Tomorrow's Pharmacist (2004)

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Hospital prereg training — a chance to increase clinical knowledge

By Lucy Handley

page 46

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Shortly after graduating last summer, I started work as a preregistration trainee at King’s Mill Hospital in Nottinghamshire. My preregistration year was structured in a series of four-week rotations around different areas of the pharmacy — the main inpatient and outpatient dispensaries, the sterile and non-sterile production units and the medicines information department.

Over the course of the year, I went to each section twice; the first time shadowing technicians and assistants and the second time learning more about what the pharmacist’s job involves. Each department had either a training file or a checklist of things that I had to cover during my time there. At the end of each rotation I had a mini-appraisal with the section leader to discuss my progress and plan my training for the next time. I also had monthly meetings with my preregistration tutor to check how I was getting on and to talk about any problems.

Outpatients

After my induction and a short time in the main dispensary, I went to the outpatient dispensary where I learnt about the different clinics that were held at the hospital and started to use the computer system. During my time there I was able to observe the pharmacists as they dealt with queries from patients and contacted doctors for information. In my second rotation to outpatients I spent a lot of time counselling patients and contacting the doctors myself.

My next base was the medicines information department, where I first had to complete a computer training package which detailed how to handle queries before I could help the other pharmacists in the department to answer theirs. Once I became more acquainted with the resources and computer system, I was able to take in my own queries, although there was always an experienced pharmacist around to help me if I got stuck.

In the sterile production unit I started by doing audits and labelling then, once I had passed the broth test to check my aseptic technique, I began to make total parenteral nutrition bags, before progressing to cytotoxics as my technique improved. In my second rotation I was signed off to do audit and volume checks, which meant I could perform the role of a technician. The same was true in non-sterile production, where I started off helping to make suspensions, before going on to check audits and volumes myself.

Ward visits

Around Christmas I started to go on regular ward visits with the other pharmacists. I got lots of practice writing patient profiles, looking up blood results on the computer and dealing with patients. At the beginning of May I was given my own ward to look after. I had regular visits with senior pharmacists, then once they were satisfied that I could do the ward unaided, I went up on my own.

The preregistration year also involved a number of regional study modules. These covered topics such as responding to symptoms, medicines information and clinical governance, as well as understanding the Drug Tariff, in time for the registration examination.

The “Dove nest experience” was held in the Lake District and had nothing to do with pharmacy! We were split into groups and given tasks designed to improve our communication and management skills, as well as physical activities like abseiling and canoeing. The other modules were held in Sheffield and were an ideal opportunity to meet people from other hospitals and find out about their experiences of the preregistration year. They were also a good excuse for some much-needed socialising.

Every week I attended a study session at the Queen’s Medical Centre, Nottingham, with the other preregistration trainees from the area. We were given case studies and group work which covered various topics, including hypertension, diabetes, antibiotics and renal failure. These sessions were really useful and have helped me at work over the past year.

Throughout the year I went on a series of visits to other departments in the hospital. These included being “nurse for a day” on a medical ward, going to the X-ray department, spending an afternoon in an outpatient clinic, and a day in theatre watching operations. I was also able to spend a day with a prescribing adviser and prescribing support pharmacist at our local primary care trust.

Exam time

As it got nearer to exam time, I sat numerous practice papers and got lots of tips from the basic grade pharmacists who had gone through it themselves the previous year. My community placement was also a good chance to learn more about the Drug Tariff and over-the-counter remedies. I spent two weeks in a community pharmacy where I had lots of practice responding to symptoms and dispensing in a different environment to the hospital dispensary.

My preregistration year has given me structured training in all aspects of hospital pharmacy and an opportunity to expand on the clinical knowledge I gained while at university. I have also been able to develop many new skills that will help me in my career as a pharmacist.