Calling all hospital pharmacists

I’ve been a hospital pharmacist (HP) for just over 11 years. Just after RX school I had two jobs - being an RPh at an outpatient / community retail pharmacy in a large, urban midwest city where I had been an intern during RX school and a part-time job working the inpatient side at a large metro hospital. After about a year and half I went to work at the hospital fulltime.

At the time (late 90’s) the large chains were hiring Rph’s like crazy and paying large signing bonuses which made it difficult for hospital pharmacies to hire enough people.

Like all HP’s in this metro area we are unionized and the union got us a large increase in pay about (~6-10%) for three consecutive years to stave off more HP’s from going into retail. Since then our pay has been close, maybe just a touch lower than our retail conterparts. That decrease in hourly salary is made up for in pay differentials, holiday and weekend pay and working OT shifts if available.

I can only speak as a staff RPh in the hospital setting. I am on a staff of about 52 Rph’s + 4 clinical coordinators, 2 operations managers and a director along with 4 pharmacy residents. We have about 50 FTE’s in the staff pharmacy positions for this 600 bed hospital. We have 4 Rph’s who strictly work nights 7on, 7off 10 hr shifts and they get paid for 80 hours per 2 weeks.

I work about 2/3 of my shifts during the day 0700-1530 and the remainder evening shifts 1430-2300 and a rarely shift in the middle of the day. We are set up for q 3rd weekend rotations of which I only work days.

I feel our benefits are superior to retail Rph’s in the area. Our union has negotiated outstanding health benefits as I only pay about $46 per paycheck for family medical coverage. I don’t even know how much vacation time we accumalte per year but I’ve neve came close to using it all. I think I have about 8 weeks banked at this time. The drawback of the union - the fees we pay and in my opinion we cannot get rid of substandard Rph’s due to union protection. One case ongoing at our institution and it’s baffling what this particular A-hole can get away with due to union protection. Gives our departmet a bad rap.

Since the hospital I am employed at is owned by a large non-profit healthcare corporation we are really feeling the economic pinch this year. Decreased Medicare payments and bad patient debt are really the main factors. We are continually trying new ways to decrease drug costs, lessen OT etc…

I feel we a pretty well respected for our cognitive skills. Our facilty is now pretty much paperless in the physicians/nurses enter all their orders (meds, labs, procedures, ect..) into the computer and on our end we just verify that the med is appropriate for their age, size, organ function and matches up with what the were supposedly taking at home (aka medication reconciliation , the JHACHO mandated pain-in-the-ass, lame attempt at making sure the MD’s are actually taking the time think about what they are ordering for their patients while hospitalized).

We do pretty much all the dosing of vanco and aminoglycosides and have been doing a majority of the dosing of inpatient use of the anticoagulatnts -warfarin, LMWH’s, direct thrombin inhibitors. Heparin is dosed via a nursing driven protocol although we can intervene at any time and change the dose at our discretion. We also start and adjust all the TPN’s.

Role on the healthcare team - pretty instrumental if you ask me. Our clinical managers and coordinators pretty much run the P&T committee and do a majority of the research and presentations. We have a ton of pharmacy driven protocols and our staff Rph’s work dencentrally in almost all areas of our hospital save for women’s care.

I know nursing leans on us continually. While I’ve typed this response I’ve probably been asked 3 questions by nursing ranging from where is drug X (nurses tend to talk first, act second so look for the fricken medication before your ask me !!!!), to a compatibility question to a clinical question for an MD regarding Pseudomnal infection and what antibiotic to use.

When working a decentral shift I’m responsible for covering 2 different stations (both med-surg-renal in nature) which is about 75 patient beds at full capacity. I’ll be completely honest, some shifts are busy (days >>> evenings) but some can be very slow and I can log a lot of interet research. I hope the IT geeks at the hospital can’t read this. For what I get paid I can’t complain one iota.

As a staff Rph there isn’t a lot of advancement. Sure the pay increases with longevity but once we reach the 10 year plateau that is the top pay level.

