Ensuring HIPAA compliance has been likened to navigating

a minefield of potential violations. Even with the best of

intentions and work ethic, a single lapse in concentration or

judgement may be detrimental to one’s employment if it re-

sults in a breach of HIPAA law. Having an understanding of

the regulations and the

challenges that go

along with them may

help us avoid costly

mistakes.

The Health Insurance

Portability and Ac-

countability Act

(HIPAA) is a federal

statute enacted in

1996. This complex

series of rules provides

standards for manag-

ing healthcare data and

incorporate the provi-

sion of privacy of Pro-

tected Health Infor-

mation (PHI). It ap-

plies to healthcare agencies and

healthcare personnel and providers

having access to individually identifia-

ble health information records such as

physicians, nurses, pharmacists, health

insurance companies, etc. HIPAA rules

are enforced by the Office for Civil

Rights (OCR) and include all forms of

this data - electronic, paper and verbal.

HIPAA is further defined by a set of

rules:

The Privacy Rule – sets national

standards for the use and disclosure of

PHI.

The Security Rule – outlines safe-

guards that must be implemented to

protect the confidentiality, integrity

and availability of electronic PHI.

The Breach Notification Rule – requires affected individ-

uals to be notified that their PHI has been compromised,

as well as notifying HHS and in some cases the media.

The Act contains five

titles (sections):

HIPAA Titles I,

IV and V – protect

coverage of health

insurance for indi-

viduals who have lost

or changed jobs or

who have pre-

existing conditions.

HIPAA Title II –

applies to processing

of electronic

healthcare transac-

tions and requires

organizations to en-

sure patient health

data is stored, ac-

cessed and transmit-

ted in a manner that

is compliant with federal privacy regulations.

HIPAA Title III – applies to general medical care.

If data contains one or more of the 18 HIPAA Identifiers, it

is considered PHI. Identifiers 1 -3 encompass patient names,

dates such as birth, death, admission, discharge, and patient

location. Identifiers 4 – 11 include numbers – phone, fax,

social security, medical record numbers and even vehicle

license plate numbers. Identifiers 12 – 18 include technology

identifiers such as email addresses, medical device serial

numbers, fingerprints, full face photographs, and any other

unique identifying numbers or codes. PHI can be shared in

many formats—for example medical records, bills, clinic

schedules, emails to or about a patient, and verbal exchanges

that may be overheard. Speaking about or with a patient in a

public area is subject to PHI regulations, and if a non-private

setting is unavailable, a quiet voice should be used. Be

HIPPA: A Minefield Filled with Good Intentions

A Publication of Neil Medical Group, The Leading Pharmacy Provider in the Southeast

July/August 2019

PHARM NOTES

Volume 22, Issue 4

Continued on page 4

Inside this issue:

HIPPA: A Mine-

field Filled with

Good Intentions

1

Battling Cancer:

The Journey

2-3

Conclusion:

HIPPA

4

Sjogren’s

Syndrome

5

The Importance

of Soft Skills in

Healthcare

6-7

Neil Medical

Group Contact

Information

8

Battling Cancer: The Journey

Page 2

PHARM NOTES

When most people hear the word cancer, we immediately

cringe and think the worst. Cancer is a scary, intimidating

word. I’m sure everyone has been affected by cancer in some

way. Some of us have their own personal experience with can-

cer or have had a family member or friend diagnosed with can-

cer. Cancer has been around for a long time, but it seems every

time I turn around I am hearing about someone new that has

been diagnosed. I have had many family members diagnosed

with cancer. A very close first cousin of mine, age 34, was

diagnosed with breast cancer last year. She went thru chemo-

therapy and then had a double mastectomy. Everything

seemed to be looking good after her surgery. Her scans came

back negative; no cancer seen. Then about three weeks later

she started having headaches, neck stiffness and vision prob-

lems. It was first suspected that she had meningitis. Her spinal

fluid was tested and cancer was found in her spinal fluid. Can-

cer was in her spinal fluid and tissues around her brain. The

physicians gave her two months max to live. My cousin passed

almost two months later. She didn’t quite make it the two

months. She went thru a lot of pain and suffering. Cancer in

the spinal fluid is very rare. Can you imagine getting this kind

of prognosis, especially at this young age?

