The fax machine is broken, please go to another pharmacy

 

Disclaimer: I’m going to vent.

 

Pharmacists are incredibly undervalued and under-utilised. Part of this comes from us not being empowered enough to make independent decisions.

 

I had a prescription from work this weekend. I chose to have this sent to a supermarket pharmacy for convenience. I got to the pharmacy and I was told the fax machine was broken and that I should go to a different pharmacy.

 

We clearly need to do some work on our prescription process.

 

The pharmacist I spoke to…

 

  • Didn’t check what the medicine was for.
  • Didn’t check the consequences to my welfare if I didn’t take this medicine.
  • Didn’t provide any other solutions apart from ‘go to a pharmacy with a fax machine’.

 

Where was his duty of care?

 

I was incredibly disappointed. My sister, who is a general practitioner, was with me and was also shocked at the way I was dealt with.

 

In my opinion, this is not the way for us to exercise professional authority, we should instead be lobbying to revise rules that are no longer fit for purpose.

 

As an inspector, I never checked if a prescription had been received after 72 hours. So why are we obstructing patients care in this way?

 

I’d love to hear other thoughts and opinions on this – especially from international colleagues.

 

Nabila Chaudhri MRPharmS is Associate Director of Pharmacy at Babylon Health & Independent prescriber & Ex-GPHC Inspector but on this occasion is writing in a personal capacity. 

 

I’m a pharmacist and I think I might be an alcoholic

 

The moment I knew I had a problem was when I had my first drink before breakfast to get rid of a hangover from the night before.

 

A swig of something strong and the horrendous hangover lifted for a few hours. The fog would lift and there would be a distant glimpse of that warm alcohol enveloping feeling.

 

And when the cloud lifts why not keep going?

 

I used to do this ‘hair of the dog’ routine quite frequently over recent years in complete denial that I had a problem. It actually wasn’t during one of these episodes that I realised I had a problem but I’ll tell you about what happened there in a minute.

 

I have worked as a pharmacist for quite a few years now. I still work in community pharmacy owned by one of the multiples in the suburbs of a city.

 

The stress that drove me to drink came from my job. The absolutely soul-destroying pressurised loneliness of being a community pharmacist was clearly too much for me to cope with. I can see that now.

 

The heavy responsibility that comes with being a pharmacist has pushed me to drink over the years. Trying to please everyone and falling on my face in the process. A grand game of denial. That feeling when you think you might have made an error or not cared for someone as best as you could.

 

The torment of working in the pharmacy at times comes from the fact you can never give everyone the same level of care. You just don’t have time. And then there are the factors that are outside your control like near misses and dispensing errors. Dispensing errors are inevitable and I find this in combination with the ‘blame’ culture in pharmacy is very hard to deal with.

 

Community pharmacy is like a battleground at the moment. I’m not saying that the pharmacy that I work in is any worse than most but the clients are challenging. Combine these difficult patients/customers with huge pressure from my corporate employer and you have a perfect stress storm.

 

There is no doubt that working in this chaos has led to my alcoholism.

 

For people who don’t currently work in community pharmacy, they need to know how difficult it is for pharmacists there. Pressure, staff, targets, diminishing budgets and in our company the constant next big idea to have to ‘buy-in’ to and ‘lead’. The thing that I struggle with most is the lack of freedom to be a pharmacist and truly care for patients. I’m tethered to the dispensing bench for eight hours a day so there is no chance to deliver good care to my patients.

 

So in my spare time, I drink to find brief relief and I feel really guilty about this. Alcohol has a serious impact which crept up on me over many years of coping. The impact on me and my family has been significant over recent years.

 

Alcohol almost messed up everything. I hate it but for addicts like me, alcohol forces a shallow heartless love of it.

 

I have never had a drink at work and I have never, therefore, put patients at risk. That said, recently I craved a drink whilst at work and that is when I knew things had to change. That scared me because I desperately need my job to support my family. I’ve got kids at University to support for example.

 

I have read in self-help books that you need to hit rock bottom. Well, I think this moment of craving a drink at work may have been my lame ‘rock bottom’.

 

I’m undecided as to whether my issue with alcohol stems from my genetics or from my environment. Were there aspects of my childhood that led me to the rock bottom point I hit a few months ago? It is a bit of torment that there might be something there that has influenced my behaviour in adulthood but if there is I can’t remember. There certainly is nothing obvious.

