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Rachel Berry, Pharmacist

Rachel Berry is working as a Pharmacist in University Hospital Galway. She studied for her A Levels in Banbridge Academy Northern Ireland and took her Pharmacy degree in Queens University Belfast. Initially she worked in retail but moved to a job as a dispensary/rotational C Grade pharmacist in a hospital in the NHS, for the next couple of years. Deciding that her career needed some direction and focus she applied to work for the HSE as a Basic Grade pharmacist and to start a Masters in Clinical Pharmacy.

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What were the main 'career decision' milestones in your life so far?

In school I was lucky enough to be in a position where my best subjects were also the ones I enjoyed most so when it came to decision time the choice of subjects for GCSE/A-Level was straightforward - sciences and maths.

During my last two years at school I organised work experience in areas I thought I might like to pursue a career e.g. medicine, retail and hospital pharmacy, veterinary medicine. Pharmacy stood out because the degree could be applied in several different areas such as business, management, research, the health service and industry. At that stage I wasn't sure exactly where my interests lay and the pharmacy degree content appealed to me so I chose pharmacy.

As an undergraduate and pre-registration pharmacist I worked in retail. By the time I was fully qualified I was sure that the business/retail side of things weren't for me and so I found a job as a dispensary/rotational C Grade pharmacist in hospital and spent the next couple of years working in the NHS.I especially enjoyed the clinical aspect of the job but unfortunately that particular post did not allow for much career development in that area.

Last year I decided that my career needed some direction and focus so I applied to work for the HSE as a Basic Grade pharmacist and to start a Masters in Clinical Pharmacy.

Who are the people who most influenced your career direction?

I think my decision to become a pharmacist was a pretty independent one although my Careers Advisor at school did agree that it was a realistic/suitable choice to make. My parents would have been supportive whatever direction I had taken but they were probably relieved that I choose a degree that would almost certainly have a job and prospects at the end of it.

How did you go about getting your current job?

I was actively looking for a new job in Scotland or Ireland at the time. My current job was advertised on the HSE careers website: It appealed to me because as part of the job you got to complete a Masters in Clinical Pharmacy and depending on where you were placed in interview, choose which hospital you worked in (the scheme involved the major teaching hospitals in HSE West and South).

I applied online and was shortlisted for an interview which assessed the candidates suitability for the job itself and the Masters. I got a phone call a few days later to say I had been successful.

Describe a typical day?

The first thing I do when I go onto the ward is to look at the drugs the nurses have ordered from pharmacy. The nurses will have ordered drugs for new patients and this is one way of spotting any potential problems early on e.g. drug not stocked by the hospital, wrong dose or strength etc. If anything strange does show up I go to those patients first and address the problem.

The next thing on the list is to go and talk to all the new patients and get a list of all the medicines they were on before admission. Most of the time this is relatively straightforward (and quite enjoyable as most of the patients like to have a bit of a chat) but there are occasions when it still isn't clear, even after speaking to the GP, the patient and the community pharmacist.

The list I obtain is compared to the drugs prescribed by the doctor. If the lists don't match I first of all look to see if there is an explanation and if not then let the medical/nursing staff know. Sometimes a patient won't be on a drug that they really should be taking according to their medical history or vice versa and I will highlight this as well.

Once the new admissions are sorted out I try to go round all the other patients and check that the drugs they are prescribed are suitable. I'll also answer any questions they have regarding their medicines and pass anything I'm unable to answer on to the medical/nursing staff. How busy I am depends on how many new patients there are and whether or not they have complicated drug histories. I have other non-clinical commitments which need to be fitted in as well.

What are the main tasks and responsibilities?

  • Taking drug histories from new admissions: This involves talking to the patient/carer, GP or community pharmacist and looking at the medical notes in order to obtain an accurate list of the patients medications. This is compared to the drug chart and any differences are highlighted to the medical and nursing teams.
  • Reviewing drug therapy: The patients drug therapy is monitored and reviewed by the pharmacist throughout their stay in hospital. The pharmacist is responsible for ensuring that each drug is prescribed in such a way that is suitable for each individual patient. We do this by looking at the suitability of the drug itself, the dose, the formulation, interactions, side effects, monitoring requirement, the patients clinical condition and lab results etc. 
  • Discharges: In many hospitals a pharmacist would review the patient's discharge prescription and talk to them about their medicines before they go home. Unfortunately, in this hospital we are under a lot of pressure due to the fact that we have an inadequate number of pharmacists for the size of the hospital. This means that we have to focus this aspect of patient care on those patients who are discharged on "high risk" drugs and those patients who are felt to be most at risk of running into problems with their medicines in the future.

As well as working on the ward I also work in the dispensary (checking drug orders and outpatient prescriptions) when required, work on projects the department is involved in (e.g. preparing a guide for the use of intravenous medicines), answer queries from the medical and nursing staff and liaise with pharmacy technicians to ensure the ward has the drugs they need on time.

What are the main challenges?

