Fintan Moore on the need to reach out if you are suffering ill effects from the stress of modern pharmacy

At the recent IPU conference in Galway, a recurring theme in conversations and discussions was the feeling that the profession of pharmacy has become more difficult and stressful. That is only to be expected, given the ever-increasing number of hoops we have to jump through to satisfy PCRS rules; and the ever-present requirement to stay within the guidelines and regulations that govern how we operate. Stock shortages are a chronic waste of time and effort and at the point of dispensing, the time we have to deal with each patient has been further eroded as we pointlessly wave boxes in front of scanners. One crucial thing to remember is that you are not alone in finding all of this difficult. 

It is easy to get isolated as a community pharmacist. Most of us work as the only pharmacist on duty at any given time, or if there are other pharmacists, the environment is often too busy to allow for any meaningful chat. It can be hard to make the time to catch up with other pharmacists socially to get advice on resolving problems, or just to cut loose with a decent rant about all the feckers trying to make your job tougher than it needs to be. I have written in the past about how online forums can be a useful outlet for practical advice or just to let off steam. As well as the long-running forums, Poitigeir and Pharmabuddy, there is also the recently-established Irish Pharmacy Forum, which can be found using the link irishpharmacyforum.proboards.com.

It would be an interesting study to analyse a batch of hospital prescriptions and see if the ones creating a ‘problem’ are statistically more likely to be written by a doctor with an illegible signature, no bleep, and no MCRN

Like any group effort, forums evolve to form their own little ecosystem, so you can find one or more that suit you.

It’s also worth remembering that in the event of any problems you face in work, the IPU has a wealth of experience that is available to assist members. For example, pharmacists who are worried by the tone of correspondence from the PCRS or the PSI often find that a phone call to Butterfield House can be helpful and reassuring. Employee/employer relationship issues can also be particularly stressful, and the IPU can provide competent, informed advice.

The main thing to remember is that whoever you are, and whatever the problem, there will be somebody willing to help you.

A Failure to Communicate

A constant bugbear in the day-to-day life of the pharmacist is the difficulty encountered in trying to get in touch with a specific hospital doctor in order to query an item on a prescription (or missing from the prescription). This can involve multiple calls to the hospital switchboard, and frequently, ending up talking to completely the wrong department. 

Sometimes our queries are urgent and need to be resolved immediately, but very often a delay is not a problem, so when we do get through to the correct doctor, we are unnecessarily distracting them from something more acutely pressing. If we could email queries to doctors, this would facilitate most answers. So, as a thought — why not give every registered doctor a healthmail account using their Medical Council registration number, ie, 123456@healthmail.ie?
The healthmail service will eliminate the risk of spam and the doctors can check the emails at a time that suits. 

There is a slight problem with this idea, in that some doctors still don’t write their MCRNs on prescriptions, but to be fair, the majority of them do. When doctors go off duty, they could set up their emails to be forwarded to a colleague. There is of course a sneaking suspicion on the part of many pharmacists, and I can’t blame them, that some doctors simply do not want to be traceable. 

It would be an interesting study to analyse a batch of hospital prescriptions and see if the ones creating a ‘problem’ are statistically more likely to be written by a doctor with an illegible signature, no bleep, and no MCRN.

Primary Care
Putting the developer first

The inability of the HSE and the Department of Health to competently manage the tendering process for the new National Children’s Hospital was no surprise. The scale and scope of a project of that magnitude was simply beyond the wit of the people tasked with delivering it on behalf on the taxpayer. For the builders, architects, planners, designers, suppliers, lawyers and everybody else riding the gravy train to the St James’s Hospital campus, the negotiations with the HSE team must have been like a bunch of Las Vegas poker sharks cleaning out a drunken tourist.

Whatever about huge once-in-a-lifetime endeavours like the new children’s hospital, where some allowances can be made for failure due to the magnitude of a specialised project, there are smaller failures around the country that seem remarkably short-sighted. Near my pharmacy in Dublin, work is due to begin on a primary care centre sometime this year, even though I have yet to hear confirmation that any GP whatsoever will be moving into it. 

In addition to that, the HSE has also agreed a 25-year lease on another building, which is to be converted from offices to consultation rooms for the local psychiatric services. Maybe I’m missing a crucial point somewhere, but I would have thought that a new primary care centre would have been designed to accommodate the psychiatric services. Assuming there was a good reason why that didn’t happen, I can’t fathom why the HSE is leasing facilities instead of buying them or building them on its own property. 

Maybe all their experts were busy working on the hospital.

Fintan Moore
Fintan Moore

Fintan Moore graduated as a pharmacist in 1990 from TCD and currently runs a pharmacy in Clondalkin.