Lost in the forest

Can you believe it is almost Thanksgiving?  Where has this year gone?  It seems that this is a yearly theme.  We get to the end of the year and wonder how the time has passed so quickly.  Often life moves at the speed of light.  I have to remind myself to slow down and regroup.  Perhaps you have felt like this before as well.  If I am not careful, I become lost amid all of the tasks to be completed.  It is important to take time, even if it is just a few moments, to find my center – to appreciate where I have been and what I have accomplished over the past few weeks or months or year, and to refocus and prioritize what needs to be done and what my goals are.  

This is especially important as we head to Las Vegas for the Midyear Clinical Meeting.  I spent some time over the past few days updating my CV, ordering business cards, registering for PPS, and contacting individuals whom I would like to meet with at Midyear.  Because I dedicated some time to reflection of the past year and organization of my thoughts, I will now be able to focus and prioritize what is left to be done before my flight leaves the first Friday in December.   This coming week will be spent finalizing my appointments and putting the finishing touches on my research project poster, tasks that now feel much more manageable.  This process of reflection followed by refocusing and prioritizing allows me to go from stressed and overwhelmed to refreshed and energized.  I am ready to face the next challenges with new insight and perspective. 

I encourage you to spend some time doing the same.  Take a few steps back to see the forest, and you will have a wonderful new appreciation for the trees!

Breaking Down Silos

This week I completed a major milestone on my residency "to-do" list.  I presented my pharmacotherapy rounds.  For those unfamiliar with pharmacotherapy rounds, it is a formal presentation, normally 1 hour in length, regarding a current, potentially controversial, clinical or administrative issue in pharmacy practice.  Some example topics from my fellow residents' presentations include perioperative use of beta-blockers, inappropriate utilization of PPI's for stress ulcer prophylaxis, and optimal blood glucose goals in critically ill patients.  My presentation focused on drug eluting bead chemoembolization for treatment of hepatocellular carcinoma.  Through my research, I learned a very important leadership lesson that expanded beyond the didactic content of my presentation.

The interventional radiology department oversees the chemoembolization process at my institution.   I worked closely with the physicians, physician assistants, and nurses in the interventional radiology department to gain a better understanding of the topic, and I couldn't have asked for a better group of collaborators.  They arranged for me to observe a chemoembolization procedure, provided me with radiology images for my Power Point, and consistently went out of their way to answer all of my questions.  What did I do to garner this special treatment?  I simply asked.

The typical pharmacotherapy rounds audience consists of approximately 60 individuals from the pharmacy department.  This week, we had a few extra guests - my colleagues from interventional radiology.  If you took a survey of those in attendance, I think you would find that most were surprised to see individuals outside of pharmacy in the audience. Their attendance stimulated good discussion, and I was extremely grateful for their support.

The purpose of this story is not to acknowledge my networking skills, but rather to serve as a reminder to others to continue to breakdown disciplinary silos.  Often, it begins by asking.  As a resident, I have seen the power of strong interdisciplinary collaboration from rounding in the SICU to attending the P&T Committee meetings.  My challenge to you is to seek out new opportunities to break down the silos and collaborate with others.  The successful outcomes will be well worth the effort.

Building a Foundation: The Importance of Mentorship

I have been blessed with great mentors the past four years. My mentors have played a vital role on the pharmacy student that I am today and have provided me with the foundation in which I rely on to make career decisions and the foundation that will help me to transform from a pharmacy student to a pharmacist. I would like to share with you why it is important to find a mentor and develop a mentor-mentee relationship. My idea of a mentor is someone who fosters a student’s knowledge and talent based on their past experiences and wisdom. As students we may possess the intellectual capacity but lack the judgment or maturity that comes from life, academics, or professional experiences. 

I remember my first research project and publication opportunity I lacked confidence and had very little experience. I was very intimidated and needed guidance. My mentor did a great job on helping me overcome the intimidation factor by sitting down with me and showing support, sharing ideas, and brainstorming along with me. The collaboration soon gave me the confidence and enthusiasm to be independent and feel comfortable to proceed and challenge myself to meet the high expectations of the department. The processes of developing that mentor-mentee relationship helped mold my success with the research project as well as grow professionally and personally.  Our relationship was successful because he recognized my weaknesses, provided constructive criticism was a positive role model, gave me access to learning resources, and most importantly, believed in my success. This was just one of my past experiences that establishing a mentor-mentee relationship with effective communication, trust, and respect for one another assisted me in accomplishing something that I thought at the time was not within my capacity. The concept of growth is important both on a personal level and as students soon to be pharmacists.

