Have you ever worked in a hospital pharmacy? It is much different from working in a retail setting, and it is highly recommended to volunteer or spend some time as a technician before you decide to devote your entire career in this setting. Hospital pharmacies are usually referred to as inpatient pharmacy. Although hospitals may have an outpatient pharmacy, which is similar to a retail setting, most people generally think of inpatient pharmacies when thinking about a hospital pharmacy setting. The inpatient pharmacy serves medications generally for patients who have a room and bed. Therefore, their policies, protocols, and systems are designed to serve in this capacity depending on the type of medical services offered at the hospital, and the size (e.g. number of rooms and patients) that can be admitted to a hospital. Many hospital pharmacies require new hires to have experience in a residency if they’ve had no prior hospital experience as a pharmacist. This may be due to the expanding role of a pharmacist to include clinical duties in areas of anticoagulation, infectious diseases, emergency room support, pediatrics, oncology, and many others. These “clinical” services being offered by clinical pharmacists are becoming appreciated by other healthcare professionals (e.g. doctors, nurses) and patients as they offer educational services about novel medications to staff, provide optimal medication recommendations in regards to effectiveness and safety for complex treatments as medicines become more and more complicated over time, and even ensure the cost-effectiveness of such treatment in some cases.
The above all sounds great on paper, but unless you have worked in a hospital pharmacy operation, you may not know what you’re getting yourself into. There are nuances to understand in hospital pharmacy that you may not have to deal with as often or at all in retail pharmacy. Here, we compile some of the many complaints that could arise in a hospital pharmacy operation in a full-service, or general hospital.
- The schedule. Full-service general hospitals don’t usually close…they can be open 24 hours a day. Therefore, pharmacies are usually staffed around-the-clock which means pharmacists will need to work around-the-clock also in shifts. Sometimes these shifts are not desirable if you’re stuck with the midnight to morning shift. Sometimes they are not the most preferred if stuck working on weekends or on holidays when you would rather be with your family or have a social life.
- Call-outs. Similar to above, when other members of the pharmacy call out sick, or go on vacation, maternity leave, you may have to cover them or be asked to take their shift. This happens often as people will always get sick, and workers will always take vacation.
- Lack of communication. When a prior shift (e.g. a morning pharmacist) is working on something important and complex, but does not communicate what they worked on to the next shift pharmacist (e.g. evening pharmacist) for a job they did not finish before they leave the pharmacy to go home. You can imagine the results when a doctor or nurse calls about the order being worked on by the morning pharmacist, but the evening shift has no clue what they are talking about.
- Staff shortages. Without proper staffing, a hospital pharmacist will be overwhelmed and perform the job of 2-3 pharmacists and technicians. This is risky because it could lead to errors and fatigue.
- Nurses. Nurses want the medication quickly, and may not always provide enough time for the pharmacist to process and send the medication after the order is sent to the pharmacy. They may not understand that only a few pharmacists manage and review the medications for proper dosing and safety for the entire hospital. Also, some medications require further processing, such as mixing in the correct diluent, etc.
- Missing medications. Sometimes, even after medications are sent, nurses cannot find the delivered medications…thus requiring pharmacists to scramble and look for the medications in the pharmacy to see if they were sent up. This wastes a lot of time, and results in duplicative work. Many times, those missing medications are later found by the nurses themselves because they may not have looked in the correct locations, or when another nurse takes the delivered medication without telling the other nurses who are looking for the medication (lack of communication).
The above are only some of the scenarios of things that may lead to complaints by hospital pharmacists. Obviously, it is highly recommended to have some exposure in this setting before embarking on this career path.