On a better note, I know a lot of people who had cancer and

were cured of the cancer. Usually the key is finding the cancer

early on. Many cancers have a high chance of cure if diag-

nosed early and treated adequately.

Cancer is a generic term for a large group of diseases that can

affect any part of the body. Cancer does not discriminate. Can-

cer does not care what the age, gender, or skin color is. One

defining feature of cancer is the rapid creation of abnormal

cells that grow beyond their usual boundaries, and which can

then invade adjoining parts of the body and spread or metasta-

size to other organs. Metastases are a major cause of death

from cancer. Cancer is the second leading cause of death glob-

ally. About 1 out of every 6 deaths worldwide is due to cancer.

Approximately one third of deaths from cancer can be linked

back to behavioral and dietary risks including: high body

mass index, tobacco use, alcohol use, lack of physical activity,

and low fruit and vegetable intake. Tobacco use is the most

important risk factor for cancer and is responsible for about

22% of cancer deaths. Late stage presentation and inaccessible

diagnosis and treatment are common.

The most common cancers are: lung, breast, colorectal, pros-

tate, skin and stomach cancer. The most common causes of

cancer death are cancers of: lung, colorectum, stomach, liver,

and breast. Cancer arises from the transformation of normal

cells into tumor cells in a multistage process that usually pro-

gresses from a pre-cancerous lesion to a malignant tumor.

These changes that occur are a result of the interaction be-

tween a person’s genetic factors and 3 categories of external

agents that include the following - chemical carcinogens such

as asbestos, components of tobacco smoke, aflatoxin (a food

contaminant), and arsenic; biological carcinogens such as in-

fections from certain viruses, bacteria, or parasites; and physi-

cal carcinogens such as ultraviolet and ionizing radiation. Age-

ing is also a fundamental factor for developing cancer. The

incidence of cancer rises dramatically with age, most likely

due to a build-up of risks for specific cancers that increase

with age. The overall risk accumulation is combined with the

tendency for cellular repair mechanisms to be less effective as

one grows older.

Between 30-50% of cancers can be prevented by

avoiding risk factors and implementing existing

evidence-based prevention strategies. The cancer

burden can also be reduced through early detec-

tion and management of patients who develop

cancer. Modifying or avoiding risk factors can

significantly reduce the burden of cancer. These

risk factors include: lack of physical activity, al-

cohol use, tobacco use including cigarettes and

smokeless tobacco, being overweight or obese,

unhealthy diet with low fruit and vegetable in-

take, ionizing and ultraviolet radiation, urban air

pollution, sexually transmitted HPV infection,

infection by hepatitis or other carcinogenic infec-

tions and indoor smoke from household use of

solid fuels. Tobacco use is the single most im-

portant risk factor for cancer. Tobacco kills ap-

proximately 6 million people every year from

cancer and other diseases. Tobacco smoke has over 7,000

chemicals, at least 250 of these are known to be harmful and

50 are known to cause cancer. Tobacco smoking causes many

different types of cancer including: cancers of the lung, esoph-

agus, larynx, mouth, throat, kidney, bladder, pancreas, stom-

ach, and cervix. Second-hand smoke has also been known to

cause lung cancer in non-smoking adults. Smokeless tobacco

causes oral, esophagus, and pancreatic cancer.

Page 3

Volume 22, Issue 4

Dietary modification is also important for cancer control.

Cancer of the esophagus, colorectum, breast, endometrium

and kidney are linked to obesity and being over-weight. Di-

ets high in fruits and vegetables help protect against many

cancers. The risk of cancer also increases as the amount of

alcohol increases.

