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Hello. Um Can everyone see us? Um, Ollie, I can see you're one of our attendees. That's perfect. If you have any questions, please feel free to share it on the chat. But Zoey don't worry about it because I'll relay any questions to you. So you just focus on your presenting. I'll keep an eye out on the comments in case you know, anyone or whoever joins has any questions and I'll relay that on to you just so, you know, and everyone who's watching this is Zoe. She's one of our pharmacists. Um She's come from, you know, Malaysia. So there's been quite a journey, I'm sure she'll talk to you about all about it later and her qualifications, she's actually managed to get herself a really good position in South Mead Hospital, which is North Bristol Trust. And before that she worked in Musgrove Park Hospital and having personally sort of met Zoe, I know how passionate she is and how dedicated she is to her work. So without further ado, let's, let's hear all about Zoe's journey in Pharma uh as a pharmacist and how um she's got here. Ok. Hi guys. Um, my name is Zoe. So I'm currently a pharmacist on South Bead Hospital. So let me, I'm just going to share my screen. Um Sorry, it would take a while. Um win. Ok, sure can. And can everyone see my screen now? That's brilliant. I can. Ok. Yeah, thanks Sherry. Ok. So first of all, I would just like to say um thank you for cherry for inviting me here today to join um the sherry session about members of the MD DDT. So, um it is my pleasure to speak um as a pharmacist. Yes. OK. So uh my, my name is patient, but you guys can call me Zoe. So um let's start just a little background about myself. So I completed my um pharmacy degree from the University of Nottingham. And I did my one year of like training a pre ra year, a training program in Mos Grove Park Hospital in to 10. That's where I met like charity. So um that's just like a year of training and then moving on, I uh secured um pharmacist job um in South Me Hospital. So I consider myself as like newly qualified because I'm just like about like nine months into the job now. So, yeah, I've been recruited as a band six rotational pharmacist. So this is my job grow and I will explain more about that later. All right, moving on. OK. So um how do I like become like a pharmacist as like what is my journey. So first of all, we need to have a qualification um in order to be qualified as the pharmacist, you will have to complete a four year long of master's degree. Although it says like master in pharmacy, but it's actually just a degree. I, I don't really act like, don't really know like why I was there. So yeah, um upon like completion of your master degree, you will have to um undergo a year of training like um it's like a foundation year training, but we call it like a preregistration training. So it's usually like you secure a spot in via or Orel. So Oriel is like a system where you um you try to uh so you were you put on your like, like your choices like where, where you want to go. So you can go into like hospital, you can apply for places in hospital or in community or even like GP practices. And then um it will, so it will based on your preference. I mean, uh so you will, you will have to take this exam called like situation judgment test sat where um they, they, they just give you a bunch of like questions about like how you would do in a s in a certain situation from there. It depends on your results and you will get like um your, your choice based on like your ranking and so on. And after one year of training, obviously, you have to go for the exam and you have to pass the GB HC exam by. So it's like G phd stands for General Pharmaceutical Counsel Exam in order to join the register as the practicing member. All right. So when we say about um the career pathway, uh we will tend to focus on these three main pathways. So first of like, firstly, it would be the Community pharmacy that would be your high street life ph uh pharmacies like boots super drug uh well pharmacy or it could be like private independent pharmacies around like um across the country. So second, it could be like a GP practice. So pharmacist like we work in GP practice or the primary care network. So in recent years, there have been like a huge um a huge like transition where a lot of like pharmacists, they tend to move towards like this PC N or like GP practice to practice as like a pharmacist. Like you would be surprised like how um like pharmacist can be involved in the primary care by helping like GP do um soft, like do do uh safe like calls or like review like patients in the community. And third, it will be hospital pharmacist, which is the group that I'm taking groups at the moment. So like you can join like an Asia Trust or like private hospital. Yeah. And apart from these three main uh career like pathways, you could, you, you can go for other pathway like prisons, you can work in the prisons, um as a military pharmacist in the wet or even like industrial like your pharmaceutical companies. Um the Gask Pfizer Johnson and Johnsons. So they would be in more involved in like the research part of it or like clinical trials. So it's more of like the background work instead of like the patient facing um work if that makes sense. Ok. Next. So I will just talk about like my experience um as a hospital pharmacist, like how my career can progress as a hospital pharmacist. So currently um as a hospital pharmacist, we progress based on banding. So we start off as like ban six, which is like my current position and most of the bed exercise pharmacist, they are rotational pharmacist. So what does it mean by rotational? So you have like rotations, it's just like uh like a training. So you'll be rotating into like different areas like for example, in the medicines you could rotate like in cardio respiratory or if you are going into your surgi surgical rotation, you have like maybe in like upper G I for example, urology or admission, I think it's like kind of um the same as like how junior doctor foundation like yeah, you guys have rotation as well. So yeah, that's us. Um in order