| · The profession (6)
· Safety
· Code of Ethics
· Homoeopathy
Letters to the Editor
|
The profession
Grasp every opportunity!
From Mrs A. G. St Clair Jones, MRPharmS, and Mrs S. E. Trust, MRPharmS
This week we heard that nurses are better trained to prescribe than
doctors and that doctors lack sufficient knowledge to prescribe drugs
appropriately (Sir Michael Rawlins on BBC Radio 4). Why, then, is the
Royal Pharmaceutical Society failing to promote our position and market
the massive efforts that go into pharmacists’ training, not to
mention the huge impact we have on patient care on a daily basis?
As pharmacists, we are heavily involved in training all new prescribers,
both junior doctors and nurses, while rarely being acknowledged for our
efforts. If the Society has any function, surely increasing public awareness
of our profession and expertise must be a priority? With a perfect opportunity
arising from this report, we feel saddened, yet again, that the Society
has missed the chance to establish us as key health care professionals
by responding to this report in the national media.
Teaching junior doctors to prescribe safely is, we believe, an integral
part of the hospital pharmacist’s role. By participation in daily
ward rounds and providing structured teaching sessions within our trust,
we aim to influence drug therapy at the point of prescribing as well
as promote safe prescribing for all prescribers.
The Society’s press release of the 19 July did not seem to find
any acknowledgement in the national press. We should take a leaf out
of the nurses’ handbook (nurses have managed to promote their profession
in an effective way, gaining massive public support) and start grasping
every opportunity to promote our role effectively.
Anja St Clair Jones
Sarah Trust
Surgical Directorate Pharmacists
Royal Sussex County Hospital
More support needed from Society
From Ms K. Ball, MRPharmS
Sir Michael Rawlins has said that junior doctors now know little about
the medicines they are prescribing and that there is a need to rethink
the medical degree to incorporate more teaching on medicines. I imagine
a reasonable proportion of the profession read the letter in The Daily
Telegraph on 22 July (and it was heartening to have much of it quoted
by David Thomas in last week’s Journal (29 July, p132).
What, though, has been the response of the Royal Pharmaceutical Society
to all this? Here was an opportunity, handed to the Society on a plate,
for it to come forward to bang the drum for hospital pharmacists and
bring to the fore all that we have been saying for years. Has the Society
said that there are already well-qualified and experienced professionals
able to deal with medicines in hospitals, but that there are not sufficient
numbers of us to attend all the ward rounds we need to in order to minimise
prescribing errors and be available to ward staff to reduce medicines
administration errors? Has it said “increase the diagnostic skills
of the junior doctors and leave the prescribing to those who know about
medicines”? No. Imagine the publicity the Nursing and Midwifery
Council would have sought, and received, had the letter in The Daily
Telegraph been in praise of nurses.
I realise now that I was hopelessly optimistic in anticipating even an
eighth of a page from the Society in the news section about the ability
of hospital pharmacists to tackle medicines issues and teach the junior
doctors on the job that which they need to know. I suspect that this
is because our professional body, too often, loses sight of the managed
sector, forgetting entirely that there are a number of its members working
in hospitals alongside consultants and the wider medical team, reducing
risk and improving outcomes for patients.
Our professional body cannot claim to be representative of the profession
unless it clearly demonstrates support for all sectors.
Kathryn Ball
Deputy Chief Pharmacist
West Cumberland Hospital
Whitehaven, Cumbria
| |
JEAN-PIERRE MOSER, head of corporate communications and membership
at the Royal Pharmaceutical Society, responds:
The week beginning
17 July was a busy one for the Society’s press office with
the media reporting on calls for improvements in doctors’ prescribing
skills and the Health Select Committee’s review of NHS charges
which reflected the Society’s evidence to the committee.
These stories have an obvious pharmacy angle and the Society was
quick to issue national media responses to both.
In responding to any news story there can be no guarantee that
coverage will be achieved and while the Society’s views on
the role of pharmacists in supporting doctor prescribing were not
covered,
its position on prescription charges received detailed coverage
in The Daily Telegraph (20 July), in The Independent (21
July) and in The Financial Times (21 July).
The Society is also working with the Hospital Pharmacists Group,
chaired by Ray Fitzpatrick, on a detailed briefing to highlight
issues that affect hospital pharmacy. This briefing will be circulated
to
MPs and peers with an interest in health. The first briefing will
be England only, with publications for Scotland and Wales currently
being developed. |
Past and present
From Mr R. W. Selfe, MRPharmS
Having served an apprenticeship during the 1940s and worked until the
late 1980s, I can appreciate the points of view of both Glyn
Kearney (PJ, 22 July, p102) and Mike
Tobyn (PJ, 29 July, p132).
