Curious about Pharmacy's Role in Anesthesia and Pain Management

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Secret_Informant

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I am curious about a new career path and pharmacy's stance on it.

The career to be a pharmacist in anesthesia is not readily discussed as such duties are usually handled in the operating room (OR) by Certified Registered Nurse Anesthetists (CRNAs) or anesthesiologists. Not one thread is posted on this subject so I was curious if you can simply teach yourself then prepare yourself as an expert to healthcare providers without going the MD or CRNA route for education. It is just too expensive and it does not make sense given my poor financial situation. ASHP does not have a stake in this specialty or a residency program designed for it, so apprenticeship opportunities are nil.

What are your thoughts on being an anesthesia pharmacist instead of other more traditional career paths?

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I'll let the actual expert anesthesiologists give a more definitive response, but my dumb self thinks that unless you can teach yourself acute trauma management, I don't think that would be a good idea...Anesthesiology is usually a 99.99% boring career, and 0.01% of absolute panic. At the oversight level, the main difference that I usually see between good anesthesiologists and bad ones are how well they manage crisis events (again, the aforesaid trauma training really helps to the point where I am surprised they are not assigned more emergency/trauma management in their residencies though this is changing).
 
I've never heard of an anesthesia pharmacist, nor do I see the need for one with anesthesiologists and CRNAs everywhere (they would agree with me too).

Sounds like a bad dream from APHA/ASHP.
 
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What would an "anesthesia pharmacist" do? The regular staff pharmacists stock the meds in the OR Pyxis and take care of narcotic discrepancies, what else is there to do? Are we making up specialties so there can be more residencies and certificates to waste people's time and money?
 
I am curious about a new career path and pharmacy's stance on it.

The career to be a pharmacist in anesthesia is not readily discussed as such duties are usually handled in the operating room (OR) by Certified Registered Nurse Anesthetists (CRNAs) or anesthesiologists. Not one thread is posted on this subject so I was curious if you can simply teach yourself then prepare yourself as an expert to healthcare providers without going the MD or CRNA route for education. It is just too expensive and it does not make sense given my poor financial situation. ASHP does not have a stake in this specialty or a residency program designed for it, so apprenticeship opportunities are nil.

What are your thoughts on being an anesthesia pharmacist instead of other more traditional career paths?
lololololol wut?
 
I gotta echo the consensus being curated here:

What could an anesthesia pharmacist perform that other clinical pharmacists couldn’t (ie ER pharmacist vs multi-tasked clinic pharmacists that deal with inpatient narcs and Pyxis threshold levels)? Not being sardonic I’m genuinely curious since I’ve never heard of such a title.

Between CRNAs, AAs, Anesthesiologists, even PAs trained in the anesthesia room, that leaves to my thinking as to what would a pharmacist be a contributor to with the drug knowledge of a specialized physician?

I’m really curious since I don’t have real knowledge on this from anything I’ve seen working in a level 1 trauma hospital with the DOD for a few years...
 
The Pharmacist’s Role in Surgery: The Indispensable Asset

https://clinmedjournals.org/article...anesthetics-and-anesthesiology-ijaa-5-067.pdf

The articles above were the reason I posted this thread. I read both of them and it got me thinking about other options within pharmacy that one could transition to. I also tutored and guided two CRNAs through my job and I know of an anesthesiologist I met who had issues of their own. I did not expect so many comments at once. I was seeking sincere responses; it seems I have a few responses: one judgmental and appropriately termed sardonic, which I ignored, other responses that show interest, curiosity, and a real-life outlook (as blunt as it was delivered) which I will accept.

Since pharmacists can prevent medication errors in the outpatient, inpatient, and community/retail setting, one pharmacist does so in the OR. This pharmacist not have a residency either yet still has an indispensable role in designing anesthesia drug trays as well as consulting with CRNAs, anesthesiologists, and the OR staff so that the medication tray meets their needs. This goes back to clinical positions that require residency or not, but that is a subject for another day.

I know hospitals deal with surgeries frequently and nurses sometimes forget what medications to use and for how long in a community hospital due to poor labeling or other reasons. This is obviously a role that clinical pharmacists already do, but an issue nurses complain about all of the time.

In case you all forgot, I worked at a trauma hospital as a pharmacy technician for 2 years where we needed these medications stocked and ready every morning by 7:30 AM. Nurses on my Adult Medicine rotation had the same problem with medications as the colors of the containers sometimes "drawed their eye" to medications that were unsafe: sometimes due to unclear labeling or the way the manufacturer designed the package or vial. In other words, the trays are not "user friendly."

Pharmacists usually oversee the administration of preoperative antibiotics through Surgical Care Improvement Project (SCIP) guidelines, so I thought of anesthesia sounded like a reasonable avenue and is a topic ASHP rarely discusses. Two pharmacists from the Medical University of South Carolina (MUSC), one of the pharmacy schools I applied to, worked in the OR and discussed pharmacy's role in anesthesia. One wrote the article above and the other has a presentation in this link.

https://cdn.ymaws.com/www.scshp.com/resource/resmgr/SCSHP_2015_AM/Matics.pdf

I posted the thread because I never heard of an anesthesia pharmacist either. If this non-profit community is not the place to direct my question, where do you advise I discuss roles that ASHP has little knowledge of?

Link to ASHP is as follows:

Title: ASHP Guidelines on Surgery and Anesthesiology Pharmaceutical Services

https://www.ashp.org/-/media/assets...hash=6070BB566054E5D3F5BE45354D84D1E1F225059A

I already found an introductory guide to get me started reading: Miller's Guide to Anesthesia. My pharmacy school (USFCOP) also provided only one lecture on non-depolarizing and depolarizing muscular blocking agents (directing the lecture towards the typical endotracheal intubation in the ER), so I was just curious.

