DIE ALGEMENE JAARVERGADERING - OVS / NOORDKAAP TAK 1981

 

DIE ALGEMENE JAARVERGADERING - OVS / NOORDKAAP TAK 1981

Die Algemene Jaarvergadering en Bestuursverkiesing van bogenoemde Tak is gehou op 21st Augustus 1981.

Die vorige Bestuur het dit goed gedink om Dr A Aucamp van die Departement Farmakologie, U.O.V.S, 'n kenner op die gebied van epilepsie, te nader om by die geleentheid as gasspreker op te tree oor die onderwerp: "Sosiale aanpassing van die epileptikus". Dr Aukamp het sy toeligting afgesluit met die vertoning van 'n film genaamd: "I am the same as everybody else". Die besluit van die Bestuur om 'n gasspreker oor 'n aktuele onderwerp uit te nooi, het weereens baie groot byval gevind by lede teenwoordig, sodanig dat hierdie praktyk voortgesit sal word op komende ledevergaderings.

Die Voorsitter, Mnr W Marais, het in sy jaarverslag gewys op die goeie ondersteuning en samewerking verkry van lede die afgelope jaar.  Dit het daartoe gelei dat 'n verdere twee sprekers, nl. mnr E Prinsloo (Hoof Farmaseutiese Dienste, OVS) oor die onderwerp: "Apteekwese Oorseen” en Dr O de Bruin, oor die onderwerp: "Sepsisbeheer in Hospitale", na die ledevergaderings genooi kon word. Die Voorsitter het ook kortliks gewys op die welslae behaal met die opstel van die pligte en leerplanne van Farmaseutiese Tegnici, asook die vordering gemaak met die beoogde verbetering van salarisse en diensvoor waardes vir Hospitaal Aptekers.

Die nuwe Bestuurslede is:

Voorsitter:

Mnr W Marais (Hoofapteker)

 P/a Apteek                                                                                                   

Pelonomi Hospitaal, Bloemfontein

                 

Onder-VoorsItter:

Mnr E Prinsloo (Hoof-Farmaseutiese Dienste, OVS)

 p/a Afdeling Hospitaaldienste

HF Verwoerdgebou. Bloemfontein

 

Sekretaris:

Mnr JS du Toit (Apteker) p/a Apteek,

Oranje Hospitaal Privaatsak X20607 Bloemfontein

Tesourier:

Mnr M Fourie (Apteker) p/a Apteek

Universitas Hospitaal Bloemfontein

 

Addisionele Lid:

Mnr F Van Zyl (Apteker

p/a 3 Militere Hospitaal

Tempe. Bloemfontein

 

Asook Verteenwordigers te

Kimberley                                Mnr C Hobbs

Bethlehem                              Mev N Smuts

Kroonstad:                               Mev C Collinson

Welkom                                    Mnr L Dafel

 

J S DU TOIT           

  

VOORSITTER SE VERSLAG OVS / NOORDKAAP TAK

As voorsitter van die OFS/Noordkaap Tak van die Suid Afrikaanse Vereniging van Hospitaal- en Inrigtingsaptekers is dit my voorreg om aan u verslag te doen oor die werksaamhede van u vereniging die afgelope jaar.

 Op die derde algemene  jaarvergadering, gehou op 22 Augustus  1980 is die volgende persone gekies tot die bestuur van die tak:

 Voorsitter                                :                W F Marais

Onder-Voorsitter :                ;                E C Prinsloo

Sekretaris                                 ;                J S du Toit

Tesouriere                               :                E E Pienaar (Mej)

Addisionele Lid                       :                C J Vosloo

 

Streeksverteenwoordigers:

Kimberley                                :                C Hobbes

Bethlehem                              :                N Smuts (Mev)

Kroonstad                                :                N Oosthuizen

Welkom                                    :                L Dafel

Aan my mede-bestuurslede wil ek vanaand dankie sê vir die positiewe, ordentlike en openhartige wyse waarop hulle u belange op die hart gedra het, asook die taktvolle - ek kan dit nie anders beskryf nie - wyse waarop hulle dikwels met my verskil het, telkens tot voordeel van die tak as geheel. Mense, dit is die demokratiese wyse om 'n ding te doen en ek waardeer dit.

Iets wat ek nie kan nalaat op hierdie stadium nie, is om te noem die besondere steun wat ek van ons Sekretaris, Jan du Toit gekry het nie. Ek het al dikwels gesê, en ek sê dit weer, dat 'n goeie sekretaris vir 'n vereniging goud werd is en dat so 'n persoon dikwels die enkele spil is waarop die vereniging se doeltreffendheid en beeld draai. Ons tak was vanjaar bevoorreg om so 'n sekretaris te hê en ek sê vir jou dankie daarvoor, Jan.

