Gloomy

Why...why...why am I having this down moment?  Could this be the Monday Blues Syndrome? If that is so...oh my, I have not experienced this for a long time. Today is one of those days of tiresome and exhaustion even before the day starts. The drizzle rain made the gloomy day dark and it is not helping at all. It was 0900hr and am still at the studio in pyjamas. How I wish for a full body massage with lavender scented essential oil to get those stiff muscle straightened and relaxed especially around the scapula. O' Allah please don't misunderstood me...Alhamdulillah it rains and thank you Allah for giving me another day to live and worship you. But, I am feeling so down and sleepy, my eyes are sore and my shoulder aches.  Like it or not, I dragged myself off the warm comfy bed and by 12 noon I forced myself to school.  

I took a glance look at the 'to-do list'. The three things listed for today were - continue writing the Introduction chapter of the thesis (supposed to be done this morning when I was busy in bed); meeting on funding for the second study with the supervisors, and finalise the SSI form for hospital R&D application. Frankly speaking, there was no sense of excitement at all...my brain just froze. Dong...Dong...The bell from the red church on Tavistock Street strikes two. O' dear Allah, it is already 1400hr - half of my day has gone unproductive. 

While I am typing this entry, there was 6 people in the research centre including me. Everyone (except me) seems busy - the only music is the sound produced from pressing the computer keyboards, papers being flipped and clipped, and water boiling from the coffee corner. It is so quite, so bored and very depressing. I wanted to shout and scream to force the air molecules to vibrate and produce some real noise! So I stood up, open my mouth wide and sang my heart out "I believe I can FLY... I believe I can TOUCH the SKY...Flip my wings and FLY AWAY...to where my heart wants to STAY". Oh yeah that was a relief!

"O dear! Kc...you can sing?"

"I can do many awkward things when I'm stressed"

 I am missing home...I am missing him

Couples

My oyster card remained empty for almost a week. Within this period I travel to and back from school on foot - 20 to 30 minutes walk each route depending on my speed of the day. Why am I doing this? Perhaps for three main reasons. First - the 1hour 'walking time'  gives the mind some space to think in a relaxing environment.  Second, it contributes to an extra 1 hour to the existing I2 hours 'off the bed and work station' and third...saves £52 of this month's pocket from public transport. I would say a reasonably good healthy deal ;)

It took me 2 days to push away the regrets of not topping up the Oyster and to put away the thoughts of 'this is taking me forever'! However from day 3 onwards, I become addicted - I look forward every morning and late evening for a brisk walk. I truely enjoy the walk in the breezy wind (and sometimes friendly English rain), no sweat (yes! the perfume and deodorant sweet scent stay the whole day) and the one  thing I enjoy most is watching people on the streets. I came across a few funny scenes like what we usually see in movies - a young lady lifting her mini skirt to pull up the thermal stokings at the bus stop infront of Maddan Tussaud; a man with an umbrella that just simply flips sides one windy rainy morning - just like Mathew Popins (instead of Marry popins)!

There is one particular behaviour I have been observing - how couples at different age walk and talk on the streets. Couples who giggles alot and 'hug-walking' as if the whole world has paused for them are generally the very young.  I prefer not to walk behind them when approaching narrow pavement  for the sake of reserving precious time. They look cute but far from romantic. The second type of couple holds take away coffee, the male usually tucks a newspaper under the armpit, and the female - ooo love that heels! I have to jog to catch up withnthem because they dont walk... they march side by side, stop at a point, then turn, exchange hugs and kisses and in a split second turn away in seperate directions and dissapear. One goes down the underground station, the other elswhere. Well, perhaps this is the couple of a long term relationship with career commitments. They look smart and dress decently...but hey, seriously take a break.

The couples in the third category is the elderly. They walk arm in arm peacefully and wait patiently for each other to take one step at a time. "Are you cold honey, take my jacket" ... "Thank you dear,  but I'm fine"... "Tell me if you need it"... "Sure, don't worry about me". They must have shared their whole life together. They look so sweet, so calm and so romantic. No kisses no huggies but their touch around each other's arm is so forever loving.

If I am a politician

Isn't the lady in this picture pretty? That was me working at the pharmacy a few years ago. Do you believe this claim? Better not because it is not true (Gotcha sleepy head!). The only truth is I am a Pharmacist (no joke). However, since I graduated in 2002, there was only one person who assured me that I have chosen the right profession and she was my lecturer (the opinion could be bias). The majority of my friends and family members thought otherwise. Out of ten polls on opinions of what type of profession would my personality fit in, six claimed that I should have been an academician, two said I might better off be a politician and one each for lawyer and in marketing field respectively. Not even a single vote for either doctor, nurse or dentist..and what more pharmacist. Ouch! How heart breaking...4 years of undergraduate and currently halfway struggling postgraduate study in 'Pharmacy' I have yet to hear someone to tell me that I work close to any profession oin the medical field. Last week, a stanger I met at Heathrow airport made a guess that I was an architecture student! Oh dear, so far away from my league, I wonder what type of art she saw in me. Do you think increasing my sample size would have given a different result? I am not convinced because the opinions have been the same for the past 10 years.

