I'm Not Suited to be a Pharmacist

[Oink]

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Not discussing the behaviorals, that's just basic "Show up on time" kinds of problems.

Academic failures (by the way, the school is 80% women to 20% men now, while both of my failures were women, I estimate that out of the 80 or so students I have had from this school in my career, just 3 of them were male):

1. (She practices just fine now, I would willingly be her patient.) Could not deal with brand/generic conversions if their life depended on it (Lasix/furosemide). Made several major mistakes with drug flow calculations that three of them went down as incident reports (among other ones, had Amiodarone calculated for a 3g (not 300 mg) push and literally was getting the 20 vials when the supervising preceptor had stopped her). Week 3, had her take PARE for calculations and failed. Sent her back to the committee with a reference that she retakes pharmaceutical calculations as a requirement during her rearranged break rotation before being sent out again. She shaped up and did fine the second time. Just a failing competency matter that was rectifiable.

2. Frat member who was marginal pass (suspected then and proven later that she basically cheated her way through the program), never worked as a tech or an intern in school. First rotation. Fundamentally just did not know anything about medications. Week 2 of 6, sent her to take the full PARE and abysmally failed (as in the NAPLEX conversion score would have been in the 30s in the 2007 era). Sent her back with the committee recommendation that she retake her third year as the entire committee agree that she was not passable to the fourth year stage. Did not graduate.

In both cases, this was known at the first week's end, counseled with faculty witnesses by midterm, basically did all the paperwork necessary. That was the kindest thing I could have done. The worst thing I could have done was think that failing those two was not worth the paperwork bother (which I'm sure goes through many of our heads). It's not comfortable, but it's not abusive either. I truly suspect your preceptor is being abusive, but I only hear one side of the story. In cases where I think that is a suspicion in myself, that's why I have witnesses when I counsel or chew out trainees so that it cannot be said that I did so unprofessionally or in discrimination.

I don't think my preceptor is intending to be abusive. I believe he is trying to push me as hard as he can to help me improve. The biggest problem with my preceptor is his feedback and the way we interpret each other. His feedback is really harsh and there is nothing constructive from what he says to me. The type of feedback that I mentioned before are actual words that my preceptor said to me. Saying there's something wrong with my head and that there is nothing he can do to help me are things he actually said to me. I will not say that I am the best or brightest student, but I definitely work hard.

I admit that I have made many mistakes during this rotation, but I have definitely improved. Many of the mistakes I have made was saying "I don't know I'll get back to you" to questions that I already know the answer to. He would scold me for not knowing the answer and then let me look it up later on.

Unfortunately, most of that improvements I've made were from help and advice outside of this preceptor. Maybe this was my preceptor's plan all along. Maybe he wanted to be so harsh on me that I will go out and seek advice from anyone that I can. But one thing I know for sure is that the stress that was caused by my preceptor made my ability to learn very hard and inefficient. Even though I am glad I learned, I don't think I learned as much as I could've because of the stress. The amount I learned does not feel worth it compared to all the work I put in.

But who knows. Maybe if my preceptor is nice, I wouldn't push myself as hard and I still wouldn't learn as much. I don't know. The workload isn't even hard at all. If I didn't have this problem with him, this rotation would've been a piece of cake. But the constant condescending words that come from him made it unnecessarily hard. He said something just recently like "You just want to be a retail pharmacist huh? Because that is how you are acting right now. As a matter of fact, you're more of a tech." That makes me feel stupid and annoyed. I was also offended when he said that because there are a bunch of retail pharmacists that I respect.

Also when my preceptor chews me out, he makes sure it's when we are alone. He would always pull me aside or just chew me out whenever nobody is around. Sometimes I think someone could've heard him, but that's just me being hopeful. Not many people work around the area that we work. It literally feels like I'm just in a dungeon alone with my preceptor and I'm just waiting to be eaten alive.

