Sunday, August 7, 2011


Posted by Matthew Lewis at Sunday, August 07, 2011

As you all have probably seen from other posts, our first week is done. That leaves three to go on this rotation. My actual site is the Neonatal Intensive Care Unit(NICU), and in terms of what a pharmacy student can contribute here, it is a lot of "I'll look that up and get back to you." We have protocols for everything on the NICU, and if something falls outside of that, we have to have a ton of evidence to support our recommendation. Then, we only go by a conservative approach. Nobody wants to cause something terrible to happen to these kids because of something we did. As a side note, in the NICU, our job is to make sure the medications don't hurt the kids through interactions or something and our second job is to get the drugs off as quickly (while appropriate) as possible.

However, I still did get some questions. My favorite was "Where is loperamide (Immodium) absorbed?" I definitely had to look that one up, and since the doc, Alan, was at his clinicals, I told him before rounds the next morning. Alan thanked me and then when it came to that particular patient he said, "Matt did some research into where [loperamide] works. Matt, if you would tell the team your answer." I must've looked shocked for a moment because Alan apologized later for not letting me know he was going to ask me to report to the team. Getting back to the story, I quickly recovered and repeated the answer I found from my research and the team's discussion continued. I was quite proud of my answer and was able to present it in a way that was professional and medically appropriate. I think that was my first real test as a P4 and I passed it.

Moving forward to today, I visited the NICU, just to see if there were any new patients for my partner, Kim, and me. I only got two, just a set of twins, which you see pretty often in the NICU. Usually, whatever happens to one twin has an impact on the other which nets them both in the unit. Kim, however, got five thanks to a set of triplets, one transfer in, and one born today. Slowly, we are picking up all the new patients that come into the unit. However, since it was Sunday, the attending (head honcho) doctor, Dr. Donn, was quite surprised to see me. When briefly asked what I was doing there on a Sunday, it was one of the interns who responded "Dedication." Hey, these are my patients too and not only do I want to represent pharmacy well, I want to know what's going on with my little guys and gals.

I'll try to get some pictures, since I do want to make it clear how sick and tiny these patients are. In the mean time, just think that a five pound bag of oranges is about how heavy these kids are (sometimes that five pounds is twice what a patient will weigh) and they could probably fit in the bag itself.

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