Data-driven healthcare is the real game-changer for our healthcare system anyways, not "Provider Status." I posted this just to get a discussion going and see if our medical model of education is still viable. Education in pharmacy is more like a Dr. Seuss story anyways: "Oh the Places You'll Go."
 
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What? I am a Board Certfied Anesthesia Pharmacist. I got it right after I passed the Board Certified Dispensing Pharmacist exam... it was quite easy, just had to extra pay 800 dollars and load a small Pyxis Machine or was it a vending machine? I forgot already

The joke is very much appreciated. Thank you for making me laugh. I never laughed genuinely in a good while.

Joking aside, Boston, MA does have vending machines for some OTC medications.

However, the true way of the future is data-driven healthcare. I think everyone knows this by now.
 
This is yet again another example of pharmacy professions love for accreditation’s and certifications. I read the article you posted. I myself have done the OR pharmacy deal and most of the things she talks about is something any pharmacist should and does ensure as a medication expert.

Well, one does not have to have a “anesthesia” pharmacist label, to do these things. One just needs to be a good resourceful and competent pharmacist to work alongside the OR team.
 
There’s what, 10 drugs utilized in anesthesia?
What’s pharmacist gonna do there
 
Can you imagine...

CRNA: "The patient's oxygen levels are low, her heart just stopped and her jaw is clamped down on the intubation tube! What do we do??"

Anesthesiologist: "I don't know let's call the anesthesia pharmacist!!"
 
The Pharmacist’s Role in Surgery: The Indispensable Asset

https://clinmedjournals.org/article...anesthetics-and-anesthesiology-ijaa-5-067.pdf

The articles above were the reason I posted this thread. I read both of them and it got me thinking about other options within pharmacy that one could transition to. I also tutored and guided two CRNAs through my job and I know of an anesthesiologist I met who had issues of their own. I did not expect so many comments at once. I was seeking sincere responses; it seems I have a few responses: one judgmental and appropriately termed sardonic, which I ignored, other responses that show interest, curiosity, and a real-life outlook (as blunt as it was delivered) which I will accept.

Since pharmacists can prevent medication errors in the outpatient, inpatient, and community/retail setting, one pharmacist does so in the OR. This pharmacist not have a residency either yet still has an indispensable role in designing anesthesia drug trays as well as consulting with CRNAs, anesthesiologists, and the OR staff so that the medication tray meets their needs. This goes back to clinical positions that require residency or not, but that is a subject for another day.

I know hospitals deal with surgeries frequently and nurses sometimes forget what medications to use and for how long in a community hospital due to poor labeling or other reasons. This is obviously a role that clinical pharmacists already do, but an issue nurses complain about all of the time.

In case you all forgot, I worked at a trauma hospital as a pharmacy technician for 2 years where we needed these medications stocked and ready every morning by 7:30 AM. Nurses on my Adult Medicine rotation had the same problem with medications as the colors of the containers sometimes "drawed their eye" to medications that were unsafe: sometimes due to unclear labeling or the way the manufacturer designed the package or vial. In other words, the trays are not "user friendly."

Pharmacists usually oversee the administration of preoperative antibiotics through Surgical Care Improvement Project (SCIP) guidelines, so I thought of anesthesia sounded like a reasonable avenue and is a topic ASHP rarely discusses. Two pharmacists from the Medical University of South Carolina (MUSC), one of the pharmacy schools I applied to, worked in the OR and discussed pharmacy's role in anesthesia. One wrote the article above and the other has a presentation in this link.

https://cdn.ymaws.com/www.scshp.com/resource/resmgr/SCSHP_2015_AM/Matics.pdf

I posted the thread because I never heard of an anesthesia pharmacist either. If this non-profit community is not the place to direct my question, where do you advise I discuss roles that ASHP has little knowledge of?

Link to ASHP is as follows:

Title: ASHP Guidelines on Surgery and Anesthesiology Pharmaceutical Services

https://www.ashp.org/-/media/assets...hash=6070BB566054E5D3F5BE45354D84D1E1F225059A

I already found an introductory guide to get me started reading: Miller's Guide to Anesthesia. My pharmacy school also only provided one lecture on non-depolarizing and depolarizing muscular blocking agents (directing the lecture towards the typical endotracheal intubation in the ER), so I was just curious.

Data-driven healthcare is the real game-changer for our healthcare system anyways, not "Provider Status." I posted this just to get a discussion going and see if our medical model of education is still viable. Education in pharmacy is more like a Dr. Seuss story anyways: "Oh the Places You'll Go."

Thanks for the articles.

What do you think the "anesthesia" Pharmacist's new roles will be?

Having worked in OR pharmacies in the past, I can assure you your average OR pharmacist do not usually design nor want to design anesthesia drug trays or processes on his or her own. It is often a collaborative project between the OR Medical staff and Pharmacy clinical and administrative personnel such as your pharmacy director/OR pharmacy supervisor/clinical coordinator and OR physicians/directors. The process is discussed in meetings, approve by committee voting and a policy is written for the staff to follow.

Having said that, I think the OR pharmacist can make good recommendations since they're in the front lines working with the OR staff and understand certain challenges. However, the decision making is ultimately done by administration. IMO, it seems superfluous and unnecessary to have an additional pharmacist/anesthesia pharmacist. What would be the new roles? How would these roles justify the cost of hiring an anesthesia pharmacist in addition to an OR pharmacist?

I agree with others. The OR pharmacist space does not need its own certification or residency. CEs would be warmly welcomed.
 
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