94 Seconds – The Smallest Things Can Make The Biggest Impact

By Karen Berger, PharmD

On Friday after school, my 10-year old had an expander put in, as the beginning of her teeth straightening process. The orthodontist has a great bedside manner, and was very patient with my daughter, Dena. She took her time and really wanted Dena to get as comfortable as she could be under the circumstances. Our appointment was at 3:30 pm and we left around 4:45 – we definitely did not feel rushed.

After dinner, around 7:30pm, I was sitting by my phone when it rang. Who is calling me? I thought, surprised. Everyone texts me! Lo and behold, it was the orthodontist, calling to see how Dena was doing in the last few hours since we left the office. We chatted briefly – I didn’t want to keep her long, especially on a Friday night. She asked a few questions and offered some advice. When we hung up, I looked at the phone. The conversation only took 94 seconds. 94 seconds!!

 

Why did I notice this? Because it only took 94 seconds to make an amazing impression on us. It is so rare that a healthcare provider of any kind makes after hours calls to check on patients. But that 94 seconds really made a difference to me. I saw this orthodontist as someone who cared and went the extra mile for her patients and their families.

 

Then, as with many other things, I thought about how this could apply to pharmacy. I certainly know most of us don’t have any extra time to do anything, but I think we can all find 94 seconds here and there to check in on a patient that may need a little extra attention. Throughout your days, and your interactions with patients, you’ll most certainly notice a few patients that have issues you could follow up on with a quick phone call. Maybe someone is looking a little down, and you could be the quick call that turns that patient’s day around.

 

Forget the metrics, let the reds go redder! Take just a minute or two here and there, and go that extra mile. We are all in this because we want to help people. Let’s all take a brief moment as often as we can, to make a little difference in our patients’ lives. You never know when your quick phone call could brighten someone’s day – the smallest things can make the biggest impact.

Being a Mum as well as a pharmacy student

 

 

 

Being a Mum as well as a pharmacy student

By:

Nour Morjan

I have been a university student for about 7 years, and this is my eighth. I became a mum while I was in my fourth year at the university. I changed my course twice, from Biotechnology engineering to Genetics and Molecular Biology to finally Pharmacy.

I started my MPharm course being a mum. As much as being a mum is wonderful and is a blessing that doesn’t make the struggle any easier.

Now I’m on my final year, I could say being a student is more than a full-time job for me and being a mum is a 24-hour job.

During my time at the university while being a mum, I lacked the support to help me overcome those difficulties and I had to make it on my own. Although, I had the full support of my husband, we both needed support and help in what we went through.

At the start, I thought it was just me going through all of that. I thought maybe as a mum, I was not capable of raising a child. The doubts took control over me, and I already have had depression and anxiety which was a separate issue for me that affected my life a lot.

There are some students in my course who are parents. As the course progressed, we started sharing the struggle we go through together. We talked about  how hard it is to juggle between house work, childcare, cooking and social life which seemed impossible.

I started to think that it wasn’t just me but all of us, students with children, are in the same boat struggling together without knowing anything about each other’s struggle.

A few months went by and then I came across Pharmacy Podcast Network on Instagram and through it I came across the lovely Pharmacist Suzanne Soliman from Chicago, USA. She is the founder of Pharmacist Moms as you already all know. I got inspired by her, so I tried looking online to find something similar in the UK which supports pharmacist mums, but I couldn’t. Instead I found how pharmacists can help new parents and mothers.

 

I contacted Suzanne and now we are going to work together to start a branch of Pharmacist Moms in the UK.

 

Very excited 🙂

Find Your Skinny Black Microphone: Advocacy As Pharmacists and Moms

Find Your Skinny Black Microphone: Advocacy As Pharmacists and Moms

 

On 3/6/19 my colleague and fellow pharmacist mom, Kathy Vest, PharmD, CDE, BCACP, and I met in a parking garage at 5:30am. With bellies full of coffee, pączkis, and butterflies, we drove 2.5 hours to Springfield, IL.  We were invited by the Illinois Pharmacists Association (IPhA)* to attend a committee hearing for HB 1442 (contraceptive prescribing bill) as ‘clinical experts.’  Yes, surreal! When you get this type of call, how could you say no? So I confirmed that my husband could take the kids to school, put on a blazer, and pushed my imposter syndrome aside.

