What role do pharmacists play in loved ones' health care?
I can remember what it was like as if it were yesterday.
During the late 1980s, I worked as a hospital pharmacist in a small community hospital in Northern California. At the time, both of my parents were still alive, living in a cute little house 2 or 3 blocks away from the hospital.
Weekend coverage at this hospital was rotated between the 2 staff pharmacists. With the help of 2 technicians, we would cover the shift from 8 am to 4:30 pm and then give the charge nurse our phone numbers if there were any issues that cropped up overnight. With only 4 intensive care unit (ICU) beds, 20 acute-care beds, and a 50-bed skilled nursing unit, it was not a large hospital.
My mom was no stranger to the hospital, as she had undergone 2 heart valve replacement surgeries and multiple bowel resections over her last 20 years. With Mom being a frequent flyer to the local community hospital, it was not uncommon for me to be the pharmacist on duty for the weekend while she happened to be an inpatient for 1 reason or another.
On this particular weekend, Mom was in the ICU following a surgery when I heard the announcement over the intercom system: “Code Blue, ICU." I was 26 years old at the time and had attended and participated in many Code Blue events, so I didn’t think twice. I grabbed my 1989 calculator and got myself down to the ICU in a hurry.
Upon entering the unit, I saw a 69-year-old woman with her gown stripped off and a nurse leaning over her side administering chest compressions. The scene was like any other Code Blue event, with 2 or 3 nurses, the physician who just happened to be in the ICU at the time, the anesthesiologist who happened to be on his Saturday afternoon pain rounds, and the respiratory therapist called away from administering a breathing treatment.
The difference? This was my mother.
The first thing was to pull the emergency medication tray out of the crash cart. I was pulling the plastic off of the tray in preparation of the first medication order when the anesthesiologist looked my way and said, “Should he be in here”? I was quick to reply, “I’m good."
"Who else was going to do this?" I thought. "I am the pharmacist on duty; I am the one who knows where everything is, the dosing calculations, and how to mix the medications."
The Code Blue lasted 30 minutes or more. Mom was stabilized, but it was not easy to get there. After a few days, she was discharged home, and life as she knew it went back to normal.
I was young and not prepared for how this process would affect me. The moment I said “I’m good,” I unknowingly made an agreement with myself to treat the patient, as opposed to being present as a loving son to my mother.
I did not understand the effort necessary to suppress the immediate, surging emotions in order to be present in a medical crisis situation for a close family member. I was successful at suppressing these emotions and was able to perform appropriately during the crisis. The challenge was, these emotions were suppressed so firmly that they were very difficult to bring back up to the surface in order to be recognized in a loving manner.
Yes, my personal situation was a little extreme. Upon retrospection, however, I have found that my objective behavior may have been a little inappropriate. Had I stepped out of the room, the staff would have managed the emergency medications appropriately.
As health care providers, we are often called upon by family members to help with their medical issues. We appreciate being able to help guide our loved ones when we have the opportunity. Throughout this process, we need to be aware of our objective behavior and assure that our loved ones are guided to their own health care provider when necessary.
We need to preemptively understand how our values and priorities exist within our health care practice setting. Do we want to be a health care provider for our family, or would we rather help our family receive appropriate care while we stand by their sides, comforting and advocating for them?