My path to critical care pharmacy and the FICM Pharmacy Sub-Committee

"I originally chose to study pharmacy after being inspired by some family-friends who owned their own community pharmacy. I studied at Nottingham University, and only changed my mindset towards hospital pharmacy at the very end of my degree and managed to secure my Pre-Registration Pharmacist year in my local district general hospital. My training was excellent, I loved the clinical aspects of the job, and I was encouraged by the team to progress my career in hospital pharmacy.

After qualifying, I took the usual route of rotational Band 6 and Band 7, taking on new challenges whenever they arose. I gained a wide range of experience throughout medicine and surgery, and took on additional roles including Clinical Trials and Education & Training. I completed my postgraduate Clinical Pharmacy Diploma, part of which I chose to complete in critical care. I liked the depth of knowledge that the consultants and nurses had on critical care, and how involved pharmacists were within the team and on the ward round. I did a couple of long rotations there and loved the variety that general critical care brought. Over the next few years, I completed my independent prescribing course and was promoted to Lead Pharmacist for Education & Training and Trust Non-Medical Prescribing Lead. I really enjoyed this role, as I was able to manage my own diary and attended some senior Trust meetings. I did this for about a year before taking some time off to have my first child. My time off on maternity leave allowed me to reflect on my career and I realised that I missed the clinical aspects of being a pharmacist, as I had become mainly office based. A colleague saw a job opportunity come up for a Critical Care Pharmacist at Royal Stoke University Hospital and suggested that I apply for it. I did, and luckily, I was successful. I joined University Hospital of North Midlands NHS Trust and settled into my role as an Advanced-level Critical Care Pharmacist.

After 6 months of finding my feet and trying to remember colleagues’ names, I had developed a good routine and was comfortable in my role. I was attending ward rounds and prescribing regularly. I had built good relationships with the ICU team – from doctors and nurses, to SALT and Dietetics – and with my colleagues in the pharmacy department. I had decided that critical care was definitely where I wanted to stay and pursue my career. I had been thinking about how to progress my career, and considering whether to complete an additional qualification such as a Masters in critical care or a Doctorate in Pharmacy. I spoke to some of my colleagues for advice, and in the end, I decided that I didn’t want to spend so much of my time outside of work on a new qualification whilst my son was so young. I may reconsider this in the future, however, for now I needed a new challenge that was a little less time consuming.

When COVID-19 arrived, it was all-hands-on-deck. The Lead Pharmacist for Critical Care happened to be abroad when our first patients were admitted to intensive care, and I was chosen to lead the team until she returned a few weeks’ later. It was a time for rapid change – new ways of working, changing rotas, flexibility and quick planning. Our Paediatric ICU was converted to an Adult ICU, and we created a new pharmacy storage area near the critical care unit, with 7-day pharmacy services to support the critical care team. We helped the clinical trials team to set up the study drugs for RECOVERY and REMAP-CAP.  Lots of colleagues helped support us, including a previous critical care pharmacist who came back to help us a couple of days a week from her role as a CCG pharmacist, and an endless list of technicians and ATOs who all stepped up. We are so grateful to everyone for their help.

Over the summer, the workload returned to normal and I was able to catch up a bit. I spent some time developing my clinical knowledge through reading, podcasts, journal articles and Twitter. Twitter can be a great learning tool, if you follow the right people! I saw on Twitter that the Faculty of Intensive Care Medicine (FICM) was opening membership to Pharmacists. I also saw that one of the consultants from my previous Trust, Dr Liz Thomas, had recently been appointed FICM Chair for Women in Intensive Care Medicine. Dr Thomas was a great inspiration and was really supportive of me during my time as a junior pharmacist on intensive care. I decided to apply to join FICM and was looking forward to accessing the e-Learning that is available on FICMLearning, BJA, as well as the twice-yearly publication, Critical Eye. With all of this included, I felt that the membership was good value.

Then arose the challenge I had been waiting for – FICM were looking for members to join their Pharmacy Sub-Committee (PSC). Encouraged by my Chief Pharmacist, I applied. A few weeks later, to my surprise and delight, I was invited to join! There are six pharmacist members including myself, and we are all committed to driving forward critical care pharmacy towards its full potential.

The FICM PSC has four key workstreams. Education (i), will review and update the current UKCPA critical care curriculum and syllabus, and develop the advanced-level education and training strategies for critical care pharmacists. Credentialling (ii), will re-work the framework for critical care pharmacist credentialing at scale. Workforce (iii), the PSC will use the pending UKCPA critical care pharmacy 2020 workforce survey to contribute to the FICM Careers Recruitment and Workforce databank, ensuring pharmacy workforce considerations are identified. We will also work to develop workforce resources to support critical care pharmacy service developments at national and local levels (from both clinical and health economics perspectives). Membership (iv), we encourage critical care pharmacist colleagues to become FICM Pharmacy members so they can benefit and contribute to these key areas of development for our pharmacy specialty.

We are working with other critical care pharmacy groups (e.g. United Kingdom Clinical Pharmacy Association (UKCPA)) to ensure we have a co-ordinated UK pharmacy response. Look out for further communication on our work through FICM, UKCPA and the critical care network groups!

So, despite originally planning on managing my own pharmacy, I am now part of a national critical care pharmacy committee. How unpredictable and exciting your career can be when you take up opportunities!"