GLIMPSES FROM FORUM Health Year 1979 Cape Town

Health Year 1979

The following report was written by the Chairman of the Cape Branch, Mr David Cunningham, and published in the April 1980 issue of FORUM

 

1979 – HEALTH YEAR

 

The Cape Town City Council sponsored the largest Health Exhibition ever seen in the Republic in the prestigious new Civic Centre- large exhibition hall – from November 29^th to December 1^st. Ten major health themes, including sport, recreation, the family, emergency, environment, curative care, welfare services and auxillary health services were expressed in the 100 exhibition stalls.

Mr DA Goldberg was the SAAHIP representative on the Regional committee for Health Year. At a regional health year committee meeting the Chairman mentioned his disappointment that Pharmacy was not represented. Mr Goldberg advised the committee that SAAHIP would undertake to have pharmacy represented. He thereupon 'phoned the President of the PSSA, Mr Arenson, and told him of the decision taken by the committee. Mr Goldberg then chaired a new committee to organise an exhibition stall. This committee included Mr W Arenson, Mr DC Cunningham, Mr G Ferguson, Mr DA Goldberg, Mr M Lazarow, Mr I Maron amd Mr R Baynes.

The pharmacy stall took the shape of an equilateral triangle, which in turn fomed the sixth part of a regular hexagon. On exhibition were some excellent specimens of Digitalis purpura, Vinca, and Rauwolfia, artistically labelled and arranged by Mrs G Scott, lecturer in Pharmacognosy at the Cape Technikon. Mr W Buchhorn of the Zeiss West Germany Optical Instruments Co, kindly lent us four modern instruments used in quality control laboratories for display. Many thanks go to Messrs Ciba-Geigy, Heynes Mathew, Warner–Parke Davis, and Reckitt and Colman for their assistance with expensive audio-visual equipment, slides and tape recordings.

Pharmacy students (especially final year students) were very helpful in staffing the pharmacy exhibition stall; the organising committee members, assisted by many SAAHIP members, Mr J Job and others, gave generously of their time and material for making the pharmacy stall a success at an outstanding Health Year Exhibition.

 

D G CUNNINGHAM

 

GLIMPSES FROM FORUM - Mr Peter Hearn - Whither Pharmacy 1979

This article was published in Forum in February 1979

Peter Hearn  was chairman of the Natal Inland Branch of SAAHIP in 1981 and served as President of SAAHIP  for three years from 1982. He was Chief Pharmacist at Edendale Hospital for a number of years before he was transferred to  the State Health Department, Pretoria, as Deputy Director. When Pierre Retief retired as Director, Mr Hearn was promoted to Director in July 1989. Mr Hearn resides in Pietermaritzburg and he celebrated his 90th birthday in February, 2022.

Whither Pharmacy?

Quote, "Pharmacists are not considered to be the experts on medicines, and certainly not on dosage." If we are prepared to take an unemotional, unbiased and honest look at this statement, then for many of us we may well find some justification for it. Perhaps to our "new generation" pharmacists it is to a large degree unfair and untrue, but to my generation and those older than I, it surely applies to a greater or lesser degree. What then can be done to change the situation? In our opinion a great deal, but it requires motivation, enthusiasm and hard work, - sustained hard work! As one can usually speak best from one's own experience, I ask your indulgence as I try to tell you about some of the things we have done at Edendale Hospital.

