempt and I don't know what's compelling me to keep going anymore. At least when class starts again there'll be a sense of productivity that can make up for the lack of actual work.
Writing continues.
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