15.1 Professional Attributes and Practices

A successful pharmacy technician must possess a wide range of knowledge and skills and certain personal characteristics. Besides accumulating a broad knowledge of pharmacy practice and drugs, technicians must have an eagerness to learn, a sense of responsibility toward patients and healthcare colleagues, a willingness to follow instructions, an eye for detail, confidence in basic mathematics, good research skills, and the ability to perform accurately and calmly in hectic or stressful situations.

Healthcare professionals at all levels are expected to act maturely, project a positive and inviting physical appearance and attitude, and be willing to work hard, get the job done, and serve the customer. This requires attention to both written and unwritten rules of personal and professional behavior, and getting into good habits of mind, body, and professional practice.

Knowledge of Policies and Procedures

It is important to get to know the ins and outs of pharmacy practice in any particular facility. Most pharmacies spell out policies in online or written materials during initial job orientation and training. In large-scale pharmacies, a policy and procedure (P&P) manual outlines the roles and responsibilities of staff members as well as the procedures of the facility. The implementation of a P&P manual is particularly important to the smooth operation of large, more complex chain and hospital pharmacies.

Make sure that you are thoroughly familiar with your pharmacy’s guidelines and abide by them in your routine practice. Below are some sample questions that may be addressed in a P&P manual or may be accepted pharmacy practice:

• Can employees fill their own prescriptions or the prescriptions of family members? Store or hospital policy may dictate that an employee cannot fill their own prescriptions or those belonging to a family member. Violations could result in job termination.

• Is compensation available if you have to work late? In some practice settings, you will need to use a time clock to punch in and out for both your breaks and your shift. Overtime pay may need to be approved by the lead technician, the supervising pharmacist, or the vstore manager.

• Are pharmacy technicians allowed to add auxiliary labels to medication vials? Some pharmacy practice settings dictate that only the pharmacist can affix auxiliary labels to medication vials; in others, the technician is required to add all auxiliary labels.

• Can a technician retrieve and fill a C-II prescription or medication order? At some pharmacies, only the pharmacist is allowed to retrieve and count C-II drugs; in others, the technician may retrieve and count, but initialing and double-counting by the pharmacist is always required as part of the final check.

• What is the process for prescription verification at time of pickup? Some pharmacies will require a signature by the person picking up the medication or a driver’s license number if it is a C-II drug. Some pharmacies will require verification by address, telephone number, or date of birth.

Guidelines such as these are not always written, so you will have to ask questions because these unwritten rules will need to be learned and followed just as will the state pharmacy laws. It may take as long as three months or more in the community or hospital pharmacy setting to fully learn the roles and responsibilities expected of you. Technicians are often trained to assume different roles in the department to increase scheduling flexibility. As new policies and procedures are implemented, you will have to read and document your understanding of these changes. If you deviate from written procedures, it could result in a medication error leading to harm to the patient and a legal case against the pharmacy, the pharmacist, and perhaps you as well.

Professional Standards of Behavior

Some of the unwritten, assumed standards of professional behavior in a pharmacy include appearance, decorum, etiquette, direct address, timeliness, dependability, cooperation, positive attitude, and restraint.

Professional Appearance

Appearance is the overall outward look of an employee on the job, which may be different from the outward look of the same person outside of work. How you look on the job affects how other people perceive you—your boss, colleagues, and customers. So your choices in dress and grooming need to help encourage people to trust you, which means projecting a sense of official responsibility, precision, and cleanliness, as this is a career in the healthcare field.

Pharmacy technicians need to dress neatly and professionally.

In many pharmacies, the technicians may be required to wear a certain color lab coat or scrubs to differentiate them from the pharmacist. You will need to wear a name tag at all times for easy identification and follow the pharmacy’s dress code, which may be crisp and professional or more relaxed and casual. Having unkempt hair or a uniform smock thrown over a pair of jeans will not help colleagues or customers trust you. The customer may not consciously register these observations, yet could leave with a vague impression that the pharmacy is not a professional operation. Proper attire, impeccable grooming, and good personal hygiene are important ways to convey a positive, professional atmosphere.