 Pharmacy, like medicine and all other professions is a very broad, complex and highly technical subject. Nobody can be expected to remember all the complexities of the various medicines, e.g., dosage, biological half-life, interactions, etc. However, we keep ourselves well informed. So, a good set of reference books becomes important. Amongst those that we have are:

            Pharmacological Basis for Therapeutics: Goodman and Gilman

A review of Medical Pharmacology: Mayers, Jawetz and Goldfin

27^th Edition of Martindale

25^th Edition of Dorland's Illustrated Medical Dictionary

The usual official books

 There are others, but we feel those mentioned are essential. To help keep ourselves right up to date, we receive the following monthly publications:

            American Journal of Hospital Pharmacy

Drug Intelligence & Clinical Pharmacy

Medicine Digest

Prescribers Journal

Drug and Therapeutics Bulletin

South African Journal of Hospital Pharmacy

British Pharmaceutical Journal

South African Pharmaceutical Journal

 Once you have come to terms with much of the technical and medical jargon, the reading of these journals becomes a much looked forward to pleasure, by both young and old pharmacists alike. You almost have to queue up to get your turn at Edendale! We also have built up a reasonably comprehensive range of literature on specific pharmaceutical products put out by the various firms.

 This is fine, but where to from here? What do we do with all this information? It serves no useful purpose to have something to offer if there is no one to offer it to! How can we hope to be considered a member of the "health team", and the fountain of all knowledge if we neither see nor communicate with the other members? How often are pharmacists as a group, considered to be pedantic obstructionists, locked in their little ivory towers, with a "NO ENTRY" sign hanging on the door!! Just as we dared to open that pharmacy door and move out to spread our influence within the hospital, matrons, sisters and staff nurses, are encouraged to visit the pharmacy at any time, to discuss problems, drugs, drug therapy, to seek information or advice, no matter how trivial or important it may be.

 Eight months ago, we established what we call "The Clinical Committee", made up by the Medical Superintendent as chairman, the heads of all medical departments and the chief pharmacist. Its function is to discuss drugs and drug usage and abuse and to formulate drug policy within the hospital. The chief pharmacist is the convenor and scribe and ensures that the minutes are distributed, and notice of meetings are sent out timeously. He also draws up the agenda. Initially the committee met monthly, but such tremendous progress has been made, that two-monthly meetings are now held. The ultimate aim is for a quarterly meeting. A special 6 monthly meeting is held to review and discuss the use and/or abuse of antibiotics only. We also put out a quarterly Drug Information Bulletin edited by one of the younger pharmacists. This has been particularly well received. Some other areas of involvement include the compiling of our own catalogue of pharmaceutical products, which could possibly form the nucleus of a catalogue for the KwaZulu Department of Health, The Community Health Scheme, which includes the peripheral clinic complex, and vaccination programmes. When a sepsis problem developed in our burns unit, the Department of Surgery, who controls it, solicited the help and co-operation of the pharmacy, to solve the problem. At the moment the Pharmacy Department is conducting a survey of disinfectants, their use and/or abuse, throughout the hospital. This survey will include an assessment of fumigation methods in the hospital.  The resultant report will be tabled at the next meeting of the Clinical Committee. Due to the fact that we have only 6 (yes SIX) pharmacists in the 1640 bed hospital, our ward activity is limited to the 5 intensive care wards, and the operating theatre. Other wards are visited whenever possible.

What have we achieved by all this? We certainly have grown, not only as people and especially as pharmacists, but also in confidence in ourselves and our abilities. We have received praise for our successes (and who does not enjoy that!), sympathy in our failures, and most important, encouragement to go on. A very satisfactory, happy and functional working relationship with our medical and nursing colleagues has developed. We have established a situation of mutual acceptance, understanding and respect. Probably because we do not believe that it is our brief to dictate to our doctor colleagues what they may or may not prescribe, but rather to identify their needs (and it obviously follows from this, the needs of the patients – who are our prime concern), relate to these needs, and to make suggestions and offer all the assistance and information possible to help meet these needs. I quote a remark made by a specialist after a Clinical Committee meeting: "Why did we not do this sooner?"

We have made such tremendous progress and now that we are talking to each other, we are learning to understand each other and are learning so much from each other. "Communication and involvement, and all that these imply, this surely is the name of the game?" Don’t be misled into thinking that everything is a bed of roses. We still have our problems and frustrations, but we like to think that we have established a platform where they can be amicably, reasonably and professionally discussed and satisfactorily worked out.

