Throughout my three years of undergraduate at St. Norbert College, I discovered my passion for social justice, community service, and physical fitness. I sought after these things personally through my involvement in Cru, Ballroom dance, and Residential Educational Housing. Growing up on a family-owned sheep farm in rural Wisconsin taught me the value of team work and discipline to accomplish goals. Since starting pharmacy school in July 2020, I have continued to be engaged with the community as Bread of Healing clinics & MCW liaison, as the PY1 co-community service representative, and becoming involved with HCAST (Health Care Against Sex Trafficking). Some of my favorite courses thus far in pharmacy school are Patient Care Laboratory, because I am able to learn valuable skills that I can apply at rotation and as a pharmacy intern at Walgreens. My goal over the remainder of pharmacy school is to research social determinants of health and solutions to health inequalities for my concentration population health. 

During my rotation at Children’s Wisconsin I was able to experience a variety of subspecialities within pediatrics including the neonatal intensive care unit, hematology and stem cell transplant, and the day hospital infusion center. Additionally, one week I was in a surgical unit and was able to practice doing many medication histories to provide the most accurate list in Epic. I had a fairly open mind coming into this rotation, as I have little experience within pediatrics. I truly feel that this has been one of the most engaging rotations because there were so many new things that I was able to learn. The timing with my didactic coursework was also beneficial as I learned about pediatrics this session and was able to practice apply this knowledge every Friday! 

During my non-patient care elective I was at Froedtert focussed on medication safety. The main project that I worked on was conducting an audit of insulin labeling and storage. I then assessed the compliance of the current practices with the Institute for Safe Medication Practices (ISMP) 2017 guidelines. A significant portion of this project involved coordinating the efforts between other pharmacy students. This was an important learning point for me personally to realize the benefit of including others on a task that would be unreasonable for me to perform solely myself. Overall, I feel that my understanding of medication safety has improved and I am able to see how this can be applied to all areas of pharmacy.

During this rotation at the Milwaukee Area Health Education Center (AHEC) I have been able to learn about public health which is closely connected with my academic concentration in population health. When I was studying to get my basic certificate of quality and safety through the Institute for Healthcare Improvement in spring 2021 there was a module that focussed on population health. This completely altered my perspective on health because critical care only affects 20% of someone's health outcomes and 50% is determined by social determinants of health and environmental factors. Ultimately, this new perspective is what motivated me to pursue a deeper understanding of population health. As a part of this rotation I was able to co-create a presentation and resources on the importance of adherence in chronic disease states such as hypertension and diabetes. This presentation will be delivered to Community Health Workers (CHW's) across the state of Wisconsin to help educate the communities they serve. When I think of what I would like to accomplish someday as a pharmacists, I think that having a background in population health will help me provide better care to my patients. 

Over the past year, as a pharmacy student, I have been able expand my knowledge on how to provide the best clinical care to patients. However, more importantly, I have become more confident in who I am and the impact I would like to make in my professional and personal life. In August 2021, I volunteered at the Bread of Healing and was able to do a home visit with a family physician. In the car ride to the patient’s home we were discussing our background in healthcare and about Milwaukee. Dr. Margie asked me what drew me to the city. In a way that I hadn’t fully expressed before, I explained that when you look at patient health outcomes (uninsured rates, poverty rates, vaccination rates, and various other social determinants of health) Milwaukee is frequently ranked lowest in Wisconsin. So, if I want my life to have the greatest impact I need to partner with the communities that are struggling the most. On my rotation with Froedtert Hospital, I was able to observe how patient education and collaboration with many partners can lead to a successful discharge for a patient to hopefully prevent a readmission and provide follow-up care to improve quality of life.

Over the past year, as a pharmacy student, I have been able to build upon my previous healthcare experiences as a Certified Nursing Assistant. I am able to remain calm and deescalate a situation when a patient is angry, upset, or threatening. Starting in April 2021, I have been able to vaccinate patients. I have really enjoyed this opportunity on rotation and as a pharmacy intern because it allows me to use my knowledge of immunology and the COVID-19 vaccines to address patient concerns. My interest in quality improvement and safety allows me to address the system-problem instead of becoming frustrated at individuals. Additionally, I have a growing passion for understanding social determinants of health and have decided to pursue this with a concentration in population health.

My experiences as a Certified Nursing Assistant and as a pharmacy intern have allowed me to develop interpersonal skills when caring for difficult patients. In situations when a patient is angry, upset, or threatening I am able to respond in a calm manner as to not escalate a situation. Additionally, I am able to listen to a patient to provide them with options best suited for their needs. I have been able to practice these skills in a pharmacy setting as an intern at Walgreens and on my previous IPPE rotations, but there is still room for me to become more confident and efficient. I am able to work independently when I am confident on a skill and am intentional to ask questions in areas that I want to improve. Throughout my rotation I hope to learn more about how a community pharmacy can encourage medication adherence, vaccine administration, and other ways to serve an underserved population.

