A Day In The Life Of A Hospital Pharmacist In Nigeria

Hospital pharmacy

Hospital pharmacy are hospital found within the premise of a hospital. They do not retail products unlike the community pharmacy. They stock products needed in the hospital. They stock different range of products with each product having one brand.
The duty and job of a pharmacist in hospital pharmacy is more of organizational work. They follow protocols, guidelines and are political. They interact with physicians and other health care professional in making drug based decisions about the safe and effective use of medicine.
They follow medical prescription in choosing, preparing, compounding and dispensing medications and provide pharmaceutical care to patients during counselling. With the aid of a medical card, a hospital pharmacy can make appropriate review of a patient to ensure the right patient gets the right medication, the right dose, route of administration, time, drug information and documentation.
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There are two models of hospital pharmacy practice. They are clinical and dispensing pharmacy. Clinical pharmacy is not practice yet in Nigeria. The dispensing pharmacy in Nigeria is more advanced because it cuts into some aspects of clinical pharmacy. The reason is because the law is yet to allow that.

Life In A Hospital Pharmacy

I was fortunate enough to work in a specialist hospital. My experience there taught me a lot about hospital pharmacy. It is quite different from community pharmacy.
You get to work in the morning and take over from the person who covered for night shift. You take the stock of drugs and place order for new product. The order can be from the hospital drug store or outside vendors. The stocking takes into consideration the day of the week. Clinical days matters a lot. When ordering for drugs on eye clinic days, the drug should be more of drugs for eyes. Same thing too with chest and lungs days, cardiovascular system health days, etc. Monday's and Friday's are usually rush hour. That means more drugs will be needed. There must not be no stock.
The next step is to enter the new stock into the shelf and recorded them. The recording can be done using a computer or bin card. Drugs meant for wards and other departments are sent according to their order. The ward or department register this order in their demand book also called index book.
The day continues with the monitoring of physical condition of drugs. This include inspecting the physical drugs and the temperature of the room and fridge using thermometer. Relative humidity is not left out.
Very few hospital in Nigeria allow pharmacist to engage in ward round. Meeting with physicians on a daily basis to discuss the strategies for individual treatment plan for each patient. The bottom line is to profer recommendation after observing the patient record and seeing the patient condition.
It normally takes some hours before prescription starts coming. Once they start coming, there is no time to do any other thing. More than 95% of patients who visit the hospital need medications. The prescription contains chief complain, medical laboratory test to do and drugs to use. The pharmacist check the patient medical history too along with the present medical history before dispensing. If there is some error in the drug, dose, duration, strength, route of administration, etc, a visit to the prescriber for clarification may be necessary. For over the counter drugs, they can be adjusted at the pharmacy. When it involves prescription only medication, a visit to the prescriber is important. This is mostly done by the head of pharmacy department. However, any pharmacy can do this.
A visit to the prescriber should be fruitful. If the visit is to clarify a bad handwriting, it should not be a difficult one. However, if it involves changing a prescription, the pharmacist must prove beyond reasonable doubt why the prescription should be adjusted.
During dispensing, a first expire first out (FEFO) to ensure drugs do not get expired in the shelf is practice. During dispensing, proper counselling is done to ensure medication adherence.
It is also the duty of the hospital pharmacy to monitor and report all new cases of adverse drug reactions, drug interactions, etc. The pharmacist is also responsible for monitoring the cost of drugs charge by the account department in case it is below the right cost or it the patient is in any insurance scheme.
Prescription for admission case and discharge is handled differently. Admission cases are usually kind of emergency that needs urgent attention. The prescription is attended to first even while other cards are there. The drug dispense is just for a day and taken to the ward where the patient is for immediate administration. On the other hand, discharge cases are arranged and sent to the ward including take home drugs.
Any prescription with a controlled drug is entered by the pharmacist into the poison book register.
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The day comes to an end with clinical presentation. One topic per week. A pharmacist explain in details every thing about a condition, best treatment regimen, and other information. Thus discussion is usually short as what is needed is just the highlight.
BefiBe closing for the day, the next person for the next shift must be around. If not, you have to wait for the person as that place cannot be left unattended to without a pharmacist except someone else is there.
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