Drug Topics Voices, August 2014

You have choices Re: “10 reasons I’m still proud to be a pharmacist” [Kelly Howard, July 24]: Remember that you have choices in your career path. If you don’t want a traditional pharmacy career in retail or hospital, look for other options ... industry, managed care, ambulatory clinics, academia, consulting. You may need to develop skill sets that were not part of your formal education. Network with pharmacists who work in the settings you want to break into. Pharmacy can be a very exciting and rewarding career. Good luck to all the new grads! AnonymousPosted at www.drugtopics.com APRN vs. PharmD I am amazed that you can find 10 reasons to be proud to be a pharmacist! Give yourself 30 more years and take another look at it. Any one that asks me about pharmacy, I tell them, “Become an APRN, you can do more. “ Anonymous Posted at www.drugtopics.com Stuck in the middle We are mostly just pointless middle men. Even in clinical situations at the hospital, I saw the view of pharmacists held by the rest of the healthcare industry. When you make a recommendation to a doctor, the response is that of the caterpillar to Alice: “Who are you?” Outside the clinical setting, all you hear is “What do you know? You’re not the doctor!” Or, when the doctor is unavailable evenings and weekends, you hear from the very same patient, “You’re supposed to know more about drugs than the doctor!” We are a largely antiquated and useless profession. I just hope that we won’t be replaced by vending machines before I can either retire or to go back to school for something useful. Seriously, if they paid even 80% of my salary to sweep floors, I would happily sweep floors rather than do my current job. Anonymous Posted at www.drugtopics.com There’s more to life There are ups and downs in any profession. Please look back at the moments when customers came back to tell you how much you helped them and how much they appreciate you. Don’t put too much emphasis on low reimbursement rates, government regulations, and other daily obstacles. Take those issues as challenges and potential opportunities to make yourself stronger and better. We need to concentrate on how we (pharmacists) can be a positive force in improving the health of our patients. Reward does not just come in dollars and cents. Customer satisfaction lasts forever. Anonymous Posted at www.drugtopics.com One proud pharmacist I‘m not sure why all pharmacists wouldn’t be proud to be a pharmacist! Anonymous Posted at www.drugtopics.com Another two-gen tribe Re: Pete Kreckel’s “All in the family: Two generations in pharmacy” [May 28]: There are five pharmacists in this family - my husband, myself, my son, my daughter, and my son-in-law. Our practice areas are quite diverse: my husband retired recently from the VA as a chief of pharmacy; I have over 20 years experience in long-term care (consulting to management); my son completed a residency and works on the ambulatory side in the VA now; my daughter completed a residency, is board certified, and has hospital background. My son-in-law is halfway through a two-year residency/masters program with UNC. I jokingly tell people that we are the family that “does drugs.” Anonymous Posted at www.drugtopics.com Simplify Re: “Pharmacists, where do you want to practice?” [Lt. Quinn Bott, PharmD, and Ayoung Kim, PharmD Candidate, June 10]: Great article on the costs involved per state. I do wish that pharmacy could be like medicine and nursing: We’d have one license and be able to practice in any state in the union. Of course, we’d have to pass the individual state’s MJPE, but it becomes silly to maintain 3+ state licenses if you like to move around or have homes in various states and want to practice in various locations. Jill Ponce Posted at www.drugtopics.com Whose profession? Re: “Pathways to specialty pharmacy” [Jill Sederstrom, July 10]: Consolidation of pharmacy provider services is never a good thing for our profession. From insurance companies picking “winners and losers” by limiting access to specialty pharmacy networks to another potential cost hurdle being implemented and accepted as an industry standard with URAC accreditation, we as a profession are moving further and further away from this being our profession at all. The corporate MBAs have already ruined the once respectable work environment at chain retail stores. By further limiting access to one of the few sources of increasing profits for our profession, we will again be a necessary expense to these non-pharmacist-led large corporations and not the stewards of our profession. Brian Petrucci Posted at www.drugtopics.com Back to basics Re: “True believers: It’s time to control our destiny” [Goose Rawlings, June 10]: I agree with everything mentioned in this article. We need to go back to old-school pharmacy. We have the clinical skill to run all these small clinics that are presently manned by nurses instead of pharmacists. We need to go back to basics and remember what made ours the most respected and trusted profession for so many years. Melody Elele, PharmD Posted at www.drugtopics.com CNOs call the shots Re: “Hospitals unnecessarily diluting IV meds” [Christine Blank, June 26]: Unfortunately, this decision is usually made by nursing without input from the pharmacy - or after ignoring said input. And, in most hospitals, the CNO is the pharmacy director’s boss and has a closed mind. Nurses feel more comfortable with larger volume IV push dosing, probably due to unhappy experiences with promethazine. I have actually worked in some hospitals where 10 mg of metochlopramide can only be administered in 50-mL infusions. Talk about medical waste, both materials and time. JACHO is not a big help in this area as most of their inspectors are pretty close-minded. Maybe articles like this will help. Anonymous Posted at www.drugtopics.com Exactly This is so true. These are the exact circumstances that I see in the hospital I work in. The CNO is the pharmacy director’s boss. No matter how lame something is, the CNO is always going to back nursing. Nursing usually requests pharmacy to further dilute drugs to make things easier for themselves. We currently are diluting reglan 10 mg in 50-mL minibags! We also have CPOE from the ER that totally bypasses pharmacy. There are a couple of ER doctors that enter phenergan 25 mg IV in a 1000 NS bag! This is so completely unnecessary and a waste of tech time and materials. And it’s crazy, because there is a nationwide shortage of 0.9% sodium chloride. I am so happy to see an article like this. I am going to bring this up with my director. Anonymous Posted at www.drugtopics.com No need Most medicines are diluted already, so there is no need for dilution in the hospital. They only need proper storage to prolong shelf life. Danica Brown Posted at www.drugtopics.com Come out of the shadows David Stanley’s June column, “To the compounder of the Oklahoma execution drug: Come out of the shadows” [June 10] was a very well written and thought-provoking editorial. I have often wondered about this issue and what I would do if asked to assist in an execution. I have my doubts on the deterrent effect of capital punishment in this country, and feel certain our society has executed non-guilty and mentally ill individuals in our lust for revenge. I try to avoid hypocrisy in my bioethical soul-searching. For me, an unavoidable darkness comes from filling the drug orders for a medical abortion and providing post-operative counseling. There is also anger that somehow, and somewhere, some difficulty in obtaining routine or emergency contraception occurred. I feel that a death row inmate deserves the same treatment as any other person receiving a drug. He or she should know the name, the mechanism of action, and what to expect (besides death). I want the person administering the drugs to be properly trained in starting an IV line and to know the medications were properly prepared. If a physician is not available, unwilling, or insufficiently trained to make the product selection, then there should be a pharmacist available to assist in the process. I do not like sadistic rapists and murderers anymore than I like pit bulls. When it comes time to put either one to death, it should be done quickly and humanely. If we are going to call ourselves a Judeo-Christian society, then we should exemplify our teachings and resist the urge to behave like Nazis. Anonymous Posted at www.drugtopics.com