Pollution of water, air, and soil with carcinogenic chemicals

contributes to the cancer burden to different degrees depend-

ing on the geographic location. Exposure to carcinogens also

occurs from the contamination of food, such as aflatoxins

and dioxins. More than 40 agents, mixtures, and exposure

circumstances in the working environment are carcinogenic

to humans and are classified as occupational carcinogens.

Exposure to all types of ionizing radiation, from both natural

and man-made sources, increases the risk of various types of

malignancy including leukemia and many types of solid tu-

mors. Risks increase when the exposure takes place at an

early age and also when the exposure amount is higher.

To prevent cancer people may: increase avoidance of the risk

factors previously listed, vaccinate against HPV and Hepati-

tis B virus, control occupational hazards and reduce exposure

to ionizing radiation including occupational or medical diag-

nostic imaging. Vaccination against HPV and Hepatitis B

viruses could prevent 1 million cancer cases each year. When

identified early, cancer is more likely to respond to effective

treatment and can result in a greater probability of surviving,

less morbidity, and less expensive treatment.

Early diagnosis consists of the following steps that must be

integrated and provided in a timely manner: awareness and

accessing care, clinical evaluation, diagnosis and staging,

and access to treatment. Compared to early diagnosis, cancer

screening is a more complex public health strategy that man-

dates additional resources, infrastructure, and coordination.

When planned effectively, appropriately financed and imple-

mented, screening can reduce deaths from cancer and, in

some cancer types like cervix, can also reduce the risk of

developing cancer.

The main goals of cancer diagnosis and treatment programs

are to cure or prolong the life of patients and to ensure the

best possible quality of life for cancer survivors. The most

effective treatment programs are those that: adhere to evi-

dence-based standards of care, are provided in an equitable

and sustainable way, and are linked to early detection and

accurate diagnosis and staging.

The first step in the management of cancer is to establish the

diagnosis based on pathological examination. Obtaining a

tumor sample is done by having a biopsy or aspiration that

may require an intervention such as an endoscopy or an im-

age guided procedure. Laboratory and pathology medicine

services are essential to accurately analyze and interpret pa-

tient samples, which guides the diagnosis, treatment, and

management of the patient. It is then critical to determine the

stage. Staging is used to help guide treatment options and

estimate a patient’s prognosis.

Cancer treatment requires consideration of evidence-based

options, which can include more than one of the following:

surgery, radiotherapy, and systemic therapy. Cancer treat-

ment services require a strong health system to ensure treat-

ment is high quality, safe, effective, and accessible to all can-

cer patients.

After active treatment for cancer, a plan can be developed to

monitor patients for cancer recurrence or spread. This follow

-up is also useful to manage health problems related to can-

cer diagnosis or cancer treatment and assess for development

of other types of cancer. These services include tests and/or

routine examinations and are vital to manage the conse-

quences of cancer diagnosis and treatment. In conclusion, try

to limit your risk factors in order to decrease your chances of

cancer.

Article by Stephanie Joye, RN, BSN, CRNI

Nurse Consultant, Neil Medical Group

Page 4

HIPPA: A Minefield Filled with Good Intentions…….………...continued from page 1

PHARM NOTES

mindful when discussing health information with a resident

when they have visitors in their room. HIPAA protects infor-

mation relating to a patients LBGTQ status as well.

Access to PHI is only permitted when this information is need-

ed for legitimate business needs and to fulfill a job function.

Access to electronic PHI should only occur with a provider’s

own log-in credentials. It is considered a violation to access

records out of curiosity such as looking up information about

friends, co-workers, public figures or for malicious intent.

Patients have rights to their information under HIPAA that

include receiving copies of their records, accessing their actual

records, requesting records are corrected if they contain inac-

curate information, and requesting restrictions on disclosures

to their records. To ensure electronic security of PHI, it is a

good idea to log out of computers or electronic charts when

not using the information, never share passwords with others,

use a strong password, and have computers set to time-out

when not in use.

