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Tuesday, August 28, 2018

Students Are The Phuture

and I fear how they are being educated.

Intern (noun): A student or trainee who works, sometimes without pay, in order gain work experience or satisfy requirements for a qualification.

CP: I always strive to present real world, everyday situations to my students on rotations. I only have them for a limited time and know they cannot possibly see everything but I want them to see things and to practise things they may not see on their other rotations.
Me: Very noble of you. I know you love to teach.
CP: Exactly. That's why I always have hired interns and students on rotations throughout the year. I host as many as I can.
Myself: Doesn't it get exhausting?
CP: Not when I know these students are the phuture of our profession. I want them trained correctly. I think of it as training my replacements.
Me: There has to be a reason you are talking with us today.
Myself: Yeah. You don't usually let us out to play with others.
CP: It's the students.
Me: Obviously.
Myself: What about them?
CP: They just don't get it. The last crop that rotated through was full of some of the most clueless students I'd ever seen. I kept asking myself, and them, why did they pick pharmacy? Granted, this was a small handful, but the situation has become noticeably worse over the last 5-10 years.
Me: Examples?
CP: I had one student who looked as though he'd rather be anywhere other than in a pharmacy.
Myself: Isn't that where they're going to work?
CP: Yes. I understand they may not choose retail but, I've never seen someone so opposed to even making an attempt at learning anything.
Me: Example?
CP: I asked him to tell me what quantity we dispense on a Proair Inhaler and to calculate the days supply.
Myself: Easy. Grab a box and read it to see it's 8.5 grams.
CP: Precisely. Except he just stared at me. Like I was going to turn into a digital Proair board that would flash him the answers. Every day was like this. Absolutely no desire to learn anything or try.
Myself: Lame. What else?
CP: This one takes the cake; and is also the reason for the entire post.
Me: <about time>
CP: Shut it. As you notice, I defined "intern" earlier, correct?
Me: Yes. A student.
CP: I received a summary review from the students I had on rotation over the previous year and read all the comments so I could learn what worked and what I could improve.
Myself: Always learning. You're pretty smart, CP.
Me: Uh-oh. What did you see?
CP: I read this comment: "I think the students on rotations should not be expected to complete tasks an intern usually does".
Me: Dafuq?
Myself: I'm going to state the obvious here for you, CP. Students are, by definition, interns, and vice versa, correct?
CP: Correct.
Me: So, what was the point of the complaint?
CP: We had our hired interns working a few shifts while the students were there and apparently the students believed the interns should have done all the work.
Myself: But how would the students learn if everyone else was doing all the work?
CP: You are a genius. That's why we get along so well. I really am at a loss to describe how I felt after reading that. I still can't get my head around it now as the new rotation season dawns. As I have stated many times, I want to encourage people to love their profession. As a preceptor it is my obligation to foster their enthusiasm and channel it into a love for their chosen profession. These students decided to make pharmacy their career. I loathe the pharmacists who host students and complain about how awful the profession has become. If you're training my kid, don't sour her on her life's dream because you found the experience awful. Seriously, don't teach students. They are entering the profession today. Teach them how to succeed based on today's environment, not on the environment when you started.
Me: What you're saying about this last example is, you can't make them learn.
CP: "I'm trying to free your mind, Neo. But I can only show you the door. You're the one that has to walk through it."
Me: Deep thoughts, by Morpheus.
CP: I just don't know what the students expect anymore. I used to believe in the quality of program to make up for the lack of quality in the students. However, with so many schools open now, the talent pool has been so diluted that we are destined to become the homeopathy of healthcare.                                

Wednesday, August 15, 2018

Sometimes I'm Right

. . . and your prescriber is not.

CP: Honestly, it's not about who was right and who was wrong. I like my ego stroked as much as the next platypus, but at the end of the day the patient was helped, medical crisis averted, life went on.
Me: What are you on about now, CP?
CP: Helping people.
Me: Um. . . like, hooray or something? Want me to wave a flag? Should I call a press conference? Correct me if I am wrong, but don't we do this every day?
CP: Yes. Yes. Yes. And, yes.
Me: Why is this different?
Myself: Yeah. Why so special?
CP: Have we ever had a problem and when we told other people about it, they didn't believe us?
Myself: Like the fact that you talk to both of us in your head?
CP: Yes. I mean, no. We see patients all the time who are going through whatever ordeal is theirs at the moment and we don't understand them. We are tasked with helping them, but sometimes, sometimes the answers aren't there.
Me: So what do we do?
Myself: We listen and we dig and we offer support.
CP: Precisely.
Me: So what happened?
CP: We had a patient call us recently who had been experiencing breathing troubles. None of her providers could explain it. She knew something was wrong. She told her neurologist who ran tests. She complained about her new medication but was told "there is no way that medication does that". So she saw a new neurologist, who ran more tests, who also brushed off the potential for this newly prescribed medication to affect her this way.
Me: And they found what was wrong?
Myself: No, dumbass. It wouldn't be a good story otherwise. Keep going.
CP: She called me.
Myself: And then?
Me: And you said she was crazy.
CP: No. I told her that, while I had not seen instances of this medication causing these side effects (dyspnoea and crushing chest pain) and after asking her my litany of questions (did anything else change? did they rule out heart attack?)
{--for purposes of speeding this along, we had a lengthy discussion and she told me all about her tests and how long this had been going on, etc. . . --} I said it may be possible and that I would research it and call her back.
Myself: And then?
CP: I researched it and called her back. Were you not paying attention?
Me: Sorry. I thought you'd want a second to let people catch up.
CP: Thanks. Anyway, after a little digging, I was able to find a record of these effects occurring in a small percentage of patients.
Myself: And then?
CP: Dude. Seriously? Find a new movie to quote. And then she thanked me. She spoke with her new pulmonologist who didn't believe her either. However, this prescriber turned to the new prescriber in their practise and asked her opinion. She said she had never heard of it either. . . until she read a study in a journal last week about this exact scenario.
Me: Vindication for the patient!
Myself: And th. . . um. . . What next?
CP: She called to thank me. She said they were surprised I figured it out, but recognised I had a special set of skills.
Me: I love a good story.
Myself: Yeah. Can I have milk and cookies now? <yawns> I'm tired.
CP: Remember kids, just because no one has seen it, doesn't mean it isn't happening. Think of all the prescribers out there who spent decades of practise never seeing measles and now are scrambling to identify it.
Me: Sometimes it's the simplest explanations. We are so programmed to run tests when the simplest option would be to hold the new medication for a few days.
Myself: She stopped the new medication and her symptoms resolved over the next 2 days. Simple.
CP: And now I get pie. She promised me a fresh pumpkin pie this fall.

Friday, August 10, 2018

Chicken Pen

You know I need a chicken pen
To inject my insulin
Basaglar gone under the skin
For the dia-beet-us