to progress to the next spending band seven, it can be like as a band seven pharmacist, you can uh still be your rotation band seven or a specialist, you take a, a specialist, specialist role, like um for example, if you a specialist in specialize in like stroke or um respiratory and things like that. So in order to progress into be seven, you have to take this post graduate clinical pharmacy diploma. So it's um the diploma lasts for about two years. So it's like a part time um study. So you, you are becoming a student, I think it's quite like tough for us because on top of like working a full time job, you have to study like as a part time in order like to progress into plan seven. Yeah. And then um from band seven to band eight. So we have like band band eight A or band eight B. So the there isn't like much difference. It's just like um slightly like above like band eight B. Obviously, it's like uh more senior than a a. So when you progress into a band like eight pharmacist, you are more likely to be, you, you do have like a specialist role. So it's um I would say like less of like the war like work, you will have more of um doing like the run like for example, managing a clinic, you run your own like clinic if you have like your, if your heart failure fast as you have run a heart failure clinic or a respiratory clinics, just a lot of like um involvement in the MDT meetings or even becoming like a manager, for example, like um pick up a manager road um in the like community pharmacy as a pharmacy manager, things like that. So um in order to progress from be 7 to 8, normally you would have like um pick up the IP call independent prescribing call and you will, yeah, and you will be qualified as the pharmacist, independent prescribing. So you'll be able to prescribe within your area of competency. Yeah. So normally like people would think about like where they would like to special life and before like pro progressing into band aid. A Yeah. Ok. Next up. Um so yeah, I would just like explain what does it look like uh as a typical day for me. So um as a be six, I will change to a pharmacist. We are very much like ward based. So we will spend like I would say um more than half of our day in a ward. So like how people like normally see like pharmacists, they are always like walking around like like looking at drug charts doing like seeing the new patients. So yeah, so a large majority of our work a consist of doing a maths, right? We call it medicines for conciliation. So what does it mean? Um it means that uh so when new patient admitted to the the hospital due the ward, we have to do like a drug history taking obviously like the, the doctor who clocked the patient, they would have done it already. They would have done like the first drug history taking, um, maybe from their, their cr or like, um, asking the patient and then prescribe it on a drug chart or like the, the chart isn't it? But, um, for our job is to like, make sure that it's correct. So, we were first, like, first of all, we would do the drug history taking by using two reliable sources. So this would include your SCR or the local, um, GP record. So, in Bristol we use something called the connecting care. And I remember when I was in, um, working in Mas Grove, we tend to use em me and I find it really useful because, um, it's, it's local to that area. So it, it's not only, so you, you, you not only can, like, look at the repeat prescription, you user can access to like clinic letters. Um, and like the GP, like all the GP records. So it's a really, like, useful, um, to, in my opinion. Yeah, when, when we are doing the drug history and then normally, like, we would just ask patient, like what they, they usually take at home because obviously the patient would know best, like what they usually take. And if the patient bring in any of their medication that would be really, like, helpful because it use as like, um, a prom for the patient and when we are doing the drug history and they will remember like what they, they get home. Yeah. And then, uh so that, that would be like the first part after we have done all the history taking drug history taking, we would normally like reconcile. So we would, we would check like that against like what has been prescribed on the chart and solve any um discrepancies in a timely manner. But obviously, um sometimes there are some medication changes. So we would document that on the like drug chart. So um just a little context for my current like trust in A T you still using the paper drug chart. So, yeah, so we, we do have like a copy of the physical drug chart which it's um, I don't because like when I was in to, we use the e electronic prescribing, which I find it really like convenient. But yeah, now we just like go back into like the favorite drug chart where you have to write, you have to like, um, annotate on the drug chart and to sign to make sure that it's been like screened by your pharmacist. Yeah. So um a large amount of time of my time I spend it to do like the Mad Rag. So, yeah, and then um the, the other half of my time I will be doing like screening discharges or TT A S. Um So the discharges tend to come in like more in the afternoon. So that's where, like, I get, like, busy with screening discharges and to make sure like the patient discharge, uh, we, we don't de delay the discharge process, so it needs to be prioritized. Yeah. Um, when we are screening discharges, um, I will solve like, uh, any, like problems with the doctors immediately and then we also order or supply medications due to ward. So in the ward they, they normally have like their own wars ward stock for, um, the common medications like paracetamol, stuff like that. But for certain medications that are, are in like stock in the war, we have to order it. Yeah. So that's what we do. And also we constipations how to take their medications. Um, for example, if the patients are newly prescribed with a Doac, for example, a dark, um, anticoagulant, we will counsel patient because it's a high risk highrisk medication. So it's our job like to like cos the patient how to take it properly, talk about like the