Consultant Pharmacist, Critical Care
My interest in Critical Care began originally as a Pre-registration Pharmacist when I was fortunate to have rotations on both the Intensive Care Unit and the Liver Intensive Care Unit at King’s College Hospital. I found critical care to be an extremely inclusive environment where everybody’s opinions were valued and participation in ward rounds to aid the decision making process was actively encouraged. The dependency of this patient group means that all opinions matter.
I completed a Diploma in Pharmacy Practice in 2004 and then secured a post as Specialist Pharmacist in Critical Care at West Suffolk Hospitals NHS Trust. In 2007 I put myself forward for a peer assessment organised by UKCPA. Following feedback from this assessment I undertook two masters level modules in critical care pharmacy and then went on to complete the MSc.
I am also an Independent Prescriber and have used this qualification routinely in critical care. Given the high requirement for therapeutic drug monitoring in this patient group, the ability to prescribe is becoming essential and ubiquitous amongst critical care pharmacists. This privilege, however, should never be used in the avoidance of teaching opportunities or correcting errors.
I think there are several. The first was the strong focus provided by the UKCPA Critical Care Group. The opportunity to participate in some of the initial work around credentialing certainly helped me focus on clinical development and progressing my career in this aspect. Opportunities to present at regional Critical Care meetings, national and international conferences were also invaluable in ensuring I was able to build the necessary rigour into my day to day practice.
Since qualifying as a pharmacist, I worked exclusively in secondary care in District General Hospitals. Whilst this was useful in making close bonds within the multi professional arena, I struggled to find appropriate opportunities of management and leadership. When I took up the post as Deputy Chief Pharmacist, I retained the role of lead pharmacist for Critical Care Services so I knew that I would have the flexibility to move in either direction (either back to clinical or to continue with management) as my career evolved.
I don’t think so. Although the opportunities to gather evidence of practice at a higher level were plentiful in my critical care role within the DGH setting, there were few opportunities to develop practice across the healthcare system. As a Deputy Chief Pharmacist opportunities for strategic development came through involvement within the Trust EPR implementation and subsequent development, and also through opportunities within the UKCPA General Committee and associated strategic developments.
I have recently collaborated on two studies (PROTECTED-UK and SUP-ICU) where I have been lead investigator at my base hospital. I have also been a key member as subject matter expert in several significant projects within critical care, and I have routinely produced, implemented and reviewed clinical guidelines for use of medicines within this area. But there is still room for improvement, and I hope to build further on this within my Consultant Pharmacist post.
In terms of education and training, I have tutored pre-registration pharmacists and pharmacists undergoing Diploma studies. I have also been involved in the UKCPA Critical Care Group committee for several years which organises regular masterclasses for practitioners starting out in critical care and at advanced level. In my previous role I also personally trained the pharmacists on a Band 7 rotation to ensure the maintenance of a high level of service to critical care. But I would like to develop this area further, which is why I have undertaken a greater responsibility for delivery of education and training within the UKCPA General Committee.
I still find working in the critical care environment to be the most rewarding of all of my professional activities and seeing a patient’s journey from being critically ill to recovery, or to ensure that patients go through their last days with dignity, is one of the greatest privileges. I am still driven by the need to challenge myself and learn new skills, and I still have much to learn. As we all know, healthcare is continually evolving and I am very much looking forward to playing a more strategic role in these developments both locally and more widely.