Community pharmacists can make a huge impact on patient lives. I know, because a lady told me so! It is one reason why I talk about the value of community pharmacy and the need for community pharmacists to keep their feet on the ground and think about the people who come into their pharmacies.
It is not about new-fangled super-clinical stuff – it is about understanding the basics and why the generalist pharmacist, like the generalist doctor are so important, but undervalued in our NHS. You can never really put a value on a good community pharmacist.
So a lady came in – I had seen her before, but never to talk to. No dispensed medicines before and no history to recall, but she was asking for a pain-killer. All community pharmacists know how to keep one ear open to what is happening. The counter staff was doing the right thing – they always do – but I watched the woman flex her hand during the conversation – so I joined her.
‘So how long have your hands been stiff?’ was the opening question, which naturally got an open-mouthed stare, ‘well I saw you flexing your hand and I wondered if your hand was stiff’.
With a disbelieving look she said ‘yes – been stiff for a few weeks, worse in the morning’.
‘Are your joints sore as well?’
‘Well yes, I was just asking what medicine might help. They feel swollen and I can’t actually get my rings off any more’.
So I go for the slamdunk – ‘do you mind?’. But without waiting for a response I took her hand in mine and squeezed a little.
There was my answer- sore, tender, stiff and swollen joints on the hand. And with some follow up questions, they were probably not the only joints affected.
It is funny that the moment sticks in my mind, holding the hand of a 40something lady in a busy pharmacy telling her that ‘I don’t like this much, you may have and acute inflammatory arthritis’. Fortunately she was registered at the local practice and they would see her straight away.
I bumped into her three months later and she came up to thank me. The GP did some blood tests and sent her as an urgent case to the early inflammatory arthritis clinic where she was seen and treated within a week. Now she was on a ‘mab’ thingy and already feeling much better. The consultant told her that ‘we caught it early’ and that was a great advantage.
As the community pharmacy training sessions focus more on DMARDS and biologics, I do still wonder if community pharmacy is losing the ‘touch’. To make a massive difference to someone you may need notice things, ask questions and hold their hand.
If hope that there are no pharmacists out there that do not understand ‘Stiffness, Swelling, Squeezing’ when people visit our pharmacies looking for help.