Karl Winckel[/caption]
The author's CVD risk, calculated using AusCVDRisk, in printable image form[/caption]
2024 Credentialed Pharmacist of the Year Brooke Shelly MPS[/caption]
Rub shoulders with Kerri Barwick MPS (centre) and other members of team PSA at CPC24[/caption]
This activity is sponsored by Reckitt. All content is the true, accurate and independent opinion of the author and the views expressed are entirely their own.[/caption]
The use of insulin, considered a high-risk medication with APINCHs classification,5 Ms Barwick notes, provides justification for a Home Medicines Review (HMR). ‘There’s an advantage to going into the home to observe the patient’s diet, consider potential interactions, and educate patients on the best effects and outcomes,’ she says.
Advice around cleaning blood glucose level (BGL) monitors to ensure accuracy can also be provided. ‘Pharmacists can explain how to put test drops through and clean blood spills on the monitor, common in pregnancy due to higher blood volume,’ says Ms Barwick.
With only 50% of women diagnosed with GDM receiving tests for heart disease and type 2 diabetes post-pregnancy,6 HMRs can be beneficial at this stage of the journey, too.
‘Along with conversations around diet choices, exercise regimes and sleep, I also explain how often testing is required over the next 5–10 years, and how to monitor for signs of the development of diabetes,’ Ms Barwick advises.
Nausea and vomiting in pregnancy
The presence of iron in pregnancy multivitamins may exacerbate symptoms of nausea and vomiting in some pregnancies, according to Ms Barwick.
‘Pharmacists can recommend a trial cessation of the iron component of pregnancy vitamins, often unnecessary in pregnancy,’ she says.
In 2020, photographer Bobbi Lockyer created a Birthing on Country project to highlight and create awareness around birthing issues and outcomes in Aboriginal women. For more, see 
Michael Hewson [he/him] identifies as a genderqueer or non-binary person. ‘I don’t feel like a man and I don’t feel like a woman. I’m just Michael and that’s all I need to be.’
What led you to a career in pharmacy?
I was feeling rather lost towards the end of high school spending far too much of Year 11 and 12 playing World of Warcraft, so I was rather blindsided when moving onto tertiary education. My mother took me to a careers expo and on the drive home I mentioned it would be great to understand how Nurofen ‘knew’ how to treat my headache. With my interest piqued, I applied, accepted and graduated (whilst still spending far too much time playing World of Warcraft.) I’ve been a pharmacist for 12 years working in pharmacies in Perth and the South West.
Tell us about your experiences as a genderqueer pharmacist?
They have not all been great. In general, the healthcare provider community is quite accepting, but with plenty of pharmacy clientele of an age where men were MEN and women were not, I have had homophobic and ignorant comments.
I wear a number of identifying pins on my uniform, including a “He/Him” pin, a rainbow flag, and occasionally the genderqueer flag. To members of the LGBTQIA+ community they are a way of communicating non-verbally that they are in a safe space, talking to someone who will show empathy and compassion. And my pronouns pin has garnered significantly more vitriol than the rainbow flag. While pronouns are nothing new, their use in the current zeitgeist has ruffled some conservative feathers and that will often trickle down to the regular Joe and Joan.
The LGBTQIA+ community is resilient and confident because we’ve had to be. We are loud and proud because the alternative gets us ignored, forgotten, or worse. I have also, however, met many beautiful, loving clients who have endeavoured to get to know me and broaden their minds about what a “professional” pharmacist should look like. Far too often coloured hair, facial piercings and tattoos are labelled “unprofessional” by people (in and out of the industry) who don’t realise we are just human beings expressing ourselves in whatever way brings us joy.
What strategies are essential to fostering respectful and culturally safe pharmacy care?
Providing a safe space is absolutely essential to the provision of effective healthcare, and these safe spaces need to be obvious and well maintained. It’s not enough to put that rainbow sticker on the window if you don’t maintain a store that is culturally sensitive in other ways. Language should be respectful, especially when acknowledging gender pronouns and gender-transitioning clients. Staff should be properly educated, open-minded and have the freedom to challenge customers when they use bigoted, racist, or homophobic language. It will happen, and your staff need to be ready to counter it in a respectful and level-headed manner. Ultimately, the provision of top quality healthcare can only happen if our clients feel visible, heard and respected; regardless of their race, religion or gender identity.
What is needed to improve health equity and outcomes for LGBTQIA+ people?
In short: a change in the way we as society view gender. When we put people in boxes based on what genitals we assume they have, we limit any positive healthcare outcomes we may potentially achieve with that person. Unless their genitals are literally the reason for their visit, they really shouldn’t even be part of the conversation.
Why are pronouns so important?
Pronouns are a quick and easy way of understanding someone’s relationship with gender. When you offer yours, either verbally or through a badge or pin, you’re letting the recipient know that you’re open to hear about their gender expression too. And more importantly, that you’ll respect their pronouns and try to get them correct as often as you can. While easy to forget, and misgender someone, the important part is that you try to get them right, and that you’ll rectify any errors you make. In creating a safe space for LGBTQIA+ clients, pronoun badges are a great place to start!
Any advice for ECPs?
Reflect on what you can bring to a team and don’t be afraid to ask for what you’re worth. Don’t get stuck in that dispensary and don’t let anyone pay you the award rate because it’s insulting. Ask for a pay rise every single year but be prepared to have a reason why you’ve earned it.
A day in the life of Michael Hewson, Pharmacy Manager, Bedford, WA.
| 8:30am | Facilitating CPOP Coffee, breakfast and the daily news precede my first patient, aged 50, on the community program for opioid pharmacotherapy who asks for his usual dose and two takeaways while he tries, as usual, to convince me to adopt a greyhound. I’m one step closer. |
| 10:00am | The regular One of my regular patients arrives with a bundle of prescriptions complaining of fatigue, a potential adverse effect of their beta-blocker. We chat about the risks versus benefits of their medicines. Not understanding why it has been prescribed, I sit the person down in our consult room and go through the list individually. I get a MedsCheck completed while we chat. |
| 12:00pm | A case of presumed sexuality I have one client who took one look at me and said: ‘You’re gay! And I can tell because I’m a lesbian.’ Sometimes it’s just obvious to those in the know, and it was cute because it made the consumer more comfortable. |
| 1:00pm | Mental health counselling Someone I haven’t met before provides a script for fluoxetine. With more sigh than voice they agree that it’s a new medicine. My offered counselling is rebuffed. I process the script with the warning that it may feel underwhelming at first but to give it a try. I print a CMI and slip our store magnet with contact details into the bag and give a cheery ‘call me if you are feeling any worse’ farewell. Then it’s on to the usual interrupted lunch – for which I bring room temperature food! |
| 2-10pm | Afternoon admin and my time After data entry for any HMRs, unpacking orders, preparing dose administration aids and meeting with pharmaceutical representatives, I serve the last of the consumers. My social battery drained, I like to recharge by going to the gym (lifting weights, not classes) or escaping into the World of Warcraft to dissociate. |
