Mr Angry

Had a difficult consultation with a gentleman today who was travelling abroad and needed malaria prophylaxis. On consulting the NPA charts it was clear that he needed one of the POM malaria regimes.

However, he was insistent that for various reasons he couldn’t take any of these and ‘just wanted to buy’ some chloroquine and paludrine.

So, rather than refuse him the sale outright, I took his telephone number and said I would look into it further.

I rang one of the national help lines to enquire about the efficacy of chloroquine and paludrine and was told they were a complete waste of time.

I then rang the travel nurse at the patient’s practice and she informed me that she had also been trying to persuade him to take one of the POM regimes and that he was coming back to see her to get his jabs.

I rang the gentleman back and told him my reasons for refusing the sale (i.e. that it wouldn’t be in his best interests if I did, and that I wasn’t willing to take the clinical responsibility for selling him something that wouldn’t work).

He was furious and didn’t see why I just couldn’t ‘sell him the tablets and be done with it’. I haven’t heard anything since but I really hope that the travel nurse could finally make him see sense.

Pseudoephedrine points

I had another word with the counter staff today to stress how important it has become to closely question and monitor sales of pseudoephedrine-containing products.

I was prompted to do this following the publication of the MHRA ‘test’ of pharmacy in Cleveland to determine how easy it was to purchase multiple packs of products containing pseudoephedrine.

I wholeheartedly agree with the swell of pharmacy opinion that it would be a huge backward step for pharmacy if the drug were reclassified, but I was also really disappointed at the Cleveland results.

Elderly organs

A lovely elderly lady came into the pharmacy today asking if we had any donor cards. As I handed one over she proudly said: “I’ve still got all my organs dear so I thought it was about time that I got myself one of these.” I couldn’t help but smile…

It's what pharmacy is all about

We are really beginning to get full use out of our consultation room now and patients also seem to be getting more used to the idea.

During the past week for example, I was able to use the consultation room to check that a little boy did indeed have chicken pox before I provided him with paracetamol and chlorphenamine under the minor ailments scheme; I could have a private discussion with a child carer who was embarrassed to discuss her problem (which turned out to be threadworms); and the counter staff used the room frequently to check for head lice before providing the necessary treatment under the minor ailments scheme.

For me, this is what pharmacy is all about. It’s giving me a great deal of job satisfaction to be able to work in this way.

Screening near you

Staying with the sexual health theme, we received the latest figures from the regional Chlamydia screening programme today.

The stats show who provided Chlamydia testing kits, broken down into locality and service provider.

In every locality the highest number of testing kits were given out not by healthcare providers but by colleges, universities, prisons and army barracks.

However it’s great to see that community pharmacy is playing an active role in this service, particularly with public health so high on the government’s agenda.

Training points

When I started at the pharmacy last year I put my name down for training in order to become accredited to provide EHC free of charge under PGD to the over 14 year olds. At the last minute this training event was cancelled (see That'll teach me) and so we haven’t yet been able to provide the service.

This week, the re-arranged training evening finally arrived and so off I went. It was a really informative evening with an exam at the end. It was also attended by a real mix of pharmacists, from pharmacy managers of independents to new locums in the area who wanted to make themselves more employable by getting this accreditation.

There was also a locum from a multiple 100 hour pharmacy that is required to start providing the service under the terms of the 100 hour contract. This pharmacy is an interesting one since only one of a number of locums showed up for the training, and as part of this service the pharmacy has to ensure continuity of service as far as possible and signpost when the service can’t be provided.

Providing continuity of service is the main reason we haven’t yet started (i.e. until all our pharmacists are accredited) so it will be interesting to see what the 100 hour store now decides to do.

How to inhale!

Had a lovely old gentleman in today who had been using various MDIs for his COPD. He had been given a Volumatic to improve his technique so I took him into the counselling room to show him how to use it.

However he understandably wasn’t too happy about carrying this around so I showed him how he should be using a MDI on its own (with my placebo inhalers that I had great fun getting hold of last year!).

He actually had a good technique apart from the ‘inhaling in’ bit which I couldn’t quite get him to understand until he brightened up and said: ‘Oh, you mean inhale like you are sucking on a fag.’

Well after that he was perfect, however the irony wasn’t lost on me…

Running out of time

I told you last week how I’m beginning to feel like I’m drowning in work. Well this morning I received a letter from the NPA training department to say that the time on our Interact training for two of our staff is running out.

The reason for the delay in training has mainly centred around one pharmacist leaving and a delay until another pharmacist (i.e. me) was recruited.

I also don’t believe in just asking the staff to complete the Interact sections on their own. I spend time with them going through all the sections, checking they are happy with product choices, and particularly pretending to be a customer with various ailments in order to check their understanding - but of course this all takes time.

So I’ve got an extension on the time for both of them to complete the course and we’ll all just have to get our fingers out to make sure they are given the dedicated training time to complete their courses on time.