‘We often get reports of interns rifling around the RUM bin.’


person picking out a bottle of pills

Fraudulent activity, drug use and supply, prior criminal history and dispensing errors are tripping up pharmacy students, interns and ECPs

Despite not being fully qualified pharmacists, several students and interns have had conditions placed on their registration in the past year as a consequence of their actions, PDL Professional Officer Georgina Woods told NAPSA Congress delegates on Wednesday.

Ms Woods, a registered pharmacist for over 20 years, said PDL is seeing more intern reports.

“We encourage you to report any incident to us whether you are a student, intern or fully qualified pharmacist because that means we can assist you if things do escalate,” she said.

However, more recently PDL has seen interns being reported to Ahpra for a variety of reasons.

“Sometimes this might be together with the pharmacist in charge or as a standalone situation,” said Ms Woods, reminding pharmacy students that even they received an Ahpra number upon enrolment into their university degree.

“As soon as you are a pharmacy student, you can be called upon by the pharmacy regulators or they can restrict you or take action against you in some way from day one of your university career,” she said.

During 2020, PDL was notified of several cases involving students and interns that related to fraudulent activity, drug use and supply, prior criminal history and dispensing errors.

“Despite not even being a fully qualified pharmacist, some students and interns had conditions placed on their registration which results in very difficult, very stressful situations,” said Ms Woods.

“I want to remind you again that as soon as you are at uni, you need to protect that Ahpra number.

“There’s no penalty for reporting to PDL, so you should do so as soon as you think there is an incident – even if you think it’s resolved.”

Here were some case studies shared by Ms Woods:

Forgery

Two interns forged their employer’s signature on documentation pertaining to supervised hours. They had actually done the hours but couldn’t get their employer to sign off on it.

Ahpra was notified in both cases. PDL provided some support but because the interns had done something illegal they weren’t able to access legal assistance (see note below).

Both were suspended immediately and were unable to register despite having completed their hours.

“They were both clever, really intelligent people, but had made a bad decision,” said Ms Woods.

Note from PDL: Fraudulent or criminal activity and wilful breaches of legislation are typically excluded from policy cover, subject to the underwriters’ conditions. PDL does not make this decision. In these cases, the Professional Officers are able to provide peer support and we always suggest that a member engage private legal assistance. This can cost thousands of dollars, then often members are left to “go it alone” when dealing with regulators, which is extremely stressful.

Falsifying documentation

A remote area ECP enrolled in interstate education event but did not attend the event. They then falsified an attendance certificate and claimed reimbursement.

“It was deliberate, intentional forgery,” said Ms Woods.

PPA audited the claim and demanded repayment of funds, and Ahpra was notified.

While the pharmacist did not get suspended, she did have to respond to Ahpra without legal assistance.

However PDL’s Professional Officers assisted her. “I understand she is back to full practise without any conditions, so that was a very fortunate outcome for her,” said Ms Woods.

Prior criminal history

Activities prior to becoming a pharmacy student can impact your university and work career, said Ms Woods.

In 2020 PDL received several reports from university students who had Ahpra notifications relating to situations that occurred prior to enrolment. There are some things students have to notify Ahpra about – the main one is if you have been charged with an offence that is punishable by 12 months imprisonment or more; if you have been convicted of or are the subject of a finding of guilt for an offence punishable by imprisonment, or anything that happened in another country to your registration.

One example was a young person caught with a substantial amount of MDMA at a music festival. They were arrested and charged. While they weren’t a pharmacy student at that time, they subsequently enrolled in a pharmacy course while still completing their corrective order. When they applied for a hospital pharmacy placement and had to declare the previous conviction, the pharmacy student had to alert Ahpra about their criminal history. She was shunted out of university, as the institution said she was no longer unable to continue with her studies with them.

Drug use and supply

In a separate case, an ECP was caught at a music festival with MDMA, arrested and charged. The Pharmacy Council of NSW suspended him as a pharmacist.

“I spoke to this member several times, he’s a lovely person, very intelligent but made a very poor decision at that time,” explained Ms Woods.

“The fallout was really massive for him, it was very stressful.”

The ECP wanted to stay working in pharmacy so he looked at working as a technician, however the Council disallowed him from doing that or working in pharmacy in any role.

“Fortunately he has undergone mentoring and is now able to practice but under very strict conditions,” she said.

Ms Woods shared the further case of the “curious intern”.

The intern took half a 2mg Suboxone film which was retained after a patient requested a reduced dose. The preceptor found out and contacted the Department of Health, then had to notify Ahpra.

“Please don’t experiment at work, we often get reports of interns rifling around the RUM bin,” she said.

“It’s very serious. The regulators will come down on you heavily if there’s any sort of drug diversion going on. So for this intern it really wasn’t a great start to their career.”

Pharmacist Toni Riley, Project Manager for the Return of Unwanted Medicines (RUM) project, told AJP that in April last year, a new one-way entry RUM bin was introduced, reducing the possibility of inappropriate access to contents by staff.

“This type of inappropriate access was exactly the reason for investing a lot of time and money in designing the new RUM bin to ensure that once a medicine is put into the RUM bin it cannot be removed,” she said.

Social media

Ms Woods described the scenario of a group of interns that had shared examination details in a WhatsApp group.

Every single member of that group had their exam results withheld even though some had already completed their exam and some hadn’t.

“This resulted in an enormous amount of stress for the graduates,” she said.

“Please don’t use social media for messaging things. We have the PSA ECP group which is fantastic but be really careful with other things. If you are talking about anything please don’t use or imply an names, even implying can land you into trouble.

“Every business should have a social media policy so please be mindful and look at that when you can.”

Clinical actions

It’s not just about drug use, said Ms Woods, There are clinical actions that can lead an intern before the regulators as well.

In one example, an intern was involved in a DAA packing error. Even though it was checked by a pharmacist (incorrectly), both the intern and the pharmacist were brought before Ahpra to explain.

“Clearly they’re looking closely at you when you’re an intern, even though your work is supervised,” she said.

In another example, an intern was asked for chloramphenicol eye drops, the request was deemed appropriate but the intern accidentally provided latanoprost eye drops.

The patient went to doctor after the condition didn’t clear up and the error was picked up. The patient accepted the apology of the preceptor.

“Thankfully this wasn’t escalated but it could easily have been,” said Ms Woods.

Her five tips for avoiding errors were as follows:

  • Watch mg and mL (for example with prednisolone, methadone)
  • Be careful of decimal points
  • Positively identify patients when handing out medications
  • Check expiry – every time
  • Familiarise yourself with legislation and guidelines

PDL is available on 1300 854 838 Australia wide 24/7 for confidential advice and support.

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