 

So one day a few months ago I stopped drinking. Just like that. I have done this before but on every occasion, I have relapsed into the usual pattern of drinking within a week.

 

I have been sober for 98 days as I write this article.

 

Christmas was really hard. I have never been to a work Christmas night out and not had a drink. This could be my last because I found it to be miserable. Colleagues understand you are the heart and soul of the party so when I said no thanks to a drink I think it raised eyebrows.

 

“What’s wrong?”

 

“Go on just have the one. We’ll share a taxi home.”

 

“Oh. [concerned look] Is everything ok?”

 

Many people become someone completely different when they drink alcohol. I was this person but had never seen it in stark reality until I went to that Christmas night out. It turns out my colleagues are not very nice at all when they are drinking. Who knew?

 

Looking back a huge part of my problem was the fact that my whole social life has for years revolved around alcohol and until recently I couldn’t stop. I feel very fortunate that I seem to have been able to do so successfully. Many people are not so lucky.

 

I’m an introvert but I have only discovered this since I stopped drinking. Working in community pharmacy demands that you are an extrovert and I find this exhausting. Maybe I’ll do a different job someday where I don’t need to be ‘on form’ all day when I’m feeling crap inside.

 

You see alcohol masks who you really are. You become a disinhibited version of yourself and the trouble with this is that you never get a chance to learn how to socialise without it. This was bleakly obvious at our recent Christmas night out.

 

I am beginning to find now that you can have fun, be silly and even dance without alcohol. For years the thought of doing these things in the absence of the influence of alcohol horrified me. And looking around I think it might horrify many of my colleagues too.

 

The thing that I didn’t notice for years was how much stress and pressure being a pharmacist causes. Coming to terms with this will be the key to staying off alcohol.

 

Looking back I think I have always been an alcoholic. I used to steal alcohol from my parents’ drinks cupboard. I remember drinking spirits secretly as far back as my teenage years. I would drink some and on occasion top the bottle up with water. I have subconsciously taken this behaviour into my adult life.

 

I have no idea if my parents noticed this behaviour. They never said and I have not asked.

 

You don’t suddenly wake up being an alcoholic. Rather I feel it is a slow drift towards oblivion punctuated by hundreds of denial related false peaks.

 

And actually, you can exist as a functional alcoholic for years and never reach rock bottom. I hate that alcohol does this to people.

 

Over the years I have exhibited behaviour that could be seen as out with the norm in relation to alcohol. The trouble is, much like a frog being boiled, you never notice that it is happening until it is too late.

 

I would drink to excess the majority of the time. For someone with a weakness for alcohol, it is really difficult to show restraint and not go on a binge. Once that first hit of dopamine kicks in there was usually no turning back for me.

 

Now that I am sober I hate going shopping for food. Supermarkets are such cruel places for people trying to curb their drinking. You get your shopping done and then you are hit with the alcohol aisle on the way to the checkout. I wish there was at least some sort of deterrent to this feast of alcohol. Maybe just put up a barrier or place the alcohol in a separate area of the shop.

 

I used to locate alcohol when I visited other peoples’ houses. Having a drinking problem is not easy. It takes skill and planning. You need to be ahead of the situation and plot your next few drinks to ensure you maintain the glow. In a completely irrational way, I used to do this when I visited other peoples’ houses.

 

I would often have chasers. Non-drinkers would never drink quick enough for me. The problem is they don’t need to get the alcohol into their system as quickly as you because they will probably have a lower tolerance. As I continued to drink over time I found that I would have to drink much more than my peers to find that fuzzy feeling.

 

I would hide alcohol around my home. The first time my partner found an empty bottle was about five years ago. The first few times this would happen my partner didn’t really think much of it but the problem was as my drinking escalated, I would forget where I put the bottles. The pattern continued and the link was made. My partner was the first person to identify that I had a problem although I didn’t believe it at that time.

 

I used to make sneaky trips to the shops to buy alcohol. I would find a multitude of excuses to go. It is this deceptive and secretive behaviour that is most destructive in relationships.

 

All of these behaviours took time and effort to plan. Skill and precision to execute whilst never getting caught out or questioned.

