Worth It

ccFlickr shared by Eduardo Llanquileo

It’s been awhile since I’ve been here…. I’ve gone from regular posts to a lapse in writing of over two months!  Even worse for my professional site which has been three months!  I sat down today and thought about what had changed and why I haven’t been writing.

I guess I have just been tired… It has been an overwhelming couple of months with many changes.   Changes that have taken the pharmacy practice I love into the scary place of perhaps not being sustainable.  Government decisions, which have been short sighted and without consultation with the front line health professionals who are affected, have been devastating.  Even as the government back pedals on some of their inane decrees in an attempt at damage control, the changes will continue and have a vast impact on the health of Albertans’ and the sustainability of pharmacy.

The emotional roller-coaster of connecting with hundreds of other pharmacists across Alberta who are in the same position has been both inspiring and enhausting.  I have met so many professionals who are utterly committed to their patients; but it is heartbreaking to hear of some colleagues, near retirement, who may lose the value of their practices they spent years building.

I am many years from retirement and am hopeful this will not be the case for me, but there have been days I have walked into the place I love and found it difficult.  Wondering if decisions, which are in government’s hands, would take away what I have been building.

Then yesterday I received a letter from the College of Pharmacists that I have been anxiously waiting for.  For over a year I’ve been putting together my case to apply for prescribing rights.  I finally completed the process and sent it off.

While I have had limited prescribing rights for years, there have been many times when caring for patients that I have felt like I had my hands tied when I couldn’t prescribe what I knew they needed.

My son handed me the letter from the College, and when I opened it he asked me why I was grinning like crazy!

I had received my prescribing authority; and it was more than the expanded ability to serve my patients that had me grinning.  It was hope.  I could see that I had been losing my joy…the reason I was building my practice in the first place.  This affirmation caused me to take a step back and realized that I am exactly where I always wanted to be.  I practice with colleagues whom I highly value and continue to learn from and I am in my own pharmacy able to care for my patient’s exactly as I want.  Definitely worth it.

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Engaged

Lately I’ve heard similar comments from different colleagues and it’s caused me to do some thinking. What is it that keeps me “in the game”?  What fuels my passion for my work,  my desire to continuously grow and change?

In any field, including health care, it is easy to become complacent.  Do the job, make no mistakes, go home and refuel so you’re ready for the next day.  I’ve had discussions with many colleagues over the past few weeks who are feeling burned out, unable to make the impact they would like, some basically waiting for retirement.

It’s caused me to think about the next 25 years of my working life.  How do I want to live them out as a professional?  What do I enjoy about health care and Pharmacy?  Tough questions, but I started small, thinking about what I enjoy on a day-to-day basis in my work.  Well….I’ll admit that it’s not the paper work, dealing with insurance companies or the myriad of technical functions that need to be done.  What I enjoy is engagement.

I love to debate the finer points of treatment strategy with colleagues. I love educating patients. I love solving therapeutic problems and making a difference in someone’s life.

These are the fuel for my passion.  I must admit though that there usually isn’t enough of that fuel in my daily work to sustain me.

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Often when I work with colleagues there isn’t time to discuss patient care or innovative practice.  And a lot of the time I am working alone.  There isn’t much I can do about either of those circumstances.  Health Care is a business and the bottom line always stands.

I have found though, another source that was a big turning point for me in renewing my interest and passion for health care.  Since I started tapping into social media I find I am fuelled up and energized by the connection I make with other professionals and the constant access to innovative learning.  The networking I do with other professionals peaks my interest, has me exploring areas of health care I never would have previously, and keeps me active in “sharpening the saw” as Stephen Covey would say.

That may sound strange as social media is usually thought of as a way to connect and “chat” with friends.  I, however, have been using social media, primarily Twitter, to tap into a vast stream of professionals interested in doing the same thing I am. That is sharing ideas and resources and not being afraid to disagree and hash out a topic.

My twitter connections are varied in the fields of pharmacy, medicine, nursing, education, politics and other areas of personal interest. The posting these fine people do provides me with a continually changing, challenging and interesting access to learning.

One of the components I love about Twitter is the ability to hold the equivalent of an online meeting. Usually called a meet-up or chat. Some of the ones I participate in for example are #meded which are folks interested in improving medical education.  Also #hcsm which stands for Health Care Social Media.  These meet-ups involve interested parties discussing  the same topic at the same time.

I’ve also followed conferences on Twitter such as #med2.0 which was held at Stanford this year. Attendants at a conference send tweets out about what they are hearing and learning (along with pictures, slides, even video) and I following along can engage in real-time discussion with participants.

Bottom line for me is that I need to be engaged to find work interesting. If I don’t try to solve a patient’s problem, explore therapeutics or learn some new pharmacology, it’s not interesting to me and I’m just putting in time.  I need to keep expanding my world.  And with social networking that expansion has become global.

