Am care and critical care review...

Posted by April at Sunday, October 23, 2011

Let us go back two months ago to my ambulatory care rotation. I was excited to start this rotation because the pharmacist plays an integral role in the management of the patient’s diabetes, hypertension and hyperlipidemia.

The most memorable moment was a quote from a patient that went something along the lines of “I do not believe I have diabetes.” Luckily, I was observing this moment and did not need to convince the patient that they did indeed have diabetes. This however did serve as a great way to integrate motivational interviewing into this interaction. We asked why the patient thought that and discussed how his symptoms and lab values were in accordance with a diagnosis of diabetes.

I also thought this rotation was valuable because of the drug monitoring focus. It reinforced how to manage and monitor diabetes medications.

Last month I started my first inpatient rotation, critical care. This environment was unique in that in was in a cardiothoracic intensive care unit. This unit is dedicated to the care of patient post cardiac surgery such as coronary artery bypass graft (CABG) or receiving a ventricular assist device. Suffice it to say there was a huge learning curve because none of this kind of stuff was taught in pharmacy school.

It was all good though. My preceptors were great. I had two of them and I learned so much. I also had topic discussions with other pharmacy students who were on a critical care rotation. I thought these were very helpful in fielding possible questions that I would get from the healthcare team. For example, we had a discussion topic on stress ulcer prophylaxis. The question that came up in regards to this topic was if a PPI was better than a H2RA. I felt like a real pharmacist being able to answer this question.

Overall, I am glad that I had this rotation and now I feel more prepared for my next inpatient rotation, transplant.