Monday, October 25, 2010

"Words Can't Bring Me Down"

Posted by Karen at Monday, October 25, 2010

After driving eight hours, I am now sitting at home in St. Louis, Missouri, waiting to start my fourth rotation at Facts and Comparisons. During my drive, I was listening to my Glee CD that I got from my roommate when something sort of inspirational happened-the song “I am beautiful” came on. Most of you have probably heard of this song. I never really paid too much attention to the lyrics until yesterday. When she sang “words can’t bring me down,” it brought up the memory of an unforgettable incident that occurred to me during my second rotation in an outpatient oncology clinic.

As part of my routine work at this clinic, I sat down with patients to go over their medications to make sure that our medication list was reflective of the patients’ most current medications. This process, called medication reconciliation, is an important step in taking care of our patients. Each time a medication reconciliation was performed, I checked to see if there were any clinically significant drug-drug interactions, whether the dosages were correct, and if each of the medications had an appropriate indication. Equally important, I asked my patients if they took any supplements or over-the-counter medications. If my patients were on a pain medication, I would inquire the specifics as to how many pills were taken and how often they took them. In addition, I inquired about how well the pain was being controlled.

One morning, as I sat down near my next patient with whom to conduct a medication reconciliation, I felt an unwelcoming atmosphere from her nonverbal body language. I quickly dismissed this thought and began my usual routine of performing a medication reconciliation. Similar to what I did with other patients, I introduced myself and explained my role. Then, when I asked her “Do you still take drug X?” and “How often do you use this medication?” she abruptly raised her voice and said, “What is the point of asking all these questions?” I was taken aback with this sudden outburst of discontent. I looked to her husband sitting to the left of her, who did not seem perturbed. I re-focused back on her and explained to her the importance for us to have an updated list of all current medications, especially since she was receiving chemotherapy. My explanation did not work. She stated that she would continue this process not because she saw benefits in it, but because it was an educational opportunity for me as a pharmacy student. Feelings of intimidation and the uninvited atmosphere overwhelmed me during these brief few minutes. Seeing that further explanation would be futile, I quickly recollected myself, thought about my original intention of performing a medication reconciliation, and went ahead and continued the interview to make sure that all pertinent questions were answered. Even though this was not the most pleasant interview, I tried not to let her “words bring me down” and maintained my professional demeanor. When we were finished, I politely thanked her for her time.

As I am writing about this incident, my patient’s words and expressions are still clear in my mind. Though it was not a pleasant experience, this is a part of life. Even with the best intentions, people are sometimes wary of your actions. Even I must be guilty of this at times. As health care professionals, we work in a helping industry, and no matter how our patients perceive us, we are here because we want to help others. The lyrics, “words can’t bring me down,” serve as an encouragement and inspiration for me to continue to believe in the work that I do. Looking at this event retrospectively, I am thankful that my patient allowed me to gain this insight and to grow from the experience. When else is a better time to experience setbacks and unpredictable events than now?

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