Jennifer
at
Thursday, October 31, 2013
This rotation was different than my
first two rotations in that all of my patients were pediatric patients. Their ages ranged from only a few days old to
late teens. I did not have much
previous experience with pediatrics, so I was very glad to have this rotation!
Daily routine:
0730-0830: I began the day with
pre-rounding. To me, the goal of
pre-rounding is to understand the patient’s medical history and current status,
think of recommendations to improve the patient’s medication regimen, and
anticipate questions the team may have during rounds. Recommended pediatric doses are often stated
in mg/kg or mcg/kg, so it took some time to become accustomed to determining correct
dosages for patients.
Some questions I would be thinking
about during this time:
What are the medications treating?
Are those the correct dosages, or do they need to be adjusted?
What should I be monitoring for (renal function, side effects, etc.)?
What changes to the medication regimen might the team be thinking about (IV to oral, increase or decrease in dosage, change to a different medication altogether)?
Can this medication be administered through a G-tube or J-tube?
Are there any home medications which are not listed on the inpatient medication list?
What are the medications treating?
Are those the correct dosages, or do they need to be adjusted?
What should I be monitoring for (renal function, side effects, etc.)?
What changes to the medication regimen might the team be thinking about (IV to oral, increase or decrease in dosage, change to a different medication altogether)?
Can this medication be administered through a G-tube or J-tube?
Are there any home medications which are not listed on the inpatient medication list?
0830 - 0900: Present and discuss
my patients with my preceptor and finalize recommendations for the team. I actually worked with several different preceptors, and they all helped me to improve my therapeutic skills.
0900 - 1000/1100: Round with the team, which consisted of the attending physician,
an intern, two residents, three medical students, the nurse, and myself.
1000/1100: Follow-up with any
questions from rounds, complete medication reconciliations, track lab values
for patients on total parenteral nutrition (TPN) and review the TPN
orders. 1330: Meet with my preceptor to verify TPN orders.
1400 - 1500: Finish medication reconciliations.
1500 - 1600: A variety of topic discussions, case presentations, and journal clubs would occur during this time.
1600: Complete any unfinished work.
It was quite a busy rotation, as you
can see from the above daily schedule, but worth every minute of it! The rounding team was very receptive to my
recommendations and valued pharmacy contributions. If treatment questions arose during rounds
that required some research, I gladly would investigate and report back to the
team. I learned about many disease states
that I had never heard of before and their recommended treatments!
