Retail to Hospital

[pharmacist_797]

Hey guys,

I recently made a transition from retail to hospital. I was in retail for a few years after graduation and things got really tough where I had to get out. Now that I am in the hospital, it's like starting all over again. I feel like I am a new graduate where my speed is super slow, I am checking orders like 80 times before hitting the accept button, asking way too many questions, and feeling unconfident about my decisions.

I wanted to ask the community, what were your challenges and how did you overcome them? My manager is already concerned going into my second week of training that I am not picking up things faster. There will be shifts coming up soon where I am the only one running the show. I don't want to get fired for making stupid stuff under pressure or compromising patient safety. I want to be successful with this opportunity.

Let alone the new clinical stuff that I am learning, learning the hospital pharmacy policies and the EHR has been a difficult experience.

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[JustFillIt]

Hey guys,

I recently made a transition from retail to hospital. I was in retail for a few years after graduation and things got really tough where I had to get out. Now that I am in the hospital, it's like starting all over again. I feel like I am a new graduate where my speed is super slow, I am checking orders like 80 times before hitting the accept button, asking way too many questions, and feeling unconfident about my decisions.

I wanted to ask the community, what were your challenges and how did you overcome them? My manager is already concerned going into my second week of training that I am not picking up things faster. There will be shifts coming up soon where I am the only one running the show. I don't want to get fired for making stupid stuff under pressure or compromising patient safety. I want to be successful with this opportunity.

Let alone the new clinical stuff that I am learning, learning the hospital pharmacy policies and the EHR has been a difficult experience.

I used to do this a long time ago too. You need to come to a point where you are confident in your skills and/or attention to detail.

If you know you are paying attention to what you are doing - you need to come to a point where you say to yourself, “okay, I trust myself”. Once you reach that point do your work, and double check yourself on the “critical stuff”. Then approve the work and put it behind you.

Be familiar with the resources you need to have access to in order to reduce the burden on your peers by asking too many questions. Are you familiar with how to use Lexicomp, Trissels, Stanford’s guide? Those are the three I used in hospital and it covered me about 90% of the time.

I think this is the best that worked for me and I became a part-time hospital champion (I have a different full time job).

 

[sunnyandseventytwo]

My manager is already concerned going into my second week of training that I am not picking up things faster.

I find this statement troubling. I've worked in a half dozen hospitals over the years, and it's still an easy 3 months before I feel like I know everything I'm doing in a new job.

I would try to get ahead of your manager as best you can. I suspect your training is like that in every other hospital: Not very structured and a lot of sitting next to another pharmacist and watching what she/he/they does and then she/he/they watching what you do. Hospital pharmacies are legendary for hiring only one person at a time and not often enough to give any real foresight to training. Think about how you learn best--for me it's having written material I can refer back to (actually, I'd like to look at it ahead of time, see how things happen and then be able to refer back to it later). And every thing you need to know guide doesn't exist anywhere, but over a few weeks you should be able to put something together yourself.

I don't ever worry about the speed I'm moving at. An old retail pharmacist once told me "the secret to lasting 35 years in retail: nobody ever died because they didn't get their prescription in 15 minutes." Things can feel more stressful in a hospital, but if someone dies because you spent an extra five minutes checking your work, they were going to die anyway (I'm assuming you're not in a terrible hospital and the crash carts are stocked/maintained).

I would recommend pretending you're working alone starting this week. Stop asking questions, work it out yourself. If it takes longer, let it take longer now rather than when you have 3 doctors on hold at 10PM and you're the only one there. Explain what you're doing if you get any complaints about how you've only verified 3 orders in the last hour.

 

[Tom Applewood]

You'll get used to it. Know where to access their policies and guidelines and standard order sets. Make sure to follow all those to the exact letter, always. Take your time. Practice and muscle memory will develop.

 

[sdh0202]

What kind of EHR does your hospital use? We are using EPIC and I love them since its so user-friendly. I made a same transition into overnight rph about a year ago (2.5 years of retail then transitioned to hospital per diem that somehow ended up in FT overnight). My first order was verifying freaking NSS bolus and I was worrying if I was doing the right thing lol. It takes time to get comfortable and you just have to be exposed to different scenario. I don't think we had structured training in my institution (mostly observing other pharmacist's work) but some of trainers have me exposed to different clinical scenario and that's how I learned everything. Know your hospital protocols and prioritize your workload. Its okay to take your time to clarify orders. No one will scream at you cuz their medicine is not ready in 15 minutes. Personally, my best surviving strategy have been prioritizing workloads, which you are well-equipped from working in retail, since I'm the only rph overnight covering 300+ beds

 

[RXDOC1986]

Hey guys,

I recently made a transition from retail to hospital. I was in retail for a few years after graduation and things got really tough where I had to get out. Now that I am in the hospital, it's like starting all over again. I feel like I am a new graduate where my speed is super slow, I am checking orders like 80 times before hitting the accept button, asking way too many questions, and feeling unconfident about my decisions.

I wanted to ask the community, what were your challenges and how did you overcome them? My manager is already concerned going into my second week of training that I am not picking up things faster. There will be shifts coming up soon where I am the only one running the show. I don't want to get fired for making stupid stuff under pressure or compromising patient safety. I want to be successful with this opportunity.

Let alone the new clinical stuff that I am learning, learning the hospital pharmacy policies and the EHR has been a difficult experience.

First, congratulation for landing a hospital job. You must have left a good impression on them. Any hospital job is hard to get. Having worked in half a dozen hospitals, home infusion and clinical oncology within the last 36 years, I was just hired at a major regional hospital. My manager told me they had over 85 qualified resumes. It's a 7on, 7off staffing job and I still had to go through 5 weeks of mandatory training. I already knew the software (EPIC), the Pyxis and everything else they were showing me. Even though everything was super familiar, I was getting a very good pay, so I paid attention and listened. I had been doing some version of their process at some other hospital over 36yrs, but didn't say a word and took notes.
1) Congrats
2) Why would a competent manager ever express doubts in front of you, this is done with HR at your 90 day review. AND NOT on your 2nd week
3) Why would they have you SOLO this quickly, and having doubts about your competence?
4) Why would they hire a hospital pharmacist with zero experience, and expect quick results
5) Yes learning EPIC, Cerner, Meditech takes a long time. I have had over 10 years on each, and still learning
6) Yes everything you do impacts patient wellbeing ALL THE TIME. It's literally life and death most every time. You have to build confidence quickly. Most software does a good job of correcting possible errors.

On a positive note, starting out, I am making about $169,000 /year - $75/hr + shift differential. I work 70hr/2 weeks but get paid for 80. Now I know they are paying a huge premium for experience.