As a locum community pharmacist I often worked within a pharmacy with a pharmatreiver. If you are not familiar with this then look it up – it is a large machine containing revolving shelves on which all of the medicines are stored. The point of mentioning is that these pharmacies were devoid of a back room dispensary. The only protection was a small counter on which I prepared the prescriptions that customers could easily peer over the top.
It seemed daunting – always on show and always being watched. However it made me talk. I had to say something to a customer waiting for me to dispense their medicines. OK – at first it was a means of distraction and misdirection – look at my face – talk to me – don’t look at what I am doing. But then it became jolly interesting. People started talking about their condition, how it affected them, their knowledge and attitude and their hopes and aspirations for the medicines I was dispensing.
I certainly wasn’t the quickest dispenser and often I had a little help, but the conversations were usually very interesting. I could offer understanding, some simple explanations and some additional direction as to how to best take these medicines to deliver the relief that was required.
From time to time the conversation dried up before the prescription was dispensed and I was desperately thinking of something else to say. But then clinical pharmacy skills kicked in. I know what is wrong with you so I should be able to guess what other common conditions are associated and what symptoms or presenting signs might be present. Many conversations continued with – so do you have any problems with…. or how is that affecting you. You began to notice things – the way they moved or stood their hands and their face – I could spot angular cheilitis at 20 paces.
I began to define parcels of care – so people with this condition – are likely to suffer from these symptoms – and would benefit from this treatment. People bought things and some products were stocked just for me. People came back and told me how they had got on with the products I had recommended and explained why it was good and why it wasn’t. Recommendations adapted and changed depending on feedback. The interaction changed as I ‘demanded’ feedback – I really want to know how you get on with this – is it easy to use, does it work, does it fit in with your life, do you want to continue.
It was all an experience – a great time of my life and career – when proactive clinical community pharmacy practice was exciting and rewarding. That time is coming again……