I like to the read TAP just to know that I’m not missing anything working the retail side.

Ed, you are the MAN! Thank you so much for this absolutely GREAT reply. It is exactly what I was looking for!

I’m leaning more toward the hospital setting after spending time in retail. I can’t stand idiots who think that they are right all the time, ie rude patients.

anyways, on this quote…
“One case ongoing at our institution and it’s baffling what this particular A-hole can get away with due to union protection. Gives our department a bad rap.”

Please tell us more, I’m intrigued. You can change the name if you have to.

Thanks for the assessment.

I’m glad you brought this up, I am actually in the midst of switching from retail to hospital…well I have an interview at a large hospital in my area! Even though I am a Technician I am glad you touched on this! Thanks TAP :)

Pretty much agree with EP. Things are set up a little differently in Ontario. We are a teaching hospital that, due to downsizing and amalgamation of programs, has lost a number of inpatient programs to the other two hospitals in town. In essence we have become an ambulatory care centre with some short stay surgery beds (~100). Our pharmacists have made a number of in roads into the outpatient clinics at our site. We have 5 clinical pharmacists, 2 drug information pharmacists, a couple of coordinators and about 20 techs.

We are not unionized, though I know of other hospitals in Ontario that are. Our technicians are unionized. I agree with EP about deadwood in the tech side. We get paid about $4-5 less than current retail pharmacists, but our pension plan is among the best in Canada.

We still have too much distribution responsibilties for my liking, but it is better than it was. My typical week is four days of 8am-4pm (1 & 1/2 of them in distribution, the rest in clinic or clinical time), then one day working 1pm-9pm. We are on call on those evening shifts until 8am the next morning. We don’t often get called anymore. We work about 1 in 5 weekends (8am to 4pm) and on call until the pharmacy opens again.

Pharmacy is heavily involved with P&T. The pharmacy director is the chair. We are involved in everything from new protocols & accreditation right down to the design of new order sheets.

I agree with EP about the various questions we receive and the good rapport we have with the physicians, residents & nursing.

I also moonlight one weekend a month in a large Canadian chain.

I worked in hospital for quite a few years before switching to retail (clinic) pharmacy, so just a few random thoughts. Pay in hospital is generally less, but benefits I felt were good. I was able to take 6 months off (including unpaid) when I had a child. We had decentralized and ‘clinical’ pharmacists, and they were well accepted, although there are always some doctors who just don’t want to be approached. If you’re in a teaching hospital, the interns and med students love you — they need all the help they can get. We had a clinical pharmacist in the ICU who was relied on heavily by the docs — but you’ve got to be competent, know your stuff and know how to work with others, and recognize that things aren’t always done by the book. As a decentralized pharmacist I often felt like a ‘gopher’ for the nurses, but they asked lots of questions and it sure was easier to resolve problems when I could just go look at the chart myself. In reading so many charts, I learned a LOT, which still helps me in retail.
I did feel like we were chronically understaffed, although that may be improving in some hospitals. Technicians played an important role as far as unit-dose cart filling, making IVs/TPNS, stocking supplies, etc. They are every bit as vital as in the retail setting. I think they tend to make more money in hospital and I worked with some very good ones.
There’s lots of politics and bureaucracy in many hospitals. Lots of committees, lots of people running around who aren’t directly involved in patient care who produce voluminous quantities of written rules. Sometimes that gets tiresome. You won’t have as much patient contact in most situations but dealing with other health professionals does result in some unique challenges. If your goal is to advance into management or supervisory positions you’ll have to wait for a vacancy but you can work on earning the position by taking on projects or leadership roles in some other areas.
You can establish a great rapport with the physicians and nurses, just be sure you’re giving good advice and be flexible!

I agree with EP also. I work in a suburban Chicago hospital, about 350 beds. Have been here for almost 18 years (over half my life). I started out in an independent pharmacy and have also done long term care and been a director of pharmacy (at the age of 25…HATED IT). Work environment can be stressful, but definately a different type of stress than retail. Our salaries are pretty competitive with the retail stores in our area for pharmacists and technicians make up to $5 more an hour than in retail. We are not union. Our benefits are competitive with the area and our hospital checks yearly to maintain that competitveness.

