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Week 2: The Second Layer of Bricks on the Wall of Pharmacy Knowledge.

September 16, 2008

 
 I’m writing this on Sunday afternoon, later than usual- I had a day off on Wednesday and worked yesterday.  The weather was beautiful on Wednesday, though, which meant I could spend time outside and got a lot of gardening done, plus I even managed to get some art done (remnants of my brief stint at the National College of Art and Design), had a night out and still got into work on Thursday, none the worse for wear. 

This week was really all about building on the first week in the Pharmacy. I’m a lot more confident this time around, though,  and am working on suppressing my instincts to avoid strangers.  Going up to talk to random strangers isn’t really wired into my psyche, so this was one area I’ve had to work on. I quickly found that the best way to do this is to make eye contact, give a friendly smile and say something along the lines of ‘Are you OK?’ or ‘Can I help you?’ This usually elicits a response like ‘No, I’m just browsing’ or ‘Yeah, actually, I’m looking for something for nausea/sleeplessness/foot problems.  

  Some years ago, I read a book by David Ott called ‘The Book of Tells’. These are the little subconscious physical signals that people give out when they’re feeling a certain way. They can be quite obvious (such as people widening their eyes or having an overly stiff face when they’re lying about something) or more subtle (looking down when they’re trying to manipulate someone). Being able to pick up on body language, I’ve found, is quite useful so far. Nodding quickly usually means they feel they’ve heard enough, while a head slightly to the side means they’re taking in what you’re saying.  

Mirroring is another interesting concept- subconsciously, the patient will feel that you have something in common, though they may not be able to tell why. Subtly copying their body language allows you to gain their trust and makes them feel more comfortable talking to you, never a bad thing when you’re discussing potentially sensitive health problems.  That’s something else I had to learn- how to ask questions tactfully and discreetly.   Compare the two below situations: 

Situation 1:

PATIENT: ‘Excuse me, I’m looking for something for my piles.’

YOU:  ‘Oh…..okay. Are they large and painful?’ 

Situation 2:

PATIENT: ‘Excuse me, I’m looking for something for my piles.’

YOU: ‘I’ll have to ask you a few questions so I can give you the right product. Do you mind?’

PATIENT: ‘Not at all.’ 

     I’ve yet to see a really blatant example of bad healthcare management in person, but I  find people are much more cooperative if you ask them first if you can ask questions.  

Finding a good reference book makes all the difference in the world. During downtimes in the pharmacy (Mondays and Tuesdays tend to be quieter, Fridays and Saturdays much busier), I dig out a couple of reference aids to look through to pick up ideas. The Pharmacy has the BNF, MIMS and OTC dictionary, but my favourite is ‘Symptoms in the Pharmacy’, which gives excellent examples of conversations and suggestions for alternatives  to recommend. Also interesting to read is a Natural Pharmacy book- I can’t remember the exact name right now, but it covers several conditions and recommends natural lifestyle changes and  gentle treatments- not everyone actually needs bisacodyl- oftentimes a more gentle bulk forming alternative (like Metamucil or Fybrogel)  will be much more suitable, particularly for children and pregnant women.   

   There’s a routine in every pharmacy and the routine differs depending on the location and business of the pharmacy. In the mornings, there’s usually stock to be scanned in and put away. When you walk into the dispensary in Boots, you’ll see a large stack of blue boxes- the height of which will determine how busy you’ll be for the next couple of hours. You then need to get the scanner from the storeroom and figure out how to get it to scan in the order (Deliveries In) , put in the reference number of the supplier and the delivery number. Boots Westport gets most of their drugs from United Drug, which has a specific number to put in, then the delivery number is included in each box on a piece of paper which lists all the items in the box. The scanner is put back into a pod and uploads the memory for the delivery. Scanning in, then, you need to scan the barcode for each product and input the number of those particular items. Once scanned, each product can be put away. You’ll often find that you have excess items: those items can be put into a back storeroom. Once the deliveries are put away, you might need to do a ‘fastfill’, also with the scanner. This means you need to walk around the healthcare section, find lines that are low (that is, items that look like they’re in danger of running out). Pregnancy tests go quickly, as do iron tablets. Spatone iron tablets usually need to be filled, whereas we have excess Solpadeine and Nurofen plus, not to mention Zirtek.   

Our most popular items? We sell a LOT of Nurofen Plus. Canesten cream is a big seller, as are Mycil ointment and Vitamin C.   Working on the tills means you get used to seeing the more popular products- this always goes over well when you’re recommending something. ‘Which of those two products is better? Well, functionally, they’re about the same, but this seems to be more popular.’ Anbesol, for example, goes far faster than Medijel, even though it’s more expensive. Is that because it’s better or because people are reassured by the expense?  

A few times this week, I was one of the ‘End of Day’ team. Two people always need to remain behind in the store, to prevent any pointing fingers if money should go missing and also to reduce personal danger in the case of, for example, a robbery. At the end of a day, we go around to all the tills, put the paper money into container boxes usually reserved for 50 euro notes under each till, then remove those and replace them with empty boxes. The full boxes are put into a safe in the back of the store. We then go into the storeroom and log into the main computer, which suspends the transactions, check the end of day till balance and log it into a book, then close the store. We do one last check-around, then leave the store, making sure to lock up well behind us. Heading home then, the Boots store can slumber until the morning comes, when everything will start all over again.

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