Jennifer
at
Wednesday, October 30, 2013
This was an ideal rotation to begin P4 year since it encompassed many disease states. The main therapeutic areas I encountered were anticoagulation, infectious diseases, hypertension, diabetes mellitus, pain management, and total parenteral nutrition. I learned a great deal while on this surgery service!
Daily routine:
0530/0600: Rounds started bright and early with the surgery team! The exact start time of rounds would vary each day between 0530 and 0600. Each morning I would be ready for any questions that might arise, with my white coat pockets filled with a few reference books, a calculator, and handy notes that I had organized. The team was quite large and consisted of the attending physician, three to five medical residents, two physician assistants, three medical students, myself and another pharmacy student. It was great to be part of the teamwork on rounds, with healthcare professionals from different departments working together to optimize patient care.
0700/0730: I would work-up my patients after rounds. By “work-up,” I mean that I would look at the patient’s profile in the computer system, gather information, and assess the patient’s treatment regimen. I would check the doses, drug-drug interactions, and think of recommendations for optimizing the medication regimen. The most challenging part of this rotation was forming a plan for the next steps in the patient’s care.
1200/1300: My classmate and I with would meet with our preceptor at this time. We would present our patient cases and describe our plans for the patient (examples: dose adjustments, medication changes). Our preceptor would ask us questions not only about the medications and disease states but also about the types of surgeries, which mainly involved the intra-abdominal area. The Whipple procedure, ileus, fistula, anastomosis, esophagojejunostomy, and total gastrectomy were just some of the many terms with which I became familiar! After discussion with our preceptor, we talked with the physician assistants about our recommendations. Counseling patients before discharge about new medications, which were often anticoagulants, was another great way I was able to contribute to patient care.
During this time, topic discussions also were held two days each week about subjects such as nutrition support and surgical prophylaxis. My fellow classmate and I would read articles and prepare summary handouts. These discussions were very useful because we would use this information when monitoring our patients.
This rotation was challenging and extremely rewarding. Teamwork, time management, and efficiency were skills that I further sharpened while on the adult surgery service. Even with the early morning rounds, I am glad to have had this experience!
