Posted by: Witch Doctor | April 8, 2009

Professional negligence

witchround

As a witch child, I remember a van with a loudspeaker going round the streets where I lived at a time when there were no elections. It turned out to be some kind of pharmaceutical emergency. The wrong drug had been dispensed and the authorities, the police presumably, were trying to contact the patient concerned before the tablets were swallowed. I have no idea of the outcome. However, it did make its mark on The Very Young Witch Doctor that a pharmacist’s job was a responsible one and that losing one’s concentration for a moment when dispensing could have serious consequences.

Errors do happen in pharmacy as they do in medicine.

As they do in all walks of life.

Sometimes they are very bad errors.

There was a time The Witch Doctor used to have to calculate and draw up doses of a drug to be injected into a patient. The circumstances were such that the wrong dose could have been fatal. The patient had to be seen first before the decision was made to proceed. Some patients ramble on incessantly. The Witch Doctor always asked every patient receiving this drug to go back into the waiting room and explained it was because she needed all her concentration so that no errors were made during the calculation. Funnily enough the patients understood this approach and seemed to welcome this safeguard. No phones were answered and no-one else was allowed in the room while that reagent was being prepared. Patient or staff jibbering away in the background, however well-meaning, could have caused a mistake to be made.

It is easy to put a mistake down to carelessness.

The Witch Doctor believes there are three main causes of careless mistakes as a result of lack of concentration.

1. Lack of time.

2. Lack of peace.

3. Lack of sleep.

Included in lack of sleep would be prolonged shifts without a break.

Pharmacists need to have a high degree of concentration throughout their working shift. I wonder how many community pharmacists find it difficult to achieve the degree of concentration they require.

Often there will be only one qualified pharmacist in a shop. If that pharmacist has a break the shop has to be shut so they may be expected to go without a proper break for hours on end.

Some pharmacists double as the shop manager. This means for example, they have to deal with staff problems, absenteeism, shoplifting, displays etc as well as all the administrative hassle from on high.

Have you noticed the little consulting rooms that have sprung up nowadays in pharmacy shops up and down the country? These professionals are now are being asked to do the nerve-racking job of making a diagnosis without proper training.

Now, The Witch Doctor is well aware that even with the help of The Book of Spells and millenniums of experience, she could not do all of this safely all of the time.

So, who is to blame if something goes wrong?

Is it the system?

Of course not!

It is the professional negligent pharmacist.

Yes.

But where exactly is the negligence?

Is the mistake the negligence?

Or does the negligence reside in the fact the pharmacist did not refuse to work under these circumstances?

Yesterday Dr Crippen drew attention to a pharmacist who was given a deferred sentence of three months imprisonment because of a serious error where the wrong medication was dispensed.

It is not clear if the pharmacist herself dispensed the prescription although the error took place within her watch.

It seems the patient did not die due to the error but from unrelated causes.

This case is worth studying because it surely sets a new precedent for all pharmacists as well as for many other health care professionals who make a negligent mistake for whatever reason.

The precedent is prison.


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