Tweeps on the Job

5 months ago if someone would’ve told me that I would be networking and using Twitter in my job, I would have laughed.  Not only did I think that Twitter was a silly  social networking site for following what the latest Hollywood stars were doing, but I actually had no idea how it worked.

cc licence flickr mkhmarketing.wordpress.com

cc licence flickr
mkhmarketing.wordpress.com

5 months later and a not too steep learning curve has landed me with an invaluable resource.

For those of you who don’t know what Twitter involves, it is a networking tool to connect to others around the globe.  How it differs from Facebook is that you connect to people you don’t necessarily know but would like to connect to for reasons of common, professional or personal interest.  The “connecting” involves being able to read the posts or “Tweets” that those persons you follow put out there in the Twitter stream.

What that looks like is a constant moving stream of “posts” from people you’ve chosen to “follow”.   Posts can be links to learning articles, pictures, links to blogs, almost anything.  So, your Twitter stream is personalized to your choices of people to follow.

Those who know me would not be surprised to hear that I have no stars on my list of people I am connected to on Twitter (or Tweeps as they are sometimes called).  What I do have is a list of professionals in all branches of healthcare, education, politics and various other disciplines who provide me with a constantly changing source of learning.

There are days where I take a couple of minutes to check my Twitter feed and I stumble upon an article that answers just the question I’ve been rattling around with.  Other times a post has me thinking in a way that I would never have ventured into.

So, Twitter has become a learning network for me as well as a resource for my practice.  I am, in an instant, in contact with others not only in pharmacy, but in medicine, palliative care, cardiology, continuing education, etc.  Here’s an example of how Twitter has been invaluable in my job.

I was filling in at a rural pharmacy one afternoon when I had a patient bring me a prescription for a new drug.  When I checked the patient records I saw he was also on an anti-arrhythmia drug (for an abnormal heartbeat). Something bothered me about the prescription but nothing was flagging on my computer.  I searched all my usual references and could come up with no reason for my uncomfortable feeling.  I decided to give the very ill patient only a few tablets and planned to call him in a few hours to see how he was doing.  A few minutes later I grabbed my lunch and pulled up my Twitter

by Fillmore Photography

feed to peruse.  There in front of me, posted by 2 connections, was the FDA warning about the drug possibly making a certain type of arrhythmia worse.  The warning had just come out the day before, but in the US not Canada.   I called the patient’s doctor and discovered that the patient indeed had that type of arrhythmia so I was able to contact him and stop him from taking the medication.

Twitter has also provided me with valuable overseas connections.  Last week I received a call about a child receiving a potential overdose with a medication only found in the United Kingdom.  After futilely searching references and the internet,  and not finding the information I needed, I sent a Direct Message over Twitter to two pharmacists in the U.K. and in a matter of minutes they sent me all the information I needed.

It has taken time to develop the relationships I have made on Twitter but I have come to value them and depend on them in some cases.  I know that if I need to bounce a professional question off a colleague they are right there, just a click away.

And have I changed my profile and added a few stars to vicariously follow?  Afraid not.  Well, unless you count Rick Mercer as a Star.  Who says you can’t also have a few laughs?

Her Name Was Alice

I had a patient once.  Her name was Alice.  Alice was in her mid-thirties, diabetic, had chronic pain, high blood pressure and was an alcoholic.  She lived on Kuper Island which was just a short ferry ride from the small pharmacy I managed in Chemainus.  Alice would come in every month or so to see me for her medication, go over her blood sugar results, take her blood pressure.  Most times Alice was sober and sometimes she wasn’t.   When she was sober I would encourage her and she seemed hopeful.  But eventually, the wagon would tip and she would be drinking again.

One such time Alice came in to see me after a night of drinking.  I came out from behind the dispensary counter and sat next to her in the waiting room chairs.  I put my hand on hers, looked into her face and asked her why.   Why did she go back to drinking?  She knew it could someday kill her.  We had discussed often the risks involved in drinking with her medication.

She looked at me and said, “Carlene…..too much pain.  So much pain. …it’s too much”

Alice was a survivor of the Kuper Island Residential School.  And while I had studied about residential schools in University and knew that most of the Aboriginal population around Chemainus had been affected by this tragedy, it was a different thing entirely to sit with a woman who had survived such pain in her life.  The alcohol helped her forget.  The community was rife with it.  No amount of convincing, referral or compassion from me could change that.

Alice was unable to overcome her addiction and shortly after that conversation died of a stomach bleed.  A consequence of the alcohol and her pain medication.

It was one of the first losses I experienced in my early years of practice on Vancouver Island, but there would be many more. At times I would be overcome with frustration when I felt unable to reach people steeped in pain. But other times I was personally challenged as a young health professional to overcome my own preconceived ideas and personal judgements.

Those years taught me the value of stepping out from behind the counter; that sometimes I need to let down my own guard and be open to being challenged in order to reach people where they are at.  Some days I am better at it than others, but patients like Alice have been and continue to be my greatest teachers.

 

*Alice’s name and certain details have been changed to protect privacy.