Vergaderingsaktiwiteite:

Vanjaar is daar, benewens die derde algemene jaarvergadering, slegs twee ledevergaderings gehou, wat suiwer "sakevergaderings" was. Die eerste daarvan het Mnr Prinsloo ons 'n verassende nuwe insig gegee in die besondere en tog soortgelyke probleme wat ons kollegas in sekere van ons Europese stamlande ondervind, asook die wyse waarop hulle te werk gaan om die probleme op te los. Ons het gevind dat ons baie van die foute wat hulle gemaak het, kan vermy. Hierdie situasie is dan ook in gedagte gehou met die aanbevelings t.o.v. die pligte en leerplanne van die Farmaseutiese Tegnici wat in beginsel deur die Aptekersraad aanvaar is.

 Dr 0 de Bruin het weer 'n goed-toegeligte lesing gegee oor 'n aktuele onderwerp, nl. sepsisbeheer in 'n hospital. Dit is 'n aspek waarby aptekers direk by betrokke is, maar soms nie in daardie lig sien nie.

Die teoretiese en ook praktiese aanslag van die lesing het baie bygedra om aktiewe deelname van die vergadering te bewerkstellig en ook hier is blywende resultate verkry.

Op hierdie wyse is u Vereeniging besig om op vele terreine te help om ‘n breere uitkyk oor die professie te bewerkstellig as bloot die lees van voorskrifte en hanteering van geneesmiddels.

Miskien is dit verblydend om op te let dat slegs  een “besigsheidvergadering” hierdie jaar uitgestel is, veral as die onderwerp ”Die Apteker en die Hospitaaladministrasie'', ‘n onderwerp wat ook voorregte van die Apteker insluit - sake soos diensvoorwaardes ens., is.  Miskien is die Apteker se diensmotief so groot, dat persoonlike voorregte ‘n ondergeskikte plek beklee. Op daardie dag a1leen kon nie 'n ordentlike vergadering byeengeroep word nie.

In 'n meer ernstige luim wil ek al die lede wat soveel jare al die ledevergaderings ondersteun, bedank vir al die wyse waarop hulle saamgesels en saamdoen. Dit was weereens hierdie jaar aangeneem om saam te keer op hierdie vlak.

Once again I would like to single out two persons for a personal word of thanks and appreciation for the enthusiasm shown by Jack Hobbes and his wife Beverley. As far as I can remember they have not missed more than three or perhaps four of our meetings in the two and a half years that Jack has been a member, despite the fact that the drive all the way from Kimberley to do so. Jack, I think this is tremendous.

Thank you.

 Committee Meetings

These have been well attended as well and quite a lot of important contact has been made through the National Executive on a national level by your Branch Committee. In this regard I might only mention a few matters like curriculae for trainees, Pharmaceutical Technicians and even Pharmacy Students.

Pleas for salary increases and better conditions of service have even been sent directly to the Prime Minister, Minister of Health and the Commission for Administration. These letters and the answers thereto will be continued to be published in Forum, and the encouraging answers are truly gratifying, more so when results are achieved like the full parity between salaries of Coloured, Indian and White Pharmacists, with a narrowing of the gap for Black Pharmacists with the promise of full parity in the very near future.

I might also announce that the pleas for a substantial increase in salaries for Pharmacists commencing their careers is being brought to Parliament this session by the Commission for Administration, and that the figure is substantially higher than the minimum suggested by your Association, although still slightly under the highest starting salary suggested by us.

In all these matters I must mention the support the Pharmaceutical Society of South Africa has given us as an affiliated Association to them. Together we have quite a strong voice.

SAAHIP have recently decided to turn part of its attention to· the Pharmacist who has stuck with this sector of the profession for a considerable number of years despite the often demoralising circumstances and in so doing have steadfastly resisted the temptation for better remuneration so often dangled before their noses. Such dedication should also not go unseen and pleas for better promotional opportunities, service conditions and pensions are also now receiving your National Executive's attention. Quite a bit of effort is already being put into this.

On the organizational level I might remind members to send their cqmments regarding the national referendum regarding the organisation and financing of the National Executive, before the 31st August 1981, but also announce that an already overwhelming vote not to accept the proposals as is, has been accepted. Some excellent adjustments to the proposals have been received and are being studied already. We would like to have your thoughts on this matter, since a new proposal is likely soon.

On the branch level I also would like to announce that your Branch Exco have decided to combine business meetings in the future. with social matters and this should comprise five to six meetings per year and be meetings with a better mix of the social, educational and promotional duties of  your Association. With interns to explore this for a year, with your permission.

Laastens will ek die firma Ciba-Geigy en ook Mnre Roy Carmichael. Roy Pienaar,  en Noel Engelbrecht spesifiek dankie sê dat hulle al die afgelope drie jaar al hierdie tak se jaarvergarderings borg. Hulle gesindheid, die moeite wat hulle doen met die reelings en die korrektheid waarmee alles geskied is vir ons baie werd. Ek wil die menere vra om ons dank ook aan die firma se bestuur oor te dra.

