Top Three Most Popular Posts: #3

The one year anniversary of this blog was October 31st! Now that the zombies have been put to sleep for another year, it's time to celebrate by taking a stroll down memory lane and looking at the top three most popular posts of the last year.

I love hosting Sarah Sundin. She's a truly gifted novelist and I hope you'll check out her books. This post, ranked #3, struck a chord with people and I think it's the way Sarah painted the picture using her authorly ways to make this time period come alive.

Pharmacy in World War II—The Drug Store

In the 1940s, the local drug store was more than just a place to get prescriptions filled and pick up toothpaste—it was a gathering place. If you’re writing a novel set during World War II, it helps to have an understanding of this institution.

As a pharmacist, I found much about my profession has changed, but some things have not—a personal concern for patients, the difficult balance between health care and business, and the struggle to gain respect in the physician-dominated health care world. On February 14th, I discussed the role of the pharmacist in the 1940s, today I’ll describe the local drug store and how its role changed during the war, and on February 18^th,  I’ll review the rather shocking role—or lack thereof—of pharmacy and pharmacists in the US military.

Welcome to the Corner Drug Store—1939

Perkins’ Drugs stands on the corner of Main Street and Elm, where it’s stood all your life. Large glass windows boast ads for proprietary medications and candy, and a neon mortar-and-pestle blinks at you. When you open the door, bells jangle. The drug store is open seven days a week, sixteen hours a day, so you know it’ll always be there for you. To your right, old-timers and teenagers sit at the soda fountain on green vinyl stools, discussing politics and the high school football game. The soda jerk waves at you.

You pass clean shelves stocked full of proprietary medications, toiletries, cosmetics, hot water bottles, hair pins and curlers, stockings, cigarettes, candy, and bandages. You know where everything is—and if you can’t find it, Mr. Perkins or his staff will be sure to help you.

The owner, Mr. Perkins, is hard at work behind the prescription counter with good old Mr. Smith and Mr. Abernathy, that new young druggist Mr. Perkins hired last year. Mr. Perkins greets you by name, asks about your family, and takes your prescription. He has to mix an elixir for you. If you don’t want to wait, he’ll be happy to have his delivery boy bring it to your house. But you don’t mind waiting. You have a few items to purchase, and you’d love to sit down with a cherry Coke.

Welcome to the Corner Drug Store—1943

Perkins’ Drugs still stands at the corner of Main Street and Elm. Large glass windows boast Army and Navy recruitment posters and remind you that “Loose Lips Sink Ships.” The neon sign has been removed to meet blackout regulations. The store is open for fewer hours since Mr. Smith retired and Mr. Abernathy got drafted. Mr. Perkins hired Miss Freeman. Not many people are thrilled to have a “girl pharmacist,” but if Mr. Perkins trusts her, that’s good enough for you. Perkins’ Drugs and Quality Drugs on the other side of town alternate evening hours so the town’s needs are met.

A placard on the door reminds you that Perkins’ Drugs is authorized by the Office of Civilian Defense as a pharmaceutical unit, meaning the store will provide a kit of medications and supplies for the casualty station in case of enemy attack. You pray the town will never need it.

Bells jangle when you open the door. The soda fountain is closed. Mr. Perkins can’t buy metal replacement parts for the machine, the soda jerk is flying fighter planes over Germany, and sugar is too scarce a commodity.

A barrel stands by the door. You toss in five tin cans, washed, labels removed, tops and bottoms cut off, and flattened. Mrs. Perkins at the cash register thanks you.

You pass clean shelves with depleted stocks. Proprietary medications, cosmetics, toiletries, and medical supplies remain, but rubber hot water bottles, silk and nylon stockings, hair pins and curlers, candy, and cigarettes are in short stock—or unavailable. Most of the packaging has changed. Metal tins have been replaced by glass jars and cardboard boxes. You pick up a bottle of aspirin and a tube of toothpaste, double-checking that you brought your empty tube. Without that crumpled piece of tin, you couldn’t purchase a replacement. Tin is too dear.

At the prescription counter, Mr. Perkins greets you by name and asks about your family. Miss Freeman gives you a shy smile and you smile back. There’s a war on and women have a patriotic duty to do men’s work so men are free to fight. Mr. Perkins frowns at your prescription for an elixir. He’s used up his weekly quota of sugar, and his stock of alcohol and glycerin are running low. Would you mind capsules instead? Of course not. Mr. Perkins phones Dr. Weber and convinces him to change the prescription. Mr. Perkins can’t have the prescription delivered—he doesn’t qualify for extra gasoline and he couldn’t find a delivery boy to hire anyway.

