July 2021 - September 2021
Children's Hospital of Wisconsin
CVS Pharmacy inside of Target
04-09-2021 - 06-11-21
Preceptor: Jeff Otto RPh
January 2021 - March 2021
Children's Hospital of Wisconsin
Preceptor: Vincent DiChiara
altScripts Specialty Pharmacy
October 2020 - December 2020
IPPE Elective (Patient Care) - Froedtert Hosptial Integrated Service Center, Specialty Pharmacy
As this is my last IPPE rotation, I expect myself to learn to fine tune my medication knowledge in preparation for APPE's. This rotation will be working with the specialty pharmacy, so I will be encountering many drugs I recently learned about in session 8. For this rotation I would like to be able to have a strong understanding on at least two most commonly dispensed medications in this clinic, and be able to discuss the data behind the medication that brought it to use for its labeled indication. I would like to be able to read through research literature on each drug I choose to find information on.
Reflection:
Throughout this speciality pharmacy rotation I spent several weeks working on my GI consults for patients receiving colonoscopy prep kits. I had been very familiar with this medication previously working in retail pharmacy, but this would be the first time I encountered having to counsel with patients over the phone, and answer questions possibly relating to the procedure itself. I feel that these GI preps have a lot of important information the patient should be aware of, so I completed several consults on this. I had the opportunity to also do several medication reconciliations and ensure patient medication lists were accurate and up to date.
Children's Hosptial of Wisconsin, Complex Care Clinic - IPE
My goal for this upcoming rotation will be to strengthen my skills in pediatric medicine by familiarizing myself with the medical needs for the special-needs population. I currently am unfamiliar with this population so I am eager to learn what the pharmacists role is in this clinic while working along side medical doctors and nurse practitioners. By midpoint evaluations I would like to feel comfortable independently working up a patient profile.
Reflection:
Over this rotation I was able to learn in depth about the medical needs of patients invovled in the complex care program. This patient population type included many patients that required feeding tubes, and this was a unique process that I learned about how tubes were surgically placed, and how families were trained and educated on use of NG/NJ/G/J tubes. This is something I've previously seen before in clinic, but I was able see this on the clinical side of things. In clinic I worked with several patients throughout appointments and review their medications. Many times I was able to determine if medications were of appropriate use, if there was an ability to discontinue a medication, and if the patient was on a proper dosage. Before I mid point evaluations I had already began working up a complex patient profile review consisting of 51 medication problems, and reviewed a history list consisting of about 70 medications.
IPPE Hospital - Froedtert
My goal for this upcoming rotation at Froedtert is to hopefully have more experience working directly with the patients or care team. I would like to enhance my medication counseling/medication review skills by being able to work directly with patients and going through their medications at least five different occasions over the ten rotation shifts. My goal is to become more comfortable working with patients on based on disease-state using my knowledge I've gained over this past session learning cardiology and endocrine.
Reflection:
My goals had slightly changed when attending this rotation due to the setting my rotation was in. I worked in the surgical and neuroscience intensive care units, and most of my responsibilities involved working up patient profile reviews for critically ill trauma patients. During this time I was able to correlate my current course load from neurology into patient-decision making in the SICU. I had been able to work on drug decision making for short-term antipsychotic drugs, which is something I had previously overlooked as a common component of frequent drugs used in this type of care setting. Instead of being able to counsel on a medication as my previous goal, I was able to look into choosing an appropriate drug based on specific patient factors.
May 2021: Session 5 rotation is located in the Children's Hospital pharmacy. I had previously attented rotation at Children's hospital and spent much of my time attending rounds. This next rotation I anticipate working more on preparation of total parenteral nutrition (TPN) in the pediatric setting. I will continue my goal from previous rotations to work on calculations as I still need to have more experience in this. I would like to work side by side with the pharmacist and "practice" these TPN calculations/orders even if they are already completed, but to be able to practice a real life scenario. This is something I want to do on a weekly basis.