side effects and things like that. And then, um, so some of like the pharmacist, they have the, like a slot in the dispensary where they would work like in a dispensary to do some like checking or clinical screening. Um, yeah, the clinical screen like the, like some, some prescriptions like outpatient prescription for example, or any, um, clinic, uh, like the, the FP 10, the FP 10 outpatient prescription. Yeah. Also we attend trainings, um, or we ourselves, we train or supervise other pharmacy staff or like the junior like pharmacy students or the uh trainee pharmacists. Yeah, that's it. Mm Next, I would just like briefly talk about like what challenges that I find um as working as a ph a hospital pharmacist. So obviously like um we have to be multitasking most of the time. So I would say like time management and prioritization is critical. So in like limited amount of time, like what can you do? Like to uh make sure you are doing it in a safe, like you have to make sure like the, the things that we are doing are safe, first of all. And also like in the best interest of our patients and work prioritization. Yeah. So it's a good, I would say it's a, it's a good chance to develop my skills. Um how you prioritize a patient like certain patient. For example, if they um like, let's say if today I have like 10 like new patients and I only have like two hours to, to do that, like, what do I like? So who, who, who would I start first? So I would normally like kind of look like in, in like first thing in the morning, I will print out my handover sheet and I would just like, look um your past medical history or is anyone on any critical or high risk medication such as like a Parkinson's? So that needs to be looked immediately, like ne ne need to be screened like by a pharmacist immediately. And yeah, um second I just find like our job is highly demanding and I'm sure like everyone like working in like as a healthcare professional is equally like busy, it's just like very like um busy workload. So I think it's very important to take uh some regular breaks in between. And we often also just like check upon our colleagues, just look off, look after each other. And yeah, I think in like times that it it is very important to um make do do do make sure like you look after your mental wellbeing. So we are able to, you know, like contribute more to the our work. Yeah. And in terms of communications, I think it can be um improved in terms of the handover of care because I find it sometimes I find it a bit frustrating um where uh it's really hard, like it's not easy to get hold of my certain doctors. So when I'm working in a ward, like the doctors, obviously, when um like doing like in hours they would be on in the ward. So it's easy, like if I have any questions, I would just um go up to them and just let them know like uh like what's the issue and how to solve but not like all the time. They are always there. So they sometimes they do that leave their bleed number, which is good. We can use it like to contact them but not, not, um, all the doctors do, like, put their, put down the bleak number. So I just find it a bit, like, tricky bit difficult to get hold of like the person I want to. Yeah, in terms of like the handover of care, I guess. Um, so like, not, so this, the same patient wouldn't be seen by the same, um group of doctors every day. So just find it like sometimes when they they hand over like certain care, like the doctors wouldn't know like what was going on with the pa with with this patient. And when the the doctor is doing like the discharges, sometimes it's been written like the the discharge summary is been written by another doctor. So they wouldn't like know like exactly what is like the journey like what the patient has been doing in the hospital. So I just find that that could be like improved in terms of, yeah, the hang over. Um and lastly, it's just increasing. So uh shortages. So the staffing levels has been like pretty bad in my current trust. So yes, just increase like um the pressure, the amount of pressure and workload. Uh So hopefully like we get more like the vacancy get to be filled up quicker and yeah, thanks. I was just like um talk about how um the cli the clinicians or anyone in the MDT can utilize our skills and knowledge. So yeah, I would say just feel free to ask your what pharmacist, just ask them any questions we are ready to have. We are happy more than happy to advice anything like um related. So I do get like um being asked a lot about um for example, if a patient is on a two, what would you do? So yeah, so we would normally tend to follow like guidelines such as new guidelines, which is uh amazing in advising what to do with patient with swallowing difficulties or with like a tube or pad tube. What would you like? How do you convert the medications? So I think we do a good job in advising like what to do and also to choose like the most cost-effective medications. Yeah. Um um and also I, I want to use this opportunity to highlight that is actually mis service. So M I send for medicines information. So I'm sure like every um hospital has the M I service where it's like a group of pharmacists or pharmacy staff. They, they, they will, they will receive like enquiries like from doctors, consultants to ask about anything. So you if you have any um questions that can't be like, so for more or more of like niche um in, for a more niche area, I think it's worth like getting, getting in touch with the M I the M I people. So, and they would have to because they, how they work is like, we, we have like a data bank of a lot of like questions or like queries from the past. So it's, I'll say like it's a good resource to use it. Like if you have like, like any like question just feel free like to email or contact them. So they will, they will, they will have the time to like research or investigate um in, in investigate like about your cures. Yeah. Ok. Um Yeah, and also like to solve enquiries from anything like any if you have any like issues about drugrelated or do advice about um nonformulary medication, for example or just um yeah, so we often advise based