First day/s

[Saturday 29th, and Sunday 30th April 2017]

“So how was your first day at work?”

Well thanks for asking! Really. I’m so grateful to every person who has asked about my first shift, about starting this job, and about what’s next for me. It’s so encouraging and I hope this answers all of your questions!

Actually, it’s also a complete relief to have an answer! Being “unemployed” never got more satisfying as a reply when people asked what I was up to. Although “unemployed” is not how I ever thought of myself. I still thought of myself as a pharmacist, although the longer I wasn’t working, the looser that description felt. I thought of myself as a birdwatcher, a photographer, a bike rider, a lady who was able to lunch more days of the week than not; but that seemed to come off a bit lame as an explanation. These titles com in addition to the long term titles of wife and sort-of housekeep; although hubby would argue with the housekeep bit, most likely. And then there’s how sick I had been, and still was, and how that was impacting my ability to work (or not!). Yes, I thought of myself as sick, because it’s hard not to. I mean I was. But it’s hard to explain the full extent of that, and the gradual process of recovery, in a short conversation.

But here I am, a pharmacist again. And I’ve so surprised myself; I’ve fit back into the role like I never left! I really thought I’d lost something irreplaceable somewhere along the line!! Really! Something that would stop me being a pharmacist again. Despite my seven years as a hospital clinical pharmacist, despite everything that I’ve done well and every proof of my good work, I let some unfair feedback from my previous job get under my skin like I do with many little, minor things, plus I have some insecurity about the gaps in my work history and how they would look to a future employer, and I started to doubt myself and worry about what next.

But, thank goodness, no. I mean there are plenty of things I can brush up on, make no mistake about that. There are definitely things I’m rusty on, and there have been a couple of minor boo boos; nothing a bit less of a rush, and a bit more math couldn’t have solved! But I’m back, really back! After my first two full-on days as the in-charge pharmacist working flat chat alongside great staff, meeting lovely patients/customers, doing the job of a pharmacist I can tell you that I’ve come home with an exhausted, almost delirious but actual happy, contented smile on my face, and I feel good! I never quite got the adrenaline rush that’s meant to come from exercise, but work is definitely a rush! One of the biggest joys, and most surprising, of starting back at work has been the methadone/Suboxone customers on the opioid replacement program: they are a really friendly bunch and I’ve enjoyed chatting with them. Okay, so I might be quite starry eyed and all at this point, but it’s all gone better than I thought so I’m staying thrilled for now. I’m back. That’s the most important thing!

Okay what else? My feet have been KILLING me!! This should be no surprise when you spend 7 or 8 hours straight standing up with maybe 10 or 20 minutes sitting down. Especially when up till now it’s been more like 9 or 10 hours of sitting down with interjections of activity. Swollen ankles, aching legs, feet sending out electric shots and shooting daggers; all symptoms of half my blood supply pooling in my lower legs!! Home time means legs up above my heart to return all that blood back to my circulation…lying on the floor with feet on the couch does the trick, if you were wondering. A pharmacist who has specialised in wound care for 30 years or more recommends all pharmacists (and anyone else standing up most of their waking hours) wear compression stockings/socks every time they work for this very reason, to keep the blood flow from pooling causing varicose veins, venous ulcers, cellulitis and more. It’s a great plan. I did wear compression tights for a while in winter a few years back because they pass as opaque black tights and they make a huge difference in how tired your legs get. But honestly, have you seen those opaque beige stockings?? I may not have much to be vain about, but I’m not quite prepared for those stockings. Plus these days I keep too warm for stockings of any kind so that helps my case, but not my legs and feet.

It’s been busy! Not as busy as it should have been on Saturday, then way busier than it should have been today, Sunday! Which evened out to 2 solid days work but we only had to do 30 minutes overtime today, and got out on time yesterday so that’s a win. Unfortunately today was the day hubby was picking me up and he had to wait half an hour in the car! I’m going to drive on Saturdays, but Sundays I have to take the train cos hubby needs the car, and the timetable just doesn’t work nicely. I’m happy to sit around Ringwood station for half an hour on a Sunday morning, but I’m not keen after dark so he agreed to pick me up…dunno if he’ll be so keen next fortnight! But oddly I haven’t felt terribly stressed even when the work is stacking up. I think that these days I accept that I can’t do everything, and just pick one task after the next and keep at it till we get through them all. To give fair due, both days I have worked with amazing help in the dispensary: a 3rd/4th year pharmacy student all day on Saturday and a dispensary technician who I wasn’t supposed to have, but who balanced front of shop with helping me on Sunday. Both were very efficient dispensers, really excellent assistants and a great help with customer service and supply of pharmacy only and pharmacist only products. Plus the shop girls took all the load of processing payments as well as providing great product advice. And there was always that pharmacist out the back providing an invaluable back up to my uncertainty; what a team!!

For some reason whoever was working Friday hadn’t seemed to order medications as they used the last one on the shelf. This is the pharmaceutical equivalent of not only finding that the last sheet on the toilet paper roll has been used up, but going to the cupboard and finding that that was the last roll! And now you have a patient/customer who needs toilet paper or…you get the metaphor. We had a fair few of these annoying and really inexcusable outages on Saturday, and it was embarrassing. It’s also a problem because we can’t order on Saturday, or rather we can but it won’t come in until Monday anyway, so we couldn’t even tell people to come back tomorrow. By the end of the day we had a longer order of medications than I’ve seen so far on a weekday, and we couldn’t order anything; quite the irritation, especially for common medications.