My expereince as a Certified Nursing Assistant has allowed me to develop interpersonal skills when caring for difficult patients. In situations when a patient is angry, upset, or threatening I am able to respond in a calm manner as to not escilate a situation. Additionally, I am able to listen to a patient to provide them with options best suited for their needs. I am able to work independently when I am confident on a skill and am intentional to ask questions in areas that I want to improve. Throughout my rotation I hope to gain confiedence on medication counseling and to learn more about a pharmacist's role in a hosptial setting. 

It seems crazy how fast the past two years of didactic learning have gone! However, I am beyond excited to finally start my Longitudinal Advanced Pharmacy Practice Experience (LAPPE) at Columbia St. Mary’s! Through my academic concentration in population health I have been able to develop a research project. I feel that this will be greatly beneficial in the development of my LAPPE project, as I have been able to learn how to balance project work with my class and work schedules. . 

I feel that I have been able to become proficient at many skills individually. During my first APPE block I will be able to become more familiar and proficient at combining all the different disease states for acute patient cases. Generally, I feel that infectious disease is the area that I am least confident in. I particularly want to become more familiar with how to utilize infectious disease protocols based on a site-specific antibiogram and more comfortable making empiric recommendations. Additionally, during this rotation I would like to be intentional to ask my preceptor and review class notes for landmark trials in the acute setting. In practice I have seen how providers and pharmacists are able to verbally reference trials to support their recommendation. 

I am excited to apply my previous experience with pharmacy to the pediatric setting. Prior to starting pharmacy school I worked with a pediatric patient as a Certified Nursing Assistant (CNA) in the home-health setting. I truly enjoyed this experience and was able to find creative ways to help the child understand their diagnosis/abilities. 

I would like to become more proficient with calculating the correct dose for a patient. I anticipate this could be in the context of weight based dosing or TPN. Additionally, I would like to become more familiar with resources that are beneficial for finding protocols or recommendations on pediatric medication dosing. For the course of this rotation I will also have my special populations class so I will be able to learn about pediatrics and then apply that to rotation. A goal that I have for this rotation is to become more comfortable asking questions when I am unsure how to do something. I have found that in topics when I am less confident I have the tendency to struggle for a while before asking for help. To accomplish this I will assess how much time I think a task will take me to complete. If I realize that I have not made measurable progress on the task, such as after 10-15 minutes, then I will formulate a question to ask for assistance. 

I enjoy problem solving and thinking through scenarios to anticipate potential errors that could be made. In undergrad I took a computer science class where we had to make various programs. To test the useability of my program I would have a friend test it out; sometimes this revealed that directions and prompts were not clear enough for a user to understand. As a basic premise, this is what comes to my mind when I think of medication safety. In addition to processing the advantages and disadvantages of when a system has a soft or hard 'stop' that requires a user to act on. 

I am looking forward to learning more of the logistics of how medication safety works, especially in a large hospital such as Froedtert. My goal is to become more knowledgeable in the systems used to track errors and then implement change to prevent future errors. To accomplish this I’ll plan on reviewing the process of LEAN workflow during the break prior to rotation.

During this rotation I would like to develop a better understanding of how partnering with community-based organizations can improve the quality of life for patients. Previous rotations had a focus on the technical skills of becoming a pharmacist; however, now I plan to focus on my soft skills such as empathy. I will prepare for this by arriving with an open mind, positive attitude, and a willingness to listen and learn. Additionally, I would like to review and research strategies for improving health outcomes in Milwaukee.

I am greatly looking forward to this rotation to maintain and expand my knowledge of motivating and caring for a geriatric population. I have a background, as a Certified Nursing Assistant, with geriatric patients through home healthcare, memory care, assisted living, and rehabilitation.

During this rotation I would like to become more proficient at reviewing a patient profile and engaging in interdisciplinary patient rounds. One way I would like to do this is by identifying patient risk factors and medications related to the areas I have covered in my didactic classes such as infectious disease, renal, cardiovascular, and endocrine (starting in July). Then I will practice critical thinking by asking: what is missing or is there anything that is unnecessary? Additionally, I would like to learn more about a pharmacist’s role in the ICU setting especially in regards to the transition of care to another area of the hospital or discharge.

To maintain my current knowledge of pharmacokinetics I would like any opportunity to practice dosing aminoglycosides or vancomycin. Additionally, I would appreciate opportunities to practice collecting accurate medications histories by using a variety of resources such as calling pharmacies to assess adherence, speaking with the patient/family, and utilizing resources such as Care Everywhere and RxNT if available.

