Communication and the pharmacy technician

1. Communication and the pharmacy technician • As a pharmacy technician you will come into contact with many different people and situations. • Often times you must tailor your message to the patient and/or client. • You should be informative to the best of your ability and be within your zone of authority. This requires communication skills and empathy. • I.e. a customer comes to the pharmacy and their prescription is denied by their insurance. You tell the customer : “your prescription was denied by your insurance. Your price is $365. Cash or credit?” • Customer: why was it denied? • Technician: you need prior authorization • Customer: what’s prior authorization? • Technician: your doctor needs to call the insurance. • Customer: why? • Technician: because he has to provide a medical reason for you to have this particular prescription. He will then call us with a PA number and we can fill your prescription. • Customer: Oh, Ok. Why did not tell me that in the first place?

2. Communication is a key attribute of a pharmacy technician. • Your patients/customer will always appreciate your forthrightness. Be direct and empathetic in your approach. The prior example can be handle by explaining in detail the issue with the client’s issurance and offering to assist with the issue or giving the client the option to pay. • Shoe on the other foot: • You need an emergency operation for acute cholecystitis • You go from the emergency room to the OR in severe pain. • You are in the recovery room and you hear the surgeon discussing your case with the attending physician and you hear him say that your serum amylase is still markedly elevated. You then hear him say that he will start a morphine drip 100 mg/100 ml at 1 mg/hr and start vancomycin 1 gram every 12 hours IV. • You begin to panic and fearing that you will die because your grandmother who had cancer also had a morphine drip. • The resident sees you crying and later you explain your concern to the resident. He explains to you that morphine is a pain killer and vancomycin is an antibiotic and that the medications are just routine meds for this condition • How does it feel to be on the short end of the communication loop?

3. Communication Process

4. Sender: the sender of the message • Message: the information conveyed • Channel: the mode of the communication • The Receiver: the person receiving the message • Feedback: probably the most important part of the communication process. Feedback includes verbal and non verbal feedback and is important in determining if the message was received correctly.

5. Barriers to communication • Language Barriers: In the US, 46 million people can not speak English as their primary language. • Illiteracy: about 20% of the population in the US have difficulties in written language. • Physical impairments: hearing, speaking • Sigmund Freud’s Defense Mechanisms are mechanism by which people unconsciously respond to uncomfortable situations. (see page 35 in the text)

6. Ways to deal with barriers to communication • Providing written instructions when necessary • Provide bilingual instruction if possible • Use of sign language if possible or use of hand gestures • Showing compassion and empathy

7. Patient’s Bill of Rights act of 2005 • Typically displaced in every hospital in America • Provides a framework to what every patient is entitled to by the nation’s healthcare system • Provides for the five rights of medication administration • Right Patient • Right Route • Right Medication • Right Time • Right Strength See page 37-38 in your textbook

8. Pharmacist Counseling • Omnibus Budget Reconciliation Act of 1990 requires the pharmacist to counsel all Medicaid patients when: • A new patient to the pharmacy • A new Rx that an existing patient is given. • When a change is made to an existing medication that a patient is taking. • When flag by a DUR (drug utilization review) • When requested by the patient • These counseling points should be covered at the discretion of the pharmacist: • Drug, dosage form, special precautions, side effects, proper storage, action to be taken in the event of a missed dose • These rights have now been extended to all patients not just medicaid patients.

9. Initiative as a pharmacy technician attribute • Initiative is defined as a desire to go beyond what is normally expected of you to show your work ethic. • A professional professes a code of ethics and at times strives to go beyond what is normally expected. • Possible scenario: often times as a technician you will receive ancillary training in other areas (for example computers and ADC functionality. The mental health department in your hospital has a malfunction in its ADC cabinet. RN calls the pharmacy frantic and says she needs haloperidol for several patients. You have some idea of what might be wrong so you grab some haloperidol vials and some tools when your colleague stops you and says “why bother its not in your job description let biomed handle it”. You have some training and know you can fix the problem quickly and help the RN complete her/his medpass.

10. Initiative Continued • A month later you are called by the senior VP of the hospital , thanking you for your quick action because a patient in the MH department was about to break free of his restraints and was going to cause a problem for the hospital due to his high profile. • A year after that you are offered a position with hospital administration.

11. Cultural competence and the pharmacy technician • In a hospital setting or in a community setting, one must understand a patient’s or customer’s cultural background when discussing a patient’s or customer’s medical issues. • Doing so, you will be realized as a culturally competent health care professional.

12. Cultural beliefs affecting dealing with patients and customers • Asian/Pacific Islander: Older family members are honored and their authority is unquestioned. • Chinese: chinese clients will not discuss symptoms of mental illness or depression; this will bring shame to the family • Japanese: belief that improper care of the body causes illness; use family decision making in relation to therapy. • Hindu and Muslims: Indians and Pakistani people don’t readily accept mental or emotional illness as a diagnosis since it effects the ability of other family member from becoming married. • Hispanic: Belief that illness is a result of sin. • African American: family and church oriented. Health prevention through church life, herbs and cleanliness. Wear copper and silver bracelets to prevent disease.

13. Cultural beliefs • Developmental disabilities and the Bill of Rights Act of 2005 define cultural competence as “services that are provided in a manner responsive to the beliefs, styles, attitudes, languages, and behaviors of individuals” • In certain hospitals, chinese americans are usually not assigned a room with the number “4” because the number sounds like the chinese word for death. • Being aware of people’s cultural differences will help you communicate more effectively with patients and customers.

14. The Professional PharmacyTechnician • In addition to the characteristics of communication and initiative the pharmacy technician must possess: • Professionalism which includes attitude to one’s duties • Image • Attire • Adaptation to changes • Enhancing skills and education