I am lucky to have developed a custom job for myself. I do home infusion, hospice, palliative care and pain management for the hospital. As for the question, are pharmacists respected in a hospital? In the past 5 years, I have worked with a NP and we have rewritten all the hospital pain management policies and procedures, re-developed the physician order sets, gotten Demerol removed from the formulary, started a Pain Management Committee and many other things. We are currently developing a Pain Consult Service which would be utilized instead of needing to consult the anesthesiologists. I sit on the Ethics Committee, Palliative Care Advisory Board, Home Health CQI Board and have been involved in mulitple other smaller committees. I sit on a Complimentary and Alternative Medication Committee which just got the hospital to hire a massage therapist for the staff. We are now working on an aromatherapy program and I am learning to compound various lotions and oils that we can use to soothe patients. I have developed and teach multiple classes to the staff and community on pain management, some of which are now mandatory. I am able to write a column for our monthly staff newsletter on ethical issues and also do ethical consults. Staff physicians will often call some of us pharmacists (who they trust) at home to get help and information. I share all of this to show that there are no limits to what can be done in a hospital setting if you want to take the initiave in an area you are interested in. One of my good friends was so respected by a physcian group here, that they hired her to work in their office as their own personal pharmacist. She’s been able to develop her own job as she goes along. Pretty exciting!

What is boils down to is the type of environment that fits you best. I’ve heard it said that hospital pharmacists need to know more and that it’s more clinical etc. I don’t think it’s a question of more knowledge, just different knowledge. I couldn’t work retail now if I tried, because I don’t know a lot of the newer drugs anymore or the current standards of care for some of the disease states, because I don’t use them in my practice. Again, different type of clinical thought process, but retail can be clinical as well. Sometimes you need to try a lot of areas until you find your niche. If you don’t like something, try a new thing. There is always another job out there. Find one that makes you happy.

I am champing at the bit, TAP, to make my presentation.

I worked full-time in retail pharmacy from 1978 to 1993, and have been a hospital pharmacist full time since 1993. In 1991, I deliberately worked full time for a relief pharmacist agency in order to “break in” to hospital pharmacy because I knew that hospital practice was less stressful and more professional. I was right. As I read EP’s post, I must plead with retail pharmacists who are contemplating the switch–please don’t get caught up in comparing benefits. Compare working conditions! First, retail pharmacy is a fatal disease. Overall, the traditional salary gap between retail and hospital has been closing due to the pharmacist shortage. I wholeheartedly agree with EP that pharmacists’ role on the healthcare team is strong and getting stronger. Although we do not yet “rule” the Pharmacy & Therapeutics committee or independently adjust all total parenteral nutrition orders in my hospital, I have no doubt that the day is coming for that. Also, we have gone all electronic in recent years, and enjoy the extra protection of bar code medication administration, i.e., it is harder to make a dispensing error with this technology in place. We are relied upon heavily to do vancomycin and aminoglycoside kinetics, and now heparin protocol montoring through ordering and following activated partilal thromboplastin times and adjusting the therapy accordingly.

What is missing in this picture?

Drive thrus, medicare D, the brutal crudeness of the ambulatory public, starvation, non-pharmacist managers, “Where’s the motor oil?” or, as one patient asked a pharmacist on these blogs, “How do you cook corn?” , phony scripts, armed robbery for the most part (rare exceptions; but never happened to me in hospital); cell phone rudeness, fun with Vicodin, the entire third-party battle, and I’m sure I could add more to the list.

If I was a pharmacy student now, I would never, ever, for one moment, have considered talking to a chain recruiter. There are some exceptions, I’m sure: a few chains that follow The Pharmacy Alliance’s DSI principles, and a few pharmacists who thrive on dealing with the public, but I’m speaking for myself here, I am not one of those. Just based upon the tone and content of the retail pharmacy blogs, it isn’t hard to figure that most retail pharmacists are very dissatisfied with their daily milieus, and want a change. Should they change? Absolutely! Perhaps if a large number of retail pharmacists vote with their feet and desert the galley slave scene in large numbers, then the captains of the galleys will change their management philosophies and start treating their pharmacy personnel with dignity.

