My Health System IPPE; How Intense is it Really?

And thats a wrap! Another semester has ended and now I have completed 3/8 of pharmacy school. Now. How was my IPPE health system pharmacy experience? I say overall I learned a lot, eye opening, and took some serious work. I’m going to lay out how our IPPE experience goes for both health system and community. For 2 weeks we work full time at the site and then through out the semester we shadow for 4 hours on a assigned morning once a week. Mine was Wednesday morning.

I have always had an interest in health system pharmacy, but never truly knew what it was all about. So this was an exciting experience for myself, especially since this was a top notch hospital. My specific rotation was a little different then other classmates that were on their hospital rotation. I wasn’t assigned a preceptor who only stayed in one area of the pharmacy like oncology or pediatric. We were moved around each week so we could see multiple areas of the health system pharmacy. Which I thought was beneficial, because I could see what I could potentially  want to do or not want to do. I shadowed central pharmacist, OR pharmacist, a variety of clinical pharmacist, administrative pharmacist, and even got to watch a surgery! I’m getting a head of myself now. First, I want to talk about how I prepared for my rotation and tips walking into your first day.

MAKE SURE TO EMAIL YOUR PRECEPTOR AHEAD OF TIME WELL IN ADVANCE AND START ALL THE REQUIREMENTS EARLY!

Hospitals are a little different then community rotations. I was required to do HIPPA training, Epic training (software the hospitals uses), drug tested/TB tested, and lots and lots of forms to fill out. Which were all due a few weeks before I even started the rotation. My number one tip is do not procrastinate on that information. This already is a semi first impression to your preceptor before you even walk in your first day. Being timely and proactive is very important. Plus, some of those trainings on my computer took me a few hours to complete, so don’t wait till the end!

First Impressions Do NOT Just Happen On The First Day. They Happen Everyday You Walk In To That Rotation. 

Everyone always talks about having a good first impression, but with this rotation I was not always with the same pharmacist. Every time I showed up I was normally not with the same shadowing pharmacist. Having a clean white coat, pen and mini notebook in your pocket (a MUST while on a rotation), and looking overall put together with a positive attitude is key. My number one complement I got when I was evaluated by each pharmacist was how I was always had a warm smile, I was timely, and always looked put together. That meant a lot to me, because I take pride in how I present myself and how I make people feel better. Basically, what I’m getting at is don’t just show a good impression on the first day, but every day.

These are a few things that I think are essential when preparing yourself and mind to your rotation. If you want to brush up on some drugs that you have learned in Top 200 or reviewing over some material that you have learned in the first year like Immunization material. However, your preceptor knows you are still early in your pharmacy school career so your knowledge is at a bare minimum most likely. Don’t worry you’ll learn a lot along the way!

During the rotation I was all over the place in the hospital. I was in central pharmacy watching them verify compounding medication, medications that go out to Pyxis machines, rechecking back in medications in storage at the start of my rotation. I was also in OR pharmacy for 3 or 4 days that first 2 weeks I was there full time. OR pharmacy is located by the surgery unit where nurses and anesthesiology would come pick up medications that were used in during the surgery. Also, the OR pharmacist I mainly shadowed with was from my undergrad college and she graduated from my undergrad pharmacy school! It was awesome to be with another Warhawk! #ULM Pharmacy is truly a small world. Making a reference back to my previous tip on making a good impression, because everyone knows everyone. Recommendation and who you know can be influential  to your career. While I was in the OR I spent sometime time watching a surgery. I was able to watch a coronary bypass surgery! This was more for the experience and to observe all the medications that were being used from the OR that I had been in for the past couple days. I do think my favorite was shadowing the clinical pharmacist. Clinical pharmacist now go on rounds with physicians, medical students, nurses, respiratory therapist, etc. all depending on the case. Which I found truly interesting and engaging. A thing I learned too was that clinical pharmacist normally have board positions and work about once a week in ambulatory care in the outpatient clinic. I shadowed in a variety of areas including pediatric, neonatal ICU, Critical Care ICU, and neurology ICU. This is where I asked a lot of questions to the pharmacist.

Another, extra thing I was given during this rotation with my other peers at the rotation site was a drug formulary project. I was given about 150 drugs and we were given a list of things we needed to look up and research. Things like if it was on the formulary, Black box warning, REMS, Beers list, recent proven efficacy, how often it was used each month in the hospital, and etc. We were suppose to collect all this information and based on our knowledge we would then have to recommend if we should remove or keep medications that were given to us and why. The collecting the data was the easy part. Took a lot of time, but definitely the easy part. The nerve racking when I had to recognize medications that had to be discontinued and give valid reasons to discontinue it. Looking up things on is this a regular dosing or if guidelines had been changed that is why it is not a favored drug no longer. Overall, it was a hard project and took a long time, but I thought it was very beneficial to my growing experience.

Keep A Pen And A Mini Notebook On Hand

Having that will help you tremendously. I used mine to answer questions, if I didn’t know a drug or word and wanted to look into it later, notes to answer my required worksheets, etc. Basically that thing is a life savor. Anyone could ask you a question and ask you to get back to them with the answer. Plus, it looks better then taking out your phone to write it in your notes section of your phone. It might just be me being old fashion, but I tried not to ever take my phone out unless they said I could look something up on my phone.

Don’t Be Afraid To Ask Questions

I always asked the pharmacist I was shadowing that day how they got there. Everyone has their own story and different paths to how they got there. I also ask what is the number one thing they would recommend to do to enhance their CV to get to the position they want. I got a variety of answers. Which to some that might be to many, however to me that just shows that there is no one way to get there. Another reason to ask questions is to learn! I am not one of those students that pretends they know everything. I will admit to you I don’t know something, but you best believe I will find out the answer.

You Might Be Given Extra Work 

I was not only given worksheets from my school, but also the formulary project I mentioned earlier and sometimes given a list of medications that were used regularly in the OR pharmacy and researching how much they cost, how to store, stability time, etc. The pharmacist might ask you to do something extra and my advice is to have a positive attitude about it and do it! I promise you its to help you learn.

How I feel after the rotation…

I enjoyed health-system pharmacy enormously! With an increase in desire for residency in my pharmacy students I know the opportunities will be more competitive filled with well qualified applicants. However, in my opinion if you are driven and passionate I think you and I will be able to maintain that goal.

I’m still open to other fields of pharmacy and there are so many now in this industry! I hope this was beneficial and gave you an outlook of my past semester Introductory Pharmacy Practice Experience!