You and Mr. Perkins discuss war news as he sets up a wooden block with little holes punched in it, then lines the pockets with empty capsule halves. He weighs powders on a scale, mixes them in a mortar, then fills the capsule shells. After he sets the capsule tops in place, he puts the capsules in an amber glass bottle with the familiar Perkins’ Drugs label.

You buy a few War Bonds. Your wages are higher than ever with the war on, and with all the shortages there’s nothing to buy. Besides, War Bonds are a solid financial investment and your patriotic duty. On a poster by the counter, a smiling pilot leans out of his plane and reminds you: “You buy ‘em. We’ll fly ‘em. Defense Bonds and Stamps.”

Mr. Perkins thanks you for your purchase, and you thank him for his service. War or no war, you know Perkins’ Drugs will always be there for you.

Resources

My main source was this excellent, comprehensive, and well-researched book: Worthen, Dennis B. Pharmacy in World War II. New York: Pharmaceutical Products Press, 2004.

http://www.lloydlibrary.org (Website of the Lloyd Library and Museum, which has many articles and resources on the history of pharmacy).

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Sarah Sundin is the author of the Wings of Glory series from Revell: A Distant Melody (March 2010), A Memory Between Us (September 2010), and Blue Skies Tomorrow (August 2011). She has a doctorate in pharmacy from UC San Francisco and works on-call as a hospital pharmacist

Up and Coming!!

This week we're celebrating Redwood's Medical Edge's one year anniversary!!

Thanks to all of you who visit, comment, follow and subscribe. Your support really does mean a lot to me!

This week we're taking a stroll down memory lane by looking at the three most popular posts of the first year. Do you think you know what they are?

Also, I'll be over at Christian Mama's Guide on Wednesday talking about those pediatric nursing topics. Hope you'll stop by and leave a comment.

Have a great week....Jordyn

Historical Overview of 19th Century Medicine

I ran across these guest posts by Eleanor Sullivan over at The Writer's Forensic Blog which were excellent and a good resource for the historical authors that follow here. They are must read as I learned a lot of fascinating facts.

To supplement, I thought I'd add a few words to her list of terms that were used then and what they mean. These are referenced from Frontier Medicine by David Dary which is another excellent resource.

Acute Indigestion: listed as a cause of death. Probably a heart attack. This is interesting as in modern medicine, women can present quite differently from their male counterparts when they are suffering from heart attack. One of these symptoms can be indigestion.

Bad Blood: syphilis

Barber's Itch: infection of the hair follicles of the face.

Black Fever: Rocky Mountain spotted fever.

Camp Colic: appendicitis

Domestic Illness: polite label for mental breakdown, depression, or the aftereffects of a stroke where a person was housebound and in need of regular nursing.

Dry Bellyache: lead poisoning

Grip/Gripe: influenza

Quinsy: tonsillitis

Scrivener's Palsy: writer's cramp

For an outstanding generalized overview of 19th century medicine, check out these links to Eleanor's Guest Posts:

1. http://writersforensicsblog.wordpress.com/2011/10/09/guest-blogger-eleanor-sullivan-19th-century-medicine-part-1/

2. http://writersforensicsblog.wordpress.com/?s=Eleanor+Sullivan

Contemporary Pharmacy: Part 4/4

Today concludes Sarah's four-part series on contemporary pharmacy. I've certainly enjoyed having her back and can't wait for her return. Today she focuses on the hospital pharmacist.

Fiction writers do mean things to their characters. If those mean things require pharmaceutical care, you may need to introduce a pharmacist character or understand how pharmacies work. As a pharmacist myself, I want to help you get those details straight.

Today’s article discusses practice in the hospital setting. Previous articles discussed an overview of the profession, pharmacy education and training, and practice in the community pharmacy setting.

Hospital Pharmacy

About 22% of pharmacists work in America’s 5800 hospitals. These can range from the small community hospital with a few dozen beds, to large teaching hospitals with thousands of beds.

Setting

The traditional hospital pharmacy is “in the basement,” away from the main hospital area. As pharmacists have become more involved in patient care, some larger hospitals have opened satellite pharmacies on the floors. To deliver medications, hospitals use employees, vacuum tube systems, dumbwaiters, or even robots.