I filled in at a chain retail (RP). My bright and able tech was interested in training for nuclear tech and told me the certification required 800 hrs qualified training. She said her pharmacy tech program for passing the certification exam only spent a few minutes ‘talking’ about the (misstated) ‘flux’ hood, which I thought a shame. The profession does itself a disservice when it does not cover aseptic technique properly in training classes (with some hands-on, at least). It’s my impression that those in RP think calculations and an emphasis on forearm strength of holding a syringe at a 45 degree in the horizontal laminar airflow hood to prepare sterile products are the big deal in HP and are daunted. Actually, in HP (hospital pharmacy), syringe pumps and ‘glove boxes’ are the ‘in’ things. In my RP shifts, both the pharmacists, and those more experienced techs that have gone through certification prep programs seem daunted by the mystery of aseptic technique to think about transferring from RP to HP.

I was just going over what pharmacy journal stuff to toss, and I found a letter published in Third Quarter Indiana Pharmacist for Indiana Pharmacists Alliance in a letter to ASHP, which stated the pharmacist president of the affiliated Health-Systems Pharmacists, felt that ASHP had no role in accrediting programs intended to train pharmacy techs for retail settings, and furthermore questioning the overall value of didactic/experiential training programs for technicians. But, after my recent RP experiences, as well as extensive knowledge of HP, I feel that the more education the better for techs. There is a definite difference in pharmacy understanding when going with the lowest denominator mentality, when in RP, the tech has been plucked from the jewelry department. While I feel no difference in integrity, nor intelligence of techs in either setting, provision of exposure to aseptic technique might benefit the public as well, especially when it comes to sanitary working conditions.

Graduated BS 20 yrs ago with 1 summer as retail intern in mom & pop; did 1 yr general hospital residency. While a resident, my husband found his job, and I followed. Had to use finder service because was unfamiliar to area and they located a great HP staff job at 150-200 bed hospital. No sign on, but they paid moving costs. They were building their clinical staff from scratch; they’d just gone through merger and lost > 50% pharmacists, so when I came, they were even willing to pay for advanced training and post-grad degree to all pharmacists. Then, had child, bought house, and we moved to the area we wanted our kid to go to school. Found another HP job 200+ bed hospital in pharmacy school area; no sign on, and took pay cut, but great chance to cut teeth with new grads, participate in cutting edge projects, and do some mentoring. However, no chance to ‘work up’, as they kept hiring from outside, so after finishing coursework for Pharm. D. I quit. Again, I worked with a temp agency and found a regular part-time HP job in a local critical access (25 beds) hospital; no sign-on, but great co-workers and a variety of activities. Hospital jobs usually offer competitive compensation, lucrative retirement programs, and employer-enhanced contribution investment programs, as well as regular scheduling, and direct-pharmacy manager relations, depending on the size of the hospital as well its funding.

In this area of the country and particular time, there are at least a dozen jobs I could get that are within a 1hr commute or wanted to stay within a couple counties with great sign-on bonuses as HP director for small hospitals or, even staffing at large hospitals, or any retail. With my background I can help out in any number of small single-pharmacy staff clinics, or other small hospitals in the area.

I’m happy about flexibility in work, and being able to staff at my small hospital, where I do order-entry, inspections, make IV’s including chemo and TPNs, clinical dosing and interact with nursing, and physicians, as well as some employee dispensing. The great thing is that my salary for a part-timer has nearly doubled in the last couple years, and I get to work in some teaching; i.e. my efforts are both directly and financially appreciated and I get to do some things I love.

There’s already been a couple good replies but I might as well throw my perspective into the hat as well.

