Balancing clinical detachment with personal touch

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FEATURE By   Oluwole Williams, BS.Pharm, Pharm.D

It takes a mixture of clinical detachment and cautious personal attention to respond to patients’ needs in ambulatory care pharmacy. When should a pharmacist apply the brakes in close personal attention to a patient’s need? And, when could an expression of clinical detachment be misinterpreted as a cold shoulder? Here are the peculiar circumstances of patient care in pharmacy practice that normally places a demand on the pharmacist’s personal communication skills and tact.

Patients presenting to the pharmacy have a baggage of personal needs and challenges outside of their pharmaceutical and medical needs that may pose an additional responsibility to their pharmacists. An unemployed patient, a patient in grief on the loss of a loved one, one recently involved in an automobile accident, a young jilted teenager, a woman who only yesterday lost a pregnancy, and an hurting unappreciated police officer are a few examples of the many members of the public who may show up in the pharmacy at an hospital or in the community.

In response to the prescription and pharmaceutical care needs of these patients, the pharmacist must maintain:

  1. An understanding attitude and a compassionate albeit unemotional involvement in the plight of the patients.
  2. A careful, patient, considerate response in all long-suffering to the potentially irritable behaviour or conduct of the affected patients.
  3. A professional response particularly for the purposes of sharing critical drug information and passing on valuable education to the patients.
  4. A cheerful mien, listening ear and polite interjections to the patient’s complaints or narration of symptoms.
  5. An open yet confidential approach in the exchange of information with the patient for the purposes of privacy and for clarity.
  6. Some level of questioning curiosity without appearing to be unduly inquisitive of the patient’s private affairs or activities.
  7. A clear clinical distance in a face-to-face conversation with patients to reduce possibilities of droplet infections or direct hand contact with patient’s nose drips or coughed up body fluids.
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Community pharmacy practice especially places on the pharmacist huge responsibilities for personal touch in patient care responses, due to the very intense competitions in the market place of prescription sales at this time. The drive for sales goals and profitability may unfortunately make a cold zombie of the pharmacist’ behaviour in any practice setting if care is not taken. It is advisable therefore that pharmacists should read and digest literature on real life clinical plus behavioural approaches to patient care; more so in an era of increasing population of patients living with psychiatric disorders.

Pharmacists in themselves must be vigilant and self-examining; taking note of when the pressures of their professional careers may be taking a toll on their personal mental health, and should not be ashamed to seek therapy if necessary. There are many instances in which pharmacists have personally made financial sacrifices for the needs of their patients and the patients have responded in warm appreciation to the genuine gestures shown by their practitioner in an embarrassing mode of behaviour. It is a good example that must not be extended for too long in repetition, so that the patient does not become an emotional drain on the practitioner.

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Opportunities for voluntary exchange of resource information relevant to prescriptions coverage particularly by certain medical philanthropies must be actively sought as a means of assuaging patient’s needs, particularly for those living with chronic conditions such as HIV, diabetes, hypertension and asthma/COPD. It is one of the ways in which a pharmacist can maintain a personal care approach with patients even while retaining a professional clinical detachment.

Pharmacists may refer patients to educational resources online, or direct patients to international agencies responsible for the monitoring or care of certain chronic disorders, so the patient may benefit from expert opinions of which community pharmacy practice time may be insufficient to meet. This allows the pharmacist an opportunity of care for the patient’s need without that peculiar lingering “guilt” of inadequate professional attention, the patient feels fulfilled and the impression of a direct personal touch or care is not lost on the patient.

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Pharmacists provide a peculiar service to the public and the health community in their role(s) as custodians of prescription medicines. Patients and other health care practitioners: nurses, medics, dieticians, dentists, physiotherapists as well as the lay staff ALL rely on pharmacists to furnish them with drug information on any prescription drug wherever and whenever they require such. In responding to the needs of these people, the pharmacist is required to demonstrate compassion and professional etiquette, notwithstanding his/her own personal needs or lingering personal challenges; It is a professional duty that must be borne ethically and with great sacrifice for the ultimate public good.

 

Oluwole Williams wrote from Glenside, Pennsylvania, USA

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