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If you have any questions, comments, or suggestions related to pharmacists with hearing loss, please contact: Dan Sheridan at pharmacy@amphl.org.
ABOUT PHARMACY
Pharmacy is a fun, but challenging profession. A pharmacy degree requires six to eight years of college. Pharmacists must also gain work experience and pass a licensure examination before being permitted to practice. The field of medicine is constantly changing, so pharmacists must be life-long learners. They must also have a strong desire to help others, and must combine good science and interpersonal skills.
Pharmacy is a clinical profession. Many hospital pharmacists have the job title “clinical pharmacist”. There are many different areas of work in pharmacy: hospital, community, industry and education/research. Many pharmacists go on to be managers. Some specialize in medical writing or work in drug information centers. Most pharmacists working in community and hospital pharmacy have direct contact with patients.
Working conditions vary from situation to situation. Even different hospitals or different retail pharmacies have different situations. Pharmacists must keep abreast of the many different drug names – both brand and generic. They must be proficient in the use of computers. They must be able to communicate with others – other pharmacists, healthcare providers and patients. Interaction in large groups (for example meetings, or helping in emergency situations) may pose a communication challenge. Patient contact would include: handing out prescriptions, giving advice to patients about medicines – both prescribed medicines and over the counter sales; conducting medication reviews; running anti-coagulation clinics and taking part in hospital ward rounds; conducting health checks in the community pharmacy (i.e. blood pressure monitoring and blood tests for diabetics). Some pharmacists in the United Kingdom have recently qualified as pharmacist prescribers and now see patients and are allowed to prescribe certain drugs for them.
The main problems a deaf or hard of hearing pharmacist faces are taking telephone questions from patients and medical staff and the group situation on ward rounds, when it is difficult to follow conversation. Different accents and different speech patterns can cause problems in following conversations as can noise levels caused by surrounding chatter, background music, alarms etc. It is best if drug names can be written down to avoid confusion and inaccurate information.
Some pharmacists may need to use stethoscopes for blood pressure monitoring as part of a “mini physical exam”. However, most pharmacists do not use stethoscopes. (There is an excellent discussion of stethoscope options elsewhere on the AMPHL web site).
Pharmacy can be a good profession for someone who is deaf or hard of hearing. There is such a variety of work environments that it‘s relatively easy to find one that is a good fit.
How much college do pharmacists need?
In the USA, pharmacy colleges vary in the number of years that it takes to complete the program. Most colleges now require a minimum of six years of study, leading to a PharmD (Doctor of Pharmacy). There are also seven and eight year programs. For example, an eight year program may require a four year degree in another field, followed by a 4 year pharmacy degree.
In the USA, pharmacists must also comply with the licensing requirements of their state. For example, Ohio requires that applicants have 1,500 hours of work experience in a pharmacy before being permitted to take the exam for pharmacy licensure. In the United Kingdom, after gaining an M.Pharm. Degree, the graduate undertakes a pre-registration year in hospital, community, or industrial pharmacy.
On the Job
There are some very nice articles on the SHHH web site, at http://www.shhh.org/html/workplace_issues.html with great advice about the working world for people who are deaf or hard of hearing. These are not specific to pharmacy, but should be useful in any profession.
More specific to pharmacy, the following is a collection of tips presented at an AMPHL meeting. This list contains twenty strategies that have helped one pharmacist to succeed, in spite of being profoundly hard of hearing. The pharmacist who presented these tips is a hospital pharmacist who used to be the pharmacy manager, before moving into a position as the hospital’s medication safety pharmacist.
1) Type of Employer: Some deaf or hard of hearing pharmacists find that it’s easier to work in a hospital instead of a retail pharmacy. There are two reasons for this. First, pharmacists in a retail pharmacy may have to deal with several thousand patients who don’t know them. By working in a hospital, they instead deal with several hundred doctors, nurses, and other employees, most of whom know them. The telephone may also be less of a problem in a hospital, as will be seen in the next item. (Keep in mind that some deaf or hard of hearing pharmacists do find that they enjoy retail pharmacy more, and that many other career options are available, including teaching and research.)
