傅钟

喜欢在台湾大学里，在傅钟下的一个石碑，刻着傅斯年校长的名言：

“一天只有二十一小时，剩下三小时是用来沉思的。”

台湾大学，一个充满人文气息的象牙塔。

幸福就是
贴近自己的心
轻轻地安抚它，放下挂碍
祝福自己
幸福，快乐，安详
然后享受那一种宁静的喜悦
^_^

Taking keys and syrup week

Many people are always curious about what pharmacist’s job is all about. But I can never explain that with a sentence or two, simply because our roles in a hospital are a little diverse. We are often doing our job behind the counter, involving thousands of processes the public or doctors can’t really see through. For example, while the patients are waiting for half an hour out there to take their medicines, we are at the inside verifying doctor’s prescriptions (including making interventions by calling back the doctor which takes up more time), allocating the right type, formulation and amount of drugs, physically filling in the drugs, counter checking by pharmacist and finally dispensed to the patient. These whole process involves at least 10 to 15 minutes on its own, depending on the length of the prescriptions, not to mention that we normally deal with tens and hundreds of patients’ medicines at one time.

So in the light of fortunate, I was given the task of taking keys to open the outpatient department (OPD) and to prepare syrups for patients in OPD. Taking keys is never my favourite as it means I need to be there at 7am when everyone starts working earliest at 7.30am, because I need to get the keys from ED and rush back to OPD to open all the lights and computers to get the OPD going. But more often that not, some patients are even more hardworking than me. They are already sitting there waiting for the counter to open to get their medicines. I can understand them: who doesn’t want to avoid the queue later and quickly get away with their medicines first?

The syrup making work was a challenging work for me. First of all, please allow me to lament a bit. No one (like pegawai) was at there to brief me practically how should I prepare the bulk syrups and to assess my skills while I am first time doing it; all they do is to ask another senior prp like me who was in charge of the syrups last week to “pass” their knowledge and skills to me. Well..all this just seems a bit risky. Who could be sure that the information passed on would be still accurate and up to standard? PRPs are all still-learning pharmacists. Phewwww…second, there is not a clear standard operating procedure as in what should be done by steps, in which part of the table, etc. At least I was not brief on that, not even about what to wear while doing syrups. I only know what to wear by looking at the notice board in front of me telling me to dress like a lab person. I have my ugliest time at the back of the pharmacy huhu…luckily it was not in front of the patient, otherwise they will be dread to see how I pour and play with their syrups..haha..i am just joking kay. Third, there were definitely not enough measuring cylinders and bigger bottles to prepare bulk syrups. Why no one has ever feedback on that! Well, I am in Malaysia. I must have forgotten! In here everyone just do what they have been ordered to, feedback was not necessary.

complaints/feedback:

no one actually briefed the new prps on making the syrup in practical and checked the syrups made.

incomplete instructions on manufacturing sheet  (sildenafil) leading to avoidable error

not enough measuring cylinder 

lack of robust SOP for extemp preparations

unorganised bottles and caps

So throughout this week, my task is to prepare three bulk syrups which many cardiology paeds patients will need to take. And to prepare other individual syrups as the Rx comes. I could proudly said that in this week I have done much more syrups than the total extemporaneous that I did during my university years and I could honestly said I try my best to keep to the high standard of a extemporaneous preparation - no pouring or contamination here and there, no miscounting tablets or quantities of syrups. So they are safely to be drink. However, there is still no guarantee from me - who tells my skills were not assessed. I couldn’t be hundred present sure what I did was right. Here is the list of syrup I have done so far:

Frusemide 5mg/ml susp

Spironolactone 5mg/ml susp

Captopril 1mg/ml susp

TB syrup - Rifampicin 25mg/ml

Propanolol syrup

Baclofen syrup

Sildenafil syrup

And ya I have made sooooo many sildenafil syrups and TB syrups this week!! Don't like the bloody red rifampicin, powders flying everywhere while I attempted to open the capsules.. on the other hand, the sildenafil syrup is a nice sky blue syrup, and each tablet cost the government around rm 100 plus! However sildenafil syrup is always tricking the newcomers - why? Because it actually needs to add a little bit water to let the content of the tablet bursts out, and this step is not stated in the manufacturing sheet. 

And lucky enough I was able to see and involved into making omeprazole syrup. This is one of the tricky syrups to do as it involves withdrawing sodium bicarb from the ampoules using syringe. 

Pity the patients. Most of them are paeds who need to take medicines in the form of syrup. Thus I always need to be extra careful when making syrups as they are indicated for the kids. While I was making the syrups, I pray in my heart hoping that the patients would feel better after drinking the medicines.

After a week's training, I can regard myself as a syrup queen now muahaha..imagine myself working in a traditional pharmacy shop full of syrups. Woah that would be fun.

Overview of Malaysia pharmacy application process

Since I have stepped into the career world of Pharmacy, I thought it would be beneficial if I can share some of my knowledge and experiences to those who might walk the same path as me.

In Malaysia, upon graduation of Pharmacy courses, we have to serve the government for at least 1 year (2013), which is also the so-called provisionally-registered pharmacist (PRP) year. After that year only we can be FRP (fully-registered pharmacist).

So what did I go through in order to get a place of work in government hospital? First of all, I need to apply through spa.gov.my for applying a government job. At the same time, I need to register myself to Lembaga Farmasi Malaysia (LFM). There will be some form to be filled in and posted to LFM, along with some documents showing that u graduated from whichever university. For the SPA cases, after applying online, we need to call to the SPA centre itself in order to ask them to book an interview date for us (otherwise it might take ages for them to get back to you). They will normally call u back to inform u the fixed interview date in Putrajaya SPA building.

To prepare for the interview, you need to study a bit about the general overview of SPA, the organisation (carta organisasi), bahagian and fungsi of KKM and lembaga farmasi as well as some knowledge about pharmacy of course. They might ask about your interest and your future directions, and if you are interested to go to outskirts like Sabah so be prepared to answer these as well.

After the interview, all you have to do is to wait, wait and wait for the letters to come. I highly encourage people to get a part time job or to go travel whilst waiting - it could be months before the letter arrived. Meanwhile, keep calling the KKM to check when is the next posting letter arriving. They will normally send the letters in one batch by pos laju so everyone got their letters pretty much on the same day. Keep in touch with your friends of the same batch so that u don’t need to call or check mailboxes every day, because you guys can take turns to do that :D

There will be two letters to be received; one is from SPA which states that a gov offer is given to you, while the later one is the posting letter stating which place you will be going. The latter will normally just tell u the state you are assigned to, while the specific hospital that you are going will be revealed when u lapor diri in the jabatan kesihatan negeri. You will be given one month’s time to lapor diri to JKN upon receiving the letter, upon which u may (by the slightest chance) appeal to KKM if you are dissatisfied with the results.

Hope it helps! ;)