“Learn, unlearn, relearn”

Written by:
Barry O’Sullivan MPSI MBA
Senior Pharmacist,
Mater Private Hospital, Cork

My classmates all took a moment to absorb what Tech leader and Irish woman Anita Sands had just said. We were sitting in a function room of a San Francisco bar at lunchtime on a May weekday in 2017. We were there as part of our studies on the Corporate MBA program with the University of Limerick.

Amongst other items, she was discussing the idea of having several careers, in differing roles rather than being a careerist in one segment. This was a concept which resonated strongly with me. Six weeks previously I had accepted a new position, leaving Community Pharmacy for Hospital Pharmacy.

Community Pharmacy was to this point all I knew and had experienced. Summer and term holidays from university I worked in a Pharmacy in Mallow. My pre-registration year was a Community placement. All of my working career to that point was Community Pharmacy but I was eager for a new challenge.

I certainly have learnt a great deal over the years working in the sector, but it was time to unlearn some of the administrative aspects of the Community Pharmacist role. It was time to commence a journey of relearning, moving my focus back to key areas of pharmacology and physiology.

For me one of the most enjoyable aspects of Community Pharmacy was the relationship-building with regular patients. The Community Pharmacist has a really unique, high-contact position in the landscape of primary care. Over the years I was involved in delivery of pharmacy services to a wide number of Nursing and Residential care units. I derived great satisfaction providing these key pharmacy services, as it gave me a chance to flex my clinical skills. Detailed patient reviews with the medical and nursing teams, and tailoring medications to the patients and their needs was why I became a Pharmacist. Site visits to discuss medications with nurses and patients were very similar to what I do now in the Mater Private Hospital, Cork where I have been for over three years.

The opportunity to move came about when my then employer, Sam McCauley Chemist group, asked me to provide additional Pharmacist support with the contract delivery in the Mater Private Hospital, Cork. For a number of years Sam McCauley’s Chemist group had provided the pharmacy services with on-site Pharmacist cover and off-site dispensing. In later years, with the marked success and expansion of services in the state-of-the-art facility, the contract was brought in-house and the Pharmacy Department of the Mater Private Hospital, Cork went live at the end of March 2020.

There was never going to be a perfect time to move but when you are open to change, you are more likely to grasp the mettle and go for it. Understandably, I had concerns about what the work would be like, being a full time Hospital Pharmacist and fixating on what I didn’t know, but in reality there was much that I did know.

Introspection in the time around the sectoral move threw up plenty of points for consideration such as not having a clinical diploma and no prior experience in hospital. To aid in the integration process, I did a lot of self-guided study, refreshing knowledge around absorption, distribution, metabolism and excretion of medications. I spoke to colleagues in other hospitals and leant on the support of the Pharmacy team members. Never be afraid to ask for help or direction.

In both sectors of pharmacy there are commonalities and transferrable skills. Clear communication, evidence-based decision making and team playing will aid greatly in problem solving. The centre of what we do as Pharmacists is the patient, and we always strive to do our best for them.

Pharmacists are expertly skilled in research skills and communication. We do it all the time, day in, day out, regardless of role or sector. We translate technical information to understandable and relatable data, appropriate to the recipient.

The learning curve at times felt almost vertical but there is an exhilaration to that too. Fuel to mental fire.

My days in the Mater Private Hospital, Cork are busy and demanding. Working across all departments, I provide, along with my Pharmacy Department colleagues, the best care we possibly can.

The pace can be quite fast and the work very varied in hospital. With COVID-19, additional complexities were added, and a greater level of infection control measures are the daily reality for the foreseeable future. For a few months, the type of patient cohort changed in the hospital in line with HSE needs and so knowledge of different types of patient care was required.

A typical day for me is a mixture of chart reviews, patient counselling, clinical staff education, medication queries and aiding in discharge planning from a medication perspective. These were all the expected aspect of the job coming in the door, but additionally there is a wide number of governance committees to do policy and procedural work for. These committees are responsible for a variety of aspects of patient care such as the CPR committee, to the main medication committee: Drugs and Therapeutics. This multi-disciplinary committee has overall governance of medication use with the sole focus of optimal patient care.

Private hospitals in Ireland operate to the standards of Joint Commission International. Their tri-annual routine inspection is preceded with a lot of work across the committees and wider hospital. Pharmacy has a significant part to play in all this so there is of protocol writing, auditing and training around this too.

Over the years I have been lucky enough to tutor some really excellent Intern Pharmacists and I make sure I explain the logic and process I follow to the students under my tutelage. Regardless of sector, the key messages have been the same: clear communication, robust processes and keeping the patient at the centre of all your activities. Again these are commonalities for all Pharmacists.

Pharmacists are a versatile and adaptive profession; with treatment guidance constantly changing, coupled with stock supply and legislative changes, we have to be.

With the success of the Mater Private Hospital Cork in recent years, the future holds many exciting expansion plans. The addition of new specialities and units will see the Pharmacy department challenged in a positive way to support this growth.

Don’t be scared of change, if change is what you seek.