Safeguarding PHI requires ongoing vigilance. Hard copies of

records and documents should be filed away or covered up

when unattended (paper MARs during a med pass). If com-

puters containing PHI are in an area that makes them visible to

other patients or visitors, a privacy screen should be used. If

electronic MARs are used, ensure the privacy feature is ena-

bled on the computer screen when unattended. Documents

should be promptly removed from fax machines and copiers.

When disposing of PHI it is important to provide safeguards

also. It should be disposed of in a locked bin or shredder or if

electronically stored, authorized methods for securely destroy-

ing should be in place. There are situations where patient au-

thorization is not required: for example, disclosing PHI to oth-

er healthcare providers for treatment purposes or for reporting

required under federal law, by court order, or per state law.

HIPAA permits “incidental disclosures” as long as reasonable

safeguards are in place. Unfortunately, these occur even under

the best of circumstances, however they are not considered

breaches and do not need to be reported. These are usually

minor instances of being overheard by a passing visitor or resi-

dent during the normal course of performing one’s job duties

in one’s designated work area. However, discussions contain-

ing elements of a resident’s PHI with a coworker in a common

area such as a facility cafe would not be acceptable, nor would

leaving a voicemail containing PHI about a resident on their

home phone without their consent. Even though unintentional,

the following examples are considered “unauthorized disclo-

sures”: faxing, emailing or mailing PHI to the wrong number

or address; giving paperwork containing PHI to the wrong res-

ident; losing/misplacing paperwork; sending unencrypted

emails or text messages containing PHI; losing a laptop con-

taining PHI data; having ones log-in to electronic charting sys-

tem compromised; and posting any comments or pictures on

social media that may contain PHI. If a suspected incident has

occurred, employees are obliged to report the details to a su-

pervisor immediately.

What are some of the consequences of a privacy breach? Fi-

nancial consequences in the form of civil penalties and fines

ranging from $100 to as much as to $2.5 million have been

known to occur, not to mention litigation costs. These penal-

ties may be imposed on an institution and/or employee violat-

ing HIPAA. Disciplinary action resulting in job termination is

often likely for an employee responsible for the violation –

even if unintentional. The reputation of both the institution and

employee may be damaged, and there may be an emotional

cost to the victim of a privacy breach. Malicious or intentional

violations may be subject to criminal penalties.

Tips for maintaining compliance:

Ensure resident is accurately identified preferably using

two or more unique identifiers such as DOB, photograph,

etc.

Verify the identity of the recipient of someone requesting

PHI – such as someone claiming to be a law enforcement

officer, someone from the medical examiner’s office, and

various outside vendors that may request information.

Ensure emails containing PHI are encrypted when sent to

a recipient outside of the company network and avoid

placing PHI in the subject line of an email. Use extreme

caution when entering the recipient’s email address to en-

sure correct email address is used. Consider password

protecting any attachments containing PHI.

Avoid using a personal cell phone or camera to take pic-

tures of PHI and avoid transmitting text messages contain-

ing PHI.

Use extreme caution and heightened judgement when

posting any information on social media (Facebook, Twit-

ter, LinkedIn, Pinterest, Instagram, etc.) that pertains to

one’s workplace, even if it seems harmless – “when in

doubt, leave it out!”

Ensure paper records are not removed from the facility or

copied without administrative permission, and ensure they

are stored in secured areas.

Avoid leaving PHI on a telephone message and don’t as-

sume a spouse or relative is entitled to know information

such as resident’s appointments, diagnoses, test results etc.

In conclusion, adhering to HIPAA regulations requires ongo-

ing vigilance, mindfulness and training. Do not hesitate to

contact your supervisor or employer if you have any questions

or need to report a concern. It may end up preserving a job, a

reputation, and in some cases an entire organization.

