It seems like just yesterday I was strolling into the basement pharmacy admin offices for my first rotation at Sparrow (Drug Information) not 2 months prior. Immediately, I knew this rotation was different and my vast community experience was going to be of little help. Thankfully, due to Dr. Carver’s infectious disease teachings, I at least had ID information down, but I was in for a learning curve as I began my critical care rotation.
The first week, I was able to get my feet wet by having a chance to take part and help the unit-based pharmacist perform their daily kinetic and renal dosing services they provide for their patients. Recently, Sparrow moved the pharmacists into a unit-based model getting the pharmacist out on the floor to answer questions and work more closely with the healthcare team to provide care for their patients. Every day it seemed I was learning a new topic and was doing my best to sponge up the information regarding pressor therapy, how much, how long, how to withdrawal therapy, what to monitor, DVT prophylaxis, stress ulcer prophylaxis, evidence based delirium treatment and pain control among many others. This ICU rotation has been my most busy and frustrating rotation to date, but it has been the most valuable and if I could have gone another week, I would have jumped at the chance.
By the second week, I had my first rounding experience and was excessively nervous looking back on it. To be that close to the medical decisions being made for the patient with the chance and expectation to contribute and double check therapy for the residents was an amazing experience. Although out of my element and really only hitting stride on what to look for in ICU patients toward the last two weeks, it really opened my eyes to hospital practice and how valuable the pharmacists are to the inpatient team and the impact they can have on patient care. While I made a few mistakes presenting patient’s to my preceptor, each mistake gave me more perspective and made look forward to coming back the next day to do better, learn more, and be the medication resource for the rounding team.
It was tough, but I wouldn’t have wanted any other rotation instead….. except maybe a generalist rotation first! While my stay in Lansing for the Summer was great, rotations 4 and 5 take me back to Ann Arbor where my Pharm.D investigation and seminar await.
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