In the 17 years I’ve lived in Illinois, I had never gone to Springfield. The day before, the nurse practitioner I work with said, “Good luck down there. It’s a one-horse kind of town.” I had never been to a committee hearing or even seen one on TV. The building is beautiful – if you are fan of architecture, Abraham Lincoln paintings, and marble columns for days, then check this place out. The committee hearing was in a small room with rows of chairs for the public, a small table with three seats for the presenters and 5 rows of tables with comfy chairs for the representatives. Each seat had a skinny black microphone on the table, with a push button to activate a green light alerting you, “It’s go time.” With ~30 lawyers and ~30 bystanders watching us, waiting for us to speak, my mind shuffled between ‘You know this stuff, it’s no sweat!’ and ‘How did I get here?’

I knew HB 1442 pretty well, as I participated in a couple of conference calls with the sponsor a year earlier. Since it was first introduced three years ago, Representative Michelle Mussman (with the help of IPhA) has been trying to get this bill passed. That morning she said to us, “It’s just been passed in the 10th state. We could have been 3rd.” Kathy and I been learning and conducting research on pharmacist prescribed contraception for the past few years. We know the pros and cons. We know some pharmacists are excited and some pharmacists are apprehensive. We knew clinical questions would come our way. We suspected the lack of an age limit in the bill would spark some debate. What we didn’t expect was for a woman’s age to the deal-breaker for so many voting representatives. Together with Rep. Mussman, the OBGYN physician to her left, and our IPhA representative, we explained that women of all ages are currently obtaining contraception – from their physician or online. If this bill is passed, a patient wouldn’t have to wait for a doctor’s appointment or a package to come in the mail. Rep. Mussman explained the potential negative medical and socioeconomic outcomes of an unplanned teen pregnancy. I’m happy to report that not one lawyer questioned a pharmacist’s ability to provide this service. At one point, a representative asked me, “So you are willing to take responsibility if you dispense the wrong/inappropriate medication?”  And I said, “Yes, just like I take that responsibility on a daily basis.”

The bill passed this committee hearing and is now on its way to the House floor! I felt like I did my duty – as a pharmacist and as a woman. I felt empowered that our voices matter. I felt American. I left thinking, why did it take me 17 years to drive to Springfield? I reached out to Laura Licari, PharmD, current president of IPhA, for her insight on this topic. She reassured me that advocacy at the state level was not always at the front of her mind (phew, I’m normal). She started her journey with IPhA when her mentor asked her to serve on the Board of Directors, which she wouldn’t have considered if not for that push (women helping women=love!). When I asked her what sparks advocacy, she told me, “When you realize that the Pharmacy Practice Act dictates your scope of practice, you also realize that every pharmacist has the power within them to advocate for change to that scope of practice through the legislative process.” When I ask her about a pharmacist’s limited time for advocacy, she admits its hard to keep up (I’m beginning to think Laura really gets me). She informed me that both IPhA and ICHP are monitoring over 6,000 proposed bills. She said, “If you feel like you don’t have the time or the expertise, make an investment with your membership. In doing so, your organization can sift through all those bills and alert you to the ones that are most relevant to your practice and profession; also you can build a diverse network of pharmacy professionals. Over time, just like me, you’ll learn about the legislative process and how you can affect change. Until then, your contribution helps both IL state associations attend meetings with legislators, organize Pharmacy Legislative Day, and monitor that long list of bills that can potentially help or harm our profession.”

My experience in Springfield made me think of how much advocacy we do DAILY as moms – for our families and ourselves. Phone calls to schools, networking on the playground, and negotiating who gets Mom’s laptop first are just a few examples. There have been times when I didn’t press the button on the skinny black microphone at home. There have been times when I CHOSE not to advocate for myself. Nervous to speak up, unsure how much it would help in the long run, and confused by the newness of motherhood – there have been silent times. Thankfully it didn’t take me 17 years to realize that in order to have MY needs and desires met, I needed to speak into the mic. I’ve hustled to obtain childcare when I need to exercise – even at 4:45am! I’ve explained to my kids how important my career is to my overall health – and their wellbeing. I’ve asked for alone time and tried not to let the guilt pull me back into the driveway.

