Clinical Pharmacy

[Alanine]

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I wanted to become a pharmacist pretty much only because of clinical pharmacy. I have no intention of working at a community pharmacy pretty much at all.
I wanted to know...and ive been worrying about this for quite some time...how is the job outlook for clinical pharmacy? Im scared that ill go through all of pharmacy school and graduate, start looking for a job, and find nothing at any hospitals around me.
Also...i wanted to know that if i DO get a job at a hospital, will i be forced to start working as 3rd shift..i was told that usually when you start working for a hospital straight out of school, they stick you in third shift and you work your way up slowly. I just wanted to know how that goes.
Thanks =)

 

[p-rog]

Five or so years from now when you graduate pharmacy school, the job outlook will probably be different than what it is now but I would think a residency would pretty much be a requirement for clinical hospital pharmacy jobs by then. It also depends on the area of the country you're looking in.

 

[WVUPharm2007]

It all depends on where you live and exactly what kind of job you want. I work in the outskirts of Pittsburgh and I started with a 50:50 clinical:staffing job with rotational hours out of school. I work rotating days and evenings. I actually prefer 1-11PM shifts, so I volunteer for those shifts primarily. This also affords me time alone without the clinical director/more senior pharmacists so I can do some high-level clinical interventions as there are no pharmacists higher up on the food chain to snipe all of the interesting things that pop up. So don't knock 2nd/3rd shift too much, it can afford you opportunity. 👍

 

[jyw003]

I wanted to become a pharmacist pretty much only because of clinical pharmacy. I have no intention of working at a community pharmacy pretty much at all.
I wanted to know...and ive been worrying about this for quite some time...how is the job outlook for clinical pharmacy? Im scared that ill go through all of pharmacy school and graduate, start looking for a job, and find nothing at any hospitals around me.
Also...i wanted to know that if i DO get a job at a hospital, will i be forced to start working as 3rd shift..i was told that usually when you start working for a hospital straight out of school, they stick you in third shift and you work your way up slowly. I just wanted to know how that goes.
Thanks =)

the way our economy has been rolling...you better cross your fingers that we will have "choices" when we graduate...

 

[Quiksilver]

the way our economy has been rolling...you better cross your fingers that we will have "choices" when we graduate...

i wouldn't be that harsh but you certainly cant take a C=PharmD approach any longer. If you want a career other then retail you might have to start proving yourself to others in the form of a decorated CV. Grades, extracurriculars, research involvement is going to have to continue beyond undergrad and into graduate level.

The opportunity is there but life is a rat race, if you want the cheese you need to find it for yourself and beat everyone else.

Hard work is required but things will fall into place.

 

[Alanine]

It sounds like i have a lot of thinking to do. =(
I would be willing to put up with 2nd or 3rd shift for a while...but its just the whole finding-a-job thing that's worrying me.

 

[MountainPharmD]

It sounds like i have a lot of thinking to do. =(
I would be willing to put up with 2nd or 3rd shift for a while...but its just the whole finding-a-job thing that's worrying me.

You are listed as Pre-pharmacy. How about worrying about something a little more pressing like getting into pharmacy school first. Depending where you are at in your pre-reqs you have six years before you need to worry about finding a job. By then there could be a shortage again.

 

[Alanine]

You are listed as Pre-pharmacy. How about worrying about something a little more pressing like getting into pharmacy school first. Depending where you are at in your pre-reqs you have six years before you need to worry about finding a job. By then there could be a shortage again.

While what you're saying is true...i am applying to pharmacy schools this summer. As i stated before, i have no intention of working at a community pharmacy. With that said, i don't want to got through 4 years of pharmacy school, complete residency, spend tens of thousands of dollars in tuition, and then wind up either jobless or hating my job at a community pharmacy. So i need to figure things out now before i start applying. Thank you though.

 

[rxforlife2004]

Clinical pharmacy is just a fancy term to describe clinical duties of pharmacy branch. I remember back in school the professors kept preaching how fancy clinical pharmacy is...blah blah blah. Now here I am working as a clinical pharmacist (actually mixed with staffing too) and i find it pretty routine after a while. In fact, I believe that a hospital staff pharmacist who just do purely order entries would learn/come across more than a strictly clinical pharmacist. Maybe just me but...oh well..