Reflection: Returning to CHW was an incredible experience. I was able to expand my work here and particpate in several pharmacy-related things. I had the opportunity to experience sterile compounding for TPN's on one rotation day, and was suprised with how much more was involved in TPN preparations. For pharmacy calculations, I spent time verifying that rx doses were correct when working up patients. I had several drug information questions asked, and I enjoyed that I was able to quickly respond and provide information from guidelines and different drug studies. This is a great reflection on how far I've progressed over the sessions on how I am able to respond in confidence to my preceptors.
SMART GOAL:Throughout my upcoming retail pharmacy rotation I would like to become more familiar with the Top 200 drugs, or the most commonly dispensed prescription medications in the retail setting. I understand that during this time I will be vaccine certified, so likely I will be performing several immunizations as well. In addition, I would like to continue my previous goal to work on pharmaceutical calculations. I anticipate that I will have a better opportunity to do so during this next rotation when assiting to verify prescription orders. By the end of my rotation I want to feel comfortable as a new immunizer and vaccinate at least one patient each week of my rotation.
REFLECTION: I had accomplished a majority of my goal by providing several vaccines for COVID-19 and Shingrix. This was a great opportunity for me to engage with nervous patients, educate them on vaccines and build a patient-pharmacist bond. I was unable to perform any pharmaceutical calcuations as this was not a setting that needed complex calculations to be done when completing orders. Having the ability to vaccinate during this rotation was succesful as I have just recently became certified.
SMART GOAL: I want to become confident in calculating pediatric preparations while on rotation in Children's Hospital ICU. I will work on practicing TPN calculations in a pediatric setting by beginning with at least one calculation prior to rotation, weekly. As I become more exposed to patient situations during rotation, I would like to increase the calculations that I complete prior to and during my rotation. This goal will improve my confidence in pharmaceutical calculations, as well as communicating prior doses with other health care professionals. While working along side the staff at Children's, I will work to relate my calculations practice to correspond with specific patient profile factors (age, size, weight, health conditions, etc.). By the end of rotation, I would like to have a minimum of 10 different calculations that are related to my experience for each week. - NOVEMEBER 2020
Reflection: I looked forward to improving on my pharmacy calculations on this rotation, but during this time I worked on learning about several conditions found in the pediatric ICU. During my time at CHW I attended rounds, completed medication histories, participated in several topic discussions, and collaborated alongside the pharmacists I worked with. For my first experience in a hospital setting I found that having exposure to several cases was most valuble.
I believe I thoughrougly accomplished my SMART goal during my first IPPE Community - Non-chain rotation, at altScripts Pharmacy. Before rotation each week I had the intention of working on a specific condition and knowing what drugs I should focus on for counseling, so that I could proficiently communicate with other staff in the pharmacy and patients. Majority of my interactions speaking with patients in the pharmacy occured over the phone. This helped me feel comfortable speaking directly with a patient and correctly counsel without having nerves overcome this.
I did not necessarily learn something new each week. But, I did improve and strengthen my knowledge on the medications and conditions that I was working with and I feel that this improved my skills overall.
I have had previous work in retail pharmacy, but I am always eager to learn something new within my field. Throughout my time in various pharmacy and patient care settings I expect to refine my current clinical skills, as well as building new ones, to provide myself with optimal patient care and advance my overall knowledge. I currently am skilled in pharmacy retail services, so I have a great patient-to-health care provider relationship. I feel confident speaking with my patients but I wish to see myself expand my communication skills to outside my zone of familiarity.
My first APPE rotation will be doing patient care, working with underserved populations. I have had the opportunity to volunteer here on a Saturday, and have already prepared some ideas I would like to implement once I have a better understanding of this clinic setting. I would like to implement a standard procedure for pharmacy volunteers on Saturdays, including a check list of what must be completed and how to appropriately transition patients from picking up medications to moving on to a clinic appointment.
If an opportunity arises to assist a patient with medication adherence issues, I want to take the opportunity to assist at least 1-2 patients by creating them a medication adherence tool.