I worked retail for 7 years post-graduation before switching to hospital a year ago. Even in school I didn’t really take hospital practice seriously, thinking it was for the keeners and nerds of the class who were better off hiding in the basement and avoiding human contact. Finally though, years of verbal abuse, pent-up rage, and one knife-point robbery took their toll and I decided to make the switch.

I’m now working in one of the larger hospitals in western Canada and I know for me I made the right choice. Instead of the full run-downs the other folks have done….I’ll hit some of my personal highlights.

WORKING CONDITIONS
Retail - Understaffed. Profit mentality at my old chain made it so they cut out all overlap, leaving 1 pharmacist supervising 6 techs at times. NO LUNCH BREAKS. Bathroom breaks? Have you ever thought of the garbage can as a legitimate possibility? I have. Work late? You’re a “professional” so they don’t have to pay you overtime, and the chain I was at did not. Worked 1 in 2 weekends work until midnight almost 1/2 of the time.

Hospital - We’re short on bodies, but we rarely feel like we are understaffed. Scheduled lunch and coffee breaks, and if it’s too busy to take them, you get OT. Work 1 in 4 weekends and about 5 evenings (till 10:30pm) per month.

PATIENT CONTACT
Retail - Every minute of every day you probably could be talking to another human. Are they a “patient” or are they a “customer”. Personally I love my patients. Customers make my skin crawl and my blood boil. You don’t get to choose which you’re speaking to, they come to you.

Hospital - We have a rotation of 2 weeks distribution, 2 weeks clinical. There’s a bunch of different clinical rotations, but I’m in family medicine and I get to talk to patients pretty much whenever I want. Or I can avoid them a fair bit if I want. Depends on the situation. But they are all patients, and they tend to actually want to speak to me about the things that I’m there to talk about.

RESPECT
Retail - It probably feels worse than it actually is, but a lot of days it sure felt like people thought you were lower than the gum on their shoes. Yell at you. Call you names. Make unreasonable demands. And the docs you deal with think you’re just being a jerk and busting their balls whenever you have to call them to decipher some mess, or sort out a brutal drug interaction they missed.

Hospital - There’s still the paternalistic Doc=God complex in a few of the MD’s here, but most are really good. As well, we are a teaching hospital so we have lots of residents around who seem to really appreciate our contribution. Sometimes the nurses get upset when there is a distribution issue….but it never devolves into the kind of crap you get when you’re out of stock of something in retail.

INTERPHARMACY RELATIONSHIPS
Retail - Even at my crazy-busy old store there were only 3 staff pharmacists plus the boss. If you didn’t get along with any of them, there was no overlap so you didn’t see them much, but they could still make you life miserable by leaving piles of problems for you to fix. And if you do get along well with someone, don’t actually expect to be able to socialize. If you’re off that night, there’s a pretty good chance that your buddy is working till midnight.

Hospital - We have 30 full time and a bunch of part-time pharmacists on staff. it’s pretty much guaranteed there’s going to be some personality conflicts. But there’s so many different places for people to be it’s rarely an issue. But you’re working days most of the time with weekends off, so you can actually go out for a beer or six(teen) with your friends (note…plural) from work. Sometimes that’s nice.

INTERPROFESSIONAL RELATIONSHIPS
Retail - Doc’s think you’re busting their balls, if you can even get through the receptionist who doesn’t speak either english or medical terminology at all. Most of my interactions with nurses in retail seemed to involve narcotic abuse which I was apparently supposed to excuse/ignore because “I’m a nurse, it’s ok.”

Hospital - Lot’s of calls and questions from nursing. Some are just as bad as what you get from the average customer in retail, but oh well. Most of our clinical rotations involve rounding with the full medical team, so lots of involvement.

COMPENSATION
Retail - The chain I was at was ok. Per hour pay was average, no pension, but had an RRSP contribution matching scheme. No real raises etc with perfomance or experience, you start at the top and stay there. Decent health and dental.

Hospital - I actually ended up making more $$$ making the switch, but this is rare. We’re unionized and we have pay-grades based on years of experience. New grads make waaaaaaaay less than in retail. Good pension. Also decent health and dental. Union dues and parking fees suck.

