“Health care is changing rapidly” seems like the new mantra for the pharmacy profession. Pharmacists are life-long learners, since most states requiring continuing education, but sometimes the lessons that may serve you best aren’t found in an article or book. Sometimes, in order to grow to new heights, you may have to uproot yourself and put down in brand new soil. “Nobody said life would be easy,” was an oft repeated quote from my mother--that always coincided with me whining about something trivial. As always, my Mom was right; life isn’t easy, and neither is change. Most people don’t like to grow until forced to, and right now, health care is being forced to change. Taking matters into my own hands, I completed a non-traditional residency this last year. And I learned growth can be more meaningful when you look back and see how far you have come.
Unlike the other seven residents in my PGY1 class this last year, I decided to work as a community pharmacist after college for a few years--and by a few years, I mean four and a half. After almost five years of flu shots, counting tablets five at a time, and wrestling with insurance companies and PBMs, I considered myself “pretty dang good” at what my job. Looking for a new challenge, I got lucky enough to land a job at the local hospital as an inpatient pharmacist. This lead to a rather steep learning curve--and by steep curve, I mean brick wall. The following is an actual phone exchange from my first week working in central pharmacy.
ICU: “We need a Precedex drip STAT!”
Me: Ummm……..sure…… no problem. *sound of my brain working furiously* Let me just enter it. What’s the other name of that drug again?
ICU: Dexmedetomidine
Me: Ummmmmmmmm…….yes of course…..almost forgot. *sound of me Googling furiously while my face turned bright red * I’ll get that dex-med-abeam up to you as fast as possible.
ICU: Can I talk to someone (anyone) else?
Right then and there I realized that I was NOT “pretty dang good” at my job anymore. Not only had I never made nor used this drug, but I couldn’t even spell it! Slowly, I improved, and after three years working as an inpatient pharmacist, I could recognize that I had come a long way. There was still one nagging problem I was refusing to face: what didn’t I know?
To quote Socrates, "The only true wisdom is in knowing you know nothing," and prior to my residency, I knew that I knew nothing. I was confident enough in my ability to get from A to B, but often I didn’t know why we took that particular route, what I needed to watch out for along the way, or when the best move might just be to stop and ask for directions—I am a guy after all. I knew I needed a better grasp of the behind-the-scenes decisions that were being made on a daily basis. Like a large number of health care providers, I got into this business because I genuinely love caring for people. I love the idea of making a person well, of making them whole again, so they can go on to live their lives to the fullest and grow and mature as human beings without their health holding them back.
In keeping with this line of thought, my first and foremost goal is to do no harm. This was at the heart of my decision to go back for a residency seven years after I graduated pharmacy school. It would be hard to forgive myself for a mistake due to my unwillingness to grow and expand my clinical knowledge. I cringed at the thought of an error that could’ve been avoided if only I was better prepared and more confident in my abilities. I have always loved pharmacy and am determined to never be the pharmacist that can’t sleep at night because they are replaying the day’s decisions over and over again in their head. I wanted to be educated and informed and have faith that I was making the best choices for my patients. Ultimately, my goal of doing no harm led me down the path to figure out what exactly it was that I didn’t know.
Now there are many pros and cons to attempting a residency after you have been out of school for just shy of a decade. My work ethic, leadership, and people skills had become well-refined over the years, and everything was going swimmingly--until I swam into that damn dam of long hours, low pay, and dramatic life style changes. It was difficult, to say the least, to go from jet setting around the world once a month to the harsh reality of working twelve days in a row every third week. My leisure reading disappeared entirely as journal articles and magazines started littering my coffee table. As my “me time” went down and my caffeine consumption went up, I experienced a major adjustment in priorities. Working in retail, I was used to the holiday or flu season rush—a quick fiery burst of hustle and bustle over 2 months – at the most. My residency, in contrast, was a long, slow burn of never-ending presentations, projects, and rotations. Slowly but surely, I adjusted as the year wore on, and writing policies and procedures (always my least favorite thing to do) became second nature. I began to understand not only inpatient care, but also healthcare as a whole in ways that I never could have comprehended. Soon I was able visualize not just the road that my patient and I were on, but the highways that connected all of our population. Beginning to understand the complicated paths of healthcare by immersion became my greatest learning experience. My newfound vision of healthcare extended beyond accomplishing day-to-day activities to being able to see the whole picture. I now knew.
Looking back, it was a challenging year of learning that lead to growth. Now I feel more confident in my daily choices and more energized in my role as a pharmacist after being empowered with the knowledge and experience I gained that year. People ask me all the time if I am glad I went back and did a residency. My answer, every time, is that I would never trade that year for anything…but I also wouldn’t want to go through it again. Growth is rarely easy. But it’s not supposed to be easy. That’s what makes progress feel so good. Take if from a guy that used to be unable to spell dexmedetomidine (nailed it!); growth is all the more meaningful when you can look back and see how far you have come.