How to be a pharmacist without really trying...

It's been a hectic week! I'm absolutely knackered, long hours in the pharmacy have really taken it out of me. I came home from work at 2pm yesterday and just wanted to lie down and sleep forever...








So, Tuesday was the first day back after our trip to the city. Tom and I went to Ngcwanguba to drop off the ARV packs. It was the first time we'd ever just dropped them and left so I'll see next week when we collect all the papers how well that worked. I don't have the highest of hopes given that we had run out of D4T (Stavudine) which is an ARV that pretty much everyone takes. They all had to take a double dose of the kids pill instead which I'm sure would have caused mass confusion - taking ARVs is complicated enough as it is!







Continuing the fun, I returned to the pharmacy to find us the victim of another power cut. Sadly for the three of us in the pharmacy, the backup generator had decided it wouldn't power our lights so we were in pitch darkness using torches to locate all the drugs. I needed to prepare for the next week's clinic so headed on down to the maternity ward to use a desk there. I was working quite well down there then got a bit distracted and ended up going to watch a birth - this one was a bit more gruesome than the last one because the woman needed an episiotomy [I'm sure I've spelt that wrong] and there was blood everywhere. The baby boy was pretty small and wasn't very lively, but the midwife sorted that out using a technique known as 'Holding the Baby Upside Down By One Leg Until He Cries' which I guess must be okay since it worked! After a nice dose of holding cute newborns I decided I should probably do some work so reluctantly handed over the child and went back to my desk.







Later on, Thabo (one of the pharmacy assistants) came down to tell me that one of the hospital managers had told him that the Department of Health had rejected our latest stock take because it was on the wrong computer template and it needed to be transferred to a new one. By the next day at 8am. Now, first of all let me fill you in on a little something called 'The Saga of Zithulele Stock Take':







The Saga of Zithulele Stock Take







Once upon a time in South Africa there was a little hospital in the middle of nowhere with a pharmacy full[ish] of pills. The pharmacist had left for the high life in Johannesburg and when the time came to do the stock take, it was left to a mixture of doctors, physiotherapists, untrained volunteers and random people who happened to be passing at the time. Many days went past and many pills were counted and all the counts were written on pieces of paper.



The next week, a young pharmacy volunteer and physiotherapist-turned-stock-taker spent two entire days inputting the hundreds of items on the papers into a computer template that was riddled with errors and inconsistencies. They then spent another day checking items in store rooms hidden all over the hospital and recounted the entire contents of four fridges. The two intrepid workers were tired of all the counting, but still they carried on.



On the final day of the stock count, with the deadline rapidly approaching, the physio and the chief medical officer of the hospital sat down and spent one final day checking, re-checking and re-re-checking, sending the young pharmacy girl here, there and everywhere recounting this, that and the next thing, until everything was finished.



And on the next day, they saw that the stock take was finished, and it was good.







Now that you have read the saga, you will understand the dismay that came over myself and Megan [the famous physio/stock taker] when we heard that we would have to transfer all of the data across onto another spreadsheet and how hopeless the task seemed when we saw that there were over 4000 items to search through on the new template. Not to be defeated, we organised a work party for that night.







Sam and I were without power anyway so went up to the Gaunts to cook dinner [or more accurately, Sam cooked dinner]. Megan and I then sat in the Gaunts for three hours straight with our laptops, meticulously transferring across all the stock counts. It was infuriating to discover that this new template was missing half the items from it and when it got to 11pm and we weren't even half way through and over 50 items didn't appear on the list, we gave up, resolving to contact the depot and inform them that they were being just a little unreasonable.







The next day saw a continuation of the saga, but it all gets a bit long and complicated so to cut a long story short, in the end Karl Le Roux used his magic powers and talked some sense into the depot and Megan and I were spared many more hours of stock taking. Fingers crossed we won't have to do that again! We had ARV clinic as usual, fun fun fun. The power cut was ongoing, and the generator had run out so I couldn't power the computer to dispense all the ARVs. This was just a tad depressing given that there were ninety patients to write all the labels for by hand and knowing all the time that at the end of the day I would have ninety files waiting for me to enter into the computer system when the power returned.







After work, I was given dinner by the legendary Lisa and Liz [again?! I hear you say] then we had cell group, then I collapsed into bed, for the next day was going to be a hard one since all the other pharmacy staff were going on a course in Mthatha.







Thursday morning I woke up knowing that I had to run the pharmacy and the ARV clinic dispensary by myself so I was a bit stressed from the word go. I went up to the clinic and carted 5 boxes of ARVs back into the pharmacy and then set up a trolley of ARVs and the computer so I could do both from the main dispensary window. Luckily, I had assistance from Nocawe (yes, that's not how you spell her name but I don't know!) who, like me, has no training for this job so together we were perfectly prepared to cope with the endless stream of patients.







It was hard without Thabo and Zandile there to answer my endless questions of where all the different drugs were [even harder when all the prescriptions were done under trade names] so I spent most of the day with my head in the South African Medicines Formulary checking what on earth Akineton, Drilix, Scopex, Myogel etc. etc. etc. were. We have run out of so many medicines that it is ridiculous: paracetamol, certain TB meds, erythromycin, flucloxacillin, pyridoxine, thiamine, lots of IV antibiotics, all the ear/eye/nose drops, gauze, steroid cream, iodine solution...you name it, it's out of stock. Even the ones that aren't out of stock are only available in massive 1000 tablet containers so need to be prepacked. To give you an idea of the scale of pill counting that the two of us did, we went through six containers of 1000 co-trimoxazole tablets alone in that one day!







After around 11am, the ARV patients started arriving so they were added to the mix. Then we started getting my usual Thursday dose of patients who defaulted from the outreach clinics and now need to be sorted out, fun fun fun. Then the ward staff started coming with the prescriptions for inpatients and I had to navigate my way around the injections and getting confused with names like 'benzathine benzylpenicillin' and 'benzamethylphenylhydrazine dibenzylimadethisupvcloxacillin'. Then patients started coming with prescriptions for the restricted drugs and I couldn't find the key for the cabinet, so by this point I kind of wanted to curl up in a ball and pretend none of this was actually happening.







But we carried on, working over lunch, seeing patient after patient and watching as the line got longer and longer. The doctors all finished up at the clinic and came to assist us and at one point there was myself, Nocawe, Karl, Liz, Jo, Joff [all doctors], Asanda and Athini [ARV counsellors] all working from the dispensary window which is little over 2m wide! It was completely crazy but somehow through the madness, everyone was seen at five thirty we said goodbye to the last person and I finally sat down after ten hours on my feet. It was the hardest day of work yet by a mile.







But all was not done! Lurking under the counter was my lovely pile of ARV files that needed to be back captured onto the system! Luckily, there is a person in this world called Liz who carried the massive box to her house [all by herself] and offered to help me with it. Lisa was making muffins with Emma and Sally and I decided enough was enough, I was done with Lent and had a muffin [GOOD TIMES] then Sally brought Tobelerone for Sammy and I to break Lent in style with [also GOOD TIMES]. The people here look after us so well, I am eternally grateful to all of them :)







We watched some Friends [the Gladys is gonna get you episode, remember that Gregor?!] then Liz made a chicken pie and Lisa and I made up a song about the chicken pie which annoyed Liz, so she put on the Lifehouse CD track 2 at maximum volume to annoy Lisa, it's good that everyone gets along so well … ;) After dinner, Liz and I sat up [with the help of some coffee] until 11.30pm inputting all the data onto the computer system which was a total mission but we survived [despite high levels of abuse..I'm joking]. And then the day of work was over!





Quite epic I think you'll agree!

xxxxxx