Seeing Double
Soon enough it was time to move on to my next rotation. This was my community one, which I would argue I came into feeling the best prepared for having been in the community setting for so long. I was eager to do it though. Having seen so much of one way of doing things, I was very interested in acquiring another perspective. I had to admit, I had some minor reservations going back to CUMC for another rotation. Having been twice burned, I viewed another visit there with a somewhat jaundiced eye. Thankfully this experience would prove to be an exception to the previous two.
Creighton Family Outpatient is a small independent pharmacy nicely tucked away in the ground floor of the medical center. I learned there that Creighton employees have their own insurance company through the university/hospital and the pharmacy is a part of that whole deal. They even have on-campus delivery available through the pharmacy, a nice little package I must say.
It was a nice work environment. A typical Monday saw us go over 200 scripts and the rest of the weekdays settled in at about 150. To put that in perspective, a typical weekday at my Wal-Mart was about 260 to 300+ on some. The Monday following Easter we actually broke 400. Thankfully too it was a great environment with the people to work with. There were no clashes of personalities or excessive drama as I've seen in some places, just a group of people dedicated to providing outstanding patient care. With the slower pace, it was much easier to call on issues with prescriptions and be more aggressive in attempting to follow up on things like refill requests than I've been used to.
One of the best things about it was the opportunity to the full gambit of what we are going to be doing very shortly. At most settings the position becomes that of a glorified technician, which does not do as much towards advancing a person as a practitioner. It was a great to have the opportunity to verify prescriptions (under observation of course) for the first time for real. Doing it for the first time on the second day of the rotation was something that became a rite of passage into the profession. And Dr. Kessler had the right idea; its good to get some experience doing that now while we were still under observation and students as opposed to later when we are pharmacists and the full mantle of responsibility is on us.
Another positive of this rotation was the opportunity to work with Craig Kessler. His depth of experience gave us a tremendous opportunity to learn. And as a veteran of the Navy, he also put in quite a bit of time at the VA afterwards so we had that common thread. And not the least of it all he was a very fun guy to work with and be around. I must say that if the pharmacy there had an opening I had been aware of, I would have gone for it. I had dismissed the idea of a residency rapidly as I approached my final year and was even further discouraged by the thought of a whole year of continuing to be a subordinate in all aspects. Had I known about the residency that was offered there, I might have even delayed my fervent desire to hit the trenches and gone for it. They were doing interviews for the position while I was there and I got to see a lot of my classmates. There were also a lot of people from the classes behind us working intern positions there. It seemed like a good place to work as an intern; if I could go back to my P1 year, I'd have probably tried to get a few hours there. Of course that would have precluded it as a rotation option since you can't do rotations at places you've worked at, so it was probably just as well that I didn't. In the end though, I think my career went in the path I wanted it to and it needed to, so I have no regrets.
Like at Wal-Mart, there are quite a few calls for clarification. That task landed almost solely on me and my colleague in this Dirk. I think my ears pressed a little more flat against my head after this rotation than they did before what with the amount of time I spent on the phone. And it was a necessary part of it too; community and hospital rotations at Creighton (and likely other colleges) require you to log in 20 "interventions". One that I think I did twice for two different people was there were Flonase prescriptions written for two sprays in each nostril twice daily (eight sprays) when the maximum recommended dose is four sprays daily (usually its the same two sprays in each nostril only its given once daily). These interventions do not have to be accepted, more often than not they are, but sometimes there is a good reason for the deviation from normal. And sometimes the doctors insist on it just because. Like any other setting we merely document that they verified that's what they wanted and we go ahead with it as long as its not something that will clearly endanger a patient.
Tuesday afternoons we typically spent with Nicole the current resident and we did a combination journal club/topic of the week. It usually worked in an alternating fashion, Dirk would do the journal club one week and I would do the case on the topic of study and then we would switch. Wednesdays we had our management meeting with Craig. Seeing as he has been a manager at two different VAs and then here, he had a lot of experience in the matter and was simply a good, practical manager. As pharmacists, the mantle of leadership is going to fall on us even aside from the possibility of being the pharmacy manager, so its an important skill set to have. Fridays were usually a quiet day and almost always we were able to leave early on those days.
It was interesting to continue on my work at Wal-Mart and do this at the same time. I must confess, I caught myself almost saying "Wal-Mart pharmacy" on my rotation, and vice versa during the time there. I must say it was an overwhelmingly positive rotation to be on and this was the second of two rotations after the break that I had not selected (having sought exclusively to go to Sioux Falls for my last three) that I thoroughly enjoyed, wished I could stay on longer, and would chose if given the choice to go back to November of 2009.
Our final day was actually doing a poster as a part of a health fair put on at one of the local churches. We ended up doing OTC prescription labels and it looked like there were quite a few of our classmates there. After doing our thing for the folks there, our time on the rotation was over. I had a certain sense of disbelief that I was contacting a preceptor for the last time that week. Soon it would be time to wrap things up completely. Of course as I write that time has come and gone. I also broke tradition; instead of Olive Garden, I got myself a pizza for the celebration dinner. This was the first and only time I broke my routine celebratory dinner.