Tuesday, June 26, 2012

Inpatient A: Internal Medicine (Regal)

Posted by Charles Berklich at Tuesday, June 26, 2012

Hello pharmacy world-

Apologies for the delay. I will start out with a little about myself so the reader may decide how interested they are in what I have to say and how it relates. My name is Charles but a lot of people call me Chuck. I am an avid rugby player and fisherman. My interest is in pharmacy informatics/healthcare IT. My background work consists of working for UM as a hardware tech for 6 years. Weird or what?

Internal medicine with Dr. Regal was absolutely outstanding as a first rotation. Internal medicine casts a huge net of information to know, so if one's clinical knowledge is not up to snuff-it is obvious. Forget the fear, Regal will pave the path for pharmaceuticals to ponder. No seriously, the right attitude and some hard work is all you need. Dr. Regal is very professional and knows his stuff, but he also is a little more my speed in terms of finding the humor in life; the 'King of Alliteration.'

A typical day would find the student arriving before rounds to work up patients. After rounding with the medical team, checking in with Regal and following up with the medical team and patients is next. The afternoon usually consists of a meeting where the student is presented with new information and given articles to read for the evening. Last, a quick once over to make sure all patients are okay and then time to leave. Don't forget to review for the bench test on the last day!

Most important things to know or review for this rotation: Anticoagulation. Lot's of time is spent dosing warfarin and counseling patients on this drug. Antibiotics, especially dosing vanco. Renal dosing of drugs. Proton pump inhibitors. In that order.

A little bit of reflection. For my first rotation, there is nothing like being thrown in to the mix not knowing what you are doing. I learned to work with the medical team, interact with patients, and interact with other professionals. I must say looking back, I do miss my patients. I also got lucky with some great attending physicians, and a great student fellow student with me (thanks Dave!).

I would like to finish with a quote. After three consecutive days of making a recommendation for a change in drug therapy to the doctor, there was still no change made. I was stumped. I kept telling the doc, he kept agreeing, yet would not change the electronic order. I didn't know what else to do.

"Being a clinical pharmacist is about being uncomfortable." Think about it.

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