The insistent clicking of Geiger counters and presence of heavy lead-lined equipment are as much a part of one Findlay alumnus’ workdays as the white pharmacist coat he dons. That’s because Kurt Hafeken, Pharm.D. ’17, has a nontraditional but essential career outside of the public spotlight – that of nuclear pharmacist.
Hafeken manages HeartLight Pharmacy Services’ Toledo lab, which compounds radioactive medications used for various tests and treatments. Most of the medication HeartLight mixes are administered by syringe for testing during procedures such as nuclear heart scans, which inject a radioactive substance called a tracer that enables imaging of blood flow and coronary heart disease detection. But nuclear medicine’s fascinating history, which dates back to Berkeley Lab’s scientific innovations in the 1930s, also has led to successful medical interventions such as thyroid ablation, in which patients drink an “atomic cocktail” that targets the overactive gland and destroys part of it to combat afflictions such as Grave’s Disease.
Nuclear pharmacy is a specialized field. Along with earning a Doctor of Pharmacy, nuclear pharmacists must complete a certificate program, which is offered at different institutions across the country both on campus and online, and requires in-pharmacy training; Hafeken earned his certificate through a 10-week online program.
While physicians are the prescribers, pharmacists such as Hafeken are responsible for compounding and dispensing doses accurately, safely, and in a timely manner.
“We have to be aware of both the expiration and the timing of delivery for our products because they have a half-life of six hours,” Hafeken explained. “They will decay rather quickly. So, a lot of our work is done early in the morning. Our major shift of the day is from 1-9 a.m. so that most of our deliveries are getting to hospitals between 6 a.m. and 7 a.m.”
The work is rigorous, detailed, safety-focused, and solitary. “It’s not in a closed hood in the pharmacy where you’re filling orders on the spot. We have everything scheduled out and it’s really easy to set yourself up for the day,” said Hafeken. “Regardless of me being a manager, my pharmacist who’s my main overnight person can do things his way and I can do things my way, and those ways don’t have to be the same as long as the job gets done. It’s very open in that sense.”
Safety protocols, however, are stringent. HeartLight uses generators that manufacture radioactivity on a daily basis for collecting, measuring, and compounding into different drugs. Therefore, constant monitoring is conducted. Hafeken wears a badge on his coat lapel that measures his level of radioactive exposure over time. He sends the badge to a company that returns his raw data. “There are set Nuclear Regulatory Commission standards that we have to follow as to what your limits are per month, per year,” he said. Also, different shielding methods are also used with equipment, from the syringes to the generators, to protect workers.
“Obviously there are points in time where we’re measuring things that will have to be openly exposing you. We gown and garb and prepare everything in a taped-off area that we have in the lab, where only someone working on the doses is allowed to be there,” Hafeken continued. And, “We’re not standing around hanging out in the lab if we don’t have anything to do in there,” he said. Technicians who draw the compounded doses receive less exposure, as do delivery drivers.
The pharmacy profession is still working to develop exposure guidelines for nuclear medicine compounding, Hafeken noted. But by following procedures, nuclear pharmacists remain safe, he said.
“I think it’s probably a big thing that scares a lot of people initially. You hear ‘nuclear’ and ‘radiation’ and these words are scary to someone who isn’t familiar with them. I always try to stress to students who come through here that we have the techniques set in place that, as long as you’re doing things right, it’s really not a concern,” said Hafeken.
The most significant drawbacks for some who are considering entering the profession are the isolation and the odd hours, he noted. Conversely, for those who prefer to work alone, nuclear pharmacists don’t interact with patients, nor must they contend with insurance companies.
Hafeken’s interest in this line of work was sparked when, as a high school student, he visited a neighbor on the job who was a nuclear pharmacist for HeartLight, an independent pharmacy. As University of Findlay College of Pharmacy student, he then returned to that lab for his first elective rotation. That summer, he was able to intern there, and was then hired as a pharmacist after graduation. He has managed the Toledo office since its opening in April (offices are also located in Columbus and Lima), and the company is looking to expand its services into Michigan.
With doctors still learning about the benefits of nuclear medicine, and new medications being developed, Hafeken said nuclear pharmacy is a growing field. “A lot of the medicine that we use has been around for a long time, but there are a few new products coming to market now more than in the past 5-10 years,” he maintained.
The practice is also lucrative. According to the U.S. Bureau of Labor Statistics, the median average pay for pharmacists without a specialty was $126,120 in 2018.
Hafeken recommends that students who think they might be interested in nuclear pharmacy complete a rotation. “I really encourage students to come out and see what it’s like. I’ve gone to Findlay and taught a class on different career paths. I try to go to career fairs whenever I can just to let people know about it. It might not be what you want to do, but I’d love to show you what it is and open that door to you. Again, it’s something that a lot of people don’t hear about, even in their schooling. There may be a line or two on a page in one class about it, but that might be it.”