Taking Pride in Consultant Pharmacy

Nursing homes are among the best places for pharmacists to practice.

Whenever I’m at a social gathering and the conversation turns to what I do for a living, I can almost always anticipate the look I’m about to get.

It’s a combination of “I’m glad I don’t work in that environment” and “I’m glad someone does that work.” The comment that nearly always accompanies this look is, “My (insert name of family member) lived at (insert a name of something nature-related with a word for a small community), and I went and visited there one time. It didn’t smell great, and it was kind of sad. I’m not sure I could work there every day.”

To maintain social graces, I acknowledge the comment and quickly move the conversation along, saving my tirade on the number of ways they are wrong.

The truth of the matter is that pharmacists work in nursing homes every day, and we work to make patients’ lives better. Our title in the facility may be consultant pharmacist, but our work is about taking care of some of the most precious community resources we have.

In his book, Being Mortal, Atul Gawande, MD, MPH, writes, “You’d think people would have rebelled. You’d think we would have burned nursing homes to the ground. We haven’t, though, because we find it hard to believe that anything better is possible for when we are so weak and so frail that managing without help is no longer feasible. We haven’t had the imagination for it.”

While some may share Dr. Gawande’s sentiment at times, it is actually easy to find daily inspirations for a better outlook.

Most facilities are full of life and enjoyment once you get past the surface. If you spend more than 30 minutes observing those who call it home and the workers who provide the care they need to live out fulfilled lives, most facilities have a wonderful sense of life, and not the impending sense of mortality that most see when they first visit.

Then, there is the role of the consultant pharmacist.

Each month, our profession is asked to come in with our expertise and shape medication regimens for these wonderful residents. I tell students who visit my site to take everything they learned in school and be ready to apply it, because that is what we are asked to do on a daily basis.

Each patient has a unique set of circumstances, and it is the consultant pharmacist’s job to take in all this information and apply it to the patient’s medications in order to ensure the best outcomes possible.

The analogy I often use is a floating puzzle. Each month, you put the pieces together as much as possible, and you hope that the pieces don’t change before your next visit.

Nursing homes can be vibrant, wonderful places in the community that serve as a place for patients to not only live out their lives, but also rehabilitate between an acute care stay and their community dwelling. These facilities should be revered as pillars of the community, and those that they house are community elders who deserve to be celebrated.

I am proud to be a consultant pharmacist. While my place of work can admittedly “stink” in rare circumstances, nursing homes are among the best places for pharmacists to practice.