on like to trust guidelines, we make sure that medications are prescribed based on the guidelines, especially the antibiotics. So we have this like micro guide. So it's like antimicrobial guidelines. So we make sure that it's it's being like uh adhered also like local formulary. So if um other doctor would like to prescribe something off label or non formulary, I think there are some paperwork that need to be completed before it can be done. Um Yeah. Next. Um it's about like managing complex patients when I say complex patients have, we mean like um patients that have like long term conditions like Parkinson's with epilepsy or mental health like issues. For example of the classic one would be like cloZAPine patient cause obviously like um with cloZAPine, it's a high risk medication. So um and in order to obey the supply, it's not as straightforward as you think. So, like in my current trial, so we have to, if the patient, if a cosy patient has been admitted, we without bringing in their own class of and we will have to contact the mental health like side the mental health trust in our region to like email them like immediately to ask for a supply. So yeah, so that I think like pharmacists play a key role and helping like the doctors to manage like such patients. And also like for Parkinson's um patient, we need to make sure that the um they get their, they take their medication um in the right time. Um get it like on on the right time because it's critical. So we would normally like confirm that with the patients um family with the patient and such. Yeah, and also to make sure that the drug history it's accurate, accurate. Um also like to contact relevant people, for example, like the chemist to get information about uh a methadone patient, for example. So we we have to phone like the chemist or the alcohol or the drugs team within the region to to find out the current dose to make sure like the patients is is actually like getting the the right dose on the on the ward. Um Not only that uh for patients that are on a compliance aid for example. So we need to make sure, yeah, that, that needs to be documented on the drug chart or anywhere that the patient is on the Dorset box. So when the patient is discharged, we have to, um, get it like, uh, done like a new do that. If there are changes to the med, uh, patient's medications, otherwise it can stay the same. Lastly, like we will have in doing the counseling. Like for if the patient has been newly started on a do a, we would we normally have to counsel patient on that. Um an issue like alert, alert card, some leaflet or even like steroid counseling for patients taking long term steroid because they are at risk of adrenal crisis. So we will have to counsel patients on the importance of like taking the steroids and what to do in a situation of emergency like adrenal crisis, like how to use the emergency steroid uh injection kit. Yeah. So I think that in that way like pharmacies can contribute and how the um other health care professionals can make use of our skills and knowledge to optimize the patient's care. Yeah. So the next steps, I would just think about like my like what I feel in the future like as a pharmacist or like in my current trust. So I'm quite like, delighted to say that we are actually moving into electronic prescribing. So it would be like paperless, which is which I think will make like our all of life life easier and also less errors, less than medication errors. So, which is something really positive and also more involvement in MDT meetings because um currently they are just the like ban a, the specialist pharmacist. They will, they involved in MT meetings. Um But for like the junior pharmacist, we don't really get the chance to uh to attend that MDT. So I hope that I would have the opportunity to um shadow like some MDT to, to yeah, to be involved in the MDT meeting and yeah, streamline communication. So it's something that needs to be uh looked into like is it, is there like a better way to communicate between um different healthcare professionals like using, I know like some trust they use like whatsapp, maybe not whatsapp like telegram or other uh platforms to communicate. So it's easier like instead of bleeping like each other because um in my trust. So not like the same bleep is carried by the same person every, every day. So if you bleep the, if you want to get hold of certain like doctors, you bleep the same number that you, you used yesterday, you wouldn't get to the same person. So that's just a bit like frustrating, isn't it? So, yeah, so I, I thought like if you have um a telegram or the work group chat, that would be uh it will make the communications better. And I heard like there will be more like trainings or learning and development, development opportunities um within like the pharmacy like team. Yeah. Ok. So I think that's it for my presentation. I hope it gives you guys like an idea of what a family do uh uh a phar a pharmacist do on a daily basis. And yeah, sir. Does anyone has any questions at all? That's so great. Thank you so much. Um Zoe, that was a lovely presentation. To be honest, I learned a lot myself from that presentation as well. Thank you. She, yeah, I think, yeah, yeah, thank you so much. I think the takeaway points definitely for us are like, you know, make sure our communication with um our MDT is very clear. We leave bleep numbers or anything when we like go and things and um just, you know, you guys make a great difference to the whole health care that we provide and correct us on a lot of medication. Teach us a lot about, you know, side effects or any changes that can be made to the medication. So that's absolutely amazing. Thank you so much for your talk this on me. And if anyone has any questions, am I OK to give your email out to people here? Yeah, absolutely. Yeah. Shall I put it in like the chat box or that would be great. And then, yeah, I will just, I send the chat box. So if anyone has any questions pop up in your mind like after just feel free to contact me at. Yeah. Ok, fine. Thank you so much. Have a lovely day. Bye bye. Have a lovely evening guys. Bye.