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I watched a news report last night about a stop work meeting by nurses.
They are (I think) first, on the scale of "most trusted", and we are second.
The rally call was "Nurses know that the current workload is unsustainable".

I have read an article by a consultant to the Guild, which quotes Kos Sclavos.
I have read an overview of Pharmacy by John Bronger, in recent pharmacy Press.

When I think about the Nurses situation, and what I/we have to do just to get through the day, I think we are not that different.
The New Age Pharmacy is unachievable because the workload of the pharmacist is unsustainable.

Nobody seems to wants to hear about the unsustainable workload.

Like Nurses, we deal with the health, and care of homo sapiens.
Like them, we are not allowed to make mistakes, however overloaded we are.
An article by Jenny Bergin (Pharmacist consultant to the Guild) in the September Pharmacy Review, quotes Kos Sclavos saying:
"It is human to make errors, but by analysing what errors occur, when they occur, and at what time they occur will allow answers to the problems to be identified."

The same article states that "there may be a positive or negative correlation with workload pharmacists' effectiveness".
While neither of these quotes makes grammatical sense to me, I can understand the messages.
That article states that Pharmacists dispensing less than 15 items per hours are associated with as many mistakes as "high volume pharmacies (more than 25 prescriptions per hour)".
The range of prescriptions/hour dispensed was 2.8 to 31.6.
Fify percent of pharmacies dispense more than 11.5 prescriptions.
In 1998/99 the number of prescriptions dispensed for every hour worked by qualified staff in the dispensary was 11.5, or one prescription every 5.2 minutes So …. Jenny Bergin Pharmacist consultant to the Guild, defines high script volume as more than 25 prescriptions per hour, and that the average per pharmacist is 11.5 items.
These figures would seem to confirm my own experience, and that of many respected commentators, that a single pharmacist working with one technician, should not do more than 120 items per day - above that figure, we are more likely to make dispensing errors.
There is a high profile Guild identity who has a large pharmacy in the Newcastle area, which has a very high script/pharmacist/hour volume.
I presume he would say that he only employs super-pharmacists who can function safely at these levels, and/or has super systems and support.
I would say that it is not possible - repeat IMPOSSIBLE - to run at more than Jenny Bergin's 25 items per hour, AND (at the same time) perform all the professional pharmacist duties in the pharmacy, with only one pharmacist.
That pharmacy runs a lot of the time with only one pharmacist.
We all know that it is not the number of items per day statistic, which is relevant. It is the number of items per each hour.
That volume number might run for 3 or 4 hours of a 9 hour day, but may account for 75% of the daily count. I have worked in pharmacies which operate at up to 50 items per hour with one pharmacist and up to two techos.
At that rate, I am simply thrashing out items at high speed, and missing heaps, I should not have to miss.
Contact with patients is (by necessity) minimal.
This rate can continue for three hours straight.
As a locum, I don't have the luxury of recognising the "regular" S2 and S3 customers, so I take a professional risk every time I nod at the Mersyndol/Ventolin passing over the counter.
If I do become involved in a ten minute consultation with a patient, on "whatever", that 50 items per hour could become 62 items per hour.
For me, that is stressful.
I would contend that this rate is not unusual in the real world.
I have also worked in Pharmacies who run at 40 items per hour for 3 hours, but end up doing only 150/160 for the whole day.
I am still at risk for the 3 heavy hours, and do not feel professionally satisfied.

So Kos Sclavos ….. it IS human to make errors!

Every one knows what errors occur, when they occur, and at what time they occur but answers to the problems have NOT been identified.
John Bronger acknowledges the shortage of pharmacists, but dismisses it because it is "worldwide" (!).
QCPP is not the answer.
CMI is going to make the problem much worse.
DMMR will exacerbate the shortage of pharmacists.
These are NOT Kos's "answers" to the problem - they MUST surely make it WORSE - correct me if I am wrong, Kos.
John Bronger praises the ability of Oz pharmacists to change, but at what cost to Oz Pharmacists?
I have seen tremendous change in the morale of pharmacists over the last few years.
Continuing education is declining, because pharmacists are burying their heads up their bottoms. Both Kos and John would surely NOT try to tell us, that improved systems and staff training only, will fix the problems of Pharmacy in 2001.
The overriding reason for most dispensing errors is the unsustainable workload for most pharmacists.
I cannot think of a single initiative, which has been directed at fixing that problem.
Educating more pharmacists into the present pharmacist workflows, will very quickly drive young pharmacists out of community pharmacy.
Standing, head-down in a dispensary for 2-3 hours straight, checking 50 items an hour, while being constantly interrupted, is not my idea of professional satisfaction.