Who do we confide in to push us to be great future pharmacists, create those challenges, and inform us about opportunities? So, my challenge to you is to seek out mentorship and establish that mentor-mentee relationship to build a sturdy foundation as you embark on your future pharmacy career.

You can seek out a mentor easily within ASHP through the mentor exchange program at www.ashp.org/mentorexchange

 It is not to late to find a mentor before Midyear!

Jeopardy, Conference for Leaders, and Pharmacy Week. . . Oh My!

As a resident, I have learned that you can fit many positive learning experiences into one week, and this past week has topped them all.

Beginning on Friday, I traveled with 11 of my fellow residents to ASHP Headquarters in Bethesda, MD for Resident Visit Day.  I had the opportunity to interact with residents from multiple programs and to build upon my knowledge of ASHP.  The more I learn about the organization, the more amazed I am of all the services the staff members provide to members!  The day concluded with a heated game of ASHP Jeopardy.  My fellow residents can attest that I was a fierce competitor, and in the end my team walked away with second place. (There was some answer stealing involved by a team that will remain anonymous, but everything was congenially resolved over dinner after the visit.)

Sunday, I flew to Chicago for the ASHP Conference for Leaders.  The Section of Pharmacy Practice Managers certainly did a good job fitting a large amount of excellent programming into 2 days!  Monday morning started bright and early with a 7 AM resident networking breakfast.  Sessions included topics ranging from the ASHP Practice Model Initiative to how to improve your negotiation skills.  One of the sessions focused on how to lead the next generation of pharmacists . . . they have us figured out pretty well!  Additionally, the conference provided me the opportunity to network with pharmacy leaders across the country.  I met Directors of Pharmacy from large, academic medical centers and from small, rural hospitals.  One gentleman I met works for a 19-bed critical access hospital in Vermont.  He explained to me that he is the clinical specialist, dispensing pharmacist, contract manager, medication safety officer, and director all rolled into one!  I would highly recommend this conference for anyone interested in pharmacy leadership.  I'm already looking forward to next year.

When I returned to the hospital, the celebration for Health-System Pharmacy Week was in full swing.  Each area of the pharmacy department held a theme party to thank employees for their dedication to pharmacy practice.  The residents’ office theme was Las Vegas in anticipation for the Midyear Clinical Meeting.  Additionally, the department organized patient information tables outside the main cafeteria to answer medication questions and educate the public regarding poison prevention.  The outpatient pharmacy held a leg health awareness day and assisted patients in purchasing leg support hose.  Following Kathy Pawlicki’s call to action, I made sure that I spoke to at least 5 patients . . . did you?

As you can tell, the life of a resident is never boring.  As we get closer to the Midyear Clinical Meeting, I am sure many students may have questions about applying for residencies, going through the National Matching Service and residency life in general.  Feel free to send me your questions at mdavlin1@jhmi.edu, and I will post my responses.

Tackling MCM 2009

This past weekend I attended my undergraduate college’s homecoming football game. As I sat in the stands and watched the players go to work on the field, I started to think about how I was going to “tackle” the Midyear Clinical Meeting as a P3 student. I have been looking forward to MCM for a long   time, and I want to make sure I get as much out of the meeting as possible. I think my preparation started over a month ago when I received my first email about the meeting. I found myself really focusing on where I wanted my career to go after pharmacy school. Once I narrowed that down, I then started to look at PGY1 residency programs on the online residency directory.

I then visited the websites for the different programs and looked at their different rotation options to make sure they had rotations available in my key areas of interest. Once I had a solid list of programs, I visited the Residency Showcase booth listings to figure out when and where the programs I want to talk to will be at the showcase.  

Since I am only a P3, I made sure that my list included programs that seem to offer expertise in more than one of my key areas of interest. My goal is to leave the MCM this year having gotten some good insight into what a PGY1 residency program is all about. The next thing I need to tackle is deciding on which student programming sessions I want to attend.

I also hope to attend some of the general programming that focuses on my different areas of interest to see if I can gain some insight into future careers that way as well.  I think my key to a successful meeting will definitely be doing my homework ahead of time and making sure I get to attend as many sessions as possible. I am also going to make sure to watch all of the Pharmacy Student Forum pre-meeting webinars as a part of my preparation. As P3s we can definitely use the MCM to explore many different areas of interest so we are better prepared when we come back as P4s. Good luck to all students tackling the planning of their MCM schedules, please feel free to share any insight on how to have a successful meeting!

