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What do you do at work?

Discussion in 'Pharmacy Residencies and Fellowships' started by htyotispharm, Jul 31, 2006.

  1. htyotispharm

    htyotispharm Member
    7+ Year Member

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    Hello everyone. I'm a senior PharmD student considering doing a residency. I've been on a couple rotations so far and have really been disappointed with what I've seen so far as with the pharmacist interaction with the other medical staff, especially on rounds. They just stand there until someone asks a question. My question is how involved are you guys at your place of employment. My professors really push for everyone to do a residency but from what I've seen I think I'll be more misreable than working in retail. If not a residency, I want to go back and get another degree but I really don't know what I want to do since retail pharmacy was the only reason I went to pharmacy school. It wasn't until I got into pharmacy school that I realized I felt like a waste everytime I went to work.
     
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  3. kwizard

    kwizard Senior Member
    5+ Year Member

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    Don't get discouraged. Your not the first nor will you be the last person to consider such dilemmas. The interaction you have w/ the medical/nursing staff will depend alot on personality and knowledge. The issue is that since pharmacists are often not expected to provide any information regarding patient care than it is quite easy to just go through the motions when rounding. For instance no one is coming to rounds to here what the pharmacist says, b/c physicians are ultimately responsible for care and unless you work in a place where the pharmacist presence is expected than there is no previous standard for how your knowledge can be applied to improve pt care.

    For instance, simple things like just having a print out of the active medications for each respective pt helps tremendously during rounds. Even reviewing home medications vs medications upon admission is an easy way to minimize med errors, dosing errors, and ultimately may shorten the duration of stay. Example: A person on dilantin (taking 400mg/day at home) admitted to a hospital for some other reason and the MD writes for dilantin 200mg/day on admission and 2 days into admission pt starts seizing (simplified scenario, but it happens). Other options would be to screen for drug interactions/dz drug interactions (i.e. demented pts on benadryl, change in mental status for a person on digoxin and no one checks the level), lab results (i.e. is there a recent test from micro that hasn't been addressed by the medical service) so you can recommend changing or streamlining antimicrobial therapy based on culture and sensitivity. Other options are to be familiar w/ the various guidelines. Are they a CHF pt that isn't on therapy to optimize their dz remission/secondary prophylaxis (i.e. ACE inhibitors, diuretics, beta-blockers, a statin).

    For every situation, look at your preceptor objectively and rationalize whether you think you could do a better job if you were in that position. Residency training can certainly be frustrating as the variation can be so wide, but in the end the pharmacist you become will be dependent on what you learned from your previous experiences and how you choose to apply them to your everyday work. Residency training certainly helps in this regard as it exposes you to more clinical arenas than what you would theoretically get on your own, but residency training isn't for everyone so just give it some time and hopefully the rotations improve as the year progresses.

    Going back for another degree as you mentioned is always an option as well; however, I think the MBA/MHA (or any other business related degrees) are the only degree that increase your likelihood of making more money after receiving the degree. Hope this helps.
     

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