Beyond the Medicine: improving mental health care every day
Karen Newman and Lou Marchant-Rutherford, Lead Pharmacists
Karen and Lou are Lead Pharmacists at Sussex Partnership with expert knowledge on people living with dementia. They work together work as a job share. In addition, Lou also works for Pharmaceutical Press as a clinical writer, primarily for the Psychotropic Drug Directory with some work for Palliative Care Formulary; and Karen has first-hand experience caring for family members.
Both Karen and Lou are passionate clinical pharmacists who strive to ensure their patients and teams receive the most up to date, relevant and effective pharmaceutical information in an area where information and trial data is limited.
What makes our job share successful?
Communication, communication, communication!
We love our stationery and have comprehensive handover documents which track our patient's pharmacological journeys, their physical health needs, and highlights any outstanding or upcoming blood tests or physical investigations (e.g. ECGs).
We have a handover book where we write updates to each other - it's proving to be a very useful historical document when you need to refer back to earlier in a patient's admission, but also upon discharge where you can track their progress and see the improvements.
Receiving and acting on feedback from our teams and patients and implementing strategies together to improve the pharmaceutical care on our wards - teamwork does make the dream work!
What are the challenges?
Catching up each week; reading through patients notes to keep on top of 30 patients who may be frail and have multiple health needs. The comms book helps to prioritise the workload and the order in which to review patients.
Keeping up to date, not just with mental health medication but also best practice in physical health, and how to aid taking medication where compliance is a challenge.
Organising cross over time - we love to talk things through; you just can't beat a face-to-face conversation.
As Pharmacist Prescribers, how do you implement this into your role?
As we are a job share we can review each other's prescribing and give each other feedback, plus we screen each other's prescriptions so there is a second pair of eyes to check for any interactions, discrepancies etc as an additional safety net.
We prioritise the review of physical health parameters (e.g. kidney functions, blood pressure, pulse) and ensure any medication prescribed is appropriate, discontinued if not, and check these parameters prior to starting any new medication in case any dose adjustment is needed.
What are your take home messages as a job share?
Overall, we find our job share to be very successful and it's nice to have someone who has the same goals to work with. It's also very handy when we have a clinically complex patient, we both investigate and research the case independently then bring our research together. This gives the benefit of two heads and double the research!
As we both prioritise clinical care, it's also nice to share the admin and paperwork jobs so we can spend equal amounts of time with our patients and their carers!
Lou's Specialist role - combining clinical writing at Pharmaceutical Press and being a lead pharmacist at SPFT
Portfolio working has always appealed to me as it provides a workload of variety and daily change. While it can be complex to manage two diaries, the benefits definitely outweigh the negatives.
In my clinical writer role, I get to keep my hand in all types of mental health care, which keeps me up to date, and also helps when I undertake on call shifts. In addition, I work on non-mental health publications e.g. Critical Care and Renal, which again helps in my daily practice with physical health medication on the wards.
I also get to share information with other members of the SPFT team, for example I was reading a paper on medication used in Autism and ADHD at Pharmaceutical Press and brought the paper to our SPFT journal club. It was great to hear from pharmacists that use these medications with their patient groups in real world practice, and I could then embed both the patient and professional voice in my writing.
Likewise with my practice as a SPFT pharmacist, I am taking this back to Pharmaceutical Press in my review of antipsychotic medication for the Palliative Care Formulary, as I have practical experience in switching antipsychotics. This ensures our publications are both evidenced based but also practical for our readers.
I've also been lucky to present and teach interns at Pharmaceutical Press, students at SPFT and at our local university. The feedback I have received about my split role is always one of curiosity and has encouraged me to be involved in various educational objectives to encourage the next generation of pharmacists to consider different types of roles in their future careers.
Overall, I would recommend portfolio working if you like variety and enjoy the challenge of managing a diverse workload. You do have to have boundaries with your time, which I find especially difficult when working on an exciting project, or have a particular patient that I have been heavily invested in in terms of making their medication management plan.
Having supportive colleagues and managers are key to success and I cannot thank them enough!