There are over 250,000 pharmacists practicing in the United States. They work in a tremendous variety of practice settings, including retail pharmacies, nursing homes, the armed forces, and the pharmaceutical industry. About one quarter of pharmacists work in hospitals. Hospital pharmacist jobs generally fall into one of two categories: pharmacists in management roles and staff pharmacists.
Hospital pharmacist jobs in management include the Director of Pharmacy, assistant directors, pharmacy coordinators, and often, drug information pharmacists. Many of these positions require a pharmacy degree plus a master’s degree and/or pharmacy residency. Pharmacy management jobs in hospitals also usually require several years of experience in hospital pharmacy practice. This ensures that the pharmacy managers understand the details of hospital drug distribution systems.
Staff pharmacists in a hospital may work in the main pharmacy, on patient care units, in intensive care units, and in operating rooms. Some staff hospital pharmacist positions require only a PharmD degree, while others require an additional year or two of pharmacy residency training. Some larger hospitals have general staff pharmacists plus specialized pharmacy practitioners who are part of specific medical teams or patient care units. These pharmacists have several years of additional training and practice in areas such as oncology, pediatrics, psychiatry, or cardiology. Other names for staff pharmacists in hospitals include patient care unit pharmacists, satellite pharmacists, and clinical pharmacists.
Many hospitals have 24-hour-a-day, seven-day-a-week pharmacy services. As such, the hospital pharmacist may work day or night shifts, and may be on-call via phone or pager. Most hospital pharmacists who work shifts are paid by the hour. Pharmacy administrators and many specialized clinical pharmacists are salaried employees.
In general, the department of pharmacy is responsible for the control and distribution of all drugs within the hospital. This includes pharmacy satellites, patient care units, emergency rooms, operating rooms, radiology departments, and intensive care units. In addition, except in emergency situations, each physician drug order must be reviewed by a pharmacist prior to dispensing, to assure it is accurate and appropriate for the intended patient. Hospital pharmacist jobs, therefore, may include a broad range of dispensing, monitoring, communication, and drug policy development roles.
Dispensing medications based upon a physician's order is what many think of as the traditional job of a pharmacist. In hospitals, this includes dispensing oral medications, as well as preparing sterile medications for intravenous injection, nutritional solutions, and potentially toxic medications such as chemotherapy. The hospital pharmacist also must stock and track dispensing of drugs with abuse potential, including some pain and compound topical medications. Many of these jobs are delegated to pharmacy technicians, who are supervised by the hospital pharmacist.
Hospital pharmacist jobs have expanded beyond the traditional dispensing roles, and these professionals are often an integral part of the medical team. They routinely communicate with nurses and physicians to advise about optimal drug therapy. Hospital pharmacists also monitor for drug interactions and side effects, take medication histories when patients are admitted, and counsel patients who are being discharged.
Drug policy development is a final crucial job of the hospital pharmacist. Pharmacists serve on medication use committees within the hospital, especially the Pharmacy and Therapeutics (P&T) Committee. This committee determines which medications the hospital will stock, and develops and monitors drug therapy programs across the institution. Because medication errors often lead to extended hospital stays, hospital pharmacists also routinely monitor for potential medication errors.
The role of the hospital pharmacist continues to evolve. As the complexity of drug therapy increases and medication costs continue to rise, there is a greater need for hospital pharmacists who have a wealth of scientific knowledge, are skilled at problem solving, and are exceptional communicators. This can help ensure safe and effective drug therapy for all hospitalized patients.