Question to Hospital Pharmacist's, from New Grad

[Me_Gusta_Drugs]

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Hi, I have a general question to hospital pharmacist's out there about order entry. Im a new grad and starting to train doing order entry in a hospital.
Looking back at when YOU started training at a local hospital, do you have any advice for someone like myself who is just starting out? What do you wish you would have known or been told in retrospect?

Take IVP vs IVPB for example. I know this varies from hospital to hospital, but how do you know what is OK to give if its not in the hospital's policy? Just look on global RPH?

I know most of it, like everything, you just learn on the job....just looking for any pearls of wisdom. I hate not knowing what I dont know. I wish there was book of common mistakes new hospital pharmacist's make.

 

[Its Z]

Because I interned for 4 years at a hospital and practically lived in the IV room, I knew all the drugs that were prepared in piggy bags and large volumes. Also after years of filling cassettes - right before the Pyxis era, I also knew the IV drugs that were either pushed or injected IM, SQ etc.

My recommendation is that you spend some time in the IV room to know exactly what's being prepared and how and what fluid they are mixed in and also walk the shelves to see what premixed IVs are available.

Your hospital should also have a Standard IV Concentration List which will outline most of the IV Piggy Bag meds.

You won't learn this overnite.

 

[spacecowgirl]

Ditto. It takes a long time and after 2+ years there are still things I don't know/have to look up because we do them so infrequently. We have prep charts that show how everything is given plus with the EMR, you are guided towards the correct route, concentration, rate, etc.

Give yourself time and cut yourself slack if you need to look everything up, you have to start somewhere.

 

[fattunesy]

Ditto. It takes a long time and after 2+ years there are still things I don't know/have to look up because we do them so infrequently. We have prep charts that show how everything is given plus with the EMR, you are guided towards the correct route, concentration, rate, etc.

Give yourself time and cut yourself slack if you need to look everything up, you have to start somewhere.

Totally agree. I would much rather work with a pharmacist who was going a little slower because they spent time making sure they were right than one who is sending out the wrong product just to be quick. I still look things up if I am not positive (GlobalRPH and Micromedex being my sources).

 

[rxforlife2004]

Hi, I have a general question to hospital pharmacist's out there about order entry. Im a new grad and starting to train doing order entry in a hospital.
Looking back at when YOU started training at a local hospital, do you have any advice for someone like myself who is just starting out? What do you wish you would have known or been told in retrospect?

Take IVP vs IVPB for example. I know this varies from hospital to hospital, but how do you know what is OK to give if its not in the hospital's policy? Just look on global RPH?

I know most of it, like everything, you just learn on the job....just looking for any pearls of wisdom. I hate not knowing what I dont know. I wish there was book of common mistakes new hospital pharmacist's make.

This is the book you need: www.globalrph.com
Look up under "Dilution"...

It's overwhelming at first, but if you're young and fast, you'll learn fast within 6 months. Make sure you aslk questions if you aren't sure ...you can't help to make mistake in hospital settings, especially dealing with IV.

IVpush, IM...will depend on hospital policy...again, go check your pharmacy IV admin book. However, if you staff long enough, you should be able to grab those concepts quickly.

Be careful with some meds , such as labetalol , vasotec, hydralazine, etc...while some can be IV pushed on floor A....it doesn't mean they can be also IV pushed on floor B...again, check ur hospital policy.

Be very careful with the rate too...

 

[VCU07]

If your hospital has decentralized pharmacists, I urge you to work with them for a period of time as it would be a great learning opportunity (Esp, when it comes to med administration: ivp vs ivbp). Finally, I agree with everyone else on getting comfortable with time. I have been doing this for 3 yrs and still I am learning everyday...as it should be!