Working on call could be one of the most stressful parts of a pharmacist’s career, but it is also an essential part of a junior pharmacist’s training and a time during which you can learn the most.
Clinical learning is at the forefront of most junior pharmacists’ minds, but it is the operational learning and high-stake decision making during the on-call experience that can change a person’s ways of working. An organised (or semi-organised) shift can help to keep patients safe and create a positive experience for yourself too.
Here are some practical tips to help you get started. If you can implement them, you’ll be well on your way to a smooth-running on-call shift and, before you know it, it will all be over.
1. It’s a marathon: pace yourself and look after yourself
Remember that you are the only point of call and that means that sometimes your needs must come first. After all, if you’re unable to concentrate you won’t be able to do your best work and give the patient the treatment they deserve.
Remember to eat — a hungry pharmacist is not a happy one. Being hungry and dehydrated will slow you down and distract you from the details. It sounds silly, but got to the toilet when you need to! You’ll make fewer mistakes and be able to concentrate fully on the task at hand.
2. Document everything
Good documentation goes a long way. When there are dozens of ‘bleeps’ to answer, it can be difficult to remember the details and prioritise tasks. Often, you’ll find yourself answering lots of bleeps before managing to progress your other tasks. Recording these details ensures that you can complete the job later on. Documentation also eases the handover to day staff.
3. Have a system for getting through your tasks
Organised systems improve efficiency. There are many ways you can prioritise your tasks (for example, by their urgency, by their stage of dispensing, or their need for discussion with a manager) and these systems can be used in combination.
4. Keep calm: your colleagues will respect the way you react
When you’re on your own, it can be easy to get caught in your own bubble. Remember, working at night is difficult for everyone: there are fewer nurses, fewer doctors and fewer pharmacists. You may be stressed, but so will your colleagues. All too often they might take it out on you — nurses may shout down the phone or bang at the hatch — but try to stay calm. They’ll remember the way you react and they’ll have much more respect for you, and be much more helpful, if you are understanding of their situation too. You might need their help one day.
5. Good relationships will make your life easier
You will never regret having great relationships with your fellow colleagues — your peers, senior pharmacists, doctors or nurses. If you take the time to nurture these relationships when you’re not on call, these people will help you out when it’s 3am and your brain is frazzled. Using a WhatsApp group for your support network can be the quickest way of getting help.
6. Be prepared for fire-fighting mode
Sometimes it will be very busy; the phone won’t stop ringing and you’ll barely have time to pick it up before you’re getting the next bleep (or six). This is when you’ll find yourself in fire-fighting mode. If everything is urgent, you might not be able to prioritise — just get started! The jobs list will only start to shrink if you start doing some of them.
At the end of your time on call, feel proud that you survived. Keep a reflective log of interesting shifts, and draw on your experiences for interviews and to train future on-call pharmacists.
With time — although it seems clichÃ© — it will get easier. As you get used to this way of working it will become second nature, and you’ll begin to enjoy the learning experience.
SinÃ©ad Peare, rotational pharmacist, Barts Health NHS Trust