Stephen Whyte is a clinical pharmacist at The Portland Hospital and has worked as part of the pharmacy team for 18 months. Prior to joining the private sector, he worked in the NHS for 4 years.
Here Stephen Whyte speaks of a typical day as a pharmacist at The Portland Hospital…
First thing each morning I make a visit to each of the wards in the hospital to collect the discharge prescriptions for patients who will be leaving the hospital that day. It is at this point that I liaise with the nursing staff to discuss urgent medication for other inpatients. This ensures that I am able to clinically screen the drug charts whilst still on the ward for accuracy and appropriateness and then arrange the appropriate supply of the patients’ medication to the ward in time for when they are due their next dose. On returning to the dispensary the pharmacy technicians are on hand to assist with the dispensing of the discharge prescriptions. Once dispensed, I and other pharmacists on duty will conduct a final verification process to cross-check the dispensed medication against the doctor’s to ensure that the doctor’s instructions are strictly adhered to.
My priorities for the day will also include organising parenteral nutrition (TPN) for those patients who are unable to digest food in the normal way. At The Portland Hospital, this mostly affects our newborns and paediatric patients. The TPN is prepared in bags, which are administered to the patients intravenously, directly into the blood stream and therefore must be made under sterile conditions. For this reason, we have them specially made up by an outside manufacturing company. For a same-day delivery to the hospital it is important that the order is placed before the cut-off time and in order to get the right daily nutritional electrolyte and fluid balance it is vital that I liaise closely with the patient’s consultant and the specialist dietitian in a timely manner.
Once the TPN orders have been arranged I will deliver the dispensed discharge medicines to the patients in their room before they leave the hospital. This gives me the opportunity to discuss with them their medication, how each medicine works, potential side-affects and to ensure that they or their carer/parents know exactly how to take them. This also allows patients the opportunity to ask any questions or concerns that they may have. An example of this could be breastfeeding post-natal mothers who are advised on the use of medicines.
Also as part of my morning duties I visit my allocated wards. I am currently responsible for covering the paediatric neuro-rehabilitation ward, the neonatal intensive care unit and special care baby unit and one of the obstetric wards. During this visit, I review and discuss with new patients their medication histories and check any medicines that they may have brought into the hospital. I also review the drug chart on a daily basis. In addition, I use other observational charts and information at the bedside or on the hospital computer system to make clinical assessments and if necessary will make a clinical intervention with the doctor, nurse or midwife looking after the patient. This is to ensure that all our patients receive the necessary and appropriate medication. Some of the patient’s data that I review includes their blood pressure and heart rate charts; fluid balance charts; blood test results; I look for signs of infection and also assess the patient’s pain charts so that I can provide clinical input to their pain management.
A pharmaceutical care plan is written for our long-stay patients. This provides a systematic and comprehensive way to manage their pharmaceutical needs. The main objective of the care plan is to ensure medication safety through identifying, resolving and preventing the patient’s actual and potential drug-related problems.
The hospital adheres to robust clinical governance procedures and any medication incident identified would be reported and fully investigated. Pharmacy staff play an important role in preventing medication errors and addressing safe medication practices.
Once my work on the wards is complete I spend the rest of the day in the dispensary either attending to the many outpatient prescriptions which are presented by the outpatients for dispensing and responding to supply and medicine information enquiries, which can range from wanting a quick confirmation of a medication dose, finding the equivalent medication availability in the UK for patients who have brought medication from abroad, finding out if certain medication will interact with other medication and cause harm to the patient to quite complex enquiries which might require a full evaluation of evidenced based information. For example, evaluating the risk of using a particular medication during pregnancy.
On occasions I may be asked to complete some of our mandatory audits or attend a multidisciplinary meeting with other hospital healthcare professionals. This is quite useful as it gives me the opportunity to represent my department and provide pharmaceutical expertise to the developments and decisions being made to improve services and patient care.
I am always developing and updating my pharmaceutical expertise and knowledge and find the HCA educational programme for clinical pharmacists to be a very valuable resource.
Overall, I find my work at the Portland to be very rewarding. The hospital is a great place to work and no two days are ever the same. This provides me with new challenges and requires me to think out of the box and work in a smarter way especially to resolve complex problems. My job as a clinical pharmacist is extremely worthwhile especially when I am involved with the care of a particular sick patient who eventually leaves the hospital fine and well and to know that I played a part of that.
The pharmacy team are available to offer confidential advice about your medicines before, during and after your stay at The Portland Hospital. The Pharmacy Department can be contacted on 020 7390 6121.