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The Community to Hospital transition

hospital pharmacy Aug 09, 2021

If you’ve always wondered about the change, but are fearful of the unknown, then I wrote this for you. Because I was there a little while back!

Comfort Is Easy

It doesn’t take long to become comfortable in the space around you. The four walls of your pharmacy, or the many walls (or wards) of your hospital. This is a good thing, mind you. You become intimately knowledgeable about certain practices and procedures. There are clinical topics you know inside and out, whether it’s hayfever or paediatric sepsis. 

There is a sense of familiarity and ease because you are in your space. But what do you do when the familiarity becomes stale? When the ease has turned to apathy and you need a change? You know it’s true when it happens. How do you move out of your comfort zone and into the unknown of hospital pharmacy? Where do you start?

Making The Change

My second child was just 5 months old when I was asked if I’d be available for some casual work at the public hospital. I’d always told myself that I wasn’t interested in hospital pharmacy. I realise now this was a defense mechanism–to stay comfortable and protect myself from possible failure. I’m only human, after all.

If you fear a career change it’s usually because of interest, not disinterest. You tell yourself otherwise because you don’t know how to get there. 

Other hospital pharmacists that I knew loved their jobs and had welcomed the change from community. So, I said yes. It was the perfect way in. No obligation. No contract. No problem if I found it too much and wanted out. I still had my other job. Plus, I had a new baby. Yes, plenty of backup options and excuses if I needed them. It made it easier to try something new.

The First Few Days

I was nervous at first. It was a big place with lots of people. I couldn’t tell the pharmacists from the assistants, and I kept asking the wrong people the wrong questions. Even break time is overwhelming when there are 10 new faces all sitting at your lunch table. I was an outsider for the first time in ages.

Back in the dispensary, I began scanning the shelves. To my horror, I realised there were bays upon bays of medicines I’d never seen before. Bags of intravenous fluids, and injections with strange-sounding names like vials of vancomycin, meropenem and piperacillin/tazobactam. My third-year, infectious diseases subject was coming back in force. Terrifying right? I was in way over my head.

New Place, new Rules

Hospitals have their own medication list and they don’t play by the rules, at least not the ones you know. The PBS is only part of the game. Medicines are charged to cost centres (think different hospital wards such as intensive care, renal ward, cardiac ward). Then, there is the SAS, S100, and special patient-approved drugs.

It was an entirely new game. I had to relearn everything.

Controlled drugs are treated like some kind of alien object to be feared. And not just S8s, either. Every benzodiazepine and codeine-containing goodie is also locked away behind a ginormous safe that you actually walk inside of. Their medication is basically kept in a vault. 

Worse, you want to get something out of there? You need swipe cards, passwords, and lots of signatures. Let’s just say public hospitals take the Poison’s regs seriously. This is a very good thing, really, but it made my job very hard.

Yes, there are going to be some shocks to the system. You don’t always have your patient in front of you, so the pace can appear slower at times. Unlike community, where you are dealing with mostly chronic disease, the conditions here are acute.  There are policies and procedures, do’s and don’ts, the right way to dispense a script (and the wrong way—which I found time and time again).

There are infinite opportunities for learning and growth, and the hourly rates aren’t a secret–you can just google them. 

Why Community Pharmacists Make Great Hospital Pharmacists

A wise pharmacist once told me that it was often those with community experience that worked the hardest and with the most integrity. 

Pharmacists with community experience have a unique sense of patient care. They are used to face-to-face interactions, so they are full of understanding and empathy. 

They communicate well and understand how things work outside of the hospital system. They are highly conscious of medication costs, time, and waste. Something that others may be less aware of.   

Perhaps it’s time for you to try something new? You may make a great hospital pharmacist, who knows? 

There is only one way to find out!