Board Certification After Awhile

Was it worth it? I know many wonder this same question, and I believe it is. It is expensive to keep current. There is a yearly fee due to BPS every year. The required approved continuing education is pricey and complicated. 

The reason I continue to believe it is worth it is because prior to obtaining this, I feel like I had something to prove. Many newer grads felt or assumed I was a BS Pharm even though I was a PharmD. Many assume that because I have been out of school over 15 years, I am behind the times. Experience is sometimes not as valued in every job culture no matter what field it is. Bright and eager new graduates come out feeling as though we are behind the times, and sometimes they are right. 

Prior to obtaining my BCPS, I had no residency to point to. Yes, we had residencies back then, but my debt load didn't endorse another year of the same at half the price. The return on investment didn't seem good enough. If I was graduating today, I would definitely do a residency. 

What happened to me after the board certification is that I quit trying to prove myself to peers. I refocused my efforts on the patients by doing a better job in going the extra mile and also by noticing the system issues that aren't being exposed. I also have stopped trying to make my career the thing I work on the most and have let it fall to a healthier place behind God and family. What will be will be.  

Should a job in pharmacy open up where I can do more of the things I enjoy: clinical decision making, brainstorming, patient advocacy, and writing, I will be moved. Until then I credit certification to validating competiveness with newer pharmacists while also solidifying my belief that experience is king. I am glad I invested in myself and hope you will too! 

Multilayers

One thing I have noticed about the errors I have made... distraction. I do not mean distraction with other team members or music, but the distraction within the order itself. Take for instance an order written for an IV fluid with no rate written from the ER. Immediately the info missing is the glaring distraction of the true issue: the MD wrote for incompatible fluids. It is easy for me to forget the multilayer dimension of errors. Overlook the error within the error. Those always seem to make me stop and think. Maybe errors come in pairs.

A pharmacist is like a detective trying to solve a case. May your cases always be easy and obvious!

Pharmacy Perfection

One of the biggest things I struggle with as a pharmacist is the idea of a profession that requires absolute perfection in everything you do; yet I am human. There is not a lot of room for error because it can detrimentally affect a patient. I remember back when I was as green as the spring grass freshly graduated from pharmacy school in 1999. I landed my first job with K-Mart, not exactly the job that I had dreamed of while I was attending pharmacy school, but they paid for my relocation from one city to another. They also did not do a lot of volume in the particular store where I was assigned. I do not remember the name of the pharmacist that worked there opposite from me initially. What I do remember about her is the words that came out of her mouth almost at her introduction, “I have never made an error while being a pharmacist.” I was too naïve at the time to realize that there was no way she was telling the truth. We are human; we will make mistakes. And at the time K-Mart did not have any mandates in place on flow or any bar-coding scanning to ensure more safety as Walgreens and CVS had. They were way behind the times as far as technological advances go.

I believe one of my first errors was dispensing Adalat CC 30 mg when the prescriptions called for 60 mg. Yes, I felt SICK. But over time I have come to realize that there are things you can do as a pharmacist to be more accurate whether it be hospital, retail, or anything in between.

According to a 2006 report by the Institute of Medicine, medication errors cause harm to roughly 1.5 million patients annually.5 Millions more are caught prior to administration, before they reach the patient. Not only do medication errors adversely impact the patient population, they are estimated to cost billions of dollars in additional treatment costs. Read more: http://www.uspharmacist.com/content/c/31431/

Here are some tips to help you become more accurate

1. Concentrate. Don’t allow distractions to stop your flow of thinking. If a technician comes up to you and needs something right away, go ahead, but realize when you start back on the order, you need to continue the exact same flow from beginning to end. Don’t try to “pick up where you left off.”

2. Do the same thing every single time. Consistency.

3. Do a second double check after you are finished checking. If that means pulling up the profile on the computer screen and holding up the order or pulling it back up electronically, just double check at the very end.

4. Any time you are going outside the usual, there is a higher incidence for errors. For example, if you have to build something from scratch in the computer on a new medication, you can be sure you are more likely to mess up on something else within the order than normal.

5. If you work retail, utilize every program they have to improve accuracy. In the hospital, just do another last review of MAR prior to moving to the next order. If in doubt; ask. It’s always better to phone the office if you work in retail or phone the nurse if you work in hospital to bounce off what you are seeing.

The most important thing is to make sure you have enough staff to safely fill medications and orders.