Access to the hospital pharmacy is restricted to pharmacists and pharmacy technicians, and briefly to nurses, administration, housekeeping staff, and delivery personnel under pharmacist supervision.

The typical hospital pharmacy is divided into work areas. One area contains computers and reference materials for pharmacists entering medication orders. A narcotics room contains all the controlled substances, usually in a secure cabinet accessible only by password or biometric scan. A “cart-filling” area contains medications as well as the large carts that will be filled with a daily supply for each patient. The IV room contains laminar flow hoods for sterile preparation of intravenous medications. There is also room for bulk storage and tables for breaks and meetings. Offices are provided for the director of pharmacy and others.

Work Conditions

In the inpatient setting, medications must be available twenty-four hours a day, every day of the year. Therefore, the largest hospitals are always open. Smaller hospitals may have off-site pharmacists enter orders electronically after hours, while nurses obtain the medications from automated systems.

On average, a hospital pharmacy employs ten pharmacists and about twice as many pharmacy technicians. Directors of pharmacy must be pharmacists by law, but they usually perform administrative duties only.

Opportunities for part-time or on-call work abound. Most employees work odd hours, including evenings, weekends, holidays, and graveyard shifts. Those in administrative or purely clinical jobs may work traditional hours.

Dress codes vary, but most pharmacists dress professionally—men wearing nice pants and shirt, with or without a tie, and women wearing a nice top with dress pants or a skirt. Technicians tend to more casual clothes, often jeans or scrubs. Lab coats may or may not be worn within the pharmacy, but are preferred when the personnel go to the floors. In the hospital setting, the long-sleeved knee-length lab coat is most common.

Work Flow

Physicians’ medication orders are transmitted to the pharmacy electronically or by fax. Many hospitals have the physicians enter the orders themselves to prevent errors due to illegibility. A pharmacist checks if the drug and dose are appropriate for the patient’s condition, age, and weight, and checks for potential problems due to allergies, drug-drug interactions, or drug-disease interactions. Many hospitals have protocols that allow pharmacists to adjust doses for certain drugs.

Technicians then pull a day’s supply of the new medications to send to the floors. Most medications in hospitals are “unit-dosed,” with each dose individually packaged in blister packs and labeled with drug name, strength, manufacturer, lot number, expiration date, and bar code.

Most hospitals supply medication on a 24-hour basis. Large carts contain drawers for each patient, which are filled with a 24-hr supply of medications and delivered once a day. Intravenous medications are batched, with a 24-hr supply sent up once a day. Exceptions are made for drugs with low stability or high cost. As medications are changed, only the new medications need to be sent up. Automated dispensing machines on the floors provide nurses access to emergency medications, stat doses, or after-hours doses. These machines are also used to dispense controlled medications, as they require passwords or biometric scans.

IVs and TPNs

One special function of the hospital pharmacy is mixture of intravenous (IV) solutions and total parenteral nutrition (TPN). These require calculations, training in sterile technique, and the use of a laminar flow hood.

Clinical Pharmacy

A growing and cherished role in hospital work is clinical pharmacy, the direct interaction with physicians, nurses, and patients to optimize pharmaceutical care. Pharmacists in a clinical role monitor lab values, read patient charts, analyze the patient’s condition and current care, and make recommendations individualized for the patient. Clinical pharmacists can improve patient care, reduce length of stay, decrease side effects, and even reduce costs.

The Hospital Pharmacy Experience

Hospital pharmacy personnel work behind-the-scenes in a fast-paced, often-interrupted, and frequently stressful environment. However, they take pride in working with complex medications for critically ill patients, knowing they do their best to improve patient care and reduce medication errors.

Sources:

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Pharmacists, on the Internet at http://www.bls.gov/oco/ocos079.htm (visited October 17, 2011).

American Pharmacists Association http://www.pharmacist.com/

American Society of Health-System Pharmacists http://www.ashp.org/

American Association of Colleges of Pharmacy http://www.aacp.org/
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Sarah Sundin is the author of the Wings of Glory series from Revell: A Distant Melody (March 2010), A Memory Between Us (September 2010), and Blue Skies Tomorrow (August 2011). She has a doctorate in pharmacy from UC San Francisco and works on-call as a hospital pharmacist.