Are You Ready to Start Your Residency?
Before we dive into the myriad of details regarding your PGY1 orientation I recommend we stop to reflect about a couple of issues. The first issue is purpose. Why are you here? Why did you decide to do a PGY1 residency and why did you choose a particular program? During your interview I tried to identify candidates who seemed to want a larger purpose than “to get a better job”. You were selected for our program partly because you wanted to matter, to make a difference to your patients, colleagues, organization and profession. The workload in pharmacy is intense; it is so easy to lose sight of your purpose. How will you keep that purpose within your scope of vision? Keeping the goal in mind is not unique to this moment in time. Why did hospital pharmacists develop unit dose, I.V. admixture programs, clinical programs, technology? It is so easy to get sidetracked by the details and forget that our purpose was to enhance patient safety. All sorts of work-arounds, compromises, and even mistakes in judgment can happen when we lose sight of our purpose.
You are beginning a very challenging assignment. A PGY1 residency is difficult, demanding, and stressful. We know there are very few accomplishments that are worthwhile that are easy to do. When you finish this assignment you won't even recognize the pharmacist that you were when you started. However, your character will be severely tested by workload and stress. Perhaps a few colleagues may serve as poor examples. You and your integrity can survive this experience by bonding together with your fellow residents and with preceptors who maintain their balance and stay away from the drama. You will feel much better about yourself if you cover your co-residents backs. Your behavior will say a lot about what sort of person you are. How you conduct yourself determines this conversation.
I think the defining characteristic of a professional is that a professional never mails it in. Your 20th patient in clinic gets the same attention as your first patient of the day. The 90th person you trained about chemo precautions saw the same energy and determination as the first. You have probably worked with pharmacists in the habit of mailing it in at times. You might see this behavior when it is busy, stressful or whatever. What do you think of those pharmacists? We are talking about another person’s well being. We are talking about your profession. Don’t ever mail it in.
You will see so many heartbreaking situations during your clinical rotations. I sincerely hope that you are moved by this experience to earn a greater understanding of a patient’s perspective. Many times we will be unable to change a patient’s final outcome, no matter how much we wish that was so. I learned from my own physician to focus on what you can do for a patient. No matter what there is always something you can help with. You can arrange for a prior authorization for an expensive medication so that a very ill patient will not have to maneuver our complicated process alone. You can find an outpatient pharmacy that stocks an unusual medication, or provides delivery service, or improve their pain or nausea regimen. There is always something you can do to help.
Finally it is important to step outside of the bubble of your own employment group. A great benefit of active membership in professional organizations like ICHP and ASHP is the opportunity to test your ideas and practices with other dedicated professionals who work and practice somewhere else. This test helps you to refine and hone your ideas and reach the level of expertise that all of us hope to achieve.
We need you to make a difference. Just remember don’t ever mail it in.
This article was written for the July/ August issue of KeePosted, the official News-journal of the Illinois Council of Health-System Pharmacists.