Friday, April 25, 2014

7QT: Diary of a PharmD Student

 

#1

Yesterday was a day filled with poop. 
I had my therapeutics workshop and the topic was irritable bowel syndrome and inflammatory bowel disease. 
What I should've told my patient...
I had to interview the patient about their bowel movements and ask them questions about the quality, quantity, and consistency of their poop. And I had to show them empathy for having to go to the bathroom eight times a day. I also had to evaluate their lab data to make sure they are a proper candidate to start this particular drug....which can only be used in certain patients (aka, patients with no contraindications to it).




The workshop was at 9 in the morning and it was 10:30 in the morning and I was already done for the day. I came home and I pretty much worked on my patient care plan all day long, then I went for a jog and prayed the rosary while jogging (or at least attempted to because I kept getting distracted) and then I kept working on the patient care plan until two in the morning. Even then, I still wasn't done. Since our preceptor works in the MICU, we got assigned very complicated patients for our patient care plan. My patient was literally on like 35 or 40 different outpatient medications and had about 20 different disease states being only 51 years old. I had to pick three of the most important disease states and evaluate them along with their treatment options and the patient's current treatment and recommend a plan of how I would change this treatment to optimize this patient's care.  I learned quite a bit from this project.

 

#2

Picture of the new building at Rush...taken with my phone.
This is the view you get when crossing the bridge from
the parking lot into the hospital.
 Today was yet another Thursday at my rotation site at Rush University medical center.

As always, it was a great learning experience. Since my regular workplace is not a hospital or a clinic but rather a retail pharmacy, I do not see any of the hospital pharmacy stuff and so on these rotations, I try to absorb as much as I can, because hospital practice is a world of a difference from a retail pharmacy practice. Right now I am with a pharmacist that works in the MICU, which is the medical intensive care unit. I cannot even even begin to tell you how much fun I have in the MICU. I just love intensive care medicine and being able to be there at the point where I can help save peoples' lives at those critical points.

 

 

 

 

#3 

I used to just want to settle and stick to retail pharmacy since I already have my foot in the door and since the pharmacist job market is very saturated in Chicago (it's basically super duper hard to get jobs unless you move to the Middle-O-Nowhere in South Illinois) but now that I'm on my rotations, my eyes have been opened.

I cannot even begin to tell you how many times I have heard stories
that are waaaaay to similar to this one! It happens so often we pretty much know
when a patient's story is made up or when they're telling the truth.
 In retail pharmacy all I'm really doing is selling drugs and perhaps making some over-the-counter recommendations. But mostly just selling drugs.... especially to the prescription drug abusers/seekers, who are plenty.

I also have to deal with annoying people that ask what isle the Plan B is and cry when they don't get their birth control pills because the doctor prescribed them a brand that is too expensive.

Or people that ask me 'where the toilet paper be' or if I can ring out the 99 items in their cart because the front checkouts are busy.







The "dropped my medicine down the toilet" story. CLASSIC.

In the hospital? None of that! What an epiphany! I don't have to deal with annoying druggies who offend you every chance they get if something doesn't go their way and to fight with insurance companies and to kiss up to the big bosses so they could give me a job when I graduate. (For those of you reading this blog because you're pharmacy students or thinking about being pharmacy students...don't get me wrong...community practice can give you a lot of valuable experience as well and can give you more people interaction...if you're an extroverted type of person and love dealing with people. I am an introvert to the nth power so I prefer living inside of my own head or in front of a computer or a book....and NOT have to be around tons of people).

Retail pharmacy = answering idiotic phone calls
and being yelled at for something you have completely no control over.

 
 In the hospital, I actually get to go on rounds with physicians and residents every morning and make valuable medication therapy recommendations to help improve the patients' health and well-being. And I actually get to use the 6 years of pharmacy school (2 years pre-pharm + 4 years pharm) knowledge that I busted my butt to learn versus in  community pharmacy, the computer does most of the thinking for me and I just go into autopilot. In community/retail pharmacy, the patient is a customer and I am not a healthcare professional but a clerk - In hospital pharmacy, the patient is our priority and the pharmacist is recognized and respected as a healthcare professional and as a valuable part of the medical team.

#4 

I have about three or four more hospital rotations coming up within the next year so I'm very excited about the different types of experiences I will have. I will hopefully begin to see where God will be pointing my heart over the next year. Right now I feel a very strong desire to pursue a residency and become a clinical specialty pharmacist at a hospital or outpatient clinic. I have amazing grades but residency programs are very hard to get into so I will see whether there is God's will in that path for me. I believe if there is, then He will have a place for me for a residency. If I don't get into a residency, then clearly it was not God's will ...or maybe I just was not good enough to get into one, and I will not be mad at God or at myself... I will just accept whatever comes because no matter what God always brings good out of every situation.

