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Figuring out how to add this to my CV

A nurse practitioner was picking up drugs for his clinic today and he dropped one and when I said, “That’s drug abuse,” he started laughing so hard that he dropped another one.

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“In an effort to preserve PPE, sterile disposable gowns will go to sterile locations. Pharmacy will now use non-sterile disposable gowns.”

LOL why does this always happen. Like, do people think pharmacy is just playing at being part of healthcare? Do you want cat dander injected into patients veins? Because that’s what happens when you have compounding in non-sterile gowns.

Don’t worry, this situation resolved after an email, before we compounded anything. But this kind of thing wouldn’t be a problem if physicians and nurses had just one week in pharmacy as students. Just one day compounding and dispensing. Most of the rest of the team has just no idea what the compounding area even looks like.

When we have students on rotation again, consider sending yours to the pharmacy for a day, and just think, years in the future, they won’t be the ones suggesting procedures that will lead to injections of cat dander.

This isn’t a guy in some obscure research lab—it’s just a pharmacist or tech making drugs in a room just like the one in your hospital’s basement.

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Red Blood Cell: White Blood Cell is a gentle-

White Blood Cell: *brutally murdering an antigen in the background* DIE, GERM!

Red Blood Cell: *louder* -and kind person!

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THE JOB

Yes, they do it!!

©Potamikou

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A hospital in NYC has officially started splitting ventilators between patients.

I don't know how to describe what I'm feeling. "Existential dread" is probably pretty close.

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Me every time I pick my phone up.

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Another semester down. It feels so surreal to only have one more didactic semester left. I’m excited, but also terrified at the same time because the only thing left will be eight rotations and an off block. I’m not ready in any way, shape, or form for what is to come.

I will admit though that something strange happened to me as I began P3 year. I lost a decent chunk of my anxieties, but also feel like I’ve become ever so slightly more confident with my knowledge despite knowing very little at this point in time. I never thought I’d get here. I look at the current P1s at school and it’s so funny because I see a younger version of myself and of my friends; the same energies that were put in by me and my pharmily will always be there in some capacity because some essence of us will be reintroduced with newer classes. We have grown so much professionally and personally over the past two years. It’s amazing.

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Clostridium difficile

Acinetobacter

Streptococcus pneumoniae

Extended-spectrum β-lactamase (ESBLs)

Enterococcus

Staphylococcus aureus

Pseudomonas aeruginosa

Enterobacteriaceae

Shigella

Neisseria gonorrhoeae

Candida

Campylobacter

Tuberculosis

Salmonella

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Feeling very anxious about clinic tomorrow night. I really want to do right by myself and my future profession. I’m just so scared of not being able to hold my own and be confident in what I know. I don’t want to freeze up again. I don’t want to feel like I’m not in control. Please send good vibes and hopes that my med student partner will understand and be receptive to my input and feedback.

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Last night was my first night in clinic for my ambulatory care elective. It was an experience for sure. My friend and I, who are both pharmacy students (P3s to be exact), were partnered with a med student (M2s). I was feeling nervous because my med student partner already had experience at the clinic. I wish they didn’t have prior experience because it might have turned out better for me.

It was kind of a disaster on my end when we went into the patient’s room. I thought that my med student partner was going to pause and allow me to interject. They didn’t. I was so flustered that I left with them without inquiring about the patient’s meds like I was supposed to do so I sounded really dumb when we had to report back. When we went back in for a second time, I sort of found myself and tried to ask some questions to our patient. In the end, it turned out okay, but I definitely didn’t put my best foot forward. I will be so much better at our next clinic session.

My med student partner was interesting. They didn’t really care that I was nervous about going in to see the patient. We didn’t establish an order of how to ask questions - I’m going to remedy that for the next time we’re in clinic. The best part of it all was that when my pharmacy preceptor/attending was showing me around the clinic to pertinent places, my med student partner had already started documenting. Granted, they did most of the work anyway, but in retrospect I felt that was rude. I’m not a confrontational person, but I will definitely be discussing how I felt with my partner before we begin seeing patients at our next clinic session.

I don’t say any of this to drag med students or medicine. I think y’all are great. But I think y’all don’t know when to step back and let other professions be a part of the conversation. I should not have to assert myself to ask the patient what I need to know. Just because it may not be important to you as a med student doesn’t mean that it’s not important to me and the overall health of the patient. I’m working towards becoming a pharmacist, a medication expert. I do recognize my shortcomings in this situation and I know how to better handle myself in future clinic sessions. Everything is a learning process.