Decorum and Etiquette

Decorum means proper and polite behavior, acting in good taste with civility. Arguing with your boss, colleagues, or patients is an example of impropriety, or a lack of decorum and civility. Health care is a demanding industry, often requiring long hours and involving stressful emergency situations and unrealistic patient demands. As a result, practitioners in the industry often suffer from fatigue and stress. Sometimes this stress shows itself in unintentional rudeness or in abrupt behavior toward coworkers, including pharmacists, physicians, nurses, medical assistants, administrators, store managers, sales representatives, insurance personnel, and other technicians.

For example, busy healthcare professionals may sometimes speak to subordinates in an inappropriate and unprofessional manner. The degree to which you maintain courtesy and respect even in the face of rudeness is a measure of your decorum and professionalism. If you return rudeness with kindness, then you often find that, immediately or over time, the quality of your interactions improves. If you answer the telephone and someone barks a command at you, then demonstrate your professionalism by attending to the content of the message and not to its tone.

Another set of social mores to be followed is often referred to as etiquette. Etiquette, defined as rules of good manners, is often recognized most easily when it is not being followed. For example, being disrespectful to a physician, a nurse, or a colleague is an obvious breach of the proper etiquette of being respectful of those in authority or with whom you work.

Proper Direct Address

In the presence of patients, refer to the pharmacist as “Doctor” if they have a Doctor of Pharmacy degree. Some states have designated all pharmacists as “Doctors” in recognition of their professional experience. Referring to the pharmacist as “Doctor” raises the level of customer respect toward the pharmacist and also toward the technician, who is the “Doctor’s Assistant.” It is also important to refer to physicians, chiropractors, osteopathic professionals, and dentists using the title “Doctor” and to other supervisors using appropriate courtesy titles, such as “Ms.,” “Mrs.,” or “Mr.,” plus the last name, or “Sir,” “Madam,” or “Ma’am.”

Customers deserve the same form of address. A degree of formality in day-to-day operations is always in order until you are requested to use more informal modes of address.

Ensuring Timeliness

Whenever you are in a work situation, your employer and colleagues depend upon you. Therefore, showing up a little early for each of your work shifts so that you can put away your belongings and prepare your mind for work is necessary. It is disconcerting to the pharmacist and other technicians if you come rushing into work just in the nick of time, or, even worse, late as they do not know for sure that you will be there.

Consider your habits and build in extra time before work, always allotting a little more than you think you will need so that you can arrive and breathe easily, enjoying a measure of mental space rather than feeling rushed and stressed. Problems usually arise when people are rushed, and things inevitably go wrong.

When planning how you will get to work to make your shifts, have a “Plan A”: the ideal way for you to get there that will work most days. But also have a “Plan B” in case you miss the bus or your car or your bike breaks down. Who could you call to get a ride? Could you get a taxi? Who could take care of your children if your childcare falls through? Think through the various pieces of your life that need to be in place for you to come to your shifts ready and able to work.

Being Dependable

If you cannot make a shift because of being ill or some major issue with transportation or family issues, make sure that you inform your employer immediately when you know this and offer a “Plan B” to have your shift covered.

Understand that when you commit to a work schedule, you are important to that workplace; people depend upon you, and you need to show up or find a replacement or some other solution. Also, it is unacceptable behavior to sleep in and miss a work shift. If you are a person who stays up late at night with friends, then plan your social life to happen on evenings when you don’t have an early shift at work.

Exhibiting Cooperation and a Positive Attitude

Cooperation is that sense that everyone in the pharmacy is working together for the same goals of serving the patients and customers, providing accurate and safe prescriptions. In the community pharmacy, there are the additional goals of providing other health aids and retail items, and of being profitable. In the institutional pharmacy, there are the additional goals of working efficiently and effectively within the larger mission of the hospital or long-term care facility, responding as part of the in-house medical teams. Your supervising pharmacist needs to have a clear sense that you are aware of the larger responsibilities of the pharmacy operation and are willing to do what is asked of you to assist in the pharmacy’s goals and mission to serve. No one wants to hire someone with whom they will have to argue about getting a task done or who resents helping others in their work.

