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MAY 13/2019

A Day in the Life of a Locum Hospital Pharmacist

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Life as a locum hospital pharmacist can be a diverse career choice where no two days are ever the same. In fact, there’s far more to the role of a locum hospital pharmacist than you might think.

Hannah Awan, a highly valued member of the Medacs Healthcare family, is a locum band 6 clinical pharmacist and knows all too well what life is like for locum pharmacists in a hospital environment. From drug charts and blister packs to working in a multidisciplinary team, Hannah explains more about a typical day as a locum hospital pharmacist and what life is really like working on a clinical ward.

Describe a typical day for a hospital pharmacist

“As soon as I get in, I have a set ward and a hand-over which gives me a list of all of the patients that are on the ward.

I need to determine which patients are new and get an idea of what their reason of admission is, other existing medical conditions that the patient has, medicines they were on prior to coming into hospital, and which medicines they are currently taking. I also need to establish whether they have any allergies or are on any blister packs.

Once I’ve spoken to the patient, I need to get a valid drug history. Sometimes the patients aren’t able to tell you everything because they might be elderly or have certain conditions, like dementia. In which case, I have to speak to their chemist or next of kin to determine what medicines they are normally on.”

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Drug charts

“I have a look at their drug chart to check that all of the medication a patient was having prior to coming into hospital is correctly charted by the doctors. It’s vital that there aren’t any medicines that have been missed off especially high-risk drugs like Parkinson medicines.

If there are any medicines that have been missed off, then it is my responsibility to go and speak to the doctor. I need to find out whether these have been intentionally held off, stopped or if it’s an error and accidentally missed off. If it’s the latter, then the doctors can prescribe it on the drug chart.”

Screening

“As a pharmacist, I have to perform what is called clinical screening. I clinically screen the medicines on the chart and check against the patient’s condition. We have a system called ICE (Integrated Clinical Environment), which allows me to check the patient’s blood test results and of other examinations, that way I’m able to monitor crucial factors like liver function and kidney function.

I need to look at the whole picture and then I’m able to determine whether any changes in medicines are required, what dosages are needed or whether any medicines need to be stopped, depending on a patient’s condition.

It is my responsibility as a pharmacist to recommend appropriate medicines to doctors. If a patient is unable to swallow or they have any enteral tubes, like a PEG tube, I can advise the nurses on whether the medicines are available in liquid form, should be crushed, or can’t be given to the patient altogether, due to not being suitable for PEG administration. In the case of the latter, I would need to recommend alternative medicine. So I’m basically working as part of a team.”

Stocking medicines

“In the morning, I have to make sure that the wards have enough supply of their stock medicines. Normally the wards would have enough but on the odd occasion when there isn’t, I would have the responsibility of ordering it for the ward.

If a patient is admitted on to the ward and is already on a certain medicine or has been newly prescribed a certain drug that is not in stock on the ward, the pharmacist has to order it for the patient in a timely manner so that it can be transported to the ward. It is essential that these medicines are supplied quickly so that there are less missed doses for patients and it doesn’t affect their treatment.”

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Discharge preparation

“Prior to discharging a patient, I have to work out whether any medication has been changed. This is particularly important when a patient has a blister pack.

Where I’m currently working, we supply a new blister pack on discharge, if changes have been made to the medicines in the previous pack. It’s my responsibility to find out what has been stopped, what’s newly started or if any doses have been changed.

I have to communicate this information to the community pharmacy that the patient usually gets their medicines from so that they are aware of the changes and can create future blister packs for the patient. It’s ensuring continuity of the patient’s care.” 

Discharging patients

“In the afternoon, I’m actually covering the discharges for two wards, finding out which patients are being discharged that day.

Once a doctor has written the discharge summary, it is my responsibility to look at the patient’s drug chart to see if everything matches up to the discharge summary. I then need to make sure that any necessary medicine is dispensed for that patient so that they are able to be discharged that day.

On the discharge summary, there is a section for the GP to be informed of any changes to medicines made whilst in hospital and if any further monitoring is required in the community.
Due to NHS waiting times, there are a lot of bed pressures. It’s quite fast paced, trying to get patients discharged as soon as possible to make sure that more patients are able to be admitted onto the ward if necessary.”

Counselling patients

“The most important step when discharging a patient is the counselling. This is so that they are aware of any alterations to their medication. Let’s say a new inhaler has been issued; it is our responsibility to counsel the patient so they know how to use the inhaler correctly.

It’s more about medicine optimisation and making sure the patient gets the most out of using their medicines.”

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Locum hospital pharmacy – a varied role

"While this is a typical day for me as a locum hospital pharmacist, the role isn’t limited to the clinical ward. Pharmacists are expected to perform a wide range of duties to enhance their learning experience.

“It all depends on which rotation (a rotation is a specific area of hospital pharmacy) I’m on.

A lot of my colleagues have different rotations to me, so they may work in dispensary or may have a medicine management rotation. It’s quite a varied role for each pharmacist.”

Find out more

If you would like to find out more about our wide range of UK locum pharmacy roles, please contact our team via email or call 01785 265 605 during office hours. You can also learn more by reading What to Expect from a Career in Locum Hospital Pharmacy.
   

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