First Rotation Completed??

Posted by Zhe Han at Friday, August 27, 2010

I could still remember feeling nervous and uncertain when P4 orientation ended. Yet one month had since gone by and I completed my first P4 rotation today! My first rotation was institutional at Providence Park Hospital in Novi. After a 3-month summer, waking up at 5:30am was the last thing that I was ready for. I was really glad that I adapted quickly and I once said to a friend, I watched sunrise every morning when heading east on M14.

The first week of my rotation focused on the distributive activities of an inpatient pharmacy. Everyone in the pharmacy was incredibly busy that week because Joint Commission surveyors were onsite. In fact, even before my preceptor brought me to the pharmacy on my first day, we went up to the floors to do a "sweep".

I was on the anticoagulation and pharmacokinetics service throughout my second week. One important lesson I learned was it is always important to go up to the floors to talk to the nurse, to see the patient and to verify pump settings.

The third week was the most interesting and the most challenging. I attended MICU rounds. My preceptor wanted me to work up at least 3 patients, understand their disease states, know what drugs they were on, whether the drugs were dosed appropriately, and what patients should be monitored for. Even though I had plenty of time to work up patients before rounds, I still felt lost. On the fourth day, I had a patient with CrCL~5 on milrinone and I caught that the infusion rate was not adjusted for the patient's renal function. After discussing with my preceptor, I recommended decreasing the rate to 0.2mcg/kg/min. So that was my first recommendation on rounds! Finally, things started to come together a little after several days of feeling lost and overwhelmed.