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We all look at the BNF with fear, wondering how we will ever remember all those different drug doses, interactions and directions for use. It is very humbling, making us realise how far we have to go before we are pharmacists.
This is why, when I started my Summer Placement this summer, I was anxious to observe the pharmacist clinically checking prescriptions.
It seems to be so effortless, the pharmacist seemingly skim-reading the prescription. In my time on placement, I have not observed the pharmacist making a single intervention.
This made me think : Is the clinical knowledge of the community pharmacist being put to best use, or is the doctors' prescribing really faultless?
I watched with concern as the pharmacist declared a prescription to be clinically safe, despite severe interaction warnings on the Patient Medication Record. Is this a sign that pharmacists learn extensively about interactions, but in reality, pay no attention to them?
On the other hand, on a hospital placement, I frequently observed pharmacists annotating drug charts, making recommendations and endorsements, and questioning doses etc. I know that hospital patients may well be more acutely ill, but is this a sign that hospital pharmacists are using more clinical knowledge, or that because of the chronic nature of conditions seen in community pharmacy, a more laissez-faire approach is adopted?
After all, we all want to use our clinical knowledge, and we will ultimately choose the setting that best allows us to do this.