PERSONAL SAFETY
Retail - You are a target. You’re like the Brinks truck driver minus the armored car and guy riding shotgun….with an actual shotgun. I like to joke that every pharmacist that I know, knows at least one pharmacist that has been the victim of an armed robbery. (Yeah…me!). But seriously, even leaving my experience out of it, it’s not far off. Store security is rubbish/non-existant, you’re open crazy convenience-store hours, and you have drugs and money. Hmm. That doesn’t sound like a victim waiting to happen at all.

Hospital - For starters, even a lot of the hospital staff don’t know where to find us. That’s a good thing. We have a secure door that you need a scan card and a PIN code to get through. We even have security guards, functioning cameras, and panic buttons. My old store had none of these. Sure someone could rob us, it just seems a whole lot less likely.

I know that’s a whole big pile of reading … but I’ve seen both sides, and the grass is definitely greener over here for me.

Ren

Oh yeah….. one big thing in Retail’s favour. If you want to have a Angry-type pharmacist blog, you really don’t have enough material in hospital.

There’s things to rant about….but nothing like retail. I work 1 relief shift a month and I always come home with a couple thousand words of stuff to write about.

:p
Ren

I’m a tech at a fairly large hospital in the US, as well as a current P1 student.

At our hospital the techs make most of the IV’s (I’d estimate around 90%). The workload for a tech is pretty large but varies by department and how many beds we have filled. They actually have techs on the dayshift that do nothing but make IV’s, and many others with specific roles such as making chemo, PD solutions, and filling bins. Evenings tend to be slower than days, but this is evened out by cutting back on staff. Weekend evenings are the busiest I have seen it, as they cut back to 4 techs and 5 pharmacists to cover the entire hospital out of the main pharmacy (we use satellites during the week and weekend days). There are also pharmacists with specialized roles such as checking IV’s, TPN’s, and bins.

EP’s description is dead on as far as a pharmacist’s role in the hospital, and I would definitely consider working there upon graduation due to the positive experience I have had. The only thing remotely different I can think of is the salary the pharmacists make. Going by what I’ve heard at the hospital from the pharmacists and some older students is that community pharmacists make approximately 20-30k more per year, but this may be before OT etc. as EP indicated. Many of the pharmacists have said this is worth it because of the satisfaction they get from working in conjunction with other healthcare professionals to help the patients. They also note that the bond among the staff makes the job satisfying. In general I have encountered many more disgruntled techs than pharmacists at the hospital.

Also, the note about the current economic situation is true at our hospital as well. We haven’t been hit as hard as some smaller hospitals in the area, but there has been a lower census, cutbacks in OT, and many initiatives to reduce spending/waste and increase patient satisfaction.

I still have a long road ahead and haven’t had practical experience in a community setting so I’m not entirely sure where I would like to see myself end up. The hospital, and especially the staff there, has been great though in my limited experience.

Thanks to everyone who has answered, and thanks to TAestP for posing the question. This has definitely helped me make up my mind, hospital here I come!

Daaaaamn….and I thought I would just work for walgreens when I graduated. Though I pride myself on my ability to resolve third-party disasters, I think my expertise as a technician would be much better utilized in a hospital setting. Thank you to ALL who posted. ^_^

I spent 13 years in hospital pharmacy. I did my share of night shifts, 5 yrs, then the rest was mainly evenings. It was a highly clinical position, with prescriptive authority protocols for TPN, pain mgmt, anticoag, antibiotics (beyond AG’s and Vanco - worked with micro lab to narrow therapy), conscious sedation… I went to & occasionally ran ‘codes’, as I was an ACLS instructor and the family practice residents were the docs around on my shifts. I had my own DEA#, could draw blood, start IV’s, and administer any drug via any route if need be. The respect I got from the docs and nurses was awesome. BUT….
My own bosses didn’t treat me with respect. Missing covering someones else’s lunch because I was at a code wasn’t a good reason. Forced OT, working every holiday because I wasn’t married with kids, getting written up for calling out one day with a migraine while those with kids could call out 3 days a week and nobody batted an eye, having union politics that favored seniority over ability… All those things added up to be too much.
My retail environment is actually better - I do get lunches, pay is better, and I’m respected by my own department. Sometimes I miss the hands-on, blood & guts, intellectual stimulation, and the close relationships with docs & nurses. Then I remember the bosses who I had in the hospital, and am satisfied with my change.