I asked my colleague and friend, Kathy, who was with me in Springfield, if she thinks there are parallels between MOM and PHARM advocacy. She said, “A few things I’ve learned about being a Mom are that 1) I wear a lot of hats as a Mom and that can be challenging (house manager, school volunteer, basketball coach, etc), 2) there is no rule book for how to be a great Mom, 3) being a Mom often comes with feelings of vulnerability, and most important, 4) I am not alone in feeling like this!  Being a mom has shown me the importance of community and supporting each other since it can be one of the hardest, yet most wonderful aspects of our lives. Involvement with pharmacy organizations has been a great way to communicate my ideas, perspectives and experiences, as well as learn from those of other pharmacists.  And recently getting involved with legislative efforts has shown me that we all have the potential to contribute and how critical our voices are to help important causes to move forward!

Here’s the superheroic takeaway: Going to Springfield reminded me that in all aspects of our lives, there is a skinny black microphone with a button ready for you to push it. When the green light is on, well, you already know what to say.

Brooke

Superheroic: A Blog for Moms with a Pharmacy Twist (be.superheroic@gmail.com)

*Are you a pharmacist practicing in Illinois?  The Illinois Pharmacists Association is offering a 10% discount for new members, courtesy of Laura Licari. FYI: she’s only the 7th woman IPhA president since 1880! Use code PRES10 at www.ipha.org.

 

Upskill and Reskill

 

Upskill and Reskill

I have a lovely author friend who writes about how to succeed at work now and in the future. Recently we were discussing life and writing and her new book* and she casually said two words that made me put my food down: upskill and reskill. And now I’m wondering how I lived so long without this phrase in my life. She explained it so eloquently as I feverously took notes circa 1999. [Remember the ‘there’s no handout’ kind of writing? Ah, the pen cramps we would get. All the loose-leaf paper we would buy…memories]

She defined it as:

Upskill: Take your existing level of expertise and widen it.

Reskill: Learn something different.

I can’t stop thinking about how this applies to pharmacists. What additional skills interest you? What additional training have you been thinking about for a while? This venture may or may not directly impact your current work situation, but it may be a futuristic pursuit. There are pharmacist moms in this group who are doing this very thing and posting about it: completing a pharmacogenomics course, MTM training, joining a new professional organization, and studying for board certification. Learning new skills in new environments offers advantages such as networking and diversifying our talent base. The goal is to reinvent ourselves by upscaling and rescaling our foundation.

Sandra Leal, PharmD, MPH, CDE, FAPhA is currently CEO of SinfoníaRx®, running as a candidate for president-elect of APhA, AND a fellow pharmacist mom. I met her in person a few years ago and she is honestly one of the most down-to-earth people I have met in this field. So let’s talk upskill and reskill. She pursued a Masters in Public Health as a personal goal. She told me, “I noted that helping people one to one was really impactful but I wanted to impact population health by addressing system issues and policy to address the repeating problems that every patient would walk in with. So many times we feel like we have to accept a broken system instead of feeling empowered to change it.”

Another pharmacist mom, Mitzi Wasik, PharmD, FAMCP, FCCP, BCPS is currently Senior Director, Patient Safety and Quality at Aetna and current president of AMCP, reflected on how she navigated this as her career shifted. She started with anticoagulation, diabetes, and immunization certificates early in her career when she was heavily involved in direct patient care, and she then pursued BCPS certification in order to stay competitive in the market as an ambulatory care pharmacist. She notes that these credentials led to a higher salary after a job change. What’s she doing right now? She told me, “Right now I am getting my MBA which is helping me from a business acumen perspective.  My position is less clinical these days but I have to be able to walk and talk the business perspective of clinical programs to tie it all together.”

I know what you’re thinking. You don’t have time to pursue any new skills or another degree. At the end of the day, the last thing you want to do is interact with more people. You may feel that new talents wouldn’t be valued by your current organization.

Here’s my hypothesis about this group: you value this profession more than numbers and money. You value yourself more than any metric that attempts to define you. You want to upskill and reskill, but you’re not sure how and when and what.

