Could protected learning time for pharmacists be a reality?

johnathanlaird150Johnathan Laird is a community pharmacist independent prescriber with a special interest in asthma. He is based in Turriff, Aberdeenshire.

As we develop into more clinically focused areas, like independent prescribing and managing lists of patients, protected learning has to become a reality. With this in mind, I was delighted to read about the RPS in Scotland advocating the need for protected learning time in their manifestoRight Medicine – Better Health – Fitter Future.

For me, being a professional is largely about managing risk and containing that risk, so that we can deliver a service for patients. My career began in the community sector, and to be honest, involved the largely technical supply role familiar to community pharmacists in recent years.

Continuing professional development is critical to deliver this role safely. In fact, my employer has supported this and for that I am very grateful.

However recently, I have been exposed to much more dynamic and complex risks associated with being a practising independent prescriber. I am willing to take responsibility for those risks, justify my actions, behave professionally and hopefully have a more positive impact on patient management. I would love to think that some day in the future I could help and support other pharmacists to take this step.

The management of a patient requires an array of areas of competence, some of which are quite different to those I had become used to before I became a prescribing community pharmacist. I love the contact I get from my new medical prescribing colleagues. I really enjoy observing and getting feedback on how it’s OK to make clinical decisions to effectively manage a patient.

A good example of feedback I got recently was about an asthmatic patient who was a smoker. For a number of months I had been fixated with helping him give up smoking, because I knew that, in terms of impact, this was probably the most profound way of improving his asthma. On conferring with one of the local GPs, she suggested parking the smoking issue and putting all my effort initially into controlling the asthma. The shift of emphasis worked and control was achieved. The patient is now more receptive to the idea of smoking cessation.

The point I’m trying to make here is that this type of feedback based learning is nearly impossible when working in isolation in the community pharmacy setting. I do wonder if, like the hospital setting, this support network is one of the very attractive features for pharmacists working in GP practices.

Protected learning time and peer review sessions like those enjoyed by doctors are therefore essential as our role as prescribing pharmacists evolves away from the traditional supply role.

The thought of having an afternoon when I could regularly meet with other prescribing pharmacists and discuss our clinical decisions is really quite exciting. I am very grateful for the feedback and support I have received from my medical prescribing colleagues but I hope eventually I will be receiving this feedback from, and be trained by, pharmacists. In this way, I think we will retain the slightly different pharmacological emphasis to our practice that is not evident in other professions.

More than that, this pharmacological emphasis is the unique selling point the pharmacy profession. I think we should follow the RPS Scotland direction and firstly protect our professional learning time before, in turn, protecting the unique pharmacist skill set.

Johnathan also writes for www.pharmacyinpractice.org

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