two staffing weekends finished and 3 days away from completion of the first residency rotation

That title is probably too long.  Accurate, but long.

So I had my second weekend staffing the satellite pharmacy and I can honestly say that I think it went much better.  The census is a little different because some areas got switched around so I think I was a little less busy.  I also was very careful with the kinetics book and hopefully I did everything up to the level of a true pharmacy superhero :-)  Because let's be honest, what fun is it to be anything less than superheroic.

The only really bad thing about this weekend is that today my allergies decided to try their best to destroy me physically, mentally, and emotionally.  Now, you might think that allergies are 1. not sentient beings and not capable of such malice and/or 2. not of themselves capable of destroying a person mentally or emotionally but that my friends is where we have been mislead.  Now, I cannot be certain that allergies are capable of thought and consciousness as I have never spoken to an allergy and received a response however, I do know that when one spends >75% of her day either sneezing or blowing her nose into terrible tissue paper hospital kleenex she will leave feeling utterly defeated on all aforementioned levels.  She will be driven to nearly run from her workplace promptly at 2:30 and drive directly home where she will eat a bowl of chocolate frosted mini wheats and watch a Grey's Anatomy re-run for her emotional well being, take 50mg of diphenhydramine, 30mg of pseudoephedrine, and 800mg of ibuprofen for her physical well being, and take a nap for her mental well being.  Such activities will cease when her boyfriend returns from his job several hours later and she will wake up feeling groggy and still congested but ready to fight through the evening re-dosing her meds frequently and supplementing her frosted mini wheats with a stuffed crust pizza.  If you don't believe me I understand but please store this information away somewhere just in case you ever find yourself on the wrong side of an allergy.

In other news:

Tomorrow I am going to a city wide patient safety meeting so that should be interesting.  Then I am going to start helping my hospital in their transition from one type of med cabinet to another... The ICUs are supposed to go live with the new cabinets soon and I am available so I am going to do whatever I can to help with the set up etc... That is basically what I'll be doing through Wednesday along with finishing my IRB submission for my year long project.  Then on Thursday and Friday I am going to a teaching certificate program so that should be interesting.

And that is the last week of my first residency rotation.  So far I have completed a monograph, written preliminary criteria for use for duloxetine, helped precept students, looked up about 30 ADRs, did the background research, come up with methods, and formulated my objectives for my year long project (MRSA in Burn Patients), researched and began creating a presentation for my grand rounds topic (malignant hyperthermia), registered for midyear, done a journal club, and generally exuded awesomeness :-)  I still feel like I have a lot to do on my longitudinal projects but I also feel like I got a lot done with the time I had.

Next I go on to my Burn rotation and I have to say I am pretty excited about it.  I'm hoping that I can remember some things from when I was a student on rotation... granted I only spent a week there but still, you'd hope I could remember something.  Anyway, I am excited to get into a patient care rotation.  I know it will mean longer hours at the hospital but B will be away this month during the week anyway so I won't be quite as motivated to get home early.  That is about the only positive that comes from him being gone on rotations a lot this year.

Well, I think that is all for tonight.  Hopefully I can finish off my battle with the evil allergy monster while I sleep tonight so I don't have to be the sneezy resident tomorrow. Wish me luck on days 8-12 of 12... looking forward to the weekend!

goodnight

reflections on my first weekend alone in the satellite pharmacy

I think it says something that it took me until Wednesday to write a post about my weekend... It was a stressful time for me.  I think I called one of the other pharmacists at least 30 times in two days.  Said pharmacist was very patient and I am very very very grateful that I had a person to call with all of my many many questions. Despite this resource however, I did not perform my tasks without flaw.  Another pharmacist who worked the Monday after me came yesterday to talk to me about a couple of things that I could have done better over the weekend.  At first I was really freaked out and upset because I couldn't figure out how I had overlooked the items in question but I decided to be proactive and go look at the binder I worked on and try to figure out where I had gone wrong.  Now I of course do not want to disclose any specifics so I will just say that I understand what happened and I could have done things better but I have shifted from feeling totally inadequate to just feeling somewhat inadequate.  I didn't cause any major issues or harm but I do have a greater appreciation for just how careful I have to be.  I think that is the most challenging thing about being a new pharmacist... always throughout school there was someone to double check my work and make sure I didn't do anything dumb. Honestly, it was kind of annoying sometimes that I couldn't do anything without a double check... BUT, now I would be thrilled to have someone check my work...