Here’s what I know about this group: We have an advantage. We are used to squeezing in really important tasks into tiny pockets of time. We practically invented multitasking. (And yes, we agree with the research – it doesn’t work well). We juggle more in one hour than most people do in a week. Ok, that seems magnified but whether it’s real or exaggerated – it impacts our mindset on whether we should add something else to our plate. Upskilling and reskilling will no doubt force adjustments to our already full schedules.

Here’s the superheroic plan: For moms with littles and moms with teens and moms with olders; for any moms who have less than zero minutes to devote to something new: use this information as a jumpstart to think about what’s next. Take care of your babies. Take care of yourself. But during your commute and while you’re waiting in line and when you’re up at 3am – think about what you would do to upskill and reskill your career. Keep thinking about it, let it marinate in your mind, and remember Sandra Leal’s words of wisdom: “Don’t put things off. There will never be a better time to invest in yourself than now and your family will be better for it.”

Brooke Griffin

Be.superheroic@gmail.com

*www.alexandralevit.com

A Day In the Life of an Academic Pharmacist

A Day In the Life of an Academic Pharmacist

I recall sitting in a therapeutics lecture as a pharmacy student thinking my professor had it easy.  She showed up to lecture for a few hours each week, a handful of weeks each year—she could spend the rest of her time preparing lectures. I honestly thought that was all she did until I completed an APPE rotation with her and realized she had a practice site with responsibilities to the site, committee work, research, service, student mentoring and teaching outside of the College of Pharmacy.

 

She stayed busy, but seemed fulfilled by her career and autonomy. This experience influenced my decision to pursue academia as a career after I completed my PGY1/PGY2 Pharmacotherapy residency training. I stayed with Idaho State University in Pocatello, taking a clinical assistant professor position with dual appointments in the Department of Family Medicine and the College of Pharmacy.

 

My position is somewhat of a unicorn in the academia world because I primarily train physician and pharmacy residents on our inpatient medicine service as opposed to focused teaching of pharmacy students. Though residents are my main learners, I do take students on APPE rotations, facilitate labs, case studies and small group discussions and lecture to other learners across campus.

 

Here’s a glimpse into my typical day:

 

5:50 am: Alarm goes off. Let’s be honest, I’ll snooze until at least 6:00. Shower, get dressed, do my hair (top knot or pony) and makeup. Dry shampoo is my best friend! Husband leaves for work around 6:15 today. He’s a physician assistant in orthopedic surgery, so his surgery days are my solo mornings.

 

6:40 am: Eat breakfast and get the girls (3 year-old and 9 month-old) up and dressed. Pack my bags—pump bag, computer bag, lunch bag, diapers and wipes for the baby and swimsuit and towel for the 3 year old’s water day. It’s a miracle I don’t forget anything.

 

7:30 am: Leave the house. My girls go to two different daycare facilities because of age restrictions. Can’t wait until the baby is one! Drop-offs go smoothly so I make it to work by 8 am.

 

8:00 am – 9:15 am: Spend an hour answering emails—So. Many. Emails!  Questions from a speaker for the Idaho Society of Health-System Pharmacist’s Fall Conference (I’m the Education Chair), set up an appointment with my research student, and then address a conflict with the residents schedules. Finally, I take a few minutes to update my ever-expanding to-do list. Sometimes I wish I could start all over with a brand-new email address. And share it selectively.

 

9:15 am: Pump break—I’m lucky enough to have a designated room with a comfy chair, a sink to clean my supplies and freezer to store the loot.

 

9:30 am: Drive to the hospital to precept patient care plans with the pharmacy resident.

 

9:40 am: Take the stairs to the 4th floor—have to fit exercise in somewhere!

 

9:45 am: Catch my breath enough to precept patients with the PGY1 resident. He presents a brief subjective and objective history followed by assessment and plan for relevant medication related problems. We discuss his plan for the most critical patients. I ask questions and assign readings.

 

10:30 am: Rounds start (mostly) on time today. I make a point to listen closely and review patient charts as we go because—brand new medical interns. Need I say more? Although I start to wonder if it’s the third-year medical residents I need to worry about after this interaction:

 

Dr. U (R3): “Problem number one sepsis, secondary to cellulitis of the leg. Patient also has a hematoma of the same leg from a recent fall.”

