Thursday, September 22, 2011

Good Bye Rotation 2.

Posted by Matthew Lewis at Thursday, September 22, 2011

Tomorrow's the last day of lung transplant, and Monday I move on to Institutional(think generalist staffing clinical pharmacist) at the VA in Detroit. First, one last bit about L.T. I feel like this rotation confirmed that transplant would be a good field for me, since there are opportunities to influence patient care directly, work as a team with many other types of health professionals, be on the cutting edge of medication therapy as more and more medications are used and developed for transplant patients to alleviate option depletion due to intolerable side effects.

Today I saw one of the patients I helped discharge about a week ago who was readmitted to the hospital. He (I have to use the pronoun to protect his identity due to HIPPA rules) had end stage cystic fibrosis and received two new lungs. I feared that he was admitted for some type of infection, but it looked like he came in due to some anemia (whew, that's a lot less damaging to new lungs). He had color, he wanted to move around and not be stuck in a bed; He didn't look sick any more. This patient recognized me as the pharmacy student who helped him out with understanding his new 21 drug regimen, and was quite thankful about everything we gave to him. He especially loves the medication schedule, since it helps him work out what medications he needs because he's still getting used to it all. His comments and condition made me feel like a graduated pharmacist to know I helped a patient understand their medications to the point of the patient having no issues, no complaints, and say I did a good job. That is something which will be the highlight of any rotation I have.

Now, talking about the VA (Vetran's Affairs) hospital in Detroit, I think I got off to a bad start and I have not even begun. Dear fellow students, if you have never worked for the VA, they require forms two weeks before you start so they can get you set up with a badge and computer access. You may not be told, and even if you are told at some point along the P4 orientation process, you will not be reminded about these forms. My point being, if you have a rotation at any government site, contact the preceptor more than two weeks ahead of time. You'll probably want to do the same for outside the state rotations as well, in case there are any state level papers that must be completed.

On the positive, I am looking forward to this rotation because of the population it serves. I have the utmost respect for people who served our country and they deserve proper care. It's the least I can do for them. This healthcare system is actually socialized medicine, which is something hotly debated in the public right now and I'm going to keep my opinions to myself on the matter. The important point about this health care system is that nowhere else is the balance of efficacy and safety vs. cost effectiveness scrutinized so closely. I will likely have to defend my recommendations with more background, studies, and protocols than in other institutions. I will also have to work within a particular formulary, so my recommendations might be limited to what we can get. This will be a good test to my therapeutic knowledge and will no doubt expand my abilities as a pharmacist.

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