Article by Dianne Higgins, PharmD, BCGP

Regional Clinical Manager; Neil Medical Group

Page 5

Volume 22, Issue 4

Sjogren’s Syndrome Sjogren’s syndrome (SS) is a slow progressing, chronic auto-

immune disease in which the moisture producing glands of the

body do not function correctly. With upwards of 4 million

Americans suffering from the disease, SS is one of the most

prevalent autoimmune diseases. Nine out of ten of those af-

fected are women. Despite its prevalence, Sjogren’s syndrome

is often under-diagnosed and the symptoms are often associat-

ed with other illnesses. SS can occur alone or in association

with other autoimmune diseases, most commonly rheumatoid

arthritis and lupus. This condition can affect people of any

age, but symptoms typically appear between the ages of 45

and 55.

Sjogren’s syndrome is an inflammatory disease that most of-

ten affects the tears and saliva glands, though it can affect

many different parts of

the body. The exact

cause of this condition

is unknown, but it is

known to be an inflam-

matory autoimmune

disorder. It is theorized

that white blood cells

infiltrate the glands that

secrete fluids, such as

the salivary glands in

the mouth or the tear

glands in the eyes.

These white blood cells

damage the glands, re-

sulting in dry mouth

and dry eyes, the hall-

mark symptoms of the

condition. SS is categorized as primary or secondary. Primary

Sjogren’s syndrome occurs in patients with no other rheumatic

diseases, while secondary Sjogren’s syndrome occurs in pa-

tients who have another rheumatologic disease, such as lupus

or rheumatoid arthritis.

Patients with this condition may notice irritation or painful

burning of the eyes. Dry mouth, swelling of the glands around

the face and neck, and swallowing difficulty are common.

Most of the symptoms and complications of Sjogren’s syn-

drome are due to decreased tears and saliva. Patients who ex-

perience dry eyes are at increased risk for infections of the eye

that may result in damage to the cornea. Patients with dry

mouth are at increased risk for dental decay, gingivitis, or oral

yeast infections (thrush) that may cause pain or burning. Addi-

tionally, patient may experience episodes of painful swelling

in the salivary glands around the face. Additional parts of the

body can be affected. Pain or stiffness of the joints with mild

swelling, rashes on the arms and legs, and inflammation in the

lungs, liver and kidney may occur rarely and be difficult to

diagnose.

Diagnosis of Sjogren’s syndrome is suspected if (1) the patient

presents with eye and/or mouth dryness, (2) eye tests reveal

inflammation, (3) mouth evaluation reveals dry oral mucosa,

and/or (4) patient’s serum reacts with immunoglobulins auto-

antigens. Biopsy of the enlarged gland may be necessary to

rule out other conditions. Blood tests can reveal abnormalities.

Erythrocyte sedimentation rate is elevated in about 70% of

patients with this condition. About a third of patients have de-

creased red blood cells and about 25% have decreased white

blood cells. Though blood tests cannot confirm diagnosis of

Sjogren’s syndrome, they can be extremely helpful in leading

to diagnosis. Diagnosis of Sjogren’s syndrome is based on all

the information obtained by the

physician including symptoms,

physical exam, and all test re-

sults.

No cure is currently available

for Sjogren’s syndrome. Treat-

ment of Sjogren’s syndrome is

aimed at relieving the bother-

some symptoms associated with

the condition while limiting the

potential for chronic damage

that may result from impaired

secretions. Dry eyes are typical-

ly treated with artificial tears

applied regularly throughout the

day. Anti-inflammatory eye

drops, such as Restasis, may be

needed to increase tear produc-

tion. If corneal ulcerations are present, eye patching and boric

acid ointments are recommended. Drugs that are known to

decrease secretions such as diuretics, antihypertensives, anti-

cholinergics, and antidepressants should be avoided if possi-

ble. Plugging or blocking of tear ducts can be used in severe

cases to increase moisture of the cornea. Dry mouth symptoms

can sometimes be alleviated by drinking water, chewing gum,

or using saliva substitutes. To stimulate secretions, pilocarpine

or cevimeline, may be prescribed to improve symptoms. Pain-

ful, swollen salivary glands can be treated with analgesics and

warm compresses. If necessary, doctors can remove stones in

the salivary glands. Early diagnosis and treatment are key to

preventing long term damage to major organs.