The fields of medicine and pharmacy are constantly developing: new clinical trials are published, new drugs developed and new ways of using medicines are introduced. It is a challenge to keep up to date with all this new information and it can appear quite daunting at first. I've recently started studying for a Master's in Clinical Pharmacy and have found it to be a great help as my learning has become more focused, manageable and "real" (I can relate it to actual patients).

On a day to day basis there is always something new or unexpected. These things could be interpreted as a challange but I like to think they keep me alert and interested in the job. In terms of the pharmacy department as a whole I think the main challenge is addressing how best we can meet patients needs and provide a quality service in the face of limited resources.

What's cool?

I enjoy the fact that there is a lot of patient contact and that we have the opportunity to make a real difference to people's lives through sometimes relatively simple actions. For example, just taking the time to sit down with someone and listen to their concerns or explain what each of their medicines is used for could make the difference between them taking medication or not. I found working as a community pharmacist quite an isolating experience and enjoy working alongside other healthcare professionals in my current role.

What's not so cool?

Some aspects of the job can be quite mundane e.g. checking drug orders but at the end of the day the ward needs the drugs and it is an essential service.

What particular skills do you bring to your workplace?

Communication skills - you need to be able to communicate information effectively in layman's terms to patients and on a professional level to other healthcare professionals.

Good interpersonal skills.

Conscientiousness - attention to detail is very important because even something that looks like a minor error/omission could have a big impact on the patient's health.

Analytical skills - you need to be able to work through information and decide if it is relevant and valid. You need to have an interest is peoples wellbeing and have a sense of your responsibility to them.

What subjects did you take in school and how have these influenced your career path?

For GCSE I studied Maths, Additional Maths, Chemistry, Biology, Physics, Geography, English Language and Literature and German.

For A-Level I took Maths, Chemistry and Biology. I chose these subjects primarily because I was good at them and also because I enjoyed them. The school I attended was very academic and I always knew my future career would involve science of some description so the choices I made were logical.

I do regret not continuing on with art, although at the time I wasn't sure I could spare the time to commit to an extra subject that wasn't really going to come in useful. I guess you just have to weigh up costs and benefits. I found it very helpful to have a good grasp of statistics and pure maths as these topics came up quite alot during the pharmacy degree.

If you are thinking of taking a degree in pharmacy make sure you look at the admission requirements in good time as they can be quite specific and I know the grades are increasing every year so you need to be sure you are capable of making the grades.

What is your education to date?

I have 9 GCSEs, 3 A-levels, a Masters in Pharmacy and am half way through a Masters in Clinical Pharmacy.

What aspects of your education have proven most important for your job?

The degree is specific to the job!

What have been the most rewarding events in your career so far?

What personal qualities do you have that helps you in your career?

When it comes to my professional/academic life I think I tend to be very organised and would probably be described as a perfectionist. The former definitely comes in useful and the latter sometimes. I suppose I am ambitious otherwise I wouldn't have moved countries for the sake of a job!

What is your dream job?

Something creative that would allow me to travel. If I suddenly developed a talent for it I'd love to be a photographer - I think a good picture is worth a thousand words when it comes to highlighting important issues or raising peoples awareness of what's going on in the world.

Does your job allow you to have a lifestyle you are happy with?

My current job is nine to five, Monday to Friday with around 5 weeks annual leave per year so it allows plenty of time for leisure activities, family, friends etc. Other hospitals I have worked in had a weekend/on-call rota but it was easy enough to organise my social life around this. The job comes with a decent salary and I am pretty much able to take holidays and treat myself to the odd shopping trip or whatever as I please (within reason)!  I am very happy with the lifestyle working as a hospital pharmacist allows me to have.

There are opportunities for career progression as a hospital pharmacist although compared to the NHS the HSE has some catching up to do. Hopefully the role will develop in the coming years as it has in the NHS where pharmacists are becoming highly specialised, have prescribing rights and are integrated more fully into the healthcare team. From my experience of the HSE there isn't really a structured training/career path after registration that all pharmacists follow but there are plenty of opportunities if you go out and look for them.

What advice would you give to someone considering this job?

Consider your options carefully. It is likely that you are expecting top grades in your Leaving Certificate if you are considering pharmacy as a career so there will be plenty of doors open to you. Make sure you do plenty of work experience in different areas of pharmacy and if it is healthcare you are interested in then consider getting some work experience in medicine etc. I know quite a few people who have completed a pharmacy degree only to realise they actually want to do medicine!

What are the three most important personal characteristics required for the job?

  • Communication/teamwork
  • Accuracy/attention to detail
  • Patience.

Have you undertaken, or do you plan to undertake any further training as part of your job?

I am currently studying for a Masters in Clinical Pharmacy. It is possible to undertake further training in specific ares e.g. psychiatry, respiratory and I may consider this if I find I develop a particular interest during my Masters. If I return to the NHS at some point I will probably do an independent prescribing course as this would open more doors for me in the future.

What kinds of work experience would provide a good background for this position?

If you are thinking of getting into pharmacy because you want to work in healthcare I think you need to rule out other careers such as medicine, nursing etc. Take some time to work in community pharmacy as well as hospital.

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