Prior
Prior to the OSCE I had completed a placement at the Nambour General Hospital. The workflow of patient review was relevant as we would complete patient medication reconciliations and review patient medication charts and case notes and use these to complete medication action plans. These are a written record of assessments and recommendations of medication and therapeutic issues. I had undertaken several myself and observed pharmacists completing these for several weeks. This meant that my confidence level was high going into the scenario.
Room 1
In this room, I read the patient’s file, reviewed the patient’s conditions and medications, considered the patient’s biomarkers, and made a list of initial concerns…show more content… This will allow me to make a list of page numbers for each drug by looking in the index, and then check each drug as time allows. Additionally, making and memorising a list of problematic medications as encouraged by the academics may assist with prioritising medications.
Room 2
In this room, I formalised questions for the patient, and provided justification for the questions asked. I felt I did a good job of this, having decided on priorities in room one. These were however more appropriate for a general patient, rather than specific to a pregnant patient as my prior knowledge of managing pregnant patients was an area of weakness.
In this room, I overheard a conversation between a pharmacy student and the doctor which created an ethical dilemma for me. This led to my decision to disregard asthma-related aspects of the patient’s care. Closing the door to the room may provide an additional level of isolation from external sound which may be beneficial.
Room…show more content… There are two reasons for this. First, I found it hard to be respectful, gentle, and suggestive. This led to my approach becoming indirect, which meant that the conversation lacked structure, and wandered. Use of appropriate protocols such as ISBAR or SOAP may help me to develop a method for delivering recommendations to other health care professionals. Secondly, in my placement recommendations were recorded in writing on a medication action plan, unless requiring urgent attention. Therefore, I may not have needed to consider how to make recommendations to doctors in conversation before now. Writing down recommendations in room 3 may help with adding structure to discussions therefore improving the discussions and outcomes reached. At least it should avoid the conversation wandering. Lack of structured discussion meant the conversation did not reach a conclusion. Avoiding this in future will require a plan.
Post
Room 4 was where the errors I had made in the other rooms became evident. Rather than feeling focused and productive, I felt lost in my discussion with the doctor. I’m certain that Doctor Jackson also found parts of our discussion unproductive. The final room could be a room where I excel, but I need to improve in the earlier