The overall disease course of Sjogren’s syndrome can vary

from very mild to rather significant depending on the timing

of diagnosis. It can take years for the diagnosis of Sjogren’s

syndrome to be completed. Patients need to remember to be

proactive about complications and any changes noticed during

the process of diagnosing the condition.

Article by Erin Taylor, PharmD Candidate

Wingate University School of Pharmacy

The Importance of Soft Skills in the Healthcare Industry

Page 6

PHARM NOTES

To succeed in a professional environment, it is necessary to

possess both hard and soft skills. Hard skills are those that have

been learned through on the job training, college education, or

experience. Soft skills are not so much learned as they are in-

nate to an individual. Soft skills are defined as personal attrib-

utes that enable a person to interact effectively and harmoni-

ously with other peo-

ple. These skills re-

late to aspects of

your personality and

are just as important

to success as hard

skills. In fact, the

soft skills that you

possess could mean the difference between simply having a

career and having success in your career. The healthcare indus-

try requires the employ of both hard and soft skills. There are 7

basic soft skills, and each plays a role in enabling a person to

effectively work as a member of a team. These skills are so

important that certain healthcare curriculums (including nurs-

ing and pharmacy) are incorporating discussions about them

into their lectures. The 7 basic soft skills and their importance

are reviewed below.

Communication Communication is the first of the seven soft skills, and while it

is important to possess in any job setting, it is essential in the

healthcare industry. Consider the number of interactions a

pharmacist could potentially have in one day, spanning from

patients or family members to physicians and nurses. In each of

these interactions, an individual must be able to clearly and

effectively communicate. In consulting pharmacy, it is im-

portant to be able to concisely communicate with a physician

about medication changes and/or optimization. In terms of

patient communication, a health care provider must be attune to

the educational level of the person that they are speaking with,

and adjust the depth of their conversation to ensure that the

information they are communicating is understood.

Another aspect of communication is listening and body lan-

guage. Active listening is important in being able to compre-

hend another person’s level of understanding. The body lan-

guage of the speaker can play an important role in the listener’s

willingness to participate in the conversation. A speaker can

also interpret the body language of the listener to gauge their

interest in the conversation.

Collaboration/Teamwork

The second soft skill is collaboration or teamwork. In the

healthcare industry especially, the ability to work on a team is a

necessary skill. Multiple individuals may comprise a patient’s

healthcare team. In the long term care field, a health care team

can be made up of a physician, nursing, dieticians, physical and

occupational therapists, pharmacists, specialists, and many oth-

er individuals. Each of these individuals must work together to

achieve safe and optimal patient care.

As an example, let’s discuss a patient who is consistently los-

ing weight and not eating well. There are many reasons why

this could be: they may not like the food they are being offered;

they may have no appetite or they may be having difficulty

feeding themselves.

Now let’s consider

what healthcare team

members could help

address this problem.

Pharmacy could recom-

mend medications that

work to stimulate appe-

tite, and a physician

could write the orders for this. A dietician could recommend

additional foods that the patient may tolerate. Occupational

therapy could help the patient with feeding. In order to deter-

mine how best to treat the patient, all of these healthcare pro-

fessionals must work together.

Adaptability

Another essential soft skill is adaptability. This is the ability to

change based on the needs of the situation you are in. It can

also mean being willing to compromise to reach a solution.

This skill can be demonstrated by showing openness to an al-

ternative way of doing things, or being willing to take on tasks

that might be outside of your comfort zone. Adaptability is an

indispensable skill for both work and life.