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For the non-medical folks that follow me

I don’t want you to distrust your team because I talk about errors. Errors are notable to talk about because they’re so relatively rare, and errors discovered in the pharmacy prior to dispensing are not a big concern. We’re all scrutinizing your medications over and over by multiple highly trained professionals before they get to you. Every highly trained professional is human, and we know it, and that’s why we have multiple humans searching for the mistakes. If you’ve learned this by following me, I hope you can be patient with the wait when filling your prescriptions. It takes time to review medical literature when necessary, check storage conditions, and call your prescriber to understand their clinical reasoning. Trust that part of the system, and give your business to independent, managed care, or slower pharmacies that allow pharmacists the time to take really good care of you.

Now if you distrust your team because they seem to have prejudices against your skin color, socioeconomic status, gender, disability, or if they plain make you feel uncomfortable, I fully support you and hope you find better allies in your team.

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OP Physical Therapy Humor

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I realized something important at work yesterday. My pharmacist in charge (PIC) told me recently (like in the past month or two) that I am good with people one-on-one. I didn’t really believe that or understand it when he said it. But for some reason, it clicked for me last night at work after I got off of the phone with a nice patient.

I’ll be honest - I don’t particularly enjoy working in community pharmacy. It is not my cup of tea, but I still do it anyway because I work with amazing people and I don’t know that I’d be able to land a hospital job right now since all of my experience thus far has been community - I might still try though.

Anyway, I digress - I know community pharmacy is not for me because I get super stressed out at work when things are hectic and it shows in my words, expressions, attitude, and actions. And I do genuinely hate that I get overwhelmed and flustered. I find that a lot of patients simply don’t understand the work that goes into preparing their meds and I want the general public to be more educated about the field of pharmacy.

We do not just slap labels onto bottles of pills - honestly, our jobs would be a lot easier if that’s all we had to do. But it isn’t that simple. Sometimes we can’t get your meds filled right away because the insurance company wants to have a prior authorization from your doctor. Sometimes your doctor hasn’t gotten back to us with a new prescription so we do what we can when we can - if we can give you an emergency supply, we will. We’re not heartless and we know that your meds are important to you. We also don’t want you to have to go without your meds. Your frustration at the cost of your copay is understandable - we get it, but please don’t blame us for it. Your insurance company sets the prices, not us.

Bottom line: You, as our patient, are important to us and we do care about you. We really do want what is best for you.

Anyway, I digress again - the only community pharmacy that I would ever consider is probably working for an independent pharmacy.

I do love talking to patients and having that one-on-one time with them, which is why I think, and am hoping, that I will be better suited for ambulatory care or hospital pharmacy. My elective this semester will be telling. We shall see how it goes.

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I love this, but funny

Right now I’d say that 1/4 of the physicians who I work with introduce themselves by their first names, which feels so respectful to me. I really love it. We’re both doctors and yes you’re the captain of the team and my residency was shorter but between professionals (and not in front of patients) we’re both doctors. Going by first names feels much more collaborative to me.

The funny thing is how you can tell that the first name doctors weren’t trained to communicate like that. I make calls all the time and I’m like, “Hi this is Deca,pharmacist, looking for—“

I’ve taken a couple of phoned orders lately from confident physicians where I get the patient’s identifying info, clarify the drug, finish the conversation, hang up, then go, “Wait, who the fuck is Amy?” Amy (or Sarah or Tahir) just spoke like a physician and the whole interaction was so normal that I didn’t even think about how I didn’t clarify whether or not she was a physician. It took some polling the pharmacy and picking through the chart to find out who I took an order from. They didn’t know that they had to identify their role in addition to their names.

I just think it’s adorable, and I really want to encourage the trend so I haven’t told any of my physician colleagues. Soon I’ll know all of their first names as well.

Anyway if you’re reading and want to do the same, just add it to the end. “Hi, this is Dave, family medicine doc,” or “This is Rose, anesthesiologist,” and that should work just fine. Don’t be anxious. This is great.

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Those customers that press the button in the drive-thru multiple times

I heard you pull through the drive-thru AND heard you press the button the first time….

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via Rachelignotofsky