Ambulatory Care

So I didn’t get this done before the start of my next rotation, but…… It’s only been just over a month since my Ambulatory Care rotation, I’d say I’m getting more timely with my posts–it’s a good thing that my experiences have been so memorable!

For those of you who are unfamiliar with what “Ambulatory Care Pharmacy” involves, the Board of Pharmacy Specialties offers the following description.

Ambulatory care pharmacy practice is the provision of integrated, accessible health care services by pharmacists who are accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. This is accomplished through direct patient care and medication management for ambulatory patients, long-term relationships, coordination of care, patient advocacy, wellness and health promotion, triage and referral, and patient education and self-management. The ambulatory care pharmacists may work in both an institutional and community-based clinic involved in direct care of a diverse patient population.

My amb care rotation (just like the rest of my rotations) was AMAZING! This is really where I see myself going as a future practitioner and this experience definitely reinforced that. I had the unique opportunity to have a 10-week amb care rotation where I split my time between Broadway Family Medicine and North Memorial Clinic in Brooklyn Center (and Maple Grove). I have so many wonderful things to say about all of the sites I was at that I can write a novel, but you all probably have other things to do than be jealous of how wonderful my rotations are! 🙂

Although both sites were doing similar work, both of my experiences were so very different. Broadway Family Medicine is a teaching clinic, so under the supervision of my preceptor Dr. Jean Moon. I got to work very closely with the pharmacy resident Dr. Heidi Le, the medical students, and the medical residents. One of the highlights of this site was the paired visits with the med student the med resident. I spent my afternoons paired with a medical student, together we would see the patient, conduct the interview and physical exam with each profession addressing their respective portions. The appointments ranged from an acute illness (cough, could etc) to diabetes to pain management.  After that, we would report our findings to the resident, then we all went in together to come up with a plan for the patient. This was a great experience because it gave me a great degree of independence in seeing and caring for patients, but also, it gave me unique insight into a pharmacist’s place in the medical team. Through these paired visits, I was able to see how other health professionals approach medication therapy and allowed me to see what unique things I can bring to the care team to help the patient.

At North Memorial, I worked with the pharmacist Dr. Mary Sauer, and together we saw patients and helped them manage conditions from diabetes to hypertension to a wide variety of mental health conditions. It was such a great experience to be in a setting where the pharmacist was so respected, needed, and sought after. Mary definitely had a great deal of independence in seeing patients and the providers really depended on her knowledge and expertise whether in the form of a casual consult or referral of a patient for her services. As I progressed through the rotation, I became more comfortable with the process of seeing patients and more confident in my knowledge, and it culminated in the highlight of this sight–seeing patients on my own! Mary allowed me to see patients, both new and follow-up. I went over their medications, identified drug therapy problems, and came up with a plan and follow up. It was such a great feeling to know my years of hard work in school have given me the tools to really be involved in a patient’s care.

Both of these sites were such great learning experiences, and they were also a tun of FUN! And if you didn’t document it, you didn’t do it, so here’s my documentation of the good times. My time with them led me up just before winter break so I got to partake in some holiday fun. I’m pretty sure not a lot of people get to be at a site where their preceptors office gets transformed into a gingerbread house, or the clinic takes part in an ugly sweater contest.IMG_1994

Part of the team at North Memorial Brooklyn Center under the cardboard ginger bread house in Mary’s office.

IMG_44251Jean and me in our “ugly” sweaters–Yes, I did have candy cane shaped lights on my sweater 😀

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Selfie with Heidi. (This may have taken several minutes and about 10 different shots, and my eyes still look weird #Struggs)

PharmD IV Paper Seminar

Despite many moans and groans, all of the PD IVs recently returned to campus during winter break for 2 days of PharmD IV Paper Seminar. During this seminar each student gave a presentation on their research paper. It was a rough transition back to the classroom, but it was so great to see all of the wonderful work that my classmates have been doing. There were so many interesting research topics from antibiotic use in foreign countries, to the use of pre-exposure HIV prophylaxis (PrEP), to ergonomic studies of med delivery within hospitals. The hard work that everybody put into their research was highlighted during these presentations.

I, like most of my classmates, was very nervous about delivering my presentation. My topic was “A Review of Hormone Replacement Therapy in Gender Transitions.” As gender transitions become more common, the need for competent providers is growing, however education is lacking from healthcare curricula. My paper was a brief overview of the different pharmaceutical options used to help people in their transition. I thought my presentation went well, and I was relieved that it’s over.

At no point did I expect a wonderful little surprise in my email that night when I got home. Dr. Paul Ranelli, PhD, MS, a professor in the Department of Pharmacy Practice and Pharmaceutical Sciences was kind enough to reach out to a PharmD-grad student in the Social & Administrative Pharmacy (SAPh) program who also has interest in transgender health. During these past 4 years, I’ve heard a million times about how small the world of pharmacy is, and it’s so wonderful to be a part of a school where the professors are really interested in the students’ passions and do what they can to connect students and help them pursue their passions. I want to thank Dr. Ranelli for getting us in contact. I think the quote below sums up how I feel, and I hope this ripple is the start of a wave of positive change to help make access to healthcare more accessible for those in need.

Kindness