clinical pharmacy

[badxmojo]

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Hi, if anyone here works in clinical pharmacy, or know someone who does, I'd appreciate it if you could tell me a little (or alot) about the job, what it consist of, the positives and the negatives.
from what I gather you come into the hospital, check the patients charts see that everything is okay.. maybe talk to some of the doctors and make reccomendations.. and then also possibly talk to the pateints about side effects and what they can do to minimize them. It sounds like a really fufilling career to me...

 

[GravyRPH]

I am a clinical pharmacist in a small 60 bed hospital. I actually do a lot more than that though so my representation may not be accurate to what a fulltime clinical pharmacist does. But, I review charts, make recommendations, answer questions, make myself available, give presentations at medical staff meetings, give input on protocols, dose certain antibiotic regimens and heparin/coumadin regimens,..... In addition to all this, I also review all the orders for the day, check the IV's, and sign off on the med cart fills. All the functions of a regular hospital pharmacist. Busy day. 🙂
Several days in the month, I also review about 100 charts in an associated convalescent care center and give recommendations, etc.

Actual fulltime clinical pharmacist positions are very difficult to find. Do not get your hopes up that you will be wheeling and dealing with the doctors when you get out of pharmacy school(despite what your profs will tell you). Unfortunately, these jobs are few and far between because they do not produce any calculable dollars. With hospitals suffering serious budgetary cutbacks and financial crunches, I don't expect many additional positions coming available. That being said, their is still some demand, and if you are set on it, you can usually find something to fit your needs. The good thing about pharmacy is if you don't like one area of work, there is 50 others waiting with open doors.

 

[badxmojo]

Thanks so much for replying..yeah I heard clinical pharmcay positions are few and far between which is disheartening because a majority of the students I talked to at my new student welcome day said they wanted to do clinical so the competition looks like it will be tight. I don't wanna end up in retail..or in some hospital basement just checking medicines.. alot of jobs I look at seem to have some clinical and some staffing which I don't think I would mind. In fact I think it'd be good to know how the medicines are made.
you never told me what you thought of the job..did you enjoy it? what r positives? negatives?

 

[GravyRPH]

Oh ya, its awesome. I came from working 5 years in retail and I couldn't stand another minute so I took a bit of a paycut and made the jump. It was so worth it.

The negatives: About 75% of the doctors ignore what you say, only about 25% listen and follow your rec's. Nearly all will call asking questions though. Many don't really see you as being much help, but that's part of the conversion process. In the beginning, a few didnt really understand why I was allowed to write in THEIR charts. This is a relatively new program at this institution, so their are a lot of hurdles that need to be overcome. "Who's this guy think he is anyways?" mentality.

The positives: The ones that do interact with you get some valuable information that produces verifiable results in their patients. To see these rec's taken and then produce the desired response is really cool! The interaction with the willing doctors (usually the younger ones) are really fulfilling. I attend all of their conferences with all the other doctors and learn a ton more then I'd ever learn in pharm school. These are doctors, actively discussing their cases with specialists, getting courses of action and literature examples. Neat stuff. Plus, I'm not in front of a computer all day. I'm not standing behind a counter all day. I don't have to deal with users wanting their Vicodins now. No calls to insurance companies. And my opinion actually matters to someone. Woo.

 

[badxmojo]

okay thanks very informative! you mentioned these jobs are more scarce then the normal staff positions and retail positions.. you have any suggestions on how to "break into" this feild? I know i'll have to do a residency coming out of school.. is it more the people you know as in connections? being at the right place at the right time? or is it your grades in pharmacy school? your performance during the residency?

 

[johnnyk]

check out this thread

Considering Pharmacy

 

[badxmojo]

thanks johnny K that was a very helpful tread... so would you say having a position in which you do some clinical and some staffing is probably more finacially rewarding per hour?
I certainly want a job that will pay me overtime if I work over 40 hours a week.. cause if i didn't i may have just gone to law school!

 

[Triangulation]

cool thread guys. i'm actually working at wag's w/a pharmacist who's considering pulling out of retail for good for a clinical position, but she's still mulling it over. Sounds like salary issues are her main concern.

 

[GravyRPH]

That other thread sounds pretty simlar to my situation just on a grander scale.

I did not do a residency and you don't need one. One would help you get into a competitive spot and it wouldnt hurt, but it really depends more on being at the right spot at the right time. Also, if you are willing to relocate or not to picky on where you live. I've never once been asked what my grades were in school.

I get paid OT if I work over 80 hours in a pay period. Pay rates are an issue but the gap is getting smaller. I am making 90k a year currently with a 10k sign on bonus. I'm hoping this will increase shortly. I was told it would about 2 months ago, but I have yet to see anything.

If you're coworker expresses her concers about wage and they want her bad enough they will accomadate her. I expressed my concerns to my current job and they gave me 10k for it. They also said they would raise my wages within 6 months, which they did. Its hard to ask that for some, but its the only way she'll get what she wants. And its an honest concern.

 

[angelic02]

What do hospital pharmacists do when a medical emergency arises? I noticed that pharmacy practice residents are part teams that respond to code blue emergencies.

 

[GravyRPH]

I can only speak of my situation. I am there if they need additional supplies, e.g. epinephrine injections or if they need a dose calculation. Usually its something like: "I need to give him/her 50mcg of neo-synephrine", and you have to instruct them how to dilute it and what volume to give.
For the most part, not a whole lot.

 

[carpe diem]

In response to Angelico02,

I was a critical care pharmacist at a large pediatric institution for a number of years before starting medical school. Critical care pharmacists at our institution were full members of the Code/Trauma team. We were responsible for obtaining the child's weight (via chart, via Mom, via estimating) and were expected to have emergency doses of code meds corresponding to the child's weight ready when MD yelled ( give Epi, give Atropine...., etc. ). The Docs didn't even care about doses....that was my job......puts some pressure on you, but you have tools to help you with that. We participated in traumas and full arrests that presented in the ER, as well as codes on the patient floors.

Many times I would go with the intrahospital transport team to radiology, or CT after a trauma or code if the patient was unstable. Several times I had to crack to pharmacy code box open on the elevators. Probably some of my most satisfying moments in pharmacy were when I was able to anticipate a patient "crashing" before the residents or nurses did , and then handing them an epi dose and a custom-made epinephring drip I had just made when they subsequently yelled "Need epi now and an epi drip stat!"

As for clinical pharmacy in general, wherever you work and whatever pharmacy degree or residency you have or don't have, know your patients well enough to know what is the best advice you can them or their docs about their drug therapy. If you do this in a diplomatic way, you'll have folks seeking out your advice and following it. This is clinical pharmacy, imho, and it's not defined by degrees or formal training, although any extra training can only help.