A Week in the Life of a Pain and Palliative Care Trainee - Epilogue

By Angela House posted 08-18-2014 08:39

One participant in the ASHP Foundation Pain & Palliative Care Traineeship shares what she has learned

One question I could not really answer while I was at the traineeship was what role I would play on the team when I went back to my workplace. Lots of thoughts raced through my head-would I be a leader? Would my colleagues take me seriously when I had to change their thought processes about end-of-life care? I knew for sure that my workplace was about to change, and with the knowledge and confidence I gained from the traineeship, I could influence how that change happened.
Knowing that Northside Pharmacy would begin consulting services for Genesis Hospice in less than a month, I got to work reviewing the formulary they were currently using–updating drugs and checking for appropriateness. The finished document was well received by the hospice and by our management team. I also collaborated with my pharmacist colleagues to design consulting forms tailored to meet the needs of both the pharmacy and the hospice.
I was super eager to share my newly gained knowledge about palliative care with my colleagues. All of the resources I obtained from the traineeship were invaluable in the process of changing attitudes about end-of-life care. “What is methylphenidate doing here under the antidepressants?” is just one example of questions other pharmacists had. I quickly backed up my claim with an EPERC fast fact, and one of the 50 tips from the excellent article 50 Practical Medication Tips at End of Life.
For my own benefit–and partially because I’m a touch OCD when it comes to organizing notebooks–I put together a 3-ring binder with 12 different sections (12! I was giddy when I found the dividers at the store. When I was in college, the most I could get was a measly 8.) In it was the formulary, opioid conversion calculation instructions, protocols for symptom management, etc.  I carried it into work one day, and it never left! In fact, our department coordinator made a replica of The Notebook for each pharmacist on staff!
Less than two weeks after returning home from the traineeship, I found myself giving a presentation on integrating pharmacy and hospice to the wonderful nurses at Genesis Hospice and Palliative Care. In just a few days after the presentation, Northside Pharmacy took over the consulting services for them, and the transition has gone smoothly. I’ve invited myself to the hospice weekly team meetings, which has been a blessing for both the nurses and me. I can answer the questions that come up right there in the meeting and make recommendations on the spot. When I return to team the following week, I get updates on the therapy changes I’ve recommended–what worked and what didn’t. It affirms my philosophy that any time medications are involved, a pharmacist should be involved, too.
I have a confidence that I never would have had, were it not for the traineeship. In years past, I’ve given presentations about pharmacy at high school career fairs where I always glossed over the board-certified specialties, thinking there was no way I would ever have the need or the desire to get one. Well, I’m pleased to be studying for my pharmacotherapy specialty certification, and I’ve applied to take the certified pain educator exam!  
To say the traineeship changed my professional life would be an understatement. I would like to think that I’m making a difference in multiple lives every day. When a hospice nurse tells me that her patient is no longer bed-bound with intolerable pain because of a medication change I recommended, I feel an overwhelming sense of relief. At first, it was a little unnerving to have my carefully researched recommendation return as an order from the doctor. I think it’s only human nature to second-guess oneself, especially the first few times a recommendation is accepted. But as time goes on, I’m getting used to it.
The number one question I was asked when I returned from Baltimore was, “So, what did you think of your experience?” I always reply that I am wiser and grateful. I am wiser with knowledge of drug therapy, and I am grateful for the caring and compassionate people who put this traineeship together. While I can’t say for sure what their original goals were when developing the traineeship, if one goal was improving the disease-shortened lives of hospice patients and patients living with serious illnesses, let me say, “Mission accomplished!”

If you missed my blog diary of my week of onsite experiential training, you can read it in full at www.ashpfoundation.org/PainTraineeDiary2014. If the Pain and Palliative Care Traineeship sounds right for you, you can learn more about it at www.ashpfoundation.org/painmanagement. Applications for 2015 are being accepted through September 19, 2014.