IPPE Elective (Patient Care) - Froedtert Hosptial Integrated Service Center, Specialty Pharmacy
As this is my last IPPE rotation, I expect myself to learn to fine tune my medication knowledge in preparation for APPE's. This rotation will be working with the specialty pharmacy, so I will be encountering many drugs I recently learned about in session 8. For this rotation I would like to be able to have a strong understanding on at least two most commonly dispensed medications in this clinic, and be able to discuss the data behind the medication that brought it to use for its labeled indication. I would like to be able to read through research literature on each drug I choose to find information on.
My goal for this upcoming rotation will be to strengthen my skills in pediatric medicine by familiarizing myself with the medical needs for the special-needs population. I currently am unfamiliar with this population so I am eager to learn what the pharmacists role is in this clinic while working along side medical doctors and nurse practitioners. By midpoint evaluations I would like to feel comfortable independently working up a patient profile.
IPPE Hospital - Froedtert
My goal for this upcoming rotation at Froedtert is to hopefully have more experience working directly with the patients or care team. I would like to enhance my medication counseling/medication review skills by being able to work directly with patients and going through their medications at least five different occasions over the ten rotation shifts. My goal is to become more comfortable working with patients on based on disease-state using my knowledge I've gained over this past session learning cardiology and endocrine.
Session 5 rotation is located in the Children's Hospital pharmacy. I had previously attented rotation at Children's hospital and spent much of my time attending rounds. This next rotation I anticipate working more on preparation of total parenteral nutrition (TPN) in the pediatric setting. I will continue my goal from previous rotations to work on calculations as I still need to have more experience in this. I would like to work side by side with the pharmacist and "practice" these TPN calculations/orders even if they are already completed, but to be able to practice a real life scenario. This is something I want to do on a weekly basis.
Throughout my upcoming retail pharmacy rotation I would like to become more familiar with the Top 200 drugs, or the most commonly dispensed prescription medications in the retail setting. I understand that during this time I will be vaccine certified, so likely I will be performing several immunizations as well. In addition, I would like to continue my previous goal to work on pharmaceutical calculations. I anticipate that I will have a better opportunity to do so during this next rotation when assiting to verify prescription orders. By the end of my rotation I want to feel comfortable as a new immunizer and vaccinate at least one patient each week of my rotation.
I want to become confident in calculating pediatric preparations while on rotation in Children's Hospital ICU. I will work on practicing TPN calculations in a pediatric setting by beginning with at least one calculation prior to rotation, weekly. As I become more exposed to patient situations during rotation, I would like to increase the calculations that I complete prior to and during my rotation. This goal will improve my confidence in pharmaceutical calculations, as well as communicating prior doses with other health care professionals. While working along side the staff at Children's, I will work to relate my calculations practice to correspond with specific patient profile factors (age, size, weight, health conditions, etc.). By the end of rotation, I would like to have a minimum of 10 different calculations that are related to my experience for each week.
I intend on coming to my rotations with new questions to be put towards that days clinical practice. I would like to encourage myself to learn something every day that can be put towards my current experimental education with all of the provided resources around me. Being a thouroughly organized individual, I will have a lit of tasks or questions for what I wish to accomplish or learn for that day.
Eagerly asking questions is my plan to build confidence in speaking with unkown individuals. I do hope that this builds my communication skills as an indivudal so that I feel comfortable speaking with all patients and/or healthcare providers by the end of my rotations. My goal is to overall shape this so that if I come across an event that might be difficult to handle, I will be able to do so in a professional and correct manner.
In the future I would like to explore the possibility of reconstituting expired drugs in to possible new medications. I have looked into two possible pathways I would be interested into pursing this. The first would be for veterinary medicine, but I would like to expand my clinical studies in that aspect first. Second would be the breakdown of basal insulins to a possible cost effective formula. Unsure if these ideas are in the works already, or if at all possible, but it would be something I would like to research into at some time
Completed June 11th, 2021
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American Red Cross
Awarded - November 2020
201127071744_Natasha_Tang.pdf (.pdf) 0.03mb Summer Session 2019 - PHAR 530: Patient Care Laboratory I
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