The biggest issue in my current staffing role is how many things (answer phone, therapeutic drug monitoring [TDM], order entry, nurse questions) need to be done with complete accuracy... There are so many distractions it can be tough to even get any one thing accomplished before being interrupted.  But I digress.  I knew what I was getting into in general, I just had no idea how I would feel about it. I mean, it really is scary to have so much riding on my abilities.  I have such a better appreciation for why some pharmacists are so funny about what job functions they will let students perform.  I have a hard enough time keeping track of what I am doing, let alone what someone else is doing under my license...

So, that was kind of a long verbal emesis session but I felt the need to give a true report.  I am trying not to be discouraged and I am telling myself that it will get easier.  I'm really glad that I am in an environment where the other pharmacists are supportive and constructive with feedback because I can't imagine how unbearable it would be to go through this learning curve if the people weren't constantly reminding me that it IS a learning curve.

On a lighter note -- it is still really cool to me that I am actually a pharmacist and I did several things this weekend that were good.  I made some interventions on orders that came through and overall I think my net impact on the hospital was positive.  For my first weekend I guess that's not too bad.

That's all for tonight kids.

goodnight

I almost forgot

Yesterday I became the stereotypical "difficult customer" at the pharmacy where I used to work... so since I have this cool residency and am all grown up, I get grown up insurance that helps pay for my prescriptions... so yesterday I go to get my prescription and they aren't too busy so I give them the card and have them re-run it... so prior to the insurance I was using a coupon to save a lot on the prescription and now with the insurance I can still use it to further lower my copay...

SO, they enter the new insurance -- rejected.  Phone call to said insurance reveals that even though the person code on the card is only 2 digits it actually needs to be 3 digits -- duh.

Now, a process called "SDL" needs to happen to bill the copay to the coupon and result in a lower copay...  bill said coupon -- rejected.  Even though the card says that cash customers use a group number ending in 008 and insured customers use a group number ending in 007 the person on the phone informs the lovely tech helping me that she needs to change the group number to end in 004 (nowhere on the card) and then magically it works.

So the funny thing is that I really felt bad for the girl helping me... just a couple months ago that was me helping some poor soul like me now... the only difference is that I could understand the issues and why it took 40 minutes to get my stuff all together.

Anyway, it was interesting to be on the other side of the counter :-)

That is all

goodnight

3 days in

I feel kind of like a broken record but seriously -- I'm just tired.  Maybe I'm not getting enough sleep at night but I am just trying to convince my body that 6 hours a night is enough... sadly I don't know if my body is listening.

I'm super excited about the hotel that the other residents and I decided to stay in for midyear.  Hotel Monteleone -- one of the oldest and most haunted hotels in New Orleans :-)  B and I will have a little get away and even though I'll have midyear stuff to do, hopefully we'll still have time to enjoy the city.

Anyway, this post was mostly pointless and now I'm super sleepy so I think I'll go to bed.

goodnight folks

and now for day 1 of 12

well, I certainly had a case of the Mondays today... Today I started a drug info rotation and I actually kind of secretly like it.  I mean, don't get me wrong, I am certain that I will be going stir crazy at some point (probably more than one) and I'll have to periodically go for short walks to maintain my sanity BUT I do enjoy the fact that I can check things off of a list of projects and I have time to work on some of my residency projects without the burden of patient care activities.  Another bonus is that there are students on the rotation so I get some experience precepting.  I'm pretty excited about that.  Overall I'm just hoping for a manageable month full of task completion :-)

On another note, I went to B's parents house to see him this past weekend and had a really nice time.  Saturday we went disc golfing with his dad and then Sunday we went to the white sox game.  I got a really cute t-shirt but the sox still lost :-(  They lose every time I go to a game... I may have been permanently banned from sox games in the future, but the shirt will still be really cute to wear watching them on TV :-)

B's mom made a comment over the weekend about the shadows getting longer and fall approaching and that made me pretty excited.  I love fall.  The temperatures are nice and it usually doesn't rain too much... there's Halloween which I enjoy and it all leads up to the big holiday season in November-December... This fall will be tough b/c B will be gone a lot but hopefully we'll work it out so we can still see each other on weekends... And then in December he'll be able to come to midyear with me so that will be fun.

I know this year is going to start to pile up on me soon, but for right now I'm maintaining a positive attitude :-) Hopefully that will be enough to see me through the hard times that are sure to come.

That's all for now kids

goodnight