Tuesday, April 10, 2007

I'm Not a Doctor, But I'm Still Smarter Than You

"Yet another post on how its so tough to be a pharmacist!" you're probably thinking. Well cram it up your stink hole, cause the rant is coming whether you like it or not.

Working at St. Paul's puts me in direct contact with the unwashed, hospitalized masses. Although I generally love what I'm doing - hot, steamy, pharmacist on patient action - because its what I've been trained to do there are a few, nagging details that they don't teach us in pharmacy school.

1. They never taught me how to talk loud enough to cover my patient's roomates poop noises coming out of her less than strategically placed commode.

2. They never taught me how to cover my nose with a necktie to cover the associated smell.

But I digress.

They also don't teach us how to take rejection from the uneducated population. Yes, I know I've spent five years in school learning, in depth, how to medicate you and resolve your drug related problems, but how dare I suggest that your family physician that you see once every six months for perhaps five minutes each visit may have been incorrect about something? Or even that the guidelines for treating diabetes have changed since 1973 (SURPRISE! You don't HAVE to go blind).

Let me fill you in, I know you crave to see how my mind works. I have this patient, lets call her Granny, cause she's a grandma and kind of reminds me of mine (although I never called either of my grandmothers granny). Anyway, she's in for her umpteenth heart attack, her kidney function is lower than a worms belly button and she's got maple syrup running through her veins. Ever the diligent pharmacy student, untempered by experience and naive to the world, I head to my trusty guidelines and develop the best damned care plan in the enitre world for her. New insulins and injections, tapered dosing and increased glucose monitoring. Damned if I'm this woman won't live to be two hundred, the way I've souped her up. After using my many counselling techniques to 'establish a relationship' or 'covenant' if you will, we share a tear about her life and family and I feel that change has been made. I order test after test to establish baseline functions and have every professional consulted to intervene on her behalf.

But, alas, its all for nothing. None of my lab values are requested like I asked, and it appears her doctor exists only in our imagninations. On day four of our time together I consult her with my plan before I leave for my four day weekend. She tells me that she doesn't feel comfortable making changes 'on her own, without her doctor's advice'. I'm dumbstruck! Was it not that very physician's recomendations that put her here in the first place? His lack of initiative to manager her case? And damned if she's doing this 'on her own'. I spent hours researching how to get her fat ass into the next decade alive. In the end I just about pinched a tear as I turned on my heel, past her ever pooping roomate, and returned to my hobbit-hole like office in the pharmacy.

In the end I made those recomendations to the attending, just to spite that old shrew. However, in the efficiency that is Canadian healthcare she was discharged on 'prescription', which of course lets all other healthcare professionals understand the complexity of her conditon. Bah, I'm too young to be this cynical.

This is an artists rendition of me after not having my recomendations even be read.

1 comment:

Lance said...

wow. that artist has you down to a tee. smoke out of the collar and everything. doesn't that get warm once in a while?