Attitude is the overall emotional stance or disposition that workers adopttoward their job duties, customers, coworkers, and employers. Attitude is extremely important in professionalism and customer relations. In a community pharmacy, the technician is on the front line of customer service. In the hospital setting, technicians often conduct their jobs behind the scenes, ordering and stocking items in the pharmacy or the nursing unit, retrieving stock for compounding operations, maintaining records, filling prescriptions or unit dose carts, preparing compounded sterile preparations in the cleanroom, and performing general housekeeping tasks to maintain cleanliness in the pharmacy environment. Whether up front or behind the scenes, in all your tasks, you must be listening and communicating well with the pharmacist, other technicians, and hospital staff. You must maintain a positive attitude even on those days that are hectic or understaffed or during times when you are not feeling 100%.

A person’s attitude is reflected in the eyes, smile, posture, and other nonverbal and verbal communication.

Having a good attitude also means taking pride in your workplace. You may need to provide feedback or offer suggestions to the supervising pharmacist or store manager on ways to improve operations and customer service. Examples include suggestions for more efficient or effective processing of medical orders, stocking of prescription or OTC (over-the-counter) products, managing customer drop-off or pickup lines, handling insurance issues, ordering from wholesalers, juggling work schedules, and so on. You should not criticize management but instead offer thoughtful, constructive solutions. Being an invaluable asset to the overall pharmacy operation can assist you in advancement and in negotiating a pay raise in the future.

Professional Restraint

Some employees like to gossip or speak badly about their supervisor, coworkers, or customers. Never engage in this type of behavior because it undermines trust and goodwill. In addition, customers may speak poorly of or inquire about physicians, specialists, and other healthcare professionals. General information and positive recommendations may be given, but opinions on the competence of a particular physician or healthcare provider should not be given out by anyone in the pharmacy. At all times, avoid making disparaging comments about other healthcare providers. If such comments are made and the person’s professional reputation is questioned, then you could be sued for slander.

Managing Change

Working in a professional setting also means managing change. By definition, health care is dynamic—always changing—as are the medications and treatments being provided: new generics, new formulations, new dosages, and so on. The pharmacy work environment also flows with dynamic small changes, such as shifts in customer service approaches, last-minute switches in work or vacation schedules, revising of insurance plan coverage, or updates to government policies.

During training in a community pharmacy, you will learn how to use the prescription software, the cash register, pricing procedures, credit card scanners, and inventory management tools. You will also gain an understanding of prescription insurance plans and the processing of claims—these, too, will be changed on a regular basis.

Similarly, in the hospital pharmacy, you will have to learn the ins and outs of the pharmacy and hospital software and medical order transmissions. Mastery will also be needed of the various automated tools used in the pharmacy, including bar code scanners, dispensing units in the pharmacy and the nursing unit, compounding devices, repackaging and dispensing machines, digital balances, and primary engineering control (PEC) workstations in the IV cleanroom. Confidence in running the pharmacy’s equipment will take time, but you can begin in classroom simulations, externships, and internships. Since the technology and procedures will be updated often, you have to be ready to always be a learner. However, you will be able to handle it because you have learned the basics.

Technicians need to work with pharmacists as part of a pharmacy team wherever they work.

Teamwork

For eight hours or longer per day, technicians and pharmacists must work together along with others as a cohesive healthcare team to provide quality care and to process prescriptions for patients efficiently and safely. Each member must establish collegial relationships built upon respect for others, an appreciation of others’ workplace contributions, and a willingness to help one another during busy times or in times of change. You also need to be honest about your own capabilities. If you feel overwhelmed on the job, do not be afraid to ask for help. For example, have a colleague double-check your filling, compounding, or dosage calculations.

Respecting Differences

In any pharmacy, you will work with personnel from varied age groups, genders, ethnicities, and religious backgrounds. Personalities differ and sometimes clash. Is someone too talkative or loud, or too quiet and passive? Are some personnel too obsessive and compulsive? Do some seek patient contact and communication primary engineering control (PEC) whereas others would rather fill prescriptions and minimize patient contact?