 

[Ketchupbottle]

Also when my preceptor chews me out, he makes sure it's when we are alone. He would always pull me aside or just chew me out whenever nobody is around. Sometimes I think someone could've heard him, but that's just me being hopeful. Not many people work around the area that we work. It literally feels like I'm just in a dungeon alone with my preceptor and I'm just waiting to be eaten alive.

Better to do this than to have an audience, because then it just feels like a public shaming.

I'm sorry, though, because the other side of this is the feeling of isolation that there's no one else that understands what you're going through. Hope you get through this! Is this rotation over soon?

 

[lord999]

Better to do this than to have an audience, because then it just feels like a public shaming.

I'm sorry, though, because the other side of this is the feeling of isolation that there's no one else that understands what you're going through. Hope you get through this! Is this rotation over soon?

Actually no, chewing out someone alone is specifically considered to be a risky and irresponsible HR behavior, that's a hostile work environment charge waiting to happen. There's almost always company policy on how to deal with this. You don't do this in public, but you do actually call in someone else as a referee to ensure both parties behavior is witnessed. For civil service, that's the Weingarten matter where a union representative may be present for any negative communication or an HR or other supervisor for a exempt employee. What that preceptor is doing is almost certainly against both the hospital and the academic place where the rule is to document, document, document. That's why I really do suspect something off about this, because the chief preceptor knows better than to do this alone (if this person even is the chief preceptor, which if not, the chief preceptor can get sanctioned for their subordinate's conduct).

VA: This is the general policy and specifically 5021 needs to be read. If you are a VA preceptor or supervisor, you should know that this exists and we are penalized for ignorance of the policy as well as violating it (i.e. I always tell the supervisors never to say that "I didn't know that the policy existed" as that pisses off OHI even more). There are very specific policies that supervisors and RPD's have to follow in addition. It is one of the very few issues where especially egregious conduct will negate FTCA protection from a personal named lawsuit (this is why I still keep professional conduct insurance personally).

http://www.ethics.va.gov/docs/policy/IL_10-2010-02_Disruptive_Behaviors_20100113.pdf

 

[lord999]

But who knows. Maybe if my preceptor is nice, I wouldn't push myself as hard and I still wouldn't learn as much. I don't know. The workload isn't even hard at all. If I didn't have this problem with him, this rotation would've been a piece of cake. But the constant condescending words that come from him made it unnecessarily hard. He said something just recently like "You just want to be a retail pharmacist huh? Because that is how you are acting right now. As a matter of fact, you're more of a tech." That makes me feel stupid and annoyed. I was also offended when he said that because there are a bunch of retail pharmacists that I respect.

Also when my preceptor chews me out, he makes sure it's when we are alone. He would always pull me aside or just chew me out whenever nobody is around. Sometimes I think someone could've heard him, but that's just me being hopeful. Not many people work around the area that we work. It literally feels like I'm just in a dungeon alone with my preceptor and I'm just waiting to be eaten alive.

Yeah, what you just described, that condescending behavior is actually abusive behavior. I would and have sent down even senior pharmacists for corrective action through the Professional Standards Board in the civil service. You don't give feedback that isn't actionable as a rule 1 matter. The tech comment alone would have been a suspension offense in the civil service (and yes, I have actually done so as a Chief).

 

[owlegrad]

I suspect the preceptor is deliberately choosing to give criticism in private so that you do not feel like you are being called out in front of an audience, although like lord999 said he is putting himself in a dangerous position if you do decide to complain about his behavior.

 

[Oink]

Today was the last day and I just found out I passed. What they specifically call my passing is "conditional passing." What that means is I could've failed, but they basically passed me because I have improved and gave my best effort. I literally gave out one of the biggest sighs of relief of my life after leaving this place.

I did report this to my experiential coordinator during the middle of the rotation, but she wanted to see me make my own adjustments first. I guess trying to do that helped me figure out what I needed to improve on. I need to learn different ways of thinking for myself, methods of proactiveness, and ways of adapting. I just wasn't getting that constructive criticism that I wanted from my preceptor. I needed some advice on how I can improve on those things. Maybe it's hard to give that kind of advice. I'm completely fine with having my mistakes pointed out. But if that is all I hear and I can't get any type of suggestions out of my preceptor, then it just seems like my preceptor is doing nothing but putting me down.

