Thursday, May 31, 2012

Getting Frame'd

Posted by Roxanne Naanos at Thursday, May 31, 2012

Hi everyone! My name is Roxanne and I am on the Bone Marrow Transplant (BMT) service with Dr. David Frame for my very first rotation.
Day 1 of rotation: Awesome! Showed up at 11 am, was assigned 2 patients, and sent home after 1 hour to work up patients!
Day 2 of rotation: Frame’d.
If there was an urban dictionary equivalent for the UM College of Pharmacy Advanced Pharmacy Practice Experience (APPE) one term that deserves a definition is, getting “Frame’d.”
“Frame’d”: not being able to answer one or many of Dr. David Frame’s questions such that you realize how much pharmacy you don’t know. 
Roxanne: “Aw man, I just got Frame’d! I don’t know anything!”
Melinda: “I’m so sorry. Try not to let it get you too down. It happens to the best of us.”
Getting Frame’d sounds discouraging but it’s really a rite of passage for us all. It doesn’t matter who the preceptor is, or what rotation you are on, in some way or another expect to get “Frame'd.” Though the process is rough, know that you are picking up a TON of information everyday!

As for the rotation itself, the Adult BMT unit is on the CS Mott side of the UM Hospital. It's really nice. Patients get their own rooms to hopefully help protect them from acquiring infections especially since their white blood cell counts are so low. Every morning we round with the team. The attending and PAs/NPs acknowledge us students and like showing us conditions we may only have seen in textbooks. Throughout rounds, Dr. Frame will ask us for recommendations on our patients. He will also ask us really random questions that are actually completely relevant but to which we never gave any thought to. When these questions are asked, I'm sure my lower jaw slightly opens and an "uhhhh" can vaguely be heard.
If you’re placed in the BMT service with Dr. Frame for your APPE, know that you are going to have to work extra hard to learn everything you need to learn. We are definitely being questioned on a ton of topics we learned in class, like anticoag, antibiotics, and anti-nausea for example -- managing nausea is a major issue in the BMT population. But we are also getting introduced to a ton of things that we haven’t learned about in class, like conditioning regimens for stem cell transplants, GVHD prophylaxis, and neutropenic fever. Protocols are key in BMT. However, for learning purposes, understanding the reasoning behind these protocols is even more important. A word of advice: know mechanisms of action and half-lives. After one and a half weeks of rotation, all I know is that I have a long way to go to master this material. Two other bloggers are on the BMT service with me this month so read up (!) and you’ll get to see this rotation through a few different sets of eyes.

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