This is going to be my main deal in this job, working every second weekend. After finishing this first one, I think it going to be okay, good even. People coming in on the weekend understand that you’re giving up your weekend for them (sometimes!) and can be really appreciative (or not)! But I think I like it! Even though I’ve taken a pay cut to be here, don’t like working Sundays, have no real entitlement to a lunch break or any other break on a weekend day, am more hectic than I’ve been in a good while, and have to keep processing scripts when I’m busting for the loo, its a job and a pretty good one, so there’s lots to be happy about! Yes, I’m happy!

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The big return

I had planned to make a big announcement about my new job when I started, just before my first official shift, but anyone who reads my blog regularly already knows about me starting work because I told you recently because of a blunder, and, well, anyone else just found out! So no announcement. Just a reminder really that I am OFFICIALLY starting my new job on Saturday 29th April, 2017.

My official pharmacist coat, the first time I’ve gotten to wear the traditional garb; my keys to EVERYTHING; a pink, personalised name badge; pocket with a pen holder, and I’m ready to go!

It’s not such a big thing, really, as I’ve already done 8 shifts over the last few weeks. Wow, eight shifts already! That crept up on me. Five of them were half days, but still; it’s work! I was really thankful that my new boss was as keen as I was for me to get in several practice shifts before I started, and it has helped me to feel comfortable and confident heading into my first shift. It has given me a chance for reacquaint myself with the FRED dispensing program, although pretty much nothing has changed since I last used it in 2009! It’s such an easy to use program compared to the 2 hospital pharmacy programs that I’ve used over the last 7 years, and nearly all of the scripts scan in; no typing involved! So cool! I’m still in love with this function!!

My name up in official pharmacy lights!

It’s given me the opportunity to learn the “order” of how drugs are arranged in the pharmacy. This is one of those words that means the opposite of what you would think…oxymoron? I think that’s the word. See whereas hospitals organise their medications sensibly by the drug name (generic name) in alphabetical order, community pharmacies have ridiculous systems, and no one, including those that work there, really know why they have such a dysfunctional “system”, and the system is different in every pharmacy.

In this pharmacy, originally drugs/medications were ordered A to Z by brand name, instead of generic drug name. Fair enough. Back when, before additional brand names and generic brand names, there was one brand name for each drug and everyone knew the brand name for each drug. Drugs were marketed by brand names and that’s mostly what they were referred to as by medical staff. So this system worked as an actual system.

Here’s that dispensary I’ve been telling you about

Then drugs started going ‘off patent’. This meant that other drug companies were allowed to come along after and use the generic drug that the original drug company had committed 10 to 15 years of research and development to, make their own formulation and sell it. Not having to spend any of that time in R & D, and just having to more or less copy what the first company has done means the new version, or “the generic” can be vastly cheaper! Their version has to be approved by the Australian Government as working in the same way, having the same drug and dosage, and having equivalent efficacy when compared to the original brand, and once this process is complete, the drug gets on the PBS like the original and off we go.

So we got the first batch of second brand names, that were still actually names. Like instead of Noten, we got Tenormin. So now we had two brand names; that was manageable. And then generics went bananas!! They stopped bothering with brand names and just wanted to spruick their company name. So instead of usable names like Noten and Tenormin that were brand names for atenolol, we got drug company names attached to the generic name like APO-atenolol, Terry White-atenolol, Chemmart-atenolol, atenolol-Amneal, atenolol-Sandoz and so on and so forth! You get the never-ending gist. A quick look online tells me that atenolol is available in 15 different brands in Australia.* In America it’s gone much more ridiculous with 143 companies making atenolol generics, and 289 brand names, all slight versions of the one before!!**

How is this relevant to me working in the dispensary? The dispensary is organised by brand name. Then the generic brand comes along and it gets its own slot. Noten is under N, Tenormin is under T. All is well. Then the company name generics come in. Our store has a deal with APO generics so where available we buy the APO generic. But it doesn’t make sense to put every generic in the A for APO section! So the generics get put away by the generic name. Atenolol still ends up in A, but APO-escitalopram goes in E and etc. Except sometimes you go to find APO-hydroxocobalamin and it’s not in H. You ask someone where you might find it and they go straight to N. You ask why, and the answer is: the original brand name was Neo-B12. Yes, that is true, but…”yeah we should move it, we should do that, we’ll do that”. But that was half the point of getting in a few shifts before the real thing, to work out some of these quirks. Another thing: in an effort to be helpful, someone decided that the top 20 most dispensed drugs should be moved out of order to the front of the stands for easy access. Sounds sort of reasonable, but its kind of annoying to go the S and remember, no, its not here, its in the section that I’ve already walked past! But hey, I’ve been able to yammer on about it this much so some of it must have sunk in.

So this shift on Saturday is my first shift “alone” as the “only” pharmacist in the pharmacy; definitely ideal for me. I say those things in talking marks because there will actually be another pharmacist out in the back room working on our supply of medications to 18 nursing homes at all times while I’m out front; another one of the ideal things about this position. So I will never be without a second opinion or some advice or instruction on how to do something that hasn’t cropped up so far, and that sounds great by me! Not that I’ll need it necessarily, but popping out the back to ask someone a quick question is much less full on than having to call the boss on a Saturday!

*http://www.nps.org.au/medicines/heart-blood-and-blood-vessels/beta-blocker-medicines/atenolol

**http://www.medindia.net/drug-price/atenolol.htm