Placement #2 - Lifestyle Pharmacy

Last week I completed my second placement, at Lifestyle Pharmacy. Lifestyle is located right in the centre of the city, so the shop is generally quite busy and the majority of their sales come from the front-end, rather than prescription dispensing. The shop is situated on a corner, has an upstairs and a downstairs, and is not large...yet they have a huge selection of products! More than once we had customers come in for some obscure product and proclaim, "I've looked everywhere for this, and the only place I can find it is here!" And I totally believe it...there is not a single spot in the store that isn't overloaded with medications, toothbrushes, bandages, herbal supplements, cosmetic creams, shampoos, scented oils, hair accessories, or something. And just to round it out, they take passport photos in the back corner of the basement.

I found it a little bit difficult to work at Lifestyle, partly because there was no possible way to learn all of the products in one week and partly because with that much stock, it is nearly impossible to be organized. The dispensary area is incredibly tiny, with essentially no free counter-space and drugs stashed wherever they fit...when I was in the back with the pharmacist and the dispensing assistant, there was really no room to move, let alone work. Fortunately, the ladies I worked with were all incredibly nice (with a side of workplace drama which I have quickly found to transcend border and culture) and willing to jump in when a customer asked me for help locating a product I had never heard of, much less knew where to find. We also had mandatory tea breaks every afternoon, and more often than not someone would supply "cakes" or "biscuits" to go with tea. I also really enjoyed the patient interaction that I got at Lifestyle...with most of the sales being from in front of the counter, I got to do a lot with helping customers select the appropriate cold medicine, eye drop, pain medication, etc. Codeine is available over-the-counter here, in low doses combined with paracetamol (acetaminophen) and other drugs, so we were constantly counseling patients on the importance of limiting use to 3 days to avoid rebound symptoms and dependence (guess how many listened?)

Mair, the main pharmacist, was fantastic about finding opportunities during "down-time" to teach me about pharmacy practice in the UK. She let me dig around in their Drug Tariff, a book updated and circulated monthly by the NHS that tells pharmacies how much they will be reimbursed for the various items they dispense. I also spent a couple hours one afternoon looking through the training modules that all of the assistants are required to complete. I was really impressed...their training is quite thorough and equips them with the knowledge to handle most basic self-care questions, without having to involve the pharmacist if she is busy and there are no complicating factors. On Wednesday I sat down with Lin, a counter assistant who went through training to be able to provide smoking cessation counseling. This is one of the "enhanced services" that pharmacies can apply to their Primary Care Trust (local division of the NHS) and receive authorization to provide. They get reimbursed for the time spent with the patient, and Lin is also allowed to prescribe nicotine replacement therapies (gum, lozenge, patch, or inhaler) which the pharmacy will be reimbursed for dispensing. There are several "advanced" and "enhanced" services that pharmacists can undertake to extend their scope of practice and provide for their communities...pretty awesome, if you ask me!