 

The only thing that matters to me now is staying sober. I will avoid the drink pushers and might even stop socialising for a while. I also might consider leaving pharmacy. I can’t go on like this. Maybe things will change with time but right now being sober whilst still working in pharmacy is taking a lot of energy.

 

Being addicted to alcohol for me is like drifting down a river. It is easier to effortlessly drift downstream. This is the equivalent to having a drink. It is difficult to swim so that you no longer drift downstream and harder still to swim back upstream. I know that putting myself in high-risk situations, like parties full of drink pushers, will turn the gently flowing river into crashing rapids flowing faster and faster. Working in pharmacy may soon be too much to bear.

 

This simplistic analogy is now how I live my life.

 

So far I am sober.

 

So far I am surviving.

 

I want to finish by saying thank you to Johnathan for accepting this article for publication. I remember reading the articles on bullying and thought how sad yet true they were. There are few people in pharmacy that speak the truth, and most importantly let other people speak their truth as he does.

 

The author of this article wishes to remain anonymous. Johnathan has re-written some parts of the original submission to further disguise identity. If you, your colleagues or your family have been affected by any of the issues in this dilemma you may wish to contact Alcoholics Anonymous by clicking here. It’s ok to ask for help.

 

In pharmacy the buck stops with you and me

 

I have watched with interest the aftermath of the This Morning clip and the uproar and social media activity that has ensued.

 

And rightly so too.

 

Whilst my team and I were busy looking after our patients the very notion of our hard work and existence was being denigrated publicly on national TV.

 

I found this a very bitter pill to swallow, but it has also left me reflecting on our profession’s perception, reputation and representation.

 

When I was 16, I attended a careers session held by my secondary school. I told the lady running the interview that I wanted to be a pharmacist. I always had wanted to be a pharmacist yet she tried to discourage me. She said to me you are a ‘straight A’ student so why don’t you become a Doctor or go to Oxbridge instead?

 

I remember feeling quite insulted and vehemently trying to defend the role of a pharmacist to her. If we are honest to ourselves, pharmacists, rightly or wrongly, have always been one of those professions that have felt they have something to prove.

 

I think I personally accepted that if we are to change the perception of pharmacists, that change would need to begin with me.

 

I can quite honestly say that for the majority of my career I have worked tirelessly to do just this. I cheekily call myself a self-proclaimed cheerleader for pharmacy and have without over-dramatising it made it my mission to champion pharmacy from the grassroots.

 

If we think about why the comments were made by those individuals on This Morning, we could say they were born from ignorance. My greater concern is that these comments were based on poor experiences of interactions within pharmacy. Perhaps these experiences left a lasting misconception of the role of a pharmacist?

 

I don’t think we can underestimate the impact of each and every interaction we make daily as pharmacists and I feel quite strongly that each of these interactions must be professional and personal. In fact, my pharmacy motto is ‘to make every contact count on a personal and professional level’. I always tell my team that you have to assume every customer is a mystery shopper/ Which reporter/ GPhC inspector/your family member and best friend rolled into one. I’ve worked hard to build a pharmacy team that share my values so that every interaction between my team and our patients is a meaningful one.

 

I found the ‘shop-keeper’ comments quite amusing.

 

Controversial, I know, but I actually enjoy being a ‘shop-keeper’. One of the main reasons I like this title is that it makes me treat my patients as customers. I feel I owe these people good customer service. I have a saying on my counter for my team:

 

“If we don’t look after the customer, someone else will”.

 

Treating a patient as a customer in my eyes notches them up on the level in terms of the care and service they receive from me and my team.

 

Finally the comments about Pharmacists ‘pretending to be doctors’ and ‘picking boxes of shelves” are the ones that I have found most grating.

 

For the 15+ years, I have been a community pharmacist. I have never pretended to be Doctor. In fact quite the opposite, I have worked to improve the reputation of pharmacists by doing so much more than just picking a box of a shelf.

 

Patients have benefited from most pharmacists offering so much more such as advice during an MUR, having a chat about concerns when starting a new medicine during a NMS intervention, receiving a flu jab or being helped to give up smoking. The list could go on and interestingly will go on as our service offering grows.

 

Societies naturally have biases and prejudices.

 

I’ve made it my professional goal to challenge these and change mindsets when it comes to perceptions and the reputation of pharmacists. Anytime someone has asked me to do a presentation on pharmacy, I have said yes. I have talked about pharmacy to local charities, schools, MPs, Patient Participation Groups, faith groups, GPs, nurses, CCG leads, Health Authority leads, at national conferences and the list goes on.

