It usually starts a few hours before a shift begins. It is my constant companion during work hours. It walks behind me on my way home, and sometimes makes itself comfortable in my bed at night.

It is the fear that so often goes hand in hand with working in community pharmacy – a feeling I’ve started calling The Phear. It’s that constant, underlying edginess that took root during school, when I worked as a counter assistant on Saturdays, and has been with me throughout my whole career. It never wavers and never settles. It’s a constant readiness – a feeling that, at any moment, you could make the one mistake that means everything comes crashing down around you.

I always hoped that it would go away, but nowadays I realise that it is the deciding factor that makes me a good pharmacist. It means that, even in the quiet moments at work, I’m still bright-eyed and waiting for the next problem to present itself. It is that knowledge that all might be calm now, but the next person to walk in might be really ill, with a badly written prescription for a controlled drug when you can’t get in touch with the doctor to check the dose, you don’t have the whole amount in stock and everywhere else is closed.

The Phear is what drives me on to be better and better. It makes sure that I continue to learn as much as I can and ensures I am keenly aware of the legalities. It keeps me permanently thinking about patient safety and drives me to have good quality discussions about efficacy with my patients. It is the kick up the bum I need when I am tired, and what keeps me from going mad when every customer is horribly rude for no apparent reason.

It certainly has its downsides. The Phear is exhausting and often unpleasant. It will make me lie awake at 2am questioning a decision I made three months ago. It’ll mean that I unexpectedly find myself worrying about a particular patient. It often leaves me feeling deflated. But it is a sort of hard-won protection. It stops me from losing my job, and my patients from losing their health or their lives.

It is The Phear that has made me into the professional that I am today. It is what makes me care passionately about my patients, day in, day out. No amount of money can take its place. And that is why I feel very strongly that membership of the Royal Pharmaceutical Society, or its faculty, or anything like that should not be used as an indicator of professionalism.

It doesn’t matter how much cash you have floating about in your wallet to join a professional body or development course. The Phear is a much more real indicator of how seriously we take our profession – and its only cost is to our peace of mind.

The Information Sage is a medicines information pharmacist

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