Monday, July 2, 2012

From Community...to Surgical ICU

Posted by Jessica Chen at Monday, July 02, 2012

Hello boys and girls, my name is Jessica! :) I'm originally from Los Angeles, California and I'm definitely am missing the beach filled summers of CA right now. Its so humid in Michigan! If you have any questions about anything Michigan/California/etc related, please don't hesitate to email me. Jesschen@umich.edu

My first rotation was a Target in Brighton with Dr. Joe Davis. I would HIGHLY recommend this particular site if you're interest is in community. I have about 6 years of retail experience (from undergrad and during pharmacy school) so Joe (that's what I call him now because we are buddies! haha) let me tailor the rotation to my taste. He suggested I do more leadership and business model rotation type projects. I definitely was excited to try something different! I still did some prescription filling, but in general I mostly counseled on medications, work on mini patient projects, perform blood pressure and diabetes checks, and I also went through the entire pharmacy to learn about EVERY SINGLE DRUG on the shelves. It was very tedious, but it really refreshed my memory. It was a wonderful first rotation and I was sad to leave!

So I went basically from 0 to 100 from community to the surgical intensive care unit (SICU). My preceptor is Dr. Melissa Pleva and so far I'm really enjoying her rotation. Don't get me wrong, the rotation is very CHALLENGING but not impossible. Dr. Pleva is always there to answer my questions and to challenge my pharmaceutical knowledge.

My typical day starts with arriving at the hospital around 6:30-7am depending on how many patients I see on Careweb (UM Hospital's electronic patient charts) the previous night. I work up patients and pay attention to any acute changes over night. From 8-11:30am we round! Rounding consists of the medical team going from one patient to another and talking about the patient's medical problems and why they are in the SICU. Our goal isn't to "cure" the patient, but to get the patient out of the ICU and into the main hospital (also called "floor status"). There is no reason to keep a patient in the ICU for more than necessary...also I was told a day in the SICU costs 5k! so expensive and a waste if its unnecessary. Anyway... back to the team! Our team is made up 1 attending, 2 fellows, 4-5 interns (1st year residents), 2 med students, a dietitian, a pharmacist, and 2 pharmacy students. In all, a HUGE team! Its very intimidating sometimes to even want to make a recommendation.

After rounds, we usually will talk about our patients and Dr. Pleva lets us go for lunch till 1pm. From 1-2pm, we present patients, go over pharmacokinetic dosing, or just other points of clarification that we didn't finish discussing after rounds because we were too hungry :( From 2-4pm, we have topic discussion with other critical care pharmacy students. We have readings assigned to us, and we discuss what we read and why its important in the critical care setting.


There you have it, community and surgical critical care in a nutshell! Now back to those readings for topic discussion....


Keep Cool! :)
- Jessica

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