Is this typical of hospital interns?

[hye345]

---

Members do not see this ad.

So, I'm in my 2nd year, and have been working in an inpatient pharmacy setting for just under a year. At first I liked it because it was relatively low-stress compared to retail, and there was lots of downtime. But the more I hear about my classmates talk about their work (in both retail and hospital settings), the more I realize that there may be a caveat...

95% of my work consists of tech duties: refilling pyxes machines, unit-dosing medications, getting med carts ready for delivery, and answering phone calls (most of which we are instructed to transfer directly to the pharmacists). So, relatively easy work, but also very repetitive, and in my opinion, not a valuable source of (pharmacy) knowledge. Other classmates of mine who work at other hospitals mention that they assist pharmacists in certain limited clinical roles, such as looking up IV compatibility (and they're the same year as me). At first I figured its because I'm "only" a 2nd year, but I spoke to a 3rd year coworker intern, and she flat-out told me that they (usually) don't have time to help the pharmacists out with any clinical stuff (too much tech stuff to do).

My question/rant is... is this a normal work environment, or am I being cheated out of a learning experience? I understand that since its a paid job, there are the obligatory menial duties to do, but I'd figure that eventually we would get more responsibility and clinical tasks/assignments.

 

[pharmacy7424]

You are not being cheated out of a learning experience because the hospital is under no obligation to provide you a learning experience. You are a paid employee and you are there to fill their needs, namely, the tech work you described.

IV compatibility is not clinical, you just look it up on a drug info source.

Your advantage to working in a hospital over retail is that you get exposure to all of the drugs in hospital practice. The downside is you don't get to get common doses drilled into your head, and you don't get counseling experience.

Make what you will of it, just don't come across to your manager as doing 'menial' tasks. As a paid employee, they will respect you less for it.

 

[confettiflyer]

I toiled doing "menial" tasks for my 1st year as an intern and said "thank you sir, may i have another?"

more opportunities opened upon their own, but it's highly dependent on the hospital. Some hospitals use interns as mostly technicians, few actually incorporate interns into workflow. This is because most interns can only work weekends and/or random days here and there. Kind of hard to build a meaningful/continous program with random scheduling, so it's much easier to just slot in interns as technicians.

that said, i learned a bunch about workflow and just "how **** works" in a hospital as an intern...came in handy as my residency focused on clinical so the learning curve with respect to how hospitals function was pretty easy.

 

[mustang sally]

You're probably learning more than you think you are. You could always discreetly look around for another job if you think there's something better out there, but I think you're pretty lucky to have a hospital internship.

Plus I'm a staff pharmacist and I still do menial tasks every day…so it's probably worthwhile learning how to do them with a smile and say "thank you sir, may I have another?"

 

[michaelhardy]

At the hospital I intern at, I've only done a few tech shifts over my two years. Usually I work in conjunction with the Clinical Pharmacists in performing pharmacokinetics, anti-coagulation monitoring, coumadin teachings, renal adjustments, narc audits and TPNs. However, I don't think this is the norm for a paid pharmacy intern, usually they just do technician work.

 

[Eichhoernchen]

When I had my IPPE at a hospital, I did not like it all. I found it pretty boring and repetitive. By the end of it, I was actually really looking forward to going back to work in my independent retail!

 

[KidPharmD]

IPPE and Interning is not the same.

Just like MOST retail interns will perform mostly as technicians so will hospital interns. With the exception of the occasional special project (read menial data collection) our interns perform as technicians with more flexible schedules to accommodate classes.

 

[hye345]

Thanks for the replies everyone. I didn't mean to come across as being 'above' tech work or anything, I generally take these duties seriously (though I'd be lying if I said I was "cheerful" about them). It's just that everyone says that a de-facto requirement of getting a residency/hospital job is interning at a hospital, so I wondered if my experience really counts towards that... whether it comes down to what one actually does while interning, or if its just simply being employed as an intern at a hospital setting. It got me worried because as pharmacy7424 mentioned, a lot of my friends who work at retail are getting experience in patient counseling and recognizing many doses/DDI, while I feel like a cog in a machine at times.

 

[KidPharmD]

I would definitely not say that a hospital internship was a de-facto residency requirement. I never interned at a hospital, and neither did many of my friends.