2) Don’t work alone: It’s helpful for a deaf or hard of hearing pharmacist to work in a setting where they don't have to work alone, so they don't have to use the telephone. Unless the pharmacy is very small, it may be possible to always have a pharmacy technician or student working with the pharmacist. Technicians have on-the-job training or perhaps a one or two year college degree in pharmacy. Pharmacies hire them and train them to do certain things. When working with a pharmacist who is deaf or hard of hearing, the technicians can answer the telephone and write notes about what the person needs. If the pharmacist has to explain something complicated, he may take the telephone, explain it, and hand it back and let the coworker listen.
Hospital pharmacists may spend much of their time working on nursing units. They will probably be the only pharmacy employee there, but will generally know the nurses very well. The nurses will thus likely be very patient with the pharmacist, usually writing notes if needed.
3) The Goldilocks theory: Remember the story of Goldilocks and the three bears? Goldilocks went into the house, and after she ate the porridge, she lay down to take a nap. The first bed was too big and too hard. The second was too small and too soft, but the third bed was just right. A deaf or hard of hearing pharmacist may find that the same thing is true in terms of the size of the hospital where they work. A very small hospital may not be as challenging, and the staffing might be small enough that the pharmacist may have to work alone. A very big hospital might mean dealing with many unfamiliar coworkers who would not know that the pharmacist is deaf or hard of hearing. Some deaf or hard of hearing pharmacists find that the perfect size hospital is about 100 to 250 beds.
4) Be Assertive: If you don't hear something, you can ask people to write it. Try to create an environment that works well for you. For example, if the pharmacy is being remodeled, it may be a good chance to ask for some features that work well for you. A carpeted floor may offer better acoustics then a tile floor, and sound-absorbing ceiling tiles may also help to cut the background noise.
5) Be Upfront: When dealing with patients, try to be very upfront that you are deaf or hard of hearing. Try to set up an environment that works well for you. For example, when you walk into a patient's room, try to make sure that the light is not behind the patient. Try to sit close to the patient, so you are not looking down at them. Consider taking written teaching materials with you, so if they don't understand you well, they'll have something else to refer to.
6) Use e-mail: Many times you can eliminate the need for a telephone call by using e-mail. Try to make a habit of answering the e-mail quickly so that people know they can rely on you to get right back to them.
7) Ask for a fax: In pharmacy, it's always a good idea to have medication orders in writing instead of just a verbal order. Verbal orders, even if you hear well, are error-prone. Encourage nurses to fax you notes instead of calling you. This also creates a better work flow in the pharmacy.
8 ) Borrow some ears: The most challenging time for a deaf or hard of hearing hospital pharmacist, in terms of communication, may be attending a code, when a patient’s heart or breathing has stopped. Codes are stressful in themselves, because a life is always on the line. To keep up with these critical situations, consider asking a pharmacy technician or student to go along with you. You may find that not all of your co-workers are comfortable attending codes, but it helps to explain that all they have to do is write down what the doctor asks for. Consider taking with you a piece of paper that has all of the common code drugs on it. With this paper, your coworkers can simply point to the drug that's needed. Also, it’s always a good practice to repeat the drug name and dose when handing the drug to the nurse. Also, try to know enough about the protocols that you can anticipate what drug will be needed next, so it's not a complete surprise.
9) Educate yourself! Try to be more educated than your peers. This will make you a valuable resource for your coworkers. Pharmacists have to do a certain amount of continuing education every year, and you may wish to do twice the required amount, just to stay ahead of the curve.
10) Beep-Beep: Consider carrying an alphanumeric pager, which displays text on it. Even a one-way pager may work well. Use basic codes, and your coworkers may be able to just pick up the phone, dial the phone number, punch in some numbers, hit the pound key and the numbers will display on your beeper. For example, 111 may mean “please come to the pharmacy”, 911 “get back here fast, please”, 444 “Do you want Chinese food for lunch?” The pager can vibrate, so you don’t have to worry about not hearing the beeps.