A simple example of adaptability would be the following: It is

flu season and as a result, multiple crucial members of the

work team are out sick. In order to make the day flow smooth-

ly, the roles of the sick co-workers must be divided up and tak-

en on by other individuals. A willingness to take on these extra

job responsibilities to ensure a smooth work day is an example

of adaptability. In healthcare, this skill is necessary. No health

related job position allows you to focus on one task at a time;

you must be able to multitask and adjust based on the current

situation. Having the ability to adjust to different situations, or

being adaptable, is imperative.

Empathy

Empathy is the ability to understand the feelings of another

person. In patient care, this skill is particularly important. Em-

pathizing with a patient involves being able to discern a pa-

tient’s feelings regarding their diagnosis and treatment. It

could also mean interacting with a patient’s family members,

and responding to them appropriately and with compassion.

Demonstrating empathy helps to foster greater trust between a

patient and a health care provider.

Empathy can also play a role in interactions with co-workers.

Take for example a co-worker who is having a particularly

rough day; they woke up late and on the wrong side of the bed,

the car wouldn’t start, and they stepped in a huge puddle on the

way to work. All of these things are in addition to the other

Page 7

Volume 22, Issue 4

unknown life stresses they have going on at home. You were

scheduled to have an important meeting with them at 9:30am.

At 9:45am, they still have not shown up for the meeting. You

pass them in the hallway, and remind them of the meeting that

they missed. They apologize and briefly mention the morning

they have had. You have two options: you can say “that is not

an excuse, we need to reschedule our meeting” or you can em-

pathize, saying “I am sorry that happened to you and I under-

stand how that can throw off your day. However, we do need

to reschedule this meeting as it is very important.” Displaying

empathy towards coworkers can help to foster stronger rela-

tionships and make for a better work environment.

Self Confidence

Self confidence is a soft skill that can also translate into hard

skills. It is being able to trust your own abilities and

knowledge. Let’s take for example the placement of an IV. In

school or through training, you received education on how to

place an IV. If you lack self confidence, you may question

your ability to place an IV even though you have had the ap-

propriate training to do so.

Self confidence can also play a role in patient and health care

provider interactions. In order to trust their health care provid-

er, a patient must be confident that the provider is capable of

treating them. If you appear to the patient to be lacking confi-

dence, they may become uncomfortable with their care, and

begin to question your ability to treat them. In terms of provid-

er interactions, it is also important to display self confidence.

Consider the following: a physician asks you, a pharmacist,

for a dosage recommendation for a patient. If you respond and

say “Uh, I don’t know... Maybe 20mg?” how likely do you

think the provider is to take your recommendation?

Having self confidence also allows you to accept constructive

criticism as well as enable you to work better under pressure.

For example, say you are a pharmacist assisting in a code situ-

ation. A physician hurriedly asks you for a dose of epineph-

rine. If you possess self confidence, you are more likely to be

able to swiftly assist the physician. This could mean trusting

your own knowledge of the dose of epinephrine, or being con-

fident enough to know that you need help, and asking some-

one else what the dose is.

Problem Solving

Problem solving is closely related to all other soft skills. It is

defined as being able to recognize an issue, come up with pos-

sible solutions, and implement a solution. Let’s take the previ-

ously mentioned example of multiple employees missing work

due to flu. The problem is that there is a work shortage, and as

a result, patient care could be compromised, or tasks might not

get completed. Possible solutions include delegating additional

tasks to other employees, or attempting to obtain additional

help through other means. The implementation of the solution

would be appointing someone to delegate tasks (a leader), as-

signing tasks to other employees, and then overseeing the

tasks to ensure completion. The need to solve problems can

arise in any position, and the problems can range from being

very small to very large. Regardless of the size of the issue,

being able to identify it and come up with solutions, is a vital

skill.