 

[sakigt]

Thanks for the replies everyone. I didn't mean to come across as being 'above' tech work or anything, I generally take these duties seriously (though I'd be lying if I said I was "cheerful" about them). It's just that everyone says that a de-facto requirement of getting a residency/hospital job is interning at a hospital, so I wondered if my experience really counts towards that... whether it comes down to what one actually does while interning, or if its just simply being employed as an intern at a hospital setting. It got me worried because as pharmacy7424 mentioned, a lot of my friends who work at retail are getting experience in patient counseling and recognizing many doses/DDI, while I feel like a cog in a machine at times.

I think it has to do with your attitude about doing "menial" tasks.

I talked to a lot of APPE students that filled the batch and considered it "boring." I asked them what drug they were filling at the moment, what its indication was and what its common dose was. If they were good by the end of the rotation they knew the answer to these questions, if they didnt care they didnt. As a tech look deeper into the steps that youre doing. When you make an IV bag whats the directions for titration on them, whats the max dose, whats the MOA, what are the side effects.... You wont have "time" to figure these things out later, youll have to just know them, and this is a great way to do that. Amiodarone goes in a special bag, whats protected from light, etc etc.

As a decentralized Pharmacist a lot of questions I get from nurses from the Accudose. Sometimes a simple comment from them (omg were always out of valium IV?!) will generate a brief investigation by me ( oh, the max par is set at 0 bc this used to be on backorder) and I fix the problem. If I wasnt a tech before I wouldnt have known how to do that. You will know how to do that.

I hardly ever did Pharmacist work as an Intern. And looking up IV compatibility is such a yawn procedure anyway, youll be able to figure out how to do that when you're a Pharmacist. Or heck, do it now if you want.

My two cents.

 

[Misaenator]

When I had my IPPE at a hospital, I did not like it all. I found it pretty boring and repetitive. By the end of it, I was actually really looking forward to going back to work in my independent retail!

I really had a bad taste with retail. Not sure if bc I was working as a tech for a big chain at crazy 24h stores or sth, but I really hope I won't have to deal with retail again. Im not gonna say I will never go back, just really not prefer to. I find inpatient hospital isn't that bad, esp when u get a chance to work at IV and unit dosing depts. I get to talk to nurses, Drs, PAs, OTs, PTs, attendings, residents, learn fr everybody. At least those knowledge are free compared to med school anyway

Sent from my HTC One using Tapatalk

 

[xiphoid2010]

It really depends on how the hospital's internship program is designed. If they do it like walgreens or CVS, then you are pretty much a souped up tech doing more or less the same jobs. Some of the more teaching oriented or better designed hospital internship programs will have it with learning objectives built in. The hospital I interned at was such. The huge teaching hospital opened up a ED satellite pharmacy and staffed it with interns in place of technicians whenever possible. The first 3 months of the training was in the central pharmacy to learn the basic ins and outs, then the real fun starts. It was AWESOME! Running to traumas and codes, getting ACLS certified and put it to use, GSW, poisoning, MI, stroke, hypothermia protocols... Now that was some excellent training!

 

[hye345]

I think it has to do with your attitude about doing "menial" tasks.

I talked to a lot of APPE students that filled the batch and considered it "boring." I asked them what drug they were filling at the moment, what its indication was and what its common dose was. If they were good by the end of the rotation they knew the answer to these questions, if they didnt care they didnt. As a tech look deeper into the steps that youre doing. When you make an IV bag whats the directions for titration on them, whats the max dose, whats the MOA, what are the side effects.... You wont have "time" to figure these things out later, youll have to just know them, and this is a great way to do that. Amiodarone goes in a special bag, whats protected from light, etc etc.

As a decentralized Pharmacist a lot of questions I get from nurses from the Accudose. Sometimes a simple comment from them (omg were always out of valium IV?!) will generate a brief investigation by me ( oh, the max par is set at 0 bc this used to be on backorder) and I fix the problem. If I wasnt a tech before I wouldnt have known how to do that. You will know how to do that.

I hardly ever did Pharmacist work as an Intern. And looking up IV compatibility is such a yawn procedure anyway, youll be able to figure out how to do that when you're a Pharmacist. Or heck, do it now if you want.

My two cents.

I see. To be fair, I'm still in the process of being trained in the IV room. When delivering drugs, I do try to connect it to what we learned about them in school, but since the emphasis is on speed and efficiency with all the automation, its more of a "yeah, I remember that drug is used for this... forgot the MOA though..." before moving on to the next one.

 

[sakigt]

When I was an intern (and didnt have as much time as an appe student) I tried to remember one a day. Didnt always happen, but I tried.