Pager companies often have web site with a “Send a Message” feature. The hospital staff can go to that web site and very easily send you a text message. Your spouse and friends can also use it to keep in touch.
For something more sophisticated, consider a two-way pager, such as the Blackberry, T-Mobile Sidekick, or Wyndtell.
11) Have a strategy for coping with meetings: One method is to take along a secretary with a laptop computer. The secretary types the gist of what people say. It’s also helpful to arrive at the meeting early and arrange the seating in the room the way that you like it. For example, if there's a meeting with eight people in it, you can put two tables together and arrange the chairs around them so that we are all facing each other. You can go to the room 15 minutes before the meeting, set up the chairs the way you want them, then go back to work until it’s time for the meeting to start.
It’s helpful to be the one who prepares the meeting agendas. That lets you focus the discussion. For example, instead of just listing the name of a drug, you can write “Should we add (drug name) to the formulary?” If it’s a critical issue that you really want to go a certain way, you can meet with the key people individually in advance of the meeting.
12) CART: When you go to a seminar, ask the person putting on the meeting for the accommodations that you need, such as CART (Computer Assisted Real-time Transcription) services or interpreters. The meeting organizers usually don’t know who can provide this service in their area, so it may help to do some research on the internet and find a local CART provider or interpreting agency, and include that information when you ask the organizers for the service. It may help to contact the local chapter of SHHH (Self-Help for Hard of Hearing People) and ask them to recommend a CART reporter, since many SHHH meetings are captioned.
13) Do more than your share: Try to do more than your share of other jobs, so your co-workers don't feel bad about answering the telephone for you. For example, if you are relying on someone else to answer the phone all the time, and their usual job is to run things to the nursing unit, volunteer to do some running for them. Try to be thoughtful to your co-workers to take the burden off of them.
14) Make yourself valuable: Try to be the resident expert at your place of employment on certain things. For example, one hard of hearing pharmacist specializes in working to prevent medication errors. He chairs the hospital’s medication safety team, and also serves as a volunteer advisor for a national medication error prevention organization. He also tries try to be an expert on the pharmacy computer system.
15) Get to know the other employees: Your work life will be much easier if as many employees as possible know you in the hospital. One way to accomplish this is to volunteer to teach orientation sessions for new nurses. It also helps to be friendly and helpful. In a hospital, if you work on a nursing unit, you will develop a nice rapport with the nurses and physicians who work in the unit.
16) Video Relay: Don't forget about the availability of video phones today (with web cams) Check out the AT&T web site for video relay interpreting and Sorenson video relay (Sorenson VRS). The CapTel phone is also wonderful, if it is offered in your state.
17) Teach your co-workers what works: One pharmacist reports “My coworkers in the pharmacy usually just try speaking clearly to me. Several of them know how to fingerspell, and they may do that if there is a word or two that I just cannot understand. They’ll write me notes to relay questions from a nurse or physician. Some people prefer to just keep a word processor open and type notes to me. I try to be assertive about letting people know what they need to do to communicate with me. “
18 ) Do the hiring: Obviously this section only applies if you are in a management position, but it can be very helpful to do the hiring for the pharmacy. While you must hire people who are well qualified for the job, it’s also an opportunity to hire people who are easy for you to understand. If you hire people who speak slowly, are patient and friendly, and are willing to work to communicate, they will likely be wonderful employees.
19) Stress coping: It's very important to have a plan to cope with stress, because working and being deaf or hard of hearing can be stressful. For some, it helps to have family time and vacations. One hard of hearing pharmacist loves to get on his bicycle and go for a long ride. Others may enjoy relaxing with friends, going for quiet walks, swimming, or yoga.
20) Don’t sweat the small stuff! A lot of stuff happens in the working world that you can worry about and obsess over, but it’s really not worth it. Enjoy the good in life, and let go of the small stuff.
Best wishes in your endeavors!
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