 

Not because I love the limelight and am a secret megalomaniac, but quite literally because I want to raise the profile of Pharmacists.

 

I sometimes have reached out to the local and national bodies in frustration and asked why aren’t you representing me more, but I have realised that their job would be so much easier if we were all representing ourselves better.

 

Quite early on in my contractor life, I approached a local senior pharmacy figure and asked him why he didn’t do more to market community pharmacy and he cited the famous JKF quote to me, he said:

 

“Reena, don’t ask what pharmacy can do for you, but what you can do for pharmacy”.

 

Initially, I was a little underwhelmed by his response, but then unwittingly this has become one of my main careers aims.

 

Finally, my pharmacy heart has been bursting with pride with every comment on the #whatwedoinpharmacy twitter thread which was a great idea to shatter the misconceptions and raise awareness of our roles. I’d also like to say a personal thank you to Amit Sahdev for his interview on This Morning. Well done for being a new, fresh, positive face of pharmacy. You did a fantastic job advocating for our profession.

 

I really hope this inspires more fresh faces to learn to use their ‘pharmacy’ voice to represent the sector in a positive light.

 

I definitely could do with some more pharmacy cheerleaders to join my gang.

 

Reena Barai is an independent community pharmacist, NPA board member, Fellow of RPS and self-proclaimed ‘cheerleader’ for pharmacy.

 

Pharmacy guilt is real

Laura Buckley

 

We’ve all had that moment. The moment when you’re two hours early up for work and you’ve got your head bent over the toilet throwing up and you’re convinced you shouldn’t be going into work. Or the alarm goes off and the migraine you’ve woken with is an extension of the headache the night before. Or the moment you are in work and the green-around-the-gills feeling suddenly appears or the really nasty cold you’ve had has drained you to the point of exhaustion. You can’t imagine anywhere else other than the safety of your own home, where if you’re sick it doesn’t matter or if you just want to lay your heavy head down on a pillow, you can.

 

But how do you tell your colleagues you won’t be in work? How, as a pharmacist, can you ring in knowing there won’t be a replacement for you or there will be an almighty struggle to get a locum and in the meantime the staff will have to signpost patients because the pharmacy can’t operate in your absence? How does a dispenser tell her colleagues she’s going to be off work and leaving her colleagues to pick up the extra workload in her absence, knowing that they’ll be more stressed when she isn’t replaced.

You’re terrified to get a sick note, knowing full well you shouldn’t be working but the guilt of leaving your colleagues without you is keeping you at work. You’re angry because you feel ill and all you want to do is rest but you just can’t do that to the team. And eventually, when you do go off sick, the guilt gnaws away knowing they’re struggling and you can’t rest properly knowing the pressure your colleagues are under. They say they’re managing, but you know it is a struggle. They’re telling you not to worry but you want to go back in to help out.

 

Pharmacy guilt is real. The guilt of being ill and being unable to support your team is really quite frustrating because when you do have to be off work or you just can’t make it in that day, it really is hard to rest. The difficulty with this can stem from a lack of trained staff to support your absence or a lack of support from employers to ensure cover.

 

As a manager, I’ve faced the struggle with both sides. I’ve felt ill and stayed in work knowing I can’t leave or the pharmacy will be in a mess. In the past I’ve been sick in the car park as I’ve left work, having somehow managed to hold it in until I’ve walked out the door. I once had to bring my son as a baby into work to ensure we continued to supply medication to patients. I’ve also seen colleagues go off sick and struggled to overcome their absence, wanting them to get well but missing them so much at work. I’ve seen colleagues walk into work and sent them home because they are clearly not well enough but they were prepared to soldier on anyway.

 

The guilt is horrible. The guilt is not fair but we in pharmacy feel it because we care about each other and we care about the patients. Nobody wants to shut their pharmacy because the pharmacist is sick and a replacement cannot be found. Nobody wants their colleagues to work extra to make up for their absence.

 

It is a fact of life, though: everybody will get sick at some point, even the caregivers. Everybody needs a break to get well. The question is: is the pharmacy supported enough to manage the absence of colleagues who desperately need the time to restore their health to be fit to look after others at work?

