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What Is Your Job Title?

Hospital Pharmacist

What Does a Pharmacist Do?

The Hospital Pharmacist has a simple goal: to provide the right medication, at the right dose, for the right patient, for the right amount of time.

Specifically working in the hospital, a Pharmacist:

• Oversees the safety and efficacy of a patient’s medications during their hospital stay. This involves ensuring the medication is corrected for their age, weight, organ function, and severity of disease along with ensuring there are no interactions between medications, and that the timing is correct for best absorption.
• Participates in multidisciplinary rounds, which means reviewing the patient’s medical conditions with other healthcare professionals (Physicians, Nurses, Occupational Therapists, Physical Therapists, Dietitians, and Social Workers) to optimize drug therapy and provide the best possible outcome for the patient.
• Is directly involved with the patient during one-on-one/family counselling sessions while patients are admitted in acute care. Counselling is done on new medications which have been started in the hospital, or they may also review certain medications that are at higher risk of causing adverse events if not taken properly (for example, reviewing inhaler technique or Warfarin teaching).
• Monitors drug levels of certain medications and can adjust accordingly as therapy requires (for example, antibiotics, cardiac medications, anti-seizure medications and anticoagulants).

What Training Is Necessary to Do Your Work?

Pharmacists obtain a Bachelors of Science degree in Pharmacy through an accredited University degree program. This is usually a four-year program along with one year of pre-requisite studies.

Where Do You Work?

I work in an acute care hospital. We also work in rehabilitation centers, and the anti-coagulation clinic. In addition to the hospital (covering all wards including ICU, NICU, Hemodialysis, and Emergency), Pharmacists work in many settings, such as long term care and specialized outpatient clinics. Some of these clinics include anticoagulation, chronic kidney disease and transplant clinics, heart failure, infectious disease, and primary care clinics throughout the province.

Who Needs Your Services and Why?

Any patient entering the health care system, whether it is an in-patient or outpatient setting benefits from a Pharmacist being involved in their care. A Pharmacist’s consultation could reveal a number of issues, or drug related problems such as:

• Patient is taking a drug for which there is no indication
• Patient currently has a medical condition which is not being treated
• Patient is being over/under dosed with a certain medication
• Patient is not receiving the medication properly (for example, poor inhaler technique with puffers for asthma)
• Patient is experiencing an adverse effect from a certain medication

What Is Your Favourite Part of Your Job?

My favourite part of being a Pharmacist is when I can teach a patient how to correctly take their medications and they display a clear understanding of why it is important. Also I enjoy clearing up common misconceptions about medications or disease states and the patient then leaves more educated and aware of their health or the health of their loved ones. I feel most rewarded when my interaction with a patient directly improves the outcome of their health.

What Challenges Do You Have in Your Job?

Staffing levels are always a concern. If there are not enough Pharmacists, there are a number of negative outcomes:

• not all the patients who need pharmaceutical care are seen,
• certain wards are exempted from pharmacy services,
• Pharmacists carry a higher workload, and overtime goes up which inevitably increases the chance for medication errors.

Drug shortages are another challenge and they always complicate situations, especially when the drug is the only one in its class of medications, or if it is a special formulation (for example, injectable vs. oral). Often in these situations, patients may not receive crucial medications in a timely manner, and alternatives given may not be the most effective.

What Are the Consequences When There Are Not Enough People with Your Training to Provide Service?

When there are not enough Pharmacists, patient care suffers. Health care professionals who are not as specifically trained as Pharmacists are forced to perform these roles instead (for example, a nurse may counsel a patient on their five new medications post-heart attack).

Pharmacy service in hospitals is tailored to those wards where the patients are most acutely ill (for example, ICU, paediatrics, oncology). As a result of understaffing, patients in the general medicine wards, or surgical wards may never have a Pharmacist involved at all. This increases the chance of medication errors, along with an increase in the chance of adverse effects from medications that are not being reviewed. Some small rural centres may not have a Pharmacist on-site at all, so Physicians and Nurses process and administer all medications without any pharmacy involvement.