 

Me: “What is your plan for the patients’ antibiotics? She currently has daptomycin and vancomycin ordered.”

 

Dr. U (R3): **Looking lost** “Uhhhhh”

 

Me: “Would you like to continue both the vancomycin and the daptomycin?”

 

Me: *in my mind* Please say no, please say no, please sa—

 

Dr. U: “Yes! Because it will be awhile before the vancomycin level is therapeutic so I’d like to make sure patient is covered with the daptomycin in the meantime.”

 

Me: *long blink* “Okaaaay. Well, let’s pause there for a second. Help me understand this infection a little better.”

 

I fire off questions about the patient such as…”She has a cellulitis? How big is the cellulitis? Do you suspect infection in the proximal hematoma—like an abscess? No? Okay, do you think this isn’t a strep cellulitis? How’s her renal function? Do you suspect MRSA?”

 

Me: “Okay, so you don’t have any reason to believe this is MRSA. What regimen would you send this patient home on, maybe that will help us narrow our coverage?”

 

Dr. U (R3)- “Well I’d just keep the IV vanco and continue oral vanco when she goes home.”

 

Me: *loooooong blink* try not to laugh, yell or cry. “Okay, let’s talk about that for a minute…”

 

11:20 am: We pause rounds so my PGY1 resident can teach the team about anticoagulation—his first team teaching moment of the residency year. The sympathy nerves get to me and I spend the first 30 seconds freaking out for him—totally unwarranted because he nails it. Relevant information and an engaging teaching style—tough skills to teach. I almost cry happy tears. The residency year just got a lot easier!

 

11:26 am: Phone vibrates with this message from our attending physician—“Your resident is a fantastic teacher!

 

11:40 am- Leave rounds a little early to swing by daycare and nurse the baby before her nap. So glad I live and work in a 10-minute radius.

 

12:05 pm- Head back to my office on campus. I’m teaching at the Noon Conference—Prescribing Pearls—to the family medicine residents today. I target my content towards our new family medicine interns. Many have never written a prescription…or learned how to write one in medical school, for that matter. To put it kindly—they’re clueless. I cover the basics of prescription writing—legal requirements versus good practice, ISMP abbreviations to avoid, etc. I also share prescribing tips like asking about refills at each appointment, canceling old prescriptions with the pharmacy, and including an indication as part of the sig.

 

I love giving this didactic every year. I get to teach them the basics of the pharmacy world and feel like a genius because it’s all “new” to them. Conversation surrounding our last topic of the hour—legal and ethical considerations of prescribing for self, family and friends—gets heated. This is my first year including this subject and I’m shocked by some of the reactions. When the presentation is over, I take notes on how it went and changes needed for next year.

 

1:15 pm: Eat a quick lunch—leftover burrito bowls from dinner the night before—while I answer a few more emails.

 

1:30 pm: Meet with a P3 pharmacy student doing a research elective with me. We plan to survey community health workers about how they help with medications and their training to do so. This student is a Rockstar. She owns her project. I spend the hour helping her edit the survey. We make a few changes to our Institutional Review Board form before submitting.

 

2:30 pm: Try to tackle a few items on the to-do list. I make it through what feels like never-ending resident evaluations in PharmAcademic, update my lecture for the following week, and coordinate with speakers for the ISHP Fall Meeting.

 

3:30 pm: Another pump break.

 

3:50 pm: Back to work on the to-do list.

 

4:10 pm: One of my PGY2 Pharmacotherapy residents drops by to discuss a patient case. The patient was bridged with enoxaparin perioperatively and just saw her surgeon complaining of calf pain.  My poor resident is devastated that the patient may have a clot. Another preceptor and I review the course of therapy with the resident and determine there was nothing that should’ve been done differently. We explain that medicine isn’t foolproof, secondary prevention isn’t guaranteed and sometimes the worst outcome happens even when we do everything correctly.