This session I will be covering the renal and cardiovascular systems in more detail. As I learn more about these medications (for hypertension, hypercholesterolemia, etc.) I would like to apply the information to address patient concerns to improve adherence and outcomes. I will plan to work on this by intentionally reviewing the course material on Thursday evenings prior to rotation. Furthermore, I am incredibly excited to be able to start vaccinating during this rotation! Community pharmacies are accessible to patients and, especially in light of the pandemic, this is a way to improve patients’ lives in a profound way.

To maintain my current knowledge of antibiotics, antifungals, and antivirals I would like any opportunity to practice counseling patients on infectious disease medications. I found these medications particularly interesting when I learned about them in session three. Additionally, this will help me maintain my interpersonal skills with patients so they feel comfortable expressing concerns or asking questions.

I would like to focus on medication counseling and on responding to drug information questions from prescribers and patients. To achieve this, I would like to actively review the material from Patient Care Lab II prior to an encounter. Additionally, I still have much to learn in regards to commonly dispensed medications. As I observe encounters that the pharmacist has with patients and/or prescribers I would like to ask follow-up questions regarding the device, medication, or disease state to further expand the foundation of my knowledge. 

To maintain my current skills, I would like to have as much contact with patients as possible. Whether this is through vital collection or collecting a medication history. This will help me to maintain my interpersonal skills with patients so they feel comfortable expressing concerns or asking questions. 

I would like to focus on my verbal drug information response skills for responding to patient and/or prescriber questions. To achieve this, I would like to first observe the correct way to responsd and then have the oppurtunity to practice. Additionally, when there are times that the pharmacy isn't particularly busy I can take the initiative to ask customers looking at over the counter drugs if they have any questions. Over the course of my rotation, I plan to be measuring my confidence weekly. 

As far as maintaining my current skills I plan to be involved with the customers as much as possible. Whether this be answering questions or just offering more information that could be benifical to them. By doing this I will be able to keep sharp my interpersonal skills that I have already developed. 

• Effectively communicated experimental procedures and safety protocols under the director of a professor 

• • Compassionate care, time management, and accurate record-keeping to meet the needs of residents

  • Listened and addressed concerns from a patient and family while maintaining confidentiality of personal information

  • Experience with patients in a rehabilitation and long-term setting

• Individualized home care by creating target based goals to improve motor, social, and verbal skills of patient

• Medication, bowel, and bladder management of a patient under the direction of family

Renewed in June 2020

Established a free medical clinic for an underserved population with Cono Norte Callao Alliance Church.

This rotation allowed me to see the bigger picture of how pharmacy can impact someone's health. Milwaukee Area Health Education Center (AHEC), among it's many roles, trains Community Health Workers (CHW's) which is a new and growing role in healthcare. CHW's work within healthcare organizations and work as a bridge between resources and the individuals who need them. A role I had during this rotation was to co-create a presentation and educational material related to the importance of adherence in chronic diseases such as hypertension and diabetes. 

During my Froedtert Hospital rotation I was able to participate in rounds with a teaching team that covered general, acute patients. This was great oppurtunity for me to apply information that I was learning in my didatic courses such as vancomycin dosing, heart failure with fluid overload, and interpreting labs. 

There were many aspects of this rotation that were a result of COVID-19. I was able to administer vaccines, instruct drive-through PCR testing, and perform rapid antigen testing. In many cases I was able to rely on my foundational immunology knowledge and explain evidence-based findings from vaccine trials to patients. The location I was at is a Spanish immersion location on the south side of Milwaukee. I was able to appreciate the assistance of bilingual technicians, color-coded labels, and translated instructions to promote adherence and safety for Spanish-speaking patients. Additionally, I applied my knowledge on over-the-counter medications and non-pharmacological recommendations to answer questions from patients.

During this rotation I was able to observe the pharmacist's role in the central pharmacy, sterile compounding, ICU, NICU, ED, and internal medicine units. One of the skills I was able to grow in the most was to critically evaluate a patient while working them up using their EHR (Epic). I particularly focussed on comparing the coverage of the empirically prescribed antibiotics to the isolate and susceptibility results from the microbiology lab. There were a few times when I was able to recommend a change in the current antibiotic therapy to my preceptor or a physician.

During my first rotation I was at Froedtert Drexel Town Square in Oak Creek. I was able to observe how having access to an EHR (electronic health record) can improve the pharmacist's ability to have an effective role in patient care. In this workflow the pharmacists has to balance a wide range of responsiblities without the support of technicians. I was able to expand my knowledge of over-the-counter medications when patients would ask questions.