Why do we continue to use nurses in pharmacy wellness programs? wonders Karalyn Huxhagen
One of the buzz words in health currently is wellness. We see GPs being tasked with considering a wellness initiative payment program that incentivises the GP and the practice to keep patients well and out of hospital.
Many pharmacy banner groups have utilised the wellness mantra in their professional programs and their in store promotions. What started as the ‘in-pharmacy baby nurse’ has expanded to immunisation clinics, wound care clinics, sleep clinics and many many more.
As a practicing community pharmacist manager I looked very hard at the economics and rationale of employing a nurse practitioner to perform these ‘in pharmacy’ clinics and did the maths.
There were many reasons why it was a very good idea in the years where pharmacists were in short supply and the going rate for a pharmacist locum exceeded what the wellness program would potentially generate.
But then I listened very intently to the pharmacists in our practice and I thought very hard about how the consumer felt about this process. The pharmacists were hungry to take on expanded roles outside of the role of dispensing and dispensary management and consumers were only comfortable in accepting these expanded services from the pharmacy team members that they knew and trusted.
The recent Consumer Health Forum survey titled ‘Consumer voices on expanding the roles of pharmacists into primary care services’ reflects what I discovered when considering the consumers comments within my own environment.
- Survey respondents were very supportive of the position that pharmacists could have a larger role in the provision of primary health services.
- Survey respondents indicated that they would be more inclined to use primary care services if they were offered by their local pharmacist.
The services identified by consumers that they would be likely to access in a pharmacy setting were:
- blood pressure checks;
- weight management;
- diabetes management;
- addiction support; and
- mental health support.
The respondents to the survey did place caveats on their comments and the most noted of these were:
- That the consumer’s GP is informed and is part of the process.
- That the pharmacist and pharmacy staff have undergone appropriate training to be able to provide a quality service in a safe environment.
- That confidentiality and privacy is maintained in the pharmacy environment.
Since the Third Community Agreement pharmacy has moved to address these issues and programs such as QCPP has raised the standards in pharmacy practice.
Pharmacists themselves have adopted these services and undergone expanded training programs in such areas as:
- wound care;
- sleep services;
- pain clinics;
- mental health first aid;
- immunisation; and
- travel health.
Many of the finalists in the QCPP Pharmacy of the Year program have highlighted just how innovative pharmacists can be in delivering primary health programs within community pharmacy.
One of the issues that I personally have with the current structure of many of the programs supported by the banner groups is the provision of nurse practitioners who deliver the programs within the pharmacy.
My major issues with this process are:
- The consumers have no rapport with the nurse who is in the pharmacy for the day and is not a regular member of the pharmacy team.
- The nurse does not have prior knowledge of the pharmacy and the services that are available and thus is limited in providing a comprehensive program to the consumer.
- The skills that the nurse is offering are skills that a pharmacist is capable of delivering with the appropriate training and competency development.
When arguing the case with wellness program directors I have been informed that they use nurses as they provide a holistic approach to the consumer.
I have been appalled that these program managers consider pharmacists are not holistic. I am even more appalled that the program managers consider that the pharmacist’s role is just to discuss medication issues.
The depth of knowledge of a pharmacist is limited only by their own initiatives to expand their competencies and skills. To bring in a nurse to fulfil a role that a pharmacist and their support staff could easily provide makes me angry.
The Pharmaceutical Society of Australia’s Health Destination project has clearly shown how effective a pharmacy team lead by a skilled and innovative pharmacist can be. The holistic approach to consumer wellness is a given in practicing as a pharmacist.
The banner group’s current approach to wellness program delivery needs a wakeup call. The wellness program directors need to carefully investigate programs such as the Health Destination Project and the current pharmacy graduate programs.
We do need support but it is not in the form of a nurse for the day!