The letter from David
Thomas (PJ, 29 July, p132) about the letter in
The Daily Telegraph that extolled the invaluable contribution made by
the pharmacist in the treatment of hospital patients will, I am sure,
be regarded as testimony to modern methods of practice.
I have to agree that in the earlier era, any discussion with the patient
about the content of their medicines was frowned upon and could have
led to an irate call from the prescriber. On the other hand, anyone who
shares the view that all our hard work only turned out “ineffective
and harmless nostrums” has obviously never taken a dose of compound
senna mixture (from the British Pharmaceutical Compendium, 1959) with
its constituents of concentrated senna infusion, magnesium sulphate and
liquorice.
It is true that, in later years, manufacturers began to offer ready-packed
versions of ointments, eye drops, etc, but a glance at the prices of
these seemed astronomical compared with the “home-made” products.
Although the cost of these was ultimately reimbursed by the NHS, in the
meantime, bills had to be paid. Nowadays these ready-packed versions
and their high prices are accepted as normal, but with what cost to the
tax payer?
As far as community pharmacy (originally called “the chemists”)
is concerned, and from the point of view of those on the other side of
the counter, expectations, which do not need spelling out, remain much
the same. What is seldom mentioned in these columns, but always of paramount
importance, is the supervision of staff, normally the responsibility
of the pharmacist, and the presentation of stock, hygiene and the 1,001
minutiae of running a business that arise on a daily basis.
Reginald Selfe
Benfleet,
Essex
Mystique of pharmacy is being lost
From Mrs S. R. Weston, FRPharmS
I really must protest at the rather cruel and inaccurate letter from
Mike Tobyn (PJ, 29 July, p132). As a retired pharmacist I enjoyed Glyn
Kearney’s letter and nodded in agreement as, no doubt, did many
others of my generation.
Mr Tobyn seems to think that we were not highly respected members of
the community. Let me assure him that we were. We did improve the lives
of our patients by checking their medicines and discussing drug regimens
with the doctors, who often called into the pharmacy for a chat. We listened
to patients’ problems and fears — it was not called “counselling” then — we
got to know them well and quietly checked that they were taking their
medicines regularly and as directed. Surely this has not changed much?
Yes, there may have been the odd “ineffective and harmless nostrum”.
Who remembers the “Mist. ADT (any damned thing)” — for
someone who the doctor considered to be an incurable neurotic. However,
the patient felt much better after taking it and surely this is the aim
of most medicines.
Yes, the mystique of pharmacy is being lost and, with it, some of the
psychological effect that came with a medicine, ie, knowing that a medicine
was being prepared specially for you alone, the hand-written label and
the smell of the sealing wax as it was heated to seal the top of the
white demy paper.
It does not quite compare to being handed a bottle of tablets with a
computer-generated label, packed in a paper bag.
So, Mr Tobyn, allow us our panegyrics. I believe it was the character
of Mrs Minniver in the film of that name, who said: “You cannot
successfully navigate the future unless you keep always framed behind
it a small clear image of the past.”
Pharmacy has changed and will change even more in the future, but that
does not necessarily mean that what you are doing now is bad when looked
upon from the pharmacy of 2056. It was different, it is different now
and will be even more different in the future.
Sheila Weston
Romsey,
Hampshire
Let us have more satire of this kind
From Mr P. J. Thomas, MRPharmS
It was an uplifting tonic to read Mike
Tobyn’s tongue-in-cheek “put
down” of all his fellow pharmacists over 50 years of age (PJ, 29
July, p132).
I am sure that as they snip the foil packets of tablets and fill the
little bottles of methadone, they will smile wryly at the pompous attitude
of “cutting edge” pharmacists designing new, effective medicines,
influencing physicians and making sure the patients unwrap the silver
foil from their suppositories.
Please let us have more satire of this kind — it might help to
dispel the grandiose, self-important image of pharmacists that seems
to be creeping into some correspondence.
Peter Thomas
Liverpool
Sympathy for the student
From Professor J. H. Perrin, FRPharmS
I read the letter from Mike
Tobyn (PJ, 29 July, p132) with concern causing
me to reread the letter from Glyn
Kearney (PJ, 22 July p102). My sympathies
are with the student. I was wondering if the preregistration student was
also given the ignominious order to dust the shelves and containers. This
thought took me back 50 years to the pharmacist who made me wonder if I
needed a degree for this and whether I would develop into such a Dickensian
character as he.
I suspect that Mr Kearney shares my concern about the level of chemical
and scientific knowledge of the student. However, I am sure the student
knows enough to say: “I should not be doing this without tests for
quality or performance.”
I believe that a significant number of students have more to offer their
pharmacist mentors than the reverse, particularly in a retail environment.
I wonder also if an adequate selection of premises and evaluation of pharmacists
are made before the suitability of placement of preregistration students
is made.
John Perrin
Gainesville,
Florida |
The
Pharmaceutical Journal