Smith J E, Shane R
Department of Pharmacy, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
Am J Hosp Pharm. 1989 Nov;46(11):2259-62.
The reasons for job dissatisfaction among hospital pharmacists are reviewed, and an option for ameliorating the problem by offering clinical career ladders is advanced. Not enough new pharmacists are being trained to replace those leaving the profession, and hospital pharmacy managers seeking to recruit and retain quality pharmacists are facing stiff competition from retail outlets, academia, and the pharmaceutical industry. Hospital staff pharmacists report less of a sense of accomplishment than other workers and are more likely to change jobs. Although inadequate pay and benefits are frequently cited, one investigator found that the greatest source of dissatisfaction was the lack of opportunity for advancement. Other professions facing similar problems have experimented with a system of parallel career ladders in which alternatives to the traditional managerial advancement track are offered. Staff nurses on a clinical ladder remain in a direct patient-care role while ascending a hierarchy of clinical practice levels; each level brings greater responsibility and rewards. Outcomes have included improved recruitment, decreased turnover, and increased interest in educational programs. In pharmacy, each level of a clinical career ladder would be defined by explicit criteria for knowledge and skill in patient care and drug therapy. As in nursing, such a ladder would create advancement opportunities and reward the acquisition of knowledge and skills. Several hospital pharmacy departments now offer clinical career ladders. Implementation of clinical career ladders has the potential to enhance the job satisfaction of hospital pharmacists and improve their recruitment and retention.
本文回顾了医院药剂师工作满意度低的原因，并提出了通过提供临床职业晋升阶梯来改善这一问题的方案。目前接受培训的新药剂师数量不足以取代离职人员，而医院药房经理在招聘和留住高素质药剂师方面正面临来自零售药店、学术界和制药行业的激烈竞争。医院药剂师表示，他们的成就感不如其他行业的工作者，并且更有可能更换工作。尽管薪酬和福利不足经常被提及，但一名调查人员发现，最大的不满来源是缺乏晋升机会。其他面临类似问题的行业已经尝试了平行职业晋升阶梯系统，该系统提供了传统管理晋升途径之外的选择。处于临床晋升阶梯上的护士在提升临床实践水平等级的同时，仍直接承担患者护理工作；每一级都带来更大的责任和回报。结果包括招聘情况改善、人员流动减少以及对教育项目的兴趣增加。在药学领域，临床职业晋升阶梯的每一级将由患者护理和药物治疗方面的知识和技能明确标准来界定。与护理行业一样，这样的晋升阶梯将创造晋升机会，并奖励知识和技能的获得。现在有几个医院药房部门提供临床职业晋升阶梯。实施临床职业晋升阶梯有可能提高医院药剂师的工作满意度，并改善他们的招聘和留用情况。
