Finding an interesting and challenging subject for second year transition was not an easy task, as there where many things that I wanted to know more about. Much of the work we had undertaken within university had been focused on long term conditions and the process for patients being discharged from the hospital to home. With this in mind and a great experience on my community placement I wanted to learn more about the role of the community pharmacist. I felt that this would build on my knowledge base, from university, of the discharge process and the management of peoples conditions within the community. I felt that a better understanding of the role of the community pharmacist, would give me greater insight when, in the future, I am involved in discharging patients back into the community.
What I did
I was able to work with both the pharmacist and the pharmacy assistants during the transition. I had the opportunity to observe the checking process in dispense, storing and ordering of medication and was able to observe consultations. The importance of the laws surrounding the dispense and storing of drugs was on of the first things that I learnt. My only experience of this had been in a hospital setting, where all drugs where stored in lockable trollies or bedside cabinets, with those drugs classified as ‘controlled drugs’ being stored in more secure locked cupboards.
The Misuse of Drugs Act (1971) prohibits certain activities in relation to ‘Controlled Drugs’ the most important are the manufacture, supply and possession of these. These drugs are graded and defined into one of three classes; Class A, Class B or Class C. The grading is done broadly and the penalties applied according to the ‘harmfulness attributable to a drug when it is misused’ (BNF 2012).
The Misuse of Drugs Regulations (2001) defines the classes of a person who are authorised to supply and possess controlled drugs while acting within their professional capacities and lay down the conditions under which these activities may be carried out (cited BNF 2012). The five schedules, which these drugs are divided into, each specify the requirements governing certain activities, for example the export, import, production, supply, possession, prescribing and record keeping of these drugs. Within the pharmacy the drugs are stored and dispensed in accordance to their schedule classification.
Role of the Pharmacist
The majority of the work at a pharmacy is to take in and dispense prescriptions. These can be from a number of different NHS areas as well as private prescriptions. In accordance to the BNF’s general guidance ‘ Medicines should be prescribed only when they are necessary, and in all cases the benefit of administering the medicine should be considered in relation to the risk involved’ (BNF 2012 p1). The Department of Health has guidelines on the responsibility for prescribing between hospitals and general practitioners and they state that the responsibility for prescribing lies with the doctor who signs the prescription (DH 2013).
Nurse prescribing is an important step in the ease of access for patients to medications and it could also reduce waiting times for some patients wanting to see a GP. There are strict rules controlling what a nurse prescriber can prescribe, these items are within the speciality of the nurse. Nathan (2005) explains that nurse prescriber can also ‘.. prescribe a limited number of non-prescription medicines listed in the Nurse Prescribers’ Formulary’ (Nathan 2005 p42). The RCN states that from nurse prescribers ‘Patients gain improved access to information and advice, which helps with understanding of decisions made about their health and care.’ These nurses will, for example, have been trained to explain to the patient what the medicine is and how it should be taken, enabling more time for the patient to ask questions increasing compliance (RCN 2013).
Prescriptions must be completed...
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