Pharmacy legends: Bonnie Salsman

March 10, 2022

 

Our series “Pharmacy legends” carries on the work Bill McLean began in "DSA corner,” his interviews with Distinguished Service Award winners. The mission of “Pharmacy legends” is to record and celebrate the stories of hospital pharmacy luminaries, and to share their insights with future generations of hospital pharmacists. To read a recent “Pharmacy legends” conversation with Rosemary Bacovsky (DSA ‘97) click here. 

Interview responses have been edited and condensed for clarity. 


Over 40 years, Bonnie Salsman’s varied career has spanned the areas of clinical practice, drug distribution, hospital pharmacy management, and medication safety consulting – some of which, as you’ll read, she did from a boat in the Mediterranean Sea. She served as Director of Pharmacy at the Camp Hill Medical Centre and the Queen Elizabeth II Health Science Centre, leading the conversion to unit dose drug distribution systems and expanding clinical pharmacy programs. 

Throughout her career, Bonnie participated in numerous initiatives for the enhancement of medication safety in Canada. She served as a member of the founding Board of the Canadian Patient Safety Institute, as a member of the Healthcare Safety Advisory Committee for the province of Nova Scotia, and as a Consultant Pharmacist and Medication Safety Consultant with ISMP Canada. 

Bonnie is a Past President of CSHP, and a past member of the Canadian Hospital Pharmacy Residency Board and the CSHP Board of Fellows. In recognition of her contributions to pharmacy practice in Canada, she received CSHP’s Distinguished Service Award in 1999. Bonnie is now a happily retired grandmother living in Halifax, Nova Scotia.  

 

Q&A with Bonnie Salsman (DSA ‘99) 

Looking back, what was the greatest challenge you faced in your career? 

When I was starting out, it took some time for administration, medical staff, and even nursing staff to embrace the roles of pharmacists. Not every physician would be particularly happy about pharmacists approaching them to discuss drug therapy! We had to prove ourselves. There was an expectation that in addition to helping the patients, we would prove ourselves in a financial sense, that we would save money by recommending different drug therapies. Today, I believe the environment has changed significantly for the better – As a profession, as individuals, as departments, and through organizations like CSHP, we’ve been able to advocate for the value of the work we do. 

 

How have you seen hospital pharmacy in Canada change since you began practicing pharmacy? 

40 years in the grand scheme of things isn’t a terribly long time, but the way technology has changed since then is remarkable. The introduction of computerized information systems and automation, beginning with unit dose systems and evolving into things like automated dispensing cabinets, really has completely transformed pharmacy practice. When I started out, there were no computers, so any drug interaction checking was done with textbooks and our brains! It would be far worse if we had to do without computers today because the number of drugs on the market is so much greater now. My first Compendium of Pharmaceuticals and Specialties was much smaller than the last one during my years of practice. The last one was on paper like onion skins, with tiny, tiny print – and the book was still enormous. 

When I was a resident, we pharmacists didn’t even have electric typewriters. There was one electric typewriter in the department, and only the secretary was allowed to use it. I remember working my first weekend all alone as a resident. I was struggling to fill and check all the prescriptions, typing them on a manual typewriter. Finally, I decided I’d just borrow the electric typewriter to get the job done faster. I was convinced no one would notice, but when the secretary came in on Monday morning the first thing she said was, “Someone’s been using my typewriter!”  

Later on, thanks to technology developing, I was able to do a lot of my consulting work from a boat. My husband and I sailed across the Atlantic in 2007 and for 8 years we spent 5 or 6 months of the year sailing in the Mediterranean. Luckily for me, the management of ISMP Canada was very supportive of my unusual lifestyle and I was able to work part time while we were onboard. Access to internet was spotty in the beginning, but as technology developed it became much easier. When I think about it, that’s a pretty dramatic change for a person who started their career typing labels on a manual typewriter!


How have you seen pharmacy technicians’ roles shift over the decades? 

When I was first starting out, just about everything technicians did was supposed to be checked by a pharmacist, and the pharmacist did the hands-on work with sterile products, for instance. If there was a patient on chemotherapy, I had to scrub up, get into the hood, make the drug, and then have a second pharmacist come and check it. Later on, technicians began to say, “Hey, the pharmacist is doing this task, but we could be doing it instead!” Technicians’ expanded roles mean that everyone on the team can really focus on where their expertise lies – for the pharmacist, dealing with the ways the drug works, and for the technician, the drug preparation and dispensing.  

 

What changes do you feel most urgently need to happen to improve pharmacy practice and patient care in Canada? 

An area that I feel continues to need attention is patient safety. As pharmacists, we need to keep advocating for anything that will enhance patient safety in the area of medications. And we need to work not only with pharmacists and other health professionals, but also with patients and consumers to try to identify where the gaps in the system are. The advocacy done by organizations like ISMP Canada and the Healthcare Excellence Canada is so important.  

 

What advice would you give to new practitioners today?  

The post-Covid environment will present new challenges for pharmacists. Stay positive and keep in mind that changes do happen gradually over time. You may not realize it at the time, but step by step, you’re making a difference.  

For anyone who wants to advance their own practice but also advance the profession, working together collaboratively is the best way to make a difference. I believe that working with CSHP and other organizations was a huge benefit to me as a pharmacist, as a manager, and as a person. I really developed a network of people who were able to support me when I was trying to make system changes, and steer me in the right direction if I needed information. Every career accomplishment I feel proud of happened because I was working with such an amazing group of people.