I'm glad I know what I need to improve on. I just need to figure out how I can improve further for my next rotations. I guess I can use the winter break to reflect on how to be better. It just sucks because I know I left this rotation with my confidence being crushed to the ground. But thinking that way isn't gonna help me either. I just need to forget about this rotation and move on I guess. All I hope for now is that I don't have this experience ever again.

 

[Ketchupbottle]

Actually no, chewing out someone alone is specifically considered to be a risky and irresponsible HR behavior, that's a hostile work environment charge waiting to happen. There's almost always company policy on how to deal with this. You don't do this in public, but you do actually call in someone else as a referee to ensure both parties behavior is witnessed.

Oh, I apologize. I don't know this from being a preceptor, I'm a new grad, so that was more of an opinion comment. But thanks for presenting that. I think even when my school was talking about feedback (including "difficult" conversations), they discussed it should be one-on-one with no witnesses.

 

[lord999]

Oh, I apologize. I don't know this from being a preceptor, I'm a new grad, so that was more of an opinion comment. But thanks for presenting that. I think even when my school was talking about feedback (including "difficult" conversations), they discussed it should be one-on-one with no witnesses.

No worries, that's something that has changed even over the short time in my career. When I was an intern in the early 00s, you were supposed to do that without witnesses and alone. That all changed with the number of harassment and hostile work environment actions, and there are almost always established policies on that. (Also, that school giving that advice in the present day is either not very experienced, or is somewhere like Iowa where everyone covers for each other). Like giving my manager Geritol as an intern (and we all pitched in for a rocking chair) among other things when she turned 50, that's funny then, but certainly not ok now.

Yeah, it's kind of a problem that preceptors (particularly new ones) are not given HR or supervisory training as a lot of mistakes that could get the company in huge trouble (as well as you) are quite avoidable under normal circumstances.

 

[Wickett]

Today was the last day and I just found out I passed. What they specifically call my passing is "conditional passing." What that means is I could've failed, but they basically passed me because I have improved and gave my best effort. I literally gave out one of the biggest sighs of relief of my life after leaving this place.

I did report this to my experiential coordinator during the middle of the rotation, but she wanted to see me make my own adjustments first. I guess trying to do that helped me figure out what I needed to improve on. I need to learn different ways of thinking for myself, methods of proactiveness, and ways of adapting. I just wasn't getting that constructive criticism that I wanted from my preceptor. I needed some advice on how I can improve on those things. Maybe it's hard to give that kind of advice. I'm completely fine with having my mistakes pointed out. But if that is all I hear and I can't get any type of suggestions out of my preceptor, then it just seems like my preceptor is doing nothing but putting me down.

I'm glad I know what I need to improve on. I just need to figure out how I can improve further for my next rotations. I guess I can use the winter break to reflect on how to be better. It just sucks because I know I left this rotation with my confidence being crushed to the ground. But thinking that way isn't gonna help me either. I just need to forget about this rotation and move on I guess. All I hope for now is that I don't have this experience ever again.

Just move on, reflect on if any of the preceptor's critiques had any merit, and just figure out what you need to improve on. I considered myself a pretty good student and reasonably knowledgeable for a 4th year, and one of my rotations was hell. Funny enough, it was my retail rotation (which is a field I considered my strength) that was terrible.

My preceptor treated me like a dog (would literally snap her fingers to tell me to come) and generally treated me like I was an idiot unworthy of her time from day one. No matter what I said or did it was wrong and stupid. I just told myself it was temporary and did what I had to to pass. I also learned I needed to improve my otc knowledge and strengthened that.

Don't let one persons opinion kill your confidence, but also don't simply play victim and refuse to reflect on what weaknesses you may have. APPEs are temporary.