In this episode, I’ll discuss what I feel is the most important thing in hospital pharmacy practice.
Twenty years ago I transitioned from community to hospital practice. A pharmacist named Andy was kind enough to mentor me and guide me through the process and he stressed the importance of “knowing what you don’t know”. I’ve come to believe that this concept – knowing what you don’t know – is the single most important thing in hospital pharmacy practice.
In the context of hospital pharmacy practice, knowing what you don’t know means having the self-awareness to recognize that a knowledge gap exists when you are asked a question by another clinician about a medication.
There seems to be a natural reluctance to say “I don’t know” and an inclination to instead give an answer – even if it is a guess or an assumption – to avoid saying “I don’t know”. But when you are looked at as the expert on the safe use of medications, a clinician will take your guess or assumption as fact, and this could result in patient harm or at best a loss of credibility.
I make sure that I teach students and residents I interact with the importance of having the self-awareness to recognize that they have a knowledge gap, and to take steps to close that gap by consulting a resource or a local expert.
There is nothing wrong with saying “I don’t know, let me check a reference about that” or “I don’t know, let me call anesthesia and check with them” when you are asked a question about a medication.
In fact, other clinicians – especially physicians – say “I don’t know” several times a day. They just use slightly different words. For example, if a hospitalist doesn’t know if a patient’s HIV regimen is appropriate they will consult an infectious disease physician to help them care for the patient. This action, calling a consult, is literally the same thing as saying “I don’t know, let me check with this other person who does”. So if physicians can say “I don’t know” multiple times per day, there is no reason we can’t do the same thing as pharmacists.
And if you are in a mentor role with a new hospital pharmacist, or a student or resident, consider passing this concept along.
To access my free download area with 20 different resources to help you in your practice, go to pharmacyjoe.com/free.
If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies.