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‘I’ll never forget my first clinical intervention as a provisionally registered pharmacist’


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By Amina Rawat

15 Sep 2020

Amina Rawat shares her experience of joining the register as a provisionally registered pharmacist in the midst of a pandemic

‘Hello, my name is Amina & I’m the Pharmacist.’

This is a phrase I’m inclined to say every day during each patient interaction, yet it still feels surreal to me. I do wonder if it’ll get easier to say as time goes on. Of course, not having sat the pre-registration exam (and not knowing when it will be) still makes it seem a little strange.

I joined the register as a provisional pharmacist on August 1. Working as a hospital foundation pharmacist in the NHS has always been my goal, and my passion for this role only intensified when I did my six-month pre-reg placement in a hospital. What sold the idea of working for the NHS to me was the sense of contribution and having a direct involvement in patient care, while also being involved in the clinical decision-making process.

This is something I’ve already had to do on numerous occasions during my first two weeks as a qualified pharmacist – from withholding Metformin in the patient who was admitted with an acute kidney injury, to requesting plasma digoxin levels in the patient who was admitted with an AF exacerbation with concurrent hyponatremia and raised urea levels. So, you can just imagine my excitement when my goal finally became a reality and I was able to officially work as a hospital pharmacist.

I never anticipated quite how intense the jump would be from pre-reg to actually becoming a pharmacist though – and of course the current Covid-19 climate has only made it harder to adjust.

The small restrictive measures, such as having to constantly wear PPE (especially during the heatwave) and being unable to speak to Covid-19 patients on the wards, greatly affect my ability to complete an accurate meds-rec for these patients. In addition to this, the trust that I work for currently has systems in place that provide electronic prescribing and electronic clinical notes, and I find navigating these systems quite challenging.

Clinical interventions

Week one was induction week where I was able to meet my colleagues and adjust to my new working environment, in addition to having a few accompanied ward visits. This is where I made my first clinical intervention (which is something I’ll never forget!). It was a Tinzaparin underdose, which seemed relatively minor to me at the time, but I quickly learnt after speaking to my colleagues that all clinical interventions are significant.

After successfully completing my induction week, I received my rota for the following two months, which consisted of mini two-week rotations in various clinical areas. My day generally begins with completing the daily ward handover. This is where I assess the number of new patients on my ward and inspect whether any outstanding clinical reviews need to be carried out.

Sometimes I find the workload very overwhelming while carrying out this task and this has challenged my prioritisation skills. One key skill I have learnt is to prioritise the workload based on clinical importance. For example, is there a Parkinson’s disease patient on my ward who needs their medicines urgently? Or is there a patient with type 1 diabetes who forgot to bring their Insulin with them? This is usually achieved by speaking to members of the ward team.

Currently, I’m working on wards as the second pharmacist still in the training and adjustment period. However, I believe when I’m the solo pharmacist on the ward, my workload will be more intense – especially with the pre-reg exam fast approaching!


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