Clinical pharmacist jobs are not as readily available as staff pharmacists. Usually a hospital, depending on the size of census, population, etc...will only need certain number of pharmacists. Say, if a hospital has 100 patients, then usually it needs only one clinical pharmacist in the morning and 1/2 shift, or so. It also depends on how many clinical programs the hospital has, and the budget too. Regardless, clinical pharmacy is just an extra function of pharmacy. The core function of us, regardless , is still despensing. Seriously, if i don't like dispensing, you shouldn't even be a pharmacist.

 

[Pharmacy Kid]

In fact, I believe that a hospital staff pharmacist who just do purely order entries would learn/come across more than a strictly clinical pharmacist. Maybe just me but...oh well..

You for real?

 

[WVUPharm2007]

In fact, I believe that a hospital staff pharmacist who just do purely order entries would learn/come across more than a strictly clinical pharmacist. Maybe just me but...oh well..

That's pretty much how I feel, too. Vanc monitoring and IV-To-PO conversion recos get old fast...this anticoag thing we started was interesting for a week...now its routine, too.

Now staffing...God knows what you'll run into. Variety, variety, variety...I get calls about questions concerning every disease state and condition you can imagine...from simple to complex. The only thing that would be more variety is medicine rounds and "dude that hangs out in the ED." And I do long-stay patient rounds every now and then, too...

 

[grizzlesgrizzlies]

From a person who is trying to get into hospital with LTC experience, I have to ask something: how difficult is the transition process from long-term care to acute care? At my facility we offer IV services (mostly for ABX regimens) and all orders are processed on physican order sheets. And also what medication orders would you see in a hospital that you wouldn't see much of in a LTC setting? (we usually just have the chronic conditions)

 

[WVUPharm2007]

From a person who is trying to get into hospital with LTC experience, I have to ask something: how difficult is the transition process from long-term care to acute care? At my facility we offer IV services (mostly for ABX regimens) and all orders are processed on physican order sheets. And also what medication orders would you see in a hospital that you wouldn't see much of in a LTC setting? (we usually just have the chronic conditions)

Acute cardio stuff...amiodorone drips...cardizem drips...neo drips...dopamine drips...each with titration protocols some new nurse (and there is ALWAYS a new nurse) needs their hand held through it...

...elecrolytes are very complex and have rules and rules about administration rates, max rates, etc...compatabilities are a concern with IVs...calcium and phos infusions can kill a person if they aren't used right and crystallize...then you have drugs can be pushed (injected via syringe directly into the vasculature) and ones which have to be infused (bag hung...injected over a longer time...)...and in which situations each need to be pushed or infused...i.e. Mag needs to be pushed in Torsades...otherwise its usually infused...

...acute pain management....PCAs...drips...

And there are other things.

Though with IV admixture experience, you'll have a leg up on someone out of school or from retail...

 

[rxforlife2004]

Differences btw LTC and Acute care? Well look at the term LTC: what population you have their? elderly mostly. So they lie in bed, get infected, on a bunch of IVs (lots of IVs), get MRSA, lots of MRSA, and on a bunch of antiBx , antifungal, TPN and nutritional support.

On the other hand, at acute hospital, you'll see all kinds of patients: one with car accident, one with chest pain pushing in ER, one with gunshot, one with bruises beaten by the wife, you name it....i've seen one emergency case because of sustaining penile fracture secondary to rolling over onto the erect penis while asleep in bed.lol...you name it.

 

[WVUPharm2007]

In my ED, they have a running list of things they've pulled out of peoples asses that goes back to the 1970s. Light bulbs, rodents, produce, a parking cone...and the scary thing is that its a rather lengthy list.

 

[grizzlesgrizzlies]

Acute cardio stuff...amiodorone drips...cardizem drips...neo drips...dopamine drips...each with titration protocols some new nurse (and there is ALWAYS a new nurse) needs their hand held through it...