In view of the high possibility of Malaysia having the general election any time this year, in this entry I would like to write about what I wish to do if I am a poltician - the Minister of Women, Family and Community Development. Now, now Malaysian friends...be kind not to relate me with any 'cow' scandals. Lets see if you still think I should be a poltician rather than a pharmacist by the end of this article:

If I am given the oppotunity to play the role as the Minister of Women, Family and Community Development; I would like to fight for flexible working schedule working schedule for female employees. Before we proceed, this is my disclaimer: I do not have education background in political or social science, most of my points are from my personal observation and what I read from the internet and not representing any political parties. 

Current scenario: Women are multitaskers - career women 0800-1700hr, mother and wife 24hr. An early start at 0500hr to get the kids ready for school (or nursery for infants) then race towards the highway before 0700hr in order to get ahead of the traffic jam. Later on, rush to fetch the kids  within the one hour lunch break and back to office for the remaining hours. Later in the evening, got trapped in the traffic for almost an hour or two before reaching home, exhausted.  The responsibility continues to have dinner ready, oversee children's homework, get bits and pieces of household errands done before a bedtime (which may be interupted by wailing baby cries). The routine repeats itself on the following day. Owh wait...there could be some urgent office work to be completed at home at night. Some of us may argue - husbands would do halve of the tasks, there is a maid to get things done, school buses and day care to handle the kids after school. The truth is, not everyone can afford such luxury (even though these have become neccesities nowadays).  Eventhough we may have all the above mentioned support - there is still insufficient quality time for love ones by the end of the day. The nature of our work could be different but however, if it is well planned ahead we may have the chance to have a big chunk done from home - effectively!

Ideas: Flexible working schedule for female employee.  This option is available but is not open to all sectors.  

Possible ways for implementation: Option for  flexible salary scheme (by number of working hours OR number of days working at home with a designated period in a year) which comes with performance and quality indicators. This option should be opened to all through a proper application and carefully selected candidates; perhaps some interviews and refelection of previous performance. Applicants who deem suitable for the scheme will be given a trial period and those who manage to perform within this period will be given the option as to whether they would like to continue with the scheme. The scheme is not permenant and can be withdrawn if they do not performe up to expectation.

Why should we have this: Having this idea in place, employers pay for the amount of hours being committed and the female employees have the flexibility to manage thier career and family life. I strongly believe that happy women build happy families; happy families create good foundation for successful generation and a successful generation is the hope of our nation!

I acknowldege that it easier to write on paper than having it implemented...but why not give a try. If this is made available, are you not tempted to participate? I would!

You

All this while I thought I understood

The feeling of being in need and empty

I am sorry if I have not done what I should

The reality shows that now I am lonely

Have I thank you enough

For all your sincere sacrifices

For listening during difficult times and making me laugh

For making my stupid cries sound wise
For being in reach at all times no matter how tough
For pulling me up when I fall and giving good advices

Thank you for making us perfectly spliced

You are a man of action, never was of words

Yes we fight (sometimes)! But our mind would eventually concur

This is more than love and  for me that is beyond suffice

In you I learned that trust should never be compromised

Challenges facing Clinical Pharmacy practice

'Clinical Pharmacy' needs no further introduction to pharmacists as it is the heart of pharmaceutical care. It has many peripheral specialised pharmacy knowledge that are equally vital to optimise the quality of health care. During the recent 2012 UK Renal Pharmacy Conference [1], this topic was well elaborated by Dr Chris Green [2]. Even though the discussion focused on the challenges facing clinical pharmacy in the UK National Health Service (NHS), I believe this is a global issue in the pharmacy world.

In the introduction of his talk, Dr Chris Green mentioned what pharmacists can learn from the Olympics. If we are the losing team, be a Challenger and ask ourselves ‘What can we do to close the gap?’ If we are the Record Holder, ask ourselves ‘What can we do to improve?’ If we are the Team Manager ask ourselves ‘How can we aggregate the marginal achievements?’ The cumulative answers will determine our current scale and what we should be aiming for and how long are we are willing to wait to achieve it. The following paragraphs may be using examples relevant to the practice in Malaysia, therefore I would like to apologise to my non-Malaysian readers. Neverthelss, we may share some basic principles.  

It is important for us to first accept the fact that the task in facing the challenges is the responsibility of the individual professionals forming the profession. This simply means it is OUR responsibility. Many of us, for many reasons, regard the responsibility entirely to the MPS, PSD, MoH [3] or the individuals holding certain posts and positions in the managerial level - an irresponsible dogma that should be eliminated as it brings more harm than good to us all. If this is not to your agreement, I doubt the content of this article would be an interest to you. You may want to stop reading at this point or carry on with an open mind. This article is written with the intention of sharing information and hopefully to inspire more pharmacists to move out from their current comfortable cocoon.