It is simply not good enough to force all this workload on us, telling us that the profession MUST handle these new initiatives, while you know that the average pharmacist is already stressed and overworked.
Kos/John … you have to be honest.
Most thinking Pharmacists would agree totally, that what you are doing is right. The only way Australian Pharmacy can move forward into this New Age Pharmacy, is by better utilisation of the pharmacists in Australia NOW.

* You have to be honest enough to encourage Pharmacists to either sell, or amalgamate with the guy down the road. That is starting to happen, but I fear we will run out of time.

* You have to change the attitude of individual pharmacists that the only statistic we should look at is the number of scripts we do in a day.
From a business point of view, 400 items a day for one pharmacist is good.
From a professional point of view it is a disaster!

* You have to change the ambitions of young pharmacists to own their own pharmacies. A partnership in an established multi-pharmacist pharmacy is the way to go.

* You have to really (like REALLY! - Yeah, DEMAND!) pressure Government to stop heaping bureaucratic crap on us.
The technology exists to do this.

Privacy Regulations have to be addressed and overcome.
Every pharmacy HAS to be linked securely to the HIC computer.
Phil Dibben has resigned the Vice Presidency of the National Guild.
As a Newcastle Boy, his input to the profession will be SADLY missed.
His opinions and statements were greatly valued by we local pharmacists.
If he said it was right …. IT was RIGHT!
Phil instigated the kind of HIC-link initiatives I am talking about.
Where are these initiatives NOW….. now that Phil is gone???

In a direct challenge, to our Leaders …. maybe you would like to komment on these ravings through the medium of Computachem.

We KNOW you are watching….!

If I am taken out by an assassination attempt, or a Bloody Big Stealth bomber in the middle of the night … ???
On a lighter note … use your Internet search engine to look for gerbil.wav.
Just type that in, and you will come up with 50 sites.
Ignore the Bin Laden filth, and the other doubtful material, but download the Gerbil story and listen to it.
Whenever I am sad, I listen to it.
It makes me laugh till I cry.
If you like it, email me.

Kind regards Roy
PS - I will stand at the November 11 Election as the kandidate for Daylight Saving. I want daylight saving to be introduced at the beginning of October.
The sun rises at 5.00am on Lake Macquarie.

Now for a little humour:

Jack was going to be married to Jill, so his father sat him down for a little fireside chat.
He said, "Jack, let me tell you something. On my wedding night in our honeymoon suite, I took off my pants and handed them to your mother, and said, 'Here honey, try these on'."
So she did and said, "Well sweetie they're a little too big, I can't wear them."

So I replied, ..."'Exactly. I wear the pants in this family and I always will'
Ever since that night we have never had any problems."
"Hmmm," said Jack.
He thinks that might be a good thing to try.
So, on his honeymoon Jack takes off his pants and says to Jill, "Here babe, try these on".
So she does and said, "These are too large, they don't fit me."
So Jack said, "...Exactly. I wear the pants in this family and I always will, and I don't want you to ever forget that."
Then Jill takes off her knickers and hands them to Jack and said, "Here, you try on mine."
So he does and said, "I can't even get into your knickers."
So Jill says,"...Exactly, and if you don't change your attitude, you never will."

Ends
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Editor's Note:
With a unique brand of humour, a capacity for expecting the unexpected and a high degree of professionalism, it is obvious that Roy is providing a first class service as a locum.
I am sure there are a number of prospective employers who would like to meet him. He now has a website located at: http://www.computachem.com.au/locums/RoyStevenson.html
You can arrange more information, and a locum booking, from this site.

Roy S.Stevenson Ph.C. M.P.S.,
Locum Pharmacist
40 Northminster Way
RATHMINES 2283.
Tel 4975 5548 Mob. 0402 406 691 Fax 0249 75 2334
ABN 11 585 465 385

Also, check out the human resource and employment sections located in the Computachem site.

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