Institutionalized

Posted by Jim Stevenson at Wednesday, February 09, 2011

In January, I joined the pharmacists at St. Joseph Mercy in Howell for my institutional rotation. To my surprise, their central pharmacy was not in the basement, but in fact had a skylight – an unheard of addition to the usual pharmacy décor. But it was not just natural sunlight that I was exposed to on rotation – I also gained an understanding of pharmacists’ roles in a small (census ~70) community hospital.
The three pharmacists at St. Joe’s rotated through staffing and clinical roles. The clinical pharmacist attended rounds every morning and handled pharmacokinetic dosing, while the staff pharmacist verified orders, checked compounded medications, and answered drug information questions. As a student, I participated in functions from both roles.
Through this rotation, I gained experience making IVs, checking compounded medications, and checking cart fills. Additionally, I ensured that patients had proper DVT and stress ulcer prophylaxis, proper antimicrobial therapy, and renally adjusted doses. However, the most helpful aspect of this rotation was talking through complex pharmacokinetic dosing situations with the pharmacists. It is one thing to calculate a dose on a pharmacokinetics test in class, and another thing completely to dose a drug to a target steady-state concentration in a patient with fluctuating renal function.