Die bestuur wie u vanaand gaan kies, wil ek alle voorspoed toewens vir 'n suksesvolle jaar. Ek het verlede jaar opgemerk dat die Apteker in die openbare sektor se sake aan die opswaai is, en my voorspelling is bewaarheid. Veral ons lede uit die Spoorweg het alreeds die opswaai agtergekom op tasbare wyse en ek weet dat ons ander lede se dinge ook aan die roer is. Daarom weet ek ook dat dit u steun was wat my en my bestuur hierdie jaar werklik bevoorreg het om namens al ons lede na vore te tree. Ons was verenig. Dis vir my bemoedigend om te weet dat die nuwe bestuur ook hierdie steun kan verwag.

 

W  P MARAIS

 

Glimpses from FORUM - A jaundiced View July 1981

 

A PRESCIENT VIEWPOINT FROM 1981

In the early 1980s an active member of the South African Association of Hospital and Institutional pharmacists submitted several opinion pieces for publication in FORUM, the Association’s official journal. He did so under nom-de-plumes, for good reason. One such article I consider as prescient, and I copy it here for you to decide for yourself. It was published in the July 1981 issue of Forum.

A JAUNDICED VIEW……

More about Cloud Nine and some thoughts about SAAHIP and the PSSA

I must say I enjoy this anonymous column writing! I can let off steam in considerable amounts without a care for the consequences and am saving on my visits to my psychiatrist.

I have been gleefully watching ripples spreading from my outpouring about Cloud Nine. Quite a number of pharmacists seem to think it referred to their hospital. Others are confident that it could not possibly be them. (easy conscience or insufferable complacency?). Tempting though it is to give the pot a few more stirs to see what happens, my better side will not do it, and the Truth must be Told. And the truth is that Cloud Nine Hospital is no single hospital, (though I can think of a few Cloud Sixes or Sevens) but it is a horrible monster, like Frankenstein, made out of bits. In this case, the worst bits from several hospitals, not all from the same town, or for that matter even from the same province! So you can all relax – it wasn’t really directed at YOU, even if you did seem to recognise one or two of the bits! There was one pharmacist who was actually quite indignant about it.  “Quite unfair” she said. Now there’s a paradox for you!

Whatever therapeutic effect I derived from the Cloud Nine affair, it was all dissipated by this business about SAAHIP being taken over by the PSSA. (Well, yes, I know it’s supposed to be only finances, but he who pays the piper ……) And talking of finances, the reason we're in this spot is that of the R25 you pay, the PSSA keeps R10 and gives us R15 to run SAAHIP.  With rising costs this isn't enough. So, what do we do? Why, instead of  asking for a bit more than only 40% of the subscription which we pay to run our Association to look after our interests or even asking for it all, for goodness sake, we go and propose to hand the lot over to the PSSA in return for…… well, in return for agreeing to submit our budget to the PSSA by January 31st, and an agreement that any increase in subscriptions will be discussed with us first! Discussed, not necessarily approved!

I know the third “A" in SAAHIP can be abbreviated to "Ass." but really don't think we should allow ourselves to be taken for a donkey ride like this. After all, we had a choice. We joined SAAHIP and not the PSSA because we knew (or so we thought) how our interests would best be served.

Now I'm not saying that the PSSA is anything but a body of fine and upstanding, honourable men. I know and have dealt with, and greatly admire many members of the PSSA's Executive. We can learn a great deal from them. We should co-operate and liaise with them and do our damndest not to dispute with them.

Our basic interests are similar, but - and here's the rub - not necessarily always identical. At times they might di£fer sharply. And then what? If we need finances to conduct a campaign opposing theirs, will we get it? Can you not think of example after example of how undesirable it might be not to be able to act with total independence?

Already they have differed with us - or at least required a great deal of convincing to the contrary. That time they were convinced. Next time they may not be.

So what shall we do? Close up shop and leave it all in the hands of the PSSA? Should we just leave it, as our Exco with colossal effrontery has dared to put it to us - assuming our consent if we don't write in and put them right? Shouldn't we have a much harder look at it?

'1 leave you with this thought - remember the Chamber Principle? - Where SAAHIP would be the Institutional "Chamber" in a Society which would "speak with one voice"? A Society in which the "Retail Chamber" would be able to outvote all the other Chambers put together?

Good. Now, do you remember why it was all dropped? Not because it was inequitable. Not because SAAHIP wouldn't agree. No. It was, if I am not mistaken, because it would put too much influence in the hands of employee pharmacists at the expense of the owner-interests which dominate the PSSA!

A straw, if ever there was one, in the wind which could sweep away fifteen or more years of steady progress, by SAAHIP, just as it is wielding ever more significant influence -· influence which must remain with us and not with a body who, however honourable and fair, have their own interests and whose knowledge of our problems is often wildly inaccurate.

Incidentally, I can disclose that there is no truth in rumours that at the next general election the Prime Minister will consider the Opposition voted out of office if he doesn1t hear to the contrary by a specified date! Exco - please note!

ICTERIS

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.

1

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