We may not yet be considered the experts, but we do notice more of our colleagues are seeking us out, not only for information and advice, but also sometimes just for a few friendly words, or a favour. Surely this is as it should be? We like to think that that we have come a long way; we know that we still have a long way to go, but we feel that we can go on, confident that we can come to terms with whatever challenges the future may possibly hold.

And what does the future hold?  Surely this depends a great deal on ourselves, our efforts, attitudes and level of motivation. But we like to think that the future is good, and we remain optimistic.

John Ruskin said: "The highest reward for a man's toil is not what he gets for it, but what he becomes by it." There is a message here for us perhaps??

 PETER HEARN

 February 1979

GLIMPSES FROM FORUM - Pharmacists Involved in Doctors' Ward Rounds 1978

This article was published in the November 1978 issue of FORUM. It was written  by Cyndy McKeown, senior pharmacist at a provincial hospital in Durban.

 

PHARMACISTS INVOLVED IN DOCTORS' WARD ROUNDS

 

Pharmacists and trainee pharmacists at this provincial hospital are in the fortunate           position of having received an invitation to accompany doctors on their ward rounds.  As a result, we are included in neurosurgery, cardio-thoracic and plastic surgery ward consultations.

 

Twice a week, we attend the neurosurgery rounds, which involves, on the one occasion, a complete assessment of alI the cases in both the ward and the intensive care unit attached to the neurosurgery ward, while on the second occasion we are involved in a teaching round. These ward round s are conducted by a consultant neurosurgeon, and are attended by other   consultants, registrars and an anaesthetist.  Those of  us attending these ward rounds feel that we have  earnt a great deal, as we are not only involved and included in the discussions around each bedside and have learnt to recognise various diagnostic neurological features and symptoms, but a tremendous bond of respect has sprung up between the neurosurgeons  and ourselves. The surgeons and registrars are now far more approachable and don't hesitate to raise any  query which they think we might be able to solve.

 

We have become so much part of the medical team on these neurosurgery rounds that we have been taken to see various operations, following discussion on the ward round, and when emergencies arise with a patient having a C.T. brain scan, we are automatically included in the team which rushes  to the scan area to assess the patient. Plans for the future involve the inclusion of one pharmacist on one of the surgical teams for a   month at a time.   During this period, the pharmacist will be instructed on taking case sheets of patients on admission and will be consulted on medication for the patient.

 Our inclusion once a week in the cardio-thoracic ward round has resulted in us gaining a far greater understanding of and ability to interpret X-Ray films. It is amazing how clear terms such as "open  drainage"     and "closed drainage" of empyemas become, once you have actually seen them being carried out. We have even been able to hear through a stethoscope the 11whooshing' of blood through a gash in the septum of the heart, caused by a knife thrust. At the same time, we have been consulted on drugs for anaerobic and fungal infections, as well   as the treatment of tuberculosis.

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The plastic surgery ward rounds, which take place twice a week, have proved especially interesting and stimulating, as we have not only gained an insight into the drugs used in this specialised field of surgery but have been  able to apply our knowledge of antiseptics and disinfectants to control sepsis in the ward. The cases in this ward include leg ulcers, malignant ulcers involving ·both bone and skin grafts, bust reductions and increases, cl eft lip and palate and burn cases. Thus, a very broad knowledge of all aspects of wound treatment and dressings is gained by alI who have participated in these ward rounds.

Being involved in these ward rounds has meant that we have had to brush up on or knowledge of pharmacology, but at the same time we are able to benefit from the practical experience of seeing a patient respond to therapy or conversely experience a drug reaction – there is nothing like actually seeing the skin rash caused by phenytoin in an epileptic child, for that particular side effect to remain in your mind. It is amazing how readily we have been accepted into these ward rounds by all the doctors involved. Although this is only scratching the surface at the moment, I feel that this is a positive step towards achieving some degree of clinical pharmacy in our hospital and something on which we can build for the future.

           Cyndy McKeown

           November 1978