 

Laura Buckley is a community pharmacist and runs an online blog which you can access here. We are massive fans of her writing so recommend you head over and have a look.

 

Safe staffing in community pharmacy saves lives

 

Whenever you get the opportunity to talk with colleagues who also work in community pharmacy, you find yourselves making comparisons about your work.

 

How many items do you do? We can’t get this in stock, can you?

 

What patient medication record system do you use?

 

I find one particular comparison most interesting…

 

How many staff do you have?

 

There is no hard and fast rule for how many staff each pharmacy should have on duty at any one time. Other than there being a pharmacist on duty for the day, it really just depends on what the employer chooses to do with everybody else. This is something I feel incredibly strongly about since not enough staff is a huge risk to patients and to the pharmacist.

 

If you’ve read my blog on why you have to wait for your prescriptions, or you work in pharmacy, you’ll understand what goes on in the dispensary. Queuing patients add a lot of pressure to the processes we do and we often find ourselves rushing round to ensure we manage the queues and get people sorted safely.

 

But how safe is safe? Not having enough dispensing or counter staff means the burden of work is increased on each member of staff, rather than shared between more people. The dispensers are more likely to make mistakes rushing around the dispensary grabbing boxes off of the shelves and they could easily mistype labels as their fingers speed across the computer keyboard, whilst they have one eye on the growing queue over the top of the screen. With not enough staff to manage the queue, the pharmacist will be required more in the dispensing process or to serve over the counter to help manage how busy things are. And whilst immediate queues are being managed, there are no members of staff free to keep on top of the pile of prescriptions that came from the surgery.

 

When there is not enough staff in a pharmacy, rushing happens quite naturally as the workload still needs to be managed but with fewer people. The pharmacy team becomes more fatigued due to increased strain on each member and fatigue affects our ability to concentrate on the work. If the pharmacist is needing to get involved in the dispensing process, for example labelling the prescription whilst their colleague is serving the next person, or picking the items whilst their colleague starts labelling the next person’s prescription, this adds to the risk.

 

But why?

 

When a pharmacist checks a prescription, if they are seeing the prescription and the items and the labels for the first time, they are more likely to pick up any mistakes in the accuracy check than if they have been involved in putting it together. It’s quite simple to understand the principle that it is easier to notice the mistakes of someone else rather than your own.

 

But why, when this is clearly understandable, are pharmacies of today not staffed safely to manage risk? I hear all kinds of stories from colleagues and through pharmacy social media groups about staffing. I know how it feels to work under immense pressure and worry about it afterwards. I know how it feels to work to the point of being exhausted.

 

Nationally, we need something in place to manage staffing levels so that pharmacy staff aren’t under unmanageable pressures. Unless you work in that particular pharmacy, you can’t possibly understand the day-to-day patterns of workflow, nor can you rely on technology to tell you that information. Rather than suffer the stress of understaffing, we need to speak up for it. We need to prevent risk rather than manage it. We need to have confidence that we are doing all that we can to minimise making mistakes that our patients could suffer from.

 

In our job, understaffing doesn’t just mean that the work builds up a bit. It doesn’t just mean that the next few days will be busier or that the job won’t get done as quickly. It could mean that Mrs Smith accidentally gets the wrong warfarin strength and ends up in the hospital, seriously ill from an overdose. It could mean that a patient gets the wrong strength of blood pressure medicines and becomes excessively dizzy, falls and breaks their hip. It could mean that somebody accidentally gets a medicine that sedates them and they drive for a living, what could go wrong?

 

Staffing levels directly impact on patient safety. It isn’t a matter to trifle with.

 

We need our staff to be safe for our patients.

 

 

 

Laura Buckley is a community pharmacist who runs a very successful blog. She is passionate about pharmacy and about parenting. Support her by checking out her blog by clicking here

Prescribing chaos, dispensing disaster: why waiting won’t kill you but impatience might

When you hand your prescription in at the pharmacy counter, there is a process to follow. If my colleagues and I don’t follow process and a mistake is made, it’s our careers on the line. We dance with risk every time we step foot in the pharmacy and fear of mistakes keeps us awake at night.

 

A common theme which community pharmacists find is the impatience of the general public when waiting for a prescription:

 

‘Can’t you just stick a label on the box and give it to me?’

 

‘It’ll only be five minutes I’ll wait’

 

‘Why does it take so long?’

