I left the hotel with Cayla around 8:15 am with plenty of time to get to the pharmacy by 9:00 am. We hopped on the LUAS from the hotel to the Dumdrum stop - but the tram was there when we got there we just jumped on forgetting about purchasing the tickets. Someone came around checking tickets and we realized we forgot to get them. We quickly ran off the tram to purchase our tickets. We safely made it to our destinations - Dumdrum for me, Stillorgan for Cayla:)
I had no phone or GPS to get me to Farmer's so I used the old fashioned ask everyone around. A nice boy directed me towards all the pharmacies in the area. It was actually quite simple - a straight shot up the road. Thank goodness. Prior to today I sent my poor preceptor, Liam Farmer, about 50 emails because I kept receiving a rejection message and thought they were not going through -- well turns out that they were most definitely sending. After the introductions, he mentioned he received ALL my emails. Oh my word - that's embarrassing - I felt so terrible, I was just nervous! Well all is well now:) He is a very kind, lovely man - and he showed me around the pharmacy.
The pharmacy is open Monday - Friday from 9 am -7 pm & Saturday from 9 am - 6 pm. It is a very cute family owned pharmacy. His father opened the pharmacy in 1969 when they moved from Galway. It is interesting because Liam, the current owner, was actually studying to become a priest then went to be a pharmacist. His sister, Marie, also works here, but does not hold the same degree. She is one of the last pharmaceutical assistant classes in Dublin. She is able to do everything a pharmacist can do basically except own a pharmacy. It is quite an amazing story, which I hope to continue to learn about as I continue my experience here!
After being here about 10 minutes, a gentleman walked in for his methadone. Liam handed him a cup with some methadone and carefully watched him consume the medication - all during which I was just standing there confused in shock! Once the patient left, I asked about this. Liam has an agreement with the doctor a couple doors down that he supervises the patients taking methadone. They decide the frequency of their visits based on what the physician requests. Some patients come in every day, others come in a couple times a week, and few come in once a week for the supervision. The ones that come in weekly are given a bottle with the remainder needed for the week. They have about 20 patients on this program with them right now.
At 10 am, a girl came in around my age, Allbhe! I was very excited because it turns out she is a pharmacy student in her last year of rotations also!! She attended the College of Surgeons for her pharmacy training. It is sooo different then in America. It is mostly didactic lectures, and her final year she obtains a master degree - but only does one rotation in one location for an entire year. So if she wanted to do hospital and was placed in a community pharmacy - she would need to teach herself! So crazy!! I explained how at Pittsburgh we have the opportunity to have seven different 5 week rotations with two 5 week off blocks. We have many different opportunities with our training and diversity of how we are taught compared to here. I could not believe it! She will be here until September 2014 - so she is just as new as me:) SO AWESOME!!!!!
They have blister packs here that they offer their patients free of charge! Liam asked me to put together my first blister pack from following an older one. It is interesting though because all of their medications are in blister packs already - They come in boxes of 28 all in daily blisters. So they blister it so they are all in one big blister pack. I told them where I work in America, its all bottles - Liam said here, the scissors are their most important tool so they can cut out the amount of medication they need. Additionally, they have about 6 different brands of every medication because they have 'branded' generics. Makes the shelves quite confusing for someone like me;)
Then, the orders started coming in...by orders I mean about 13 different suppliers brought in their medications to the pharmacy. It is important to always purchase the best deals here, even if that means using a ton of different suppliers from all over the country. Some countries make the medication cheaper, so Liam belongs to a group of pharmacists called Indie Pharm. About 50 other pharmacies belong to this group across the country. This group identifies the suppliers with the best deals and suggests it to the pharmacies.
Today's order was quite possibly the world's biggest order that I have ever seen!! There were boxes upon boxes upon totes upon totes of medications. All with different branded names. It took me foreverrrrr to get the order put away. Before putting it away, it is important to check it in with what they were billed for. So I needed to check it off the paper, put it away, then type it into the computer, send it, check it in, and move on to the next tote. It was quite the process. I noticed it is a lot of 'but 1 get X free'. It would be up to like 9 free bottles if you purchase one! Sooo crazy!!
I went to lunch around 12:30 when I went to the city centre down the road and got completely lost in the mall. There is just one entrance and one exit - haha I thought the little man running towards a door so literally walked to every one of those exits. This sign means 'emergency exit' here. haha oops!! So it took me 40 minutes to get back to the pharmacy when I ran in with a panic because I was nervous that I took an hour lunch. I apologized and decided to stay later today to make up for it.
A dietician came in to teach a class regarding Lipotrim. This 'diet' I suppose you can call it is for people who need to lose more than 20 stone (1 stone = ~6 kg). It starts with 2 weeks of just shakes - plain, boring shakes. But then after 2 weeks of shakes, you start re-introducing real food into your body along with their maintenance bars. The idea behind this is you are erasing your palate and then as you re-introduce foods, you avoid any potential triggers so you do not crave the type of food anymore. It is very plain plain food - skinless chicken in a very specific size, and certain amounts of each food, vegetables, then after 5 days of real food you can have a potato. Then you can start having more meals and less maintenance bars. Apparently, it requires A LOT of monitoring and the physicians are far too busy for the monitoring it requires. Therefore, the PHARMACISTS are in the perfect position to help monitor these patients and stay in contact with the physicians if needed. They come in for weigh ins and tests to ensure its safety since it essentially induces ketosis!!! I was in shock. I am not 100% sure of the details but it sounded like diabetic patients could do it also under monitoring if they stop their medications with hope that they can stop them forever from the weight loss alone! SOO CRAZY! Allbhe and I wanted to try these bars to find out just how they tasted, so we decided one day this week we would try some out!! :)
Then a patient came in with some questions for the pharmacist regarding her eye drops: ketorolac, prednisolone, and oxafloxacin. She wanted to know if any of these eye drops could impair her ability to drive. Well the computers decided not to work at this moment so we were forced to look in the books. Allbhe and I researched this question in the BNF- British National Formulary. We determined that that ofloxacin could potentially cause some blurred vision so she should be careful. It is a very nicely organized book! It is very similar to how ours is set up, so it was nice to use!
What an amazing first day here!!!!! I seriously already love this pharmacy, the people here, and the atmosphere!! I could not wait to get home and tell Cayla:) or get wifi to tell my family how lovely it is here!
I had some trouble finding my way to Elaine's house, haha, so I frantically ran into this convenient store and asked if I could use their wifi to google map directions! They very kindly assisted me in allowing me to use their internet to get directions home.. finally an hour later I made it to Elaines:) It is such a cute, homey house:) I love it!!!
I ran inside with excitement and shared my day with Cayla:) Then we decided to go food shopping so we could cook instead of eating out so we went to the shopping center (mall). Elaine very kindly drove us to the food store since it decided to start raining as we were leaving. The shopping centre is AMAZING. We decided to get food from Tescos, which I guess is similar in price and size as a giant. Only difference = no OTC medications are in these stores at all!
We went home, and made sandwiches as Elaine said, 'wow you ladies do get a lot of food...' hahahhaha!!!
This is definitely very long, but I learned so much on my first day, and I cannot wait to continue:)
Irish Word of the Day: Shopping Centre = Mall!
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