Kyle McDonald is a husband and dad to two kids; he coaches his son’s soccer team and recently received his blue belt in karate. Kyle also just celebrated his 7 year anniversary as a pharmacy technician at Gibbons Guardian Pharmacy. He claims it’s the longest he’s ever done anything. Pharmacy was not what he expected when he first took a job as a pharmacy assistant in 2010 at a compounding pharmacy in Canmore. Kyle was looking for a change from his previous career as a massage therapist but was not expecting to end up loving pharmacy. He found that compounding and preparing medications was a lot like cooking and baking – another love of his. That put him on the path to becoming a regulated pharmacy technician and he graduated from the distance program at Red Deer College in 2013.
Working in a rural community of about 8000, Kyle has lots of opportunity to build relationships with patients and really get to know them. It helps him better respond to his patients’ needs, whether it’s expediting the filling of a prescription for a parent with a crying child or identifying when someone could benefit from blister packs. Like others, Kyle and his teammates were challenged with how to best introduce workflows that allowed him and his pharmacist colleagues to work to full scope of practice. When efforts to integrate a pharmacy technician working to full scope first started, the pharmacist was completing the therapeutic check at the end of the prescription filling process. The pharmacists were also double checking everything Kyle had already checked. The team has since been able to rework the flow of the therapeutic check so that’s not happening anymore.
Kyle describes the staffing model at his pharmacy as an hourglass. He is often the sole pharmacy technician working with multiple pharmacy assistants and pharmacists. Within this model Kyle checks prescriptions and blister packs filled by the pharmacy assistants, and is responsible for inventory management delegating tasks to the pharmacy assistants when necessary. It’s quite common for one of the pharmacy assistants to complete a narcotic count but Kyle will reconcile what was counted to ensure appropriate supervision is provided. Kyle is also a super-user of the pharmacy’s computer system and is responsible for system management and improvement. This involves creating new sig short codes based on practice needs. He often provides advice to other pharmacies using the same system about which reports they should be accessing. Kyle is also the team member most often responsible for in-taking prescriptions from patients. This works for the pharmacy flow, because it allows him to triage requests for the pharmacist. When a patient asks a question that requires the pharmacist’s therapeutic knowledge, Kyle is able to gather information from the patient and relay it the pharmacist. Regularly accessing Netcare and obtaining patients’ recent lab results for the pharmacist’s review is also part of Kyle’s role.
Reflecting on the current state of practice in community pharmacy, Kyle finds there’s a lot of opportunity overall but “it feels like we’ve stagnated in the profession in community”. At times, the customer service based industry of community pharmacy is in opposition with providing healthcare. In a convenience-driven and fast-paced society, patient expectations of healthcare professionals have also changed. Kyle sees opportunities for the profession to evolve along with the recent pharmacy compensation framework changes in Alberta. There are many opportunities for the pharmacist to provide a more thorough assessment of the patient’s care needs; when a patient is initiated on compliance packaging is one example. “It’s always been done, but not to the same extent”. Pharmacy technicians have a role to play in identifying patients that will benefit from Comprehensive Annual Care Plans. It may mean a little more work, but Kyle is okay with that and is ready to step up to fulfill that role.
While the pharmacy’s model seems to be working, Kyle sees many opportunities for his role and scope to expand. Kyle believes there is more opportunity for pharmacy technicians to collaborate with pharmacists to implement care plans, such as warfarin adjustments as a result of INR monitoring. Providing travel vaccinations is a big part of the pharmacy’s services. Kyle also believes that if he were able to complete the technical task of administering injections, workflow would be improved. When asked what he, and other pharmacy technicians, can do to expand opportunities for pharmacy technician practice, Kyle’s response is to “set an example by doing it first. Even if you can inspire one or two people, let’s do it.”