I have worked retail, staff hospital pharmacist and clinical pharmacist in the hospital.

Inpatient Staffing in the hospital is the pits-because we were always short handed, extra shifts etc. The nurses always bad mouthed pharmacy, everything was the pharamcy or pharmacist’s fault. How many times can the same nurse call and ask the same IV compatibility question? Crazy- runners to deliver got more respect from our boss than the pharmacist- because they would pull the union crap. And the phones just kept ringing- the order insnot in the computer for me to give the med the nurse said. I haven’t entered it from the crappy fax with the shitty handwriting yet and its on the bottom of the stack of my faxes because I can’t finish entering one order with out the phone ringing because a nurse needs to know compatibility for the same med she called for last night and then calls right after that to bitch because the order isn’t entered yet. And then calls again because the med isn’t on the floor for her to give to the patient and then calls again because she wants to see if you had time to enter the order into the computer yet, and then gets mad when you say- if you would stop calling me I could enter the order….oh yeah and the runner had the night off so you are the Pharm.D and the runner and the IV pharmacist and the everthing with a pager to make sure you don’t miss the call you are not in the pharmacy to answer because you sat down (almost) on the toilet to pee and as your ass cheeks just about hit the toilet seat the pager goes off……….

Retail plain sucked. Sorry, just couldn’t take it.

The better place was /is clinical pharmacy - decentralized (still get treated sort of like crap by the nurses, but the MD interns and residents thought you were golden) and you actually had time to review renal dosing, aminoglycosides, vanc, warfarin etc. Discharge patient counseling is fun (you do get an obnoxious patient sometime- but you just let that go because for the most part they are good- and of course they haven’t a clue you are a Pharmacist even though you introduce yourself that way and they think you are a nurse - so if you piss them off you can always tell them you are a nurse - not really :)

The bad thing in the hospital now is Med rec - it came along and fucked up being a clinical pharmacist because now the time is spent comparing the med list the patient thinks they are on to the med list the inpatient doc ordered to the discharge med list to make sure the patient has everhthing they need.

At any rate, currently if you are going to work hospital- the government is the place to be for benefits and pay. Our pay is comparable to retail in the area because we have a consolidated mail out facilty near by and the RPH there gets paid like retail- but works better hours.
Vacation and sick leave are good.
Family leave is good if you ever need it.
If you are interested in a working professional Pharm.D. program you can get tutition reimbursement.

Pay level, vacation time, benefits (Insurance, 401k, fringe) versus community pharmacy in the same area

=> pay is awesome. I got around 60 /hour + OT sometimes…overall around 120-125K/year (not including OT)

=> benefits: Vacation is accummulated as PTO. Annually, u can accummulate up to 3-4 weeks vacation. 401K isn’t that bad either.

- Role on the healthcare team (P&T — do they care what you think/say?)
==> Very important. Without you, meds are all messed up with wrong strength/frequency/dose…

- Level of staffing of Pharmacists and Technicians (Is it adequate?)
==> Sometimes u can get very busy, but never as crazy as in retails. PLus, the busy is due to pharmacy-related tasks, not because of insurance or some stupidity in retails.
- Responsibilities of the technicians and the role they play in the pharmacy
=> See above post from other techs. They said them all
- Amount of work expected to be completed with respect to hours in a shift
==> You will have enough time.
- Respect from physicians, nurses, administrators
==> It depends. Some are nice, some are not. But regardless, there will never be a time when a nurse or a doctor would say something like, “F*** this. i’ve been waiting….”. You can write them up.
- Opportunity for professional development and/or career advancement
==> I rather be a clinical/staff then being a manager…too much headache