These differences cannot be allowed to interfere with the work at hand. There must be respect for other personnel, both individually and with regard to their roles in the pharmacy. Unresolved issues should be brought to the attention of the supervising pharmacist privately. Any criticism of an individual’s quality of work should be viewed as a constructive learning experience. Problems may range from a small typo to a larger medication error, but personal differences should never be a factor in addressing a problem in the workplace. Remember, you are part of a team with a role and mission much larger than yourself.

Appreciating the Contributions of Colleagues

Being aware and appreciative of each team member’s contributions is essential to the smooth operation of a pharmacy. Seek out those who are more knowledgeable or skilled to obtain information or learn how to handle a difficult situation. For example, oftentimes pharmacists consult technicians about insurance issues because technicians are well versed in the nuances of various plans. At other times, technicians rely on the guidance of pharmacists to manage a difficult patient.

Recognizing these contributions with common courtesies, such as “Thanks for staying late to help out during this busy time” or “Thank you for helping me locate that OTC medication for the customer,” can build rapport among team members. You can also build rapport by showing an interest in coworkers’ personal lives. On breaks, simple questions like “Where did you go on vacation?” or “Did you have a fun weekend?” contribute to team building.

A pharmacy technician should seek guidance from a pharmacist on how to handle a challenging situation.

Good Communication Skills

The glue that holds all teams together is communication. Communicating effectively takes practice and involves both verbal and nonverbal communication strategies. Model yourself after someone whom you admire, and keep in mind that some of your coworkers have different roles and thus different communication needs and styles.

Listening and Verbal Communication Skills

The heart of verbal communication is, of course, listening. Paying close attention to the words and the voice that you are hearing is important. Maintain eye contact with the person speaking, and send the speaker other nonverbal signals of being attentive to indicate that you are genuinely interested in what they are saying. Ask questions to clarify issues, and repeat portions of the conversation to confirm that you have correctly heard what was said.

There is the additional challenge of hearing the correct drug name and term when there are so many similar ones that are very difficult to say and remember. Learning the correct pronunciations and definitions is one hurdle you can overcome with study. Listening and asking a coworker to carefully repeat and pronounce difficult words are the best ways to learn on the job. Repeat difficult words to yourself several times. You may also find it helpful to acquire pocket-sized reference guide on drug names handy and make notes in it regarding pronunciation and usage.

Nonverbal Communication Skills

Facial expression, posture, hand gestures, and of course eye contact are all methods of communicating without using words. As small children, we learn quickly how to interpret nonverbal communication. Mannerisms and gestures often indicate agreement or disagreement.

Watch colleagues and customers carefully. Their attitudes and reactions to information can often be determined through their nonverbal communication. Technicians need to learn how to interpret nonverbal communication, clarify it, and respond accordingly. The goodwill that you communicate always comes back to you in one way or another.

Pharmacy technicians should always interact with other professionals respectfully.

Personal Conduct and Lifestyle

Personal telephone calls, texting, and visits should be conducted only during breaks. Telling offensive or off-color jokes is not acceptable and can make colleagues and patients feel uncomfortable. When in doubt as to the expected behavior in a situation, watch and learn from someone else in the pharmacy who is a suitable model, and perform your assigned task. If you are not sure, ask questions of the senior pharmacy technician or the supervising pharmacist.

Appropriate workplace behavior also demands that you do not let your personal life interfere with your work performance. You must be “on top of your game” to safely and efficiently input, fill, and dispense prescriptions and interact with customers and healthcare personnel for hours-long shifts. If you bring your personal problems to the workplace, you may not have the concentration needed to perform your job responsibilities accurately and safely. Interpersonal issues, such as family obligations, personal health, dating, and the need for more flexible work hours, may cause tension and adversely affect job performance. Intimate personal relationships with coworkers or pharmacists are discouraged or not allowed in most practice settings. A transfer to another pharmacy may be appropriate if you plan to carry on a relationship with a colleague.

De-stressing and exercising off the job mean that you can be more attentive on the job.

Technicians must take care of themselves as well as their patients. Although refusing to work a long shift or overtime is not always a realistic option, technicians can heed the recommendations of the Healthcare Provider Service Organization (HPSO) to help combat fatigue and, therefore, prevent medication errors. These include getting enough sleep and exercise, eating healthy foods, and avoiding illegal drugs and too much caffeine or alcohol (see Table 15.1).