It’s been a while. I’ve been busy but I’ve finally had some time to sit down and write today. I’m skipping my off-block (block 7). It wasn’t interesting. So here’s block 8, liver transplant.
After my off block, I was wondering why I decided to be an overachiever and choose solid organ transplant for block 8. I mean what was the point, matches for a residency were not looking promising, I was still burnt out (1 month of “break” did not re-energize me), and I was feeling kind of hopeless to be quite honest.
I hadn’t blogged like I said I would. I was still unmotivated. What was I even doing with my life? But ready or not, block 8 was coming for me. And boy was it tough!
I was looking at patient profiles at 6:30 am in the hospital and leaving some days at 5 pm. I felt like a zombie. Home, work, assignments, sleep, then repeat. Life? What life? I promised myself that I would not sacrifice my hygiene and self-care this block.
But it becomes so tempting when you feel like you have no time. Do I need to eat? I don’t have time to cook or money to buy outside food? Will skipping my shower or not washing my face give me more time? No, Shika! You will not fall into that trap. You promised to take care of yourself. But something has to give. As much as I enjoy it, sleep has to be cut short.
On a positive note, I was in the gym six days a week. That’s was my daily endorphin rush. The gym kept me sane. I got stronger and made major gains during block 8. But that’s a whole other story. Back to the main topic.
I cut my sleep and I felt it right away. It was a lose-lose situation. I got more time but I needed more time because I got slower. My brain did not work at 100% and I could feel it. I felt sluggish, stupid, and tired. Some days I did not even know if I would survive this rotation. What was I doing at my other blocks? The learning curve on this one was steep.
Upside to the Downhill?
But through all the struggle, I learned a lot. I feel like this rotation helped me by showing me where a pharmacist can be. The pharmacists at this rotation were practicing near the top of their license. I have so much respect for them.
They are brilliant and they know what they’re doing. Doctors ask for their input and they are valuable members of the multidisciplinary teams. They also know how to make all the information that they know patient-friendly.
These were the cool pharmacists. You want to sit at the table with them. But, unfortunately not everyone could have a seat at the table. That included me. I’m not going to delude myself.
What I Loved
Something that I loved about this rotation was patient contact. The pharmacists are very involved with patient care. They educate patients on their medications after their transplants and see patients at the clinic.
Transplant patients are on a variety of medications including immunosuppressants, antibiotics, antivirals, antifungals, and a multitude of other prophylaxis medications. So, they must know why they are taking these meds and how to take them. That’s where the pharmacists come in.
They teach the patient and show them how to fill their pillbox. They monitor immunosuppression levels and adjust meds accordingly. I think this is a great area for pharmacists who would love to practice at the top of their license.
My Main Challenges
What I found difficult was rounding. I was intimidated by the presence of all these health professionals that knew what they were doing. It made it difficult for me to bring up my recommendations even when I had them.
I found myself questioning if it was important or if they were needed. This was my downfall on my rotation. I wasn’t visible enough to the rest of my healthcare team because I didn’t speak up enough.
There were also a lot of meetings. They were a lot to keep up with daily and sometimes it made it difficult to catch up with the patient care aspects.
On the neutral side was writing notes for patient charts. The notes were pretty detailed and way longer for transplant than what I was used to. They were kind of tedious and long at first.
But later I started to get better especially once I knew what I needed for my notes. Being able to write notes in the charts made me feel more like I was a part of the team.
Pharmacy normally doesn’t write too many notes unless it has to do with vancomycin pharmacokinetics and anticoagulation. Here, I was writing transplant phase notes right after transplantation, discharge phase notes, and even outpatient notes. I made my mark on the patient records.
The End of Block 8
The end of block 8 was bittersweet. While I was glad to get a break from >45-hour workweeks, I was going to miss my patients. I had already started building a relationship with them.
On my penultimate day, one of my patients told me that it had been a month since she got her transplant. I couldn’t believe that I had been following her for that long. But, it was time to go and I was also glad to be getting out as the COVID-19 pandemic started to ramp up because the hospitals had no clue what they were going to do with their students.
Would they stay or would they be sent home? No one wants to delay their graduation. Not when they are this close.
My next block and last block of pharmacy would be coming up. How I waited for this moment for so long. Hopefully, coronavirus wouldn’t cancel it.
Thanks for reading my rant,
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