I Don't Know
Although pharmacists pride themselves on being drug experts, expecting to know everything about every medication is foolish--and even dangerous.
'Hey, you know about all of that stuff, don’t you?' That was the comment from a customer after I tried to answer a question for him about a medication at work recently. The man pointed over my shoulder at the many shelves of prescription drugs behind me as he asked me that question. He smiled and left and I turned around and looked at all of those drugs and thought to myself, 'No, I don’t know everything about all of those drugs.' But guess what, that’s okay!
To be honest, I don’t even remember the medication in question that day or what that particular patient was asking me. I just know that it was an unusual question and I didn’t know the answer. I told the man I didn’t know but that I could find out the answer for him. After a few minutes looking up some things online I gave him an appropriate response and he was satisfied and left. It was a simple case of me needing to look up something I didn’t know off the top of my head.
I’ve accepted the fact that I’m not all-knowing and that there will be some situations at work where I will need help. I’ve accepted the idea that it is okay to tell a patient or a co-worker the simple phrase, ‘I don’t know.’ It wasn’t always like that for me. Things have changed.
Early in my career, I placed a fair amount of pressure on myself to have the answers for patients and other pharmacists or technicians when they asked me questions at work. I didn’t realize that it was unrealistic for me to expect perfection out of myself. One person can’t possibly know everything about every drug or every medical condition, can they? That just isn’t possible.
Pharmacists pride themselves on being the drug experts of the medical community. This is true, but one shouldn’t imply that we have Athena-like wisdom and skill regarding every drug related problem or question. One can’t be expected to know everything about every drug in existence. That, to me, is an unrealistic goal.
Learning that it is okay to be human and to have shortcomings is one of the lessons that pharmacy students and young practitioners really should learn as soon as possible. It can be reckless or even dangerous to make assumptions and fall back on a limited knowledge base to make clinical decisions that directly impacts the lives of patients. To err on the safe side by looking up a dose or interaction even if you are sure of the answer ahead of time is always the safe play for pharmacists.
I can recall parents calling me at work asking me about acetaminophen dosing for children. It’s one of the most common questions you can get as a pharmacist. Many times I’ve looked on the back of a children’s bottle of Tylenol or looked up the weight-based appropriate children’s dosage for Tylenol. I still double check my math every time or look up the answer online for parents just to be safe. That double check gives me some comfort in knowing I am making the appropriate recommendation to a parent.
Pharmacy students are always asking me for advice. One of the things I try to tell students and younger pharmacists is that it is literally impossible to know everything about every drug or every medical condition. And even if you pulled off that feat, there would be a ton of new studies and information released that would challenge what you already knew. But learning that you don’t and can’t know it all and accepting that fact is an important lesson for pharmacists and for life in general.
You may feel pressure from outside sources to know what that dose should be for the IV antibiotic a certain critical patient needs. Or maybe there is this unusual over-the-counter product a customer is asking you about at work. How about questions regarding what the proper course of treatment will be for that nursing home patient who can’t sleep and is already on a laundry list of prescription medications? It’s fine to not be able to spit out an answer on the spot during rounds or behind the counter at work. That makes you human, not a bad pharmacist!
I’ve learned that experience can help you have the answers more often than not at work. But I’ve also learned that being able to say the phrase ‘I don’t know’ may be one of the most important things you could ever say in your career. ‘I’ll get back to you,’ ‘Let me look that up to make sure,’ ‘I will call you back with an answer,’ or ‘I’m not sure but I will find out’ are all things I’ve said to patients many times without any guilt. People respect honesty. And they respect someone who is at least willing to find out an answer if they don’t know it already.
So please don’t think you need all the answers to all the questions you come across at work. That is unrealistic and impossible to achieve. But realizing your own limitations and accepting the fact that you don’t know everything will help you to become a better pharmacist. Try to learn one simple fact that has helped me immensely during my career at work. Try to learn that it is fine to tell a patient the simple little phrase that will serve you well during your career. Learn to say I don’t know. Trust me, it will help you!