...elecrolytes are very complex and have rules and rules about administration rates, max rates, etc...compatabilities are a concern with IVs...calcium and phos infusions can kill a person if they aren't used right and crystallize...then you have drugs can be pushed (injected via syringe directly into the vasculature) and ones which have to be infused (bag hung...injected over a longer time...)...and in which situations each need to be pushed or infused...i.e. Mag needs to be pushed in Torsades...otherwise its usually infused...

...acute pain management....PCAs...drips...

And there are other things.

Though with IV admixture experience, you'll have a leg up on someone out of school or from retail...

Thanks for the advice! I forgot to mention that we also do TPNs so I also know all the electrolytes and whatever else that goes into it. As for IV orders I would do the order entry (with consideration to compatibility of diluents/stability) but the techs usually do the mixing. I figure I'll probably take an IV admixture course at a pharmacy school in the near future so I can get a refresher on that.

 

[Alanine]

Clinical pharmacy is just a fancy term to describe clinical duties of pharmacy branch. I remember back in school the professors kept preaching how fancy clinical pharmacy is...blah blah blah. Now here I am working as a clinical pharmacist (actually mixed with staffing too) and i find it pretty routine after a while. In fact, I believe that a hospital staff pharmacist who just do purely order entries would learn/come across more than a strictly clinical pharmacist. Maybe just me but...oh well..

Clinical pharmacist jobs are not as readily available as staff pharmacists. Usually a hospital, depending on the size of census, population, etc...will only need certain number of pharmacists. Say, if a hospital has 100 patients, then usually it needs only one clinical pharmacist in the morning and 1/2 shift, or so. It also depends on how many clinical programs the hospital has, and the budget too. Regardless, clinical pharmacy is just an extra function of pharmacy. The core function of us, regardless , is still despensing. Seriously, if i don't like dispensing, you shouldn't even be a pharmacist.

.

 

[steph pharmD]

Regardless, clinical pharmacy is just an extra function of pharmacy. The core function of us, regardless , is still despensing. Seriously, if i don't like dispensing, you shouldn't even be a pharmacist.

I'd have to respectfully disagree.
I think it depends on the size of your institution, any affiliation it has with a medical school, and the history of clinical pharmacy there. In school I worked at a 150ish bed hospital and being the "clinical pharmacist" was simply IV to PO, renal adjustment of famotidine, vanc/AG kinetics, and interdisciplinary rounds.
Now I work at a 600+ bed, tertiary, university-affiliated hospital. We have clinical pharmacy specialists, decentralized pharmacists, and staff pharmacists. As a decentralized pharmacist, when I am not doing my 25%ish staffing component, I rarely touch medication or patient labels. Specialists never dispense medications.
There is a large (and ever growing) need for clinical pharmacists to be part of a rounding medical team. I am routinely intervening about things like dose adjusting certain medication up to account for obese patients, choosing an appropriate oral antibiotic when a patient is converted off of IV and no cultures are obtained or grown, steering physicians aware from inappropriate medications for elderly, and just general guidance to the most efficacious and safe use of medications within a specific patient.
It is hard work to get a clinical job, but it is very obtainable. For internal medicine specialists, these are what I see as the various paths to get there. Graduation is first, followed by either a PGY-1 residency, and 3 - 5 years experience + BPS certfication or by a PGY-1 and PGY-2 in pharmacotherapy, or by a 2 year pharmacotherapy fellowship.
I do acknowledge that originally pharmacists were the dispensers of medications. We are so much more than that now! Which is great, because computers are taking over our original dispensing role...

 

[Sparda29]

It all depends on where you live and exactly what kind of job you want. I work in the outskirts of Pittsburgh and I started with a 50:50 clinical:staffing job with rotational hours out of school. I work rotating days and evenings. I actually prefer 1-11PM shifts, so I volunteer for those shifts primarily. This also affords me time alone without the clinical director/more senior pharmacists so I can do some high-level clinical interventions as there are no pharmacists higher up on the food chain to snipe all of the interesting things that pop up. So don't knock 2nd/3rd shift too much, it can afford you opportunity. 👍

I'd like those shifts too. Go clubbing after your shift is over, come back home at 5AM, sleep until 12PM, back to work.