Your Emotional Garden

It's amazing how life sometimes marches in your door and looks you right in the face.

Trying to juggle rotations, moving, my daughter, and my personal life has been a challenge to say the least, which is why when my vacation month was unexpectedly moved from March to October, I was excited. I needed the break!

At first I thought I would take the time to work on my house, train on my bike, research all the residencies I might be interested in, and perhaps even travel to some of the places I was considering residency. Somehow, that didn't happen. What happened is that everything I had not taken the time to deal with came up. I had a sudden health issue that forced me to look at my life and how I was living it and where I really wanted to be. I was tired of hustling and always being on the run, and for once I took time to let the day happen as it may. My emotions were everywhere; I was confused; I was scared; and I doubted my path. Little personal issues that I had ignored for too long had been growing, and like weeds they threatened to overtake my "garden". 

I am using my time off to weed my emotional garden, to readdress where I am and where I really want to take my future. What is my personal truth? What do I truly need and want in my life? I am not talking only about pharmacy, although that is prominent on my mind. Sometimes, we get so busy with school and rotations and planning the next several years of our lives, that we forget to look at other aspects of our lives, such as our relationships.

What I have realized was that on the other side of that door that life forced open is a huge network of close friends, family, coworkers and peers, and even friendly strangers, all of whom can give you the support, companionship, love, understanding, fun and anything else you may need to cultivate your emotional garden.

I have had a lot of weeding to do, but I have now uncovered some beautiful flowers that I had neglected, and with each weed I pull, my garden becomes fuller and brighter. Cultivate your garden, make sure to keep those weeds under control, and watch your relationships, your life and yourself flourish.

Do You Have Time for Five?

Sunday is the start of National Hospital & Health-System Pharmacy Week and I can’t wait to see what our residents have planned for us at the VA in Madison.

Like so many of you, I look forward to this very special week because it’s a chance for the entire pharmacy department to acknowledge and celebrate our achievements in ensuring safe and effective medication use. I hope that each of you takes time this week to reflect on the powerful impact that you, as a member of the health care team at your practice site, have on the care of patients.

Pharmacy Week also provides us with an opportunity to move beyond the walls of the pharmacy to reach out to help our patients and their families gain a clearer understanding of what we do and why we’re such a vital member of the patient care team.

Kathy Pawlicki, chair of the ASHP Section of Pharmacy Practice Managers, issued a call to action for her section members that I’m going to share with you: Try to talk to five patients this week.

I know that with everything you’re juggling, carving out time to make patient visits may be daunting, especially if your role doesn’t give you a lot of opportunities for direct patient interaction. But your effort could have a tremendous impact. Patients and their families need to know about the work we do as members of the patient-care team. We also want to make sure that they understand what their medications are for, and how to use them when they leave the hospital. And who better to share that information than you?

I hope that you will accept this important challenge to start a dialogue with at least five of your patients. If you do, let me know about your conversations here or on the discussion forum at ASHP Connect.

Facing Your Fears

In preparation for my residency interviews last year, I developed a list of my professional strengths and weaknesses.  I knew that many programs asked candidates to describe their strengths and weakness within the context of the interview, and I wanted to have a well developed answer.  At the time, I did not foresee this list being utilized for any purpose beyond the scope of the interview.

As I progress through residency training, my list of strengths and weaknesses has become a road map for my goals of residency training.  Developing clinical confidence, especially in the area of critical care, is at the top of my list of areas of improvement.  The month of October is in full swing, and I am completing my critical care rotation in the Surgical ICU.  My current preceptor will confirm that when I began my month in critical care, I was apprehensive to say the least.  Honestly, I was scared.  What if I make the wrong recommendation?  What if my preceptor thinks I'm not a good resident?  Will I be confident enough to speak up to the surgical team?  Just thinking about the rotation made me a little tachycardic.  

My apprehension is subsiding, and my preceptor has supported me every step of the way.  Each day, I take on a larger patient load, and I am beginning to develop a rapport with my team.  Importantly, I have realized the vital role pharmacists play in the medical management of critical care patients. 

All pharmacists, residents and pharmacy students feel more comfortable in specific areas of pharmacy practice.  ASHP accredited residency programs are intentionally designed to push residents outside of their comfort zones.  I challenge you to face your fear in pharmacy practice.  You will be amazed at your personal growth, and I promise the tachycardia will subside.

I'm off to the ASHP Annual Conference for Leaders this Sunday.  Check back next week for the details of my trip!