Keeping patients safe
There's a lot more to being a pharmacist than pouring pills from a big bottle into a little bottle.
The key parts of the job are to make sure the right pills get into that little bottle, and especially that medications don't negatively interact with each other.
Pharmacists also talk with patients -- sometimes people who tend to avoid doctors -- and sometimes, those pharmacists save lives in the process.
At the Sanford Clinic pharmacy in Detroit Lakes, the job also entails making IV solutions and topical anesthetics for the same-day surgery unit.
And for registered pharmacist Julie Kauffman, the job also involves supervising other members of the team: pharmacists John Sanger and Gary Regelstad and technicians Ginny Kimball and Angie Rusness.
That part of the job though is easy, she said.
"This is a really good group -- we're more like colleagues working together -- and because it's such a small department, I am also a worker."
When it comes to moving pills from the big containers to the prescription bottles, the technicians do a lot of that work.
The pharmacists themselves focus on making sure those prescriptions are safe and effective.
"My job is to make sure the right pills get into the little bottles and that the medications don't interact with each other," Kauffman said.
The first line of defense against that happening is obviously the doctors who prescribe the medication.
But a patient may have prescriptions from several doctors from different healthcare systems who aren't able to coordinate care.
"One doctor may put you on one pain medication and another may put you on another (similar medication). You won't get any more pain relief, but you'll see a lot more side effects."
For medications that are essentially stronger versions of over-the-counter drugs like Ibuprofen and Aleve, the long-term side effects of taking a double-dose could be ulcers and kidney failure.
Before filling a prescription, pharmacists use specialized software to search for drug interactions.
"The screen comes up and interactions are categorized by severity," she said.
The most serious interactions, called contraindications, could cause serious harm to patients.
"These two drugs are never to be given together," she said.
When a pharmacist catches potential problems with a prescription, the next step is to contact the doctor who ordered the prescription.
Medical professionals work together to solve the problem.
"Now it's much more of a team approach," Kauffman said. "The new doctors are more used to working that way, it's the way they were trained, but I've never had any doctor who wouldn't work with me."
Most doctors have a regimen of drugs they know very well and prescribe often.
"It's when they get outside of their comfort zone they need help," she said. "I don't know everything either, but I'm very good at going online to find stuff out and find what they need."
Consulting with patients when they come in to pick up a prescription is another key part of the job -- and that talk can be more important than people realize.
"We have people who always take advantage of that and people who never want to talk," she said. "I try to give that open-door feeling," that there is always time for a medical conversation.
More than once, Kauffman has steered people into the emergency room after one of those conversations.
"A lot of people don't want to go to a doctor," she said. They'd rather talk to a pharmacist, perhaps because they're easily accessible, she said.
"I do know of a couple lives I've saved," after hearing patients talk about their symptoms, she said.
She remembered one woman in particular with pneumonia who came in with her husband to talk to the pharmacist.
After being alarmed by what she saw and heard, Kauffman had him take her right to the emergency room, and found out from the emergency department the next day that the woman would likely have died had she not gone in when she did.
"That's the nice thing about working here -- there's more time to talk to patients," Kauffman said of Sanford Pharmacy.
She worked for 20 years at the Kmart pharmacy, and worked early in her career at the St. Mary's hospital pharmacy. She also worked in the blood lab there.
She graduated with a four-year pharmacy degree from NDSU in 1989.
She and her husband, Jim, are both Cottage Grove natives. They married in 1984, and the year before that Jim moved to Detroit Lakes and bought a barbershop (Jim's Barbershop, which he still owns and operates).
Their children, Alex and Lauren, both graduated from Detroit Lakes High School. Alex lives in West Fargo, where he works in prescription delivery, and Lauren is a junior at Gustavus Adophus College in St. Peter, where she is majoring in mass communications.
Kauffman joined Sanford during a difficult time, after the clinic had purchased the Prescription Shoppe pharmacy from David Brenk, who died a short time later.
Construction was ongoing and the pharmacy moved several times within the building. Pharmacy staff were dealing with new computer equipment and software, and with grief over Brenk's untimely death.
"I had to learn things fast," she said. "There was a new pharmacy computer system they weren't understanding very well -- it was all new, and things were in disarray. I needed to get them back on track, fast."
She was helped by a quick-learning staff and by helpful pharmacists in Fargo.
"We have a really good rapport between all the pharmacies in the Sanford system," she said. "I don't think I could have done my job -- learning the whole system -- without a couple of pharmacists in Fargo who have been invaluable."