 

‘I’ve got a bus waiting, hurry up!’

 

The process of your prescription can be lengthy! It is usually labelled by a dispenser on the computer, picked off of the shelf and stickered and checked by the dispenser and then passed to the pharmacist.

 

The pharmacist undertakes three main checks:

 

  1. Legal Check
  2. Clinical Check
  3. Accuracy Check

 

Legal checks make sure the prescription is, as it says on the tin, legal. Is it in date, does it comply with the rules, is it signed by a genuine prescriber? You’d be surprised, but people try and get away with forgeries. Most pharmacists have come across forgeries and I’ve had experience in referring to the police in the past. Certain drugs are more at risk of being forged and handwritten prescriptions are also a red flag to watch out for.

 

Clinical checks make sure the doctor/nurse prescriber/dentist/pharmacist prescriber has prescribed medicines appropriately for the patient. This is perhaps the most misunderstood part of being a pharmacist. Just because your doctor is qualified to write prescriptions and knows what medication you take, does not mean that they are an expert in medication or that they are going to prescribe appropriately! The clinical check involves ensuring the medicines are suitable for the patient, their age, their weight, their gender, any allergies and any health conditions they already have (since some medicines can worsen pre-existing conditions). I’ve lost count of how many times I’ve stopped a patient receiving antibiotics they are allergic to “well the doctor KNOWS I’m allergic to penicillin”! It also involves checking the doses of the medicines (often a big risk is children as the doses are commonly weight dependent) to ensure they aren’t too high or in the odd case, too low to be of benefit. “The GP weighed my daughter, she knows the dose is right” And to add to that, if you already take medication or you’ve been prescribed multiple medicines, we need to be sure they are okay to be prescribed together. The more medicines you take, the greater the risk of interactions and many can be severe or require dose alteration. If there’s a problem, we then have to contact the surgery and battle the receptionists to get access to the prescriber to query it.

 

Once we are comfortable everything is legally and clinically safe, only then do we pick the boxes of tablets up. And then it’s a case of spot the difference. Has the dispenser picked up the right items? Have they labelled it for the right person? Is it the right quantity, form and strength? Is the label titled with the right item on it and are the directions matching that of the prescription with the correct warnings on the label? Are the medicines in date? Dispensers are great and when they’re good at their jobs, they work very hard. But as with ANYONE, they’re human and they can so easily pick the wrong item or label it wrong and it can be missed.

 

Then, and ONLY THEN do we bag up the medication to be handed to you.

 

If you’d like to factor in multiple distractions to this process: other prescriptions to be checked, ‘someone wants a word with the pharmacist’, a delivery of controlled drugs arrives to be checked, a colleague needs help finding a medicine they don’t know the generic name for, there’s  a phone call for the pharmacist, there is a first aid incident in the shop, the computer system has crashed, someone needs the controlled drug cupboard keys and other reasons to be broken off, then you add time to the process and risk.

 

So in a nutshell, that’s why you have to wait.

 

Patients who want their prescriptions filled safely wait patiently; impatience is a killer.

 

Once we are comfortable everything is legally and clinically safe, only then do we pick the boxes of tablets up. And then it’s a case of spot the difference. Has the dispenser picked up the right items? Have they labelled it for the right person? Is it the right quantity, form and strength? Is the label titled with the right item on it and are the directions matching that of the prescription with the correct warnings on the label? Are the medicines in date? Dispensers are great and when they’re good at their jobs, they work very hard. But as with ANYONE, they’re human and they can so easily pick the wrong item or label it wrong and it can be missed.

 

Then, and ONLY THEN do we bag up the medication to be handed to you.

 

If you’d like to factor in multiple distractions to this process: other prescriptions to be checked, ‘someone wants a word with the pharmacist’, a delivery of controlled drugs arrives to be checked, a colleague needs help finding a medicine they don’t know the generic name for, there’s  a phone call for the pharmacist, there is a first aid incident in the shop, the computer system has crashed, someone needs the controlled drug cupboard keys and other reasons to be broken off, then you add time to the process and risk.

 

So in a nutshell, that’s why you have to wait.

 

Patients who want their prescriptions filled safely wait patiently; impatience is a killer.

 

 

Laura Buckley is a community pharmacist who runs a very successful blog. She is passionate about pharmacy and about parenting. Support her by checking out her blog by clicking here