 

4:40 pm: Engage in a philosophical discussion on the future of the pharmacy with my office mate—an almost daily occurrence for us. We ponder the effects of Amazon’s purchase of Pillpack on community pharmacy, whether I should encourage or discourage my brother from pursuing pharmacy, and if provider status is really necessary (sacrilege, I know!).

 

5:00 pm: Leave to get the girls from daycare. I pick up the 3 year old first. I’ve inadvertently trained her to ask “what you brought me?” when I pick her up every day, and today is no different. I let her choose a fruit leather flavor and she asks me to open it, which I do. She cries because I didn’t open it the “right way like daddy does it”. It’s a no-win situation.

 

5:30 pm: Arrive at home to an apron-clad husband pulling salmon off the Traeger. Dinner is ready! I love it when he beats me home.

 

6:30 pm: Clean up dinner, bathe the babes, jammies, prayers and bedtime stories. Husband takes the three year-old while I put the baby to sleep.

 

7:30 pm: Crack open the email from our ASHP Accreditation Site Surveyor and get to work on collecting documents for our upcoming site visit. I try not to work at home when I can help it. I’m successful most nights—tonight isn’t one of them.

 

9:00 pm: Think about exercising, but go for a bowl of sherbet instead. Veg on the couch reading a book.

 

10:00 pm: Get ready for bed and hit the hay so I can do it all over again tomorrow!

 

I’ve discovered many hidden rewards in teaching—and encountered so many challenges. Some days I feel like a well-paid babysitter. I hate those days! Some days seeing my learners succeed makes me proud enough to share their success with the mailman. I love those days! Most days fall somewhere in between. Each one varies—different learners, different responsibilities, different challenges and different successes. And that’s why I love it!

 

 

Kasidy McKay, PharmD, BCPS

Clinical Assistant Professor

Idaho State University

mckakasi@isu.edu

 

Tiny Changes That Can Make You a More Fulfilled Pharmacist

Pharmacy students, I love them!! They have such a joy about them as they look forward to graduation and becoming pharmacists. They look forward to the patient interaction, making a difference in patient’s lives and empowering patients to lead healthier lifestyles. I have had the pleasure of being a preceptor for many years now. After graduation, there is sometimes a slow shift from the attitude of joy to frustration.

While most pharmacists still love their career, it is not unusual to hear chatter about insurance claims, grumpy patients and irresponsible doctor’s offices. When and how does this shift happen? Pharmacists have demanding jobs and one can easily get caught up in the the busy work of the profession and let it consume our day. One way to get through a difficult day is to turn your thoughts around. Go from thinking how tired you are on your twelve hour shift to how you brought a smile to Mrs. Smith’s face and brightened her morning. Do not concentrate on how frustrated you are with a prior authorization claim but think about how you taught Mr. Smith how to organize his medications. Now he is more compliant and having better outcomes with his medications. Turning negative thoughts into positive thoughts can be the difference between having a good day or a bad day.

When you can’t change a certain situation, the best thing to change is a certain someone. Yourself! The attributes that you want to be known for in the pharmacy are often the characteristics you want to be known for in your everyday life. What qualities do you want to be known for as a pharmacist? You can be kind, friendly, resourceful, content, caring, inspiring. Of course we are pharmacists, but the title is so much more. What standards represent you and would make you feel more complete and satisfied with your day in the pharmacy? What would you like to be known for from your patients, coworkers and other pharmacy staff? You can be whomever you choose to be! So just go out and be YOU!

As pharmacists, we are constantly giving to others. We are also required to multitask frequently throughout the day. The career not only requires physical stamina for the long shifts but complete focus on error prevention. Take time for yourself on your days off. There is no need to feel guilty about self-care. You can”t give from an empty vessel and that includes not only giving back to your patients but also to your family and friends. Be sure to take time to rest, take a walk, meditate, read a book, get fresh air, write in a gratitude journal. Taking care of yourself allows for change to manifest in your life. Take care of yourself because although this may sound cliché, you are worth it!

While pharmacy can be a very difficult and trying career it is also a very fulfilling career. When you take the time to turn your thoughts around, be all you want to be and fit in occasions for self-care you will feel more satisfied with your days at the pharmacy. These are all factors that contribute to having the rewarding pharmacy career that you deserve!

 

Written by: Lisa King, RPh