#5 

 But going back to my experience today I pretty much had to wake up at 5am after going to sleep at 2am because I had to finish up one of my 2 big projects for my rotation: my patient care plan. By 5:30am, I was already on the highway in order to beat the traffic going downtown Chicago and by little after 6 o'clock, I was already at the hospital finishing up my patient care plan and preparing for the day's activities. Our preceptor met us at 7am and gave us time to work up our patients before going on rounds, and then a little past 8 o'clock, we went on rounds in the MICU. It was a very long and exhausting day... I remember looking at the clock and thinking that I've already been there for over eight hours and it is only 2 o'clock. We had a topic discussion on metabolic disorders with our preceptor in the afternoon... after which we were released to go home. I pretty much ate dinner, changed into comfortable clothing, and went right to bed because I was too exhausted after this long day and running on 3 hours of sleep. I am even too tired to type right now so I'm just talking to my Mac and it's converting my words into text...but it's making a whole bunch of errors so I'm going to have to go back and proofread the whole darn thing.

The picture I took earlier today as we were getting ready for a topic discussion in one of the conference rooms in the MICU. The conference room was glass windows all around so we had a very nice view of Chi-town.
Since I don't want to ruin the beautiful and joyful spirit of Easter and the upcoming canonizations, I will tell you next week about the experience my friend had on rotation in the emergency department. It's kind of a very controversial topic...so as I said... I will tell you about it next week.


#6

 In the end, remember this:


#7

I am so excited and so looking forward to the canonizations this weekend. It's actually my niece's first communion this Saturday so after we come home from the party, I'm probably going to stay up all night and watch the canonization (I think it's broadcast live at 2am). I don't know too much about John XXIII but I ya'll know I absolutely love and adore the hero and patron Saint of my life: John Paul II. I already know I'm going to cry a river watching the canonizations.


Leave some love in the comments!
Agnes

9 comments:

  1. Hang in there! Your first quick take reminds me of the musical episode of Scrubs when they sang the song, "Everything comes down to poo". Cracks me up every time.

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    1. I'm hanging in there Ann- Marie!!! THanks so much for your support and for reading!!! ;-) And yes, everything comes down to poo!!! ;-D HAPPY EASTER!!!

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  2. Do you have any children yet? Why not - they would be adorable!

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    1. Eileen, no not yet, unfortunately. We just got married 8 months ago and I'm trying to finish my last year of pharmacy school before we have a baby (although if you go back and read some of my older posts, you will know that I have baby fever and melt at the sight of pregnant bellies and cute kids). We are using natural family planning to discern when the best time would be to start a family and we just don't think that right now is the best time. Neither of us have parents that live close that could help us with the baby and either my husband would have to quit his job or I would have to quit pharmacy school...and I ain't doing that...5 years of intermittent sleepless nights and 100's of exam later...I WILL FINISH THIS THING!!! If God puts a desire in our hearts to become pregnant sooner, then of course I will follow His Will because He knows what's best for us. Thanks for reading!!

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  3. The poop story reminded me of all the crazy stories my nurse friends have told me, wow better you then me!
    I'm SO excited for the canonizations on Sunday...even though I'll be working all day at church for YM things, I'm hoping to wake up early and catch some of the footage:)

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  4. Hi Agnes! I came upon your blog when I was doing some pharmacy school searches and love that you have a great school, work and life balance. I am currently a P1 and making decent grades, which shouldn't be happening my first year with non-clinical classes. Any advice for next year when things get "real" so I can improve myself overall?

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    1. I'm sure you have already heard this Jaina...but basically, my advice is, just to stay on top of everything. The exams creep up on you very quickly (especially our school, it is a quarter system, so we have 1-2 exams every week). If you leave studying to the night or two before, you WILL BE overwhelmed. As for me, I HATE HATE HATE pulling all nighters. I have done many of them because of my foolishness and procrastination. My BIGGEST piece of advice that has worked for me and gotten me [almost] straight A's is taking your own notes. The key to my success was re-writing or re-typing the lecture notes or power point slides...to consolidate. I hate reading paragraphs and I hate having to go through hundreds of pages of notes the night before the exam because I feel overwhelmed. So, I keep up with the material and as we have daily lectures for our core classes (therapeutics, pharmacology), I am always re-typing or re writing the most important points from the notes and I can usually consolidate 100+ pages of therapeutics into my own 20 typed pages. That makes it a little more manageable to study! Let me know if you have any other questions!

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    2. I posted a reply but it disappeared but thank you for the advice. I have noticed times when I will slack and when I did start making my own notes I noticed that I was spending more time making them and less time reviewing them atleast, if not more, than two or three times. My school is on a block schedule so a course typically finished in one semester we finish in 6 weeks with an exam every Monday which can be overwhelming. I should take summer to figure out my study habits because I enjoy the material but when it comes to taking the tests, i don't know what happens.

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    3. Yes, it's not easy. But definitely use the summer to think about what how you want to study next year. Note taking can be time consuming and sometimes it feels like it's just better to read the 100's of pages of notes instead of spending hours on consolidating them by taking your own notes...however the other MOTIVATOR I use for taking my own notes and consolidating is the fact that you will be able to use those notes on rotations. SO for therapeutics and pharmacology, I re typed notes so that I could have them available electronically, for easy access on my smart phone or tablet while on rotations. You also don't want to be scrolling through long lectures to find an answer when a preceptor asks you something. So I'm not just doing notes for the exams, but for my future self: for rotations and for later on when I'm a pharmacist and want to quickly review something.

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