Time Management

Having the capability to manage your job responsibilities and

complete all job tasks in a specific time frame is another im-

portant skill to posses. A small example of this would be a

physician in a doctor’s office: they must be able to dedicate

time necessary to address each patient’s concerns, but they

must also balance their time to ensure they see all patients

scheduled in that day.

Time management is also necessary when one is multitasking.

In a typical work day, there are certain tasks or projects that

must be completed. Throughout the day, unexpected meetings

or conversations may also become necessary. Being able to

prioritize tasks to ensure they are completed is an essential soft

skill. The skill of time management can go hand in hand with

adaptability.

The importance of soft skills in the healthcare industry cannot

be denied. Take the following situation as an example: you are

a patient coming into the hospital with a DVT. You are in

pain, scared, and wondering what is going to happen. Your

doctor tells you that you have a DVT, and he is going to give

you some medicine and send you home. Your nurse enters the

room and says “Take this pill. We are sending a prescription to

your pharmacy and you can go home.” You are discharged

home, and pick up your medication but are scared to take it

because you know nothing about it.

Now let’s consider a different situation. You come to the hos-

pital, and your doctor enters the room and introduces himself.

He tells your diagnosis, explains how he intends to treat it and

asks if you have any questions. He then leaves the room, and

consults pharmacy for a dosage recommendation. A pharma-

cist enters your room and explains the medication you are

about to take, including how to take it, possible side effects,

and when to return to the doctor. Your nurse then comes in

with the medication, and explains that a prescription is being

sent to the pharmacy. She states that she hopes you feel better,

and explains your discharge instructions. How is the second

situation different from the first? Which situation would you

want to be a patient in?

Soft skills are largely inherent, however, it is possible to de-

velop these skills. A push is being made for these skills to be

discussed and assessed in all healthcare curriculums. On an

individual level, a person should evaluate their interactions

with others. They should take stock of how they react in dif-

ferent situations, and identify areas for improvement. In the

healthcare industry, soft skills are vital to achieving optimal

patient outcomes. They are also essential in maintaining a

healthy and positive work environment. Arguably, soft skills

are just as important to success as hard skills.

Article by Whitney Schlick, PharmD Candidate

UNC Eshelman School of Pharmacy

PHARM NOTES

Kinston Pharmacy

2545 Jetport Road

Kinston, NC 28504

Phone 800 735-9111

Louisville Pharmacy

13040 East Gate Parkway

Suite 105

Louisville, KY 40223

Phone 866 601-3041

Mooresville Pharmacy

947 N. Main Street

Mooresville, NC 28115

Phone 800 578-6506

To all the Pharm Notes Family,

We’ve probably all been told that TOGETHER you’ll go further, be stronger, accomplish more, and

be more successful. So here’s some food for thought:

At a Midwestern fair, many spectators gathered for an old-fashioned horse-pull (an event where

various weights are put on a horse-drawn sled and pulled along the ground).

The grand-champion horse pulled a sled with 4,500 pounds on it. The runner-up was close, with a

4,400 pound pull.

Some of the men wondered what the two horses could pull if hitched together. Separately, they

totaled nearly 9,000 pounds, but when hitched and working together as a team, they pulled over

12,000 pounds!

We all bring our individual strengths and talents to the

workplace…..but when we can combine our efforts and

work together as a team…..we can accomplish so much

more! It’s powerful….and more importantly….its true.

Till next time…...

Cathy Fuquay

Pharm Notes Editor

Pharm Notes is a bimonthly publication by Neil

Medical Group Pharmacy Services Division.

Articles from all health care disciplines pertinent

to long-term care are welcome. References for

articles in Pharm Notes are available upon request.

Your comments and suggestions are appreciated.

Contact: Cathy Fuquay (cathyf@neilmedical.com)

1-800-735-9111 Ext 23489

...a note from the Editor

Thank you for allowing Neil Medical Group to partner with

you in the care of your residents!

Burlington Pharmacy

509 S. Lexington Ave

Burlington, NC 27215

Phone 866 937-3857