Pharmacy Practice in Various States

[njac]

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As the residency hunt of 08-09 continues. Our local residents spoke to our class yesterday and one mentioned that at her PGY-1 back east pharmacy was so restricted that they couldn't even write orders for Vanco troughs.

How are things in the state where you live/go to school? Here in New Mexico I think things are pretty progressive. We can write progress notes in the chart, doctors can write "Vanco/Coumadin dosing per pharmacy" where they give an initial dose and from that point on we order labs and change dosing as required.

I've heard that the midwest is relatively progressive and New England tends to be pretty conservative - most pharmacy activity is behind closed doors. Please share your experience!

 

[CYP3A4]

I live in Chicago and from what i have seen pharmacy practice in hospitals for the most part is fairly progressive. Obviously, the bigger teaching institutions are more progressive than smaller community hospitals.

 

[rxforlife2004]

As the residency hunt of 08-09 continues. Our local residents spoke to our class yesterday and one mentioned that at her PGY-1 back east pharmacy was so restricted that they couldn't even write orders for Vanco troughs.

How are things in the state where you live/go to school? Here in New Mexico I think things are pretty progressive. We can write progress notes in the chart, doctors can write "Vanco/Coumadin dosing per pharmacy" where they give an initial dose and from that point on we order labs and change dosing as required.

I've heard that the midwest is relatively progressive and New England tends to be pretty conservative - most pharmacy activity is behind closed doors. Please share your experience!

I am a hospital pharmacist in California, and here...i can write any orders for PK trough/peak, as long as it is "per pharmacy" by MD. I can also order any lab related to the drug regimen that i am responsible too, such as if i dose epogen, i can order Fe/TSat, iron supplement, or even vitamin B6 if deemed appropriate.

Never a nurse or lab personnel questions an order from the pharmacist yet...unless it's grossly wrong.

 

[njac]

come on, I know there are people in other states!

 

[WVUPharm2007]

WVU is pretty dang progressive from what I've seen.

 

[njac]

WVU is pretty dang progressive from what I've seen.

my preceptor was talking about the dean of WVU today. She said she's pretty badass.

 

[WVUPharm2007]

my preceptor was talking about the dean of WVU today. She said she's pretty badass.

Odd, I have the opposite opinion...but I digress...

 

[njac]

Odd, I have the opposite opinion...but I digress...

oh, I understand. I guess this lady was her resident almost 30 years ago. Totally different relationship.

 

[stumbleine88]

I see this thread is old, but wanted to bring it back for more opinions! Has anyone worked in both midwest and northeast and is able to compare? Anyone feel "judged" for being from the northeast or have people assume you have lesser experience?

 

[xiphoid2010]

I see this thread is old, but wanted to bring it back for more opinions! Has anyone worked in both midwest and northeast and is able to compare? Anyone feel "judged" for being from the northeast or have people assume you have lesser experience?

I don't believe that you will be judged. Pharmacy practice varies greatly by institution, and a lot is determined by who's and how pharmacy practice is championed. In the midwest, you will find very progressive place like the VA, and you will find backwater ones where all pharmacy does is order processing and dispense.

 

[psychoandy]

I see this thread is old, but wanted to bring it back for more opinions! Has anyone worked in both midwest and northeast and is able to compare? Anyone feel "judged" for being from the northeast or have people assume you have lesser experience?

don't let haters stop you from doing your thing. i got "judged" tons at midyear, but I didn't let it bother me. just because i don't formally manage vanco and i don't live in a fancy PPMI world doesn't mean that i don't check dosing, f/u levels, discuss with the nurse to actually get the level drawn, then talk to the team...oh god i'm using ashp buzzwords.

as long as you care and have critical thinking skills it doesn't matter what area of the country you come from.