 

[confettiflyer]

I see. To be fair, I'm still in the process of being trained in the IV room. When delivering drugs, I do try to connect it to what we learned about them in school, but since the emphasis is on speed and efficiency with all the automation, its more of a "yeah, I remember that drug is used for this... forgot the MOA though..." before moving on to the next one.

Sterile compounding is my favorite, building up skill comes in handy on those random night shifts you may inevitably pick up where your technicians are out of the pharmacy and a STAT drip needs to be made.

Just be prepared to stab yourself with an 18G needle once or twice.

 

[Sparda29]

So, I'm in my 2nd year, and have been working in an inpatient pharmacy setting for just under a year. At first I liked it because it was relatively low-stress compared to retail, and there was lots of downtime. But the more I hear about my classmates talk about their work (in both retail and hospital settings), the more I realize that there may be a caveat...

95% of my work consists of tech duties: refilling pyxes machines, unit-dosing medications, getting med carts ready for delivery, and answering phone calls (most of which we are instructed to transfer directly to the pharmacists). So, relatively easy work, but also very repetitive, and in my opinion, not a valuable source of (pharmacy) knowledge. Other classmates of mine who work at other hospitals mention that they assist pharmacists in certain limited clinical roles, such as looking up IV compatibility (and they're the same year as me). At first I figured its because I'm "only" a 2nd year, but I spoke to a 3rd year coworker intern, and she flat-out told me that they (usually) don't have time to help the pharmacists out with any clinical stuff (too much tech stuff to do).

My question/rant is... is this a normal work environment, or am I being cheated out of a learning experience? I understand that since its a paid job, there are the obligatory menial duties to do, but I'd figure that eventually we would get more responsibility and clinical tasks/assignments.

This is normal for hospital interns. For the most part, it is too busy for me to be teaching clinical stuff. When there is some downtime, I usually print out some DUR lists and have the intern go through and look for possible IV to PO switches.

 

[hye345]

This is normal for hospital interns. For the most part, it is too busy for me to be teaching clinical stuff. When there is some downtime, I usually print out some DUR lists and have the intern go through and look for possible IV to PO switches.

We don't even get to do that part 🙁

The one thing I worry about is not having the school knowledge 'stick' (since the running line is that an internship helps students remember/use what they learn in school).

 

[Sparda29]

We don't even get to do that part 🙁

The one thing I worry about is not having the school knowledge 'stick' (since the running line is that an internship helps students remember/use what they learn in school).

I didn't learn much in school. Learned A LOT on rotations.

 

[HouTX]

I see. To be fair, I'm still in the process of being trained in the IV room. When delivering drugs, I do try to connect it to what we learned about them in school, but since the emphasis is on speed and efficiency with all the automation, its more of a "yeah, I remember that drug is used for this... forgot the MOA though..." before moving on to the next one.

so you can't look up the drugs at home or at school? once you're a licensed rph, you would still have to learn about new drugs. the learning doesn't stop when you graduate.

 

[sakigt]

so you can't look up the drugs at home or at school? once you're a licensed rph, you would still have to learn about new drugs. the learning doesn't stop when you graduate.

As someone who listens to educational podcasts on the way to and from work and has a stack of literature to review during slow times this is oh so true.

 

[njac]

What someone else said about menial tasks never going away.

As a specialist, I still joke about being the highest paid tech in the department.

If a Pyxis needs filled, I fill it.

Doesn't do me any good to write an order for a drug if a nurse can't access it...

 

[confettiflyer]

What someone else said about menial tasks never going away.

As a specialist, I still joke about being the highest paid tech in the department.

If a Pyxis needs filled, I fill it.

Doesn't do me any good to write an order for a drug if a nurse can't access it...

Same, so I covered my ICU specialist's spot last week and did the following menial tech things:

1) retrieved items from pharmacy and hand delivered to a nurse
2) refilled a Pyxis machine for a stock out I noticed
3) troubleshot a very high pitched noise coming from behind a Pyxis machine causing the screen to turn off
4) briefly glance at medication bins for expired and/or out of place things
5) helped workflow downstairs by helping label our IV batch for a bit

This on top of my unicorn duties like arguing with my ICU doc about appropriate meropenem use and of the like.

I appreciate the pharm students' enthusiasm (I was the over eager intern that wanted to do more), but like others said, learning is a process and not a checklist. There's value in the most menial tasks like delivering a med.

Case in point, my knowledge of my hospital's floor plan back due to helping with Pyxis issues or random stat med delivery helped me find the closest way to get from point A to B....helpful when you're on the code team and it's called in an oddball place you wouldn't ordinarily go to.