Dr Chris laid out five challenges or potential opportunities (depending to our individual perspective) that the profession or precisely WE need to tackle in order to place clinical pharmacy in the ground of our health care system, namely:

1. Leadership
2. Innovations

3. Clinical developments
4. Patient safety
5. Education & Training

Leadership

There is a reason for Leadership being first in the list - clearly stated realistic vision. Leadership is also important to initiate and sustain the wind of progressive changes. I have a simple analogy to share, carefully read these next three sentences: Strong leadership is the foundation of any successful organisation. A successful organisation has leadership qualities at all levels. All levels must be willing to be lead to achieve the clearly stated realistic vision.

If we draw a figure out of the above sentences, it will turn out to be a circular process. The better we are, the bigger our Leadership Cycle will be. There will be less turbulence and more positive energy when every unit of the cycle flow in uniformity. However, there are three factors that can potentially introduce gaps within this cycle. The gaps are contributed to either unrealistic vision which may put the cycle on pause or poorly communicated vision which may result in diversion of many peripheral stand-alone cycles. Both circumstances are equally destructive to the organisation. Perhaps it is time for our professional bodies to explore the potential of current technology as a mean of communication to ensure visions are clearly delivered and understood. The third factor is lack of leadership qualities in the individuals within the cycle.

Each one of us is a leader and should work in unity to build our professional Leadership Cycle. We must know how can we fit in. This is easily said than done because we do (at some point of our career) come across situations that can be frustrating; and when nothing much can be done about it (mostly due to unnecessary red tapes and lousy policies) it can be demotivating! Whether we like it or not...face it, do no turn our back and hide! Sharpen our leadership skills by analysing the root of the problem and find the most appropriate solution within the limitation.

Innovations

When is the last time we initiated something new? When is the last time we challenged ourselves to do something out of the norm?

Clinical developments

Are we joining the front line of the growing clinical developments? In the scientific world where evidence based is the only communicable langguage, we must be more than just a commentator. Pharmacists should be looking across the boundries and grab the opportunities to be hands-on in research. It is high time for us to be loud professionally otherwise we will always be the profession that has a history of rewarding clinical experience with management that does not reach any extraordinary potentials.

Patient safety

Data Rich but Information Poor : we have mega databases that are nicely kept but poorly utilised to generate information.  

Education & Training

Professional training and education is a vital investment. Many efforts has been put forward and is still taking place in our local system. The latest development is the BPS examination. A lot of ground work has taken place over the years before the recent BPS comes to reality. It would best for us to embrace the changes and look forward for the potential opportunities it may bring rather than bragging on the disadvantages. Other education and training that  we should aim to achieve in the near future are:

·         Career path (credentialing, consultant post)

·         Antibiotic stewardship

·         Medicine optimisation

·         Medication safety

·         Pharmacist prescriber

In conclusion, changing a gigantic system is difficult and almost impossible within days. It is best to stop wasting our energy pushing the wall. A more promising result is likely to be achieved by changing ourselves and the people within our reach.  Lead others to be a better leader than ourselves because change is a long term investment. There is obviously a lot of work to do in nailing clinical pharmacy practice into the health care system and there are many more challenges awaiting us. I would like to end this entry with a quote from President Barrack Obama:

 ‘Change will not come if we wait for some other person or some other time. We are the ones we've been waiting for. We are the change that we seek’ [4].

 
References:
1. UK Renal Pharmacy Conference 2012, 28-29 September 2012, Manchester
2. Dr Chris Green - ^{Clinical Director Pharmacy & Medicines Management, Countess of Chester NHS Foundation Chair UK Clinical Pharmacy Association}
3. MPS (Malaysian Pharmaceutical Society), PSD (Pharmacy Service Division MoH), MOH (Ministry of Health, Malaysia)
4.  http://www.brainyquote.com/quotes/authors/b/barack_obama.html#F2hvA2ldPzqCwZRd.99

Smiles

A walk in English Summer

This summer has been sober

It is like all season without sunshine

Could not rely on the forecast either

Rain drops hit on me when it says 'Today will be fine'

One morning the sun finally smile

Warm breeze passed by to kiss

Alas! Summer is here after quite a while

Everybody is out with style...bliss!

Out comes the mini shorts and flip-flops

Sun glasses, singlets and skirts

Then you'll see walking bodies with no tops

Sunbathing or playing squirts

Would you mind walking with me to Regents Park?

I want to feed the ducks, pigeons and the beautiful white swan

It is still long before dark

Plenty of time to have some fun 

Come on...let me take you to the wide green field

Can you see the squirrels on the dancing trees?

This is where I come to get the sored heart healed

Feel the wind, smell the acacia scent...hmmm peace

 Down the other end is the English garden

Tall and round water fountain greets the entrance

Pink roses, purple lavenders, yellow iris, coreopsis golden

In winter when everything is white or grey, you'll miss their presence







Myself, my friend Azy and my sister, Nora at The English Garden in Regents Park London