Blog Viewer

In practicing pharmacy, we often have the references we swear by…we have our national practice guidelines, the dosing protocols from our respective institutions, our drug database standbys, and even other pharmacists.  Some of us even carry our own “peripheral  brain” to and from work.  This external brain might be on our phone or handheld device, in a binder, or in a small pocket-sized notebook.  I have a little notebook I have made as a new practitioner that I always carry with me as a practice guide, even though I confess I rarely use it.  Still, I can’t quite bring myself to leave it at home.  It feels a little bit like Peanuts character Linus’s much-loved blanket, at times.  I don’t really want to carry it around, but it makes me feel better to have it in tow.  Having these references at my disposal makes me feel confident that I can face any crisis or at least know where to begin to look things up if I have a clinical conundrum at work. Don’t get between me and the hundreds of pages of the CHEST 9^th edition!  I am a clinical pharmacist, and I am armed to do business!

In all seriousness, though, we can be just a little bit too focused on those references and guidelines sometimes. The art of practicing pharmacy is obviously much more than can be contained in one notebook or even in one mobile device with supercomputing capabilities.  We all intuitively understand this:  we know practicing pharmacy is much more than being up on all the latest literature and being savvy at electronic medical record shortcuts.  But yet, this knowledge does not always translate over into how we practice.  It isn’t always about what we know:  it is about what we do with what we know.  How we treat people.   How we act at work.  How we care for others—not just our patients but also our colleagues.  These are the lessons we take with us no matter how many years it has been since we were students.  I call it “practicing from the heart.”

Let me explain by way of example:  One of the first lessons I learned as a pharmacy intern was how to mix IVs.  I loved mixing (and still do!) because I felt it was very meaningful to be able to mix the drugs that would be instrumental in helping the patients at my hospital feel better.  When I mixed the IVs, I made the decision to put a little heart next to my initials on each IV bag that I made because I made each bag with love in my heart for the patient who was to receive it.  I wanted the patient, if they looked up at the bag, to see something familiar (my little heart) jumping out of all the medical jargon.  I wanted them to see the heart and know that someone was thinking of them and made that medicine especially for them.  My colleagues in the pharmacy had a good laugh about me sentimentally putting hearts on all of my IV bags, but I kept doing it anyway.  At some point, one of my colleagues pointed to my heart on the bag and asked a patient, “My friend mixed this IV and insists on putting these little hearts on here.  Honestly, does the little heart make you feel any better?”  To which the patient replied, “Why, yes! Please tell your friend, yes, yes, yes, it does…and thank you, thank you very much.”  So my hearts got a little bit bigger and a lot prouder that day.  I don’t get to mix as much as I used to.  But I keep putting the hearts on the bags I do mix—right next to my initials.  It is part of my commitment to practice from the heart. 

I also have colleagues who practice from the heart:  The ICU pharmacy where I work is by its nature and intense work environment and can be stressful at times, but I have a colleague who always brings a positive attitude with her which makes working with her an absolute joy.  When I was training as a newly hired clinical pharmacist, she was unfailingly kind, helpful, and encouraging, even when dealing with difficult clinical situations.  She made me feel at home right away with her warm smile and words of encouragement, which helped me build my confidence as a new practitioner.  Whenever there was an issue which came up unexpectedly, she would always jump right in with me in the trenches to get the job done.  Sometimes this meant dropping everything she was doing to mix some infusions for a patient who was coding in the unit.  Other times, this meant running down to central pharmacy (sometimes several times an hour) to get a drug that was unavailable on the floor to get it to the patient’s nurse (and ultimately the patient!) a few minutes sooner.  While still other times, this meant she would work alongside me off the clock through a break or through our lunches when we had some really pharmacologically challenging patients in the unit.  My colleague practices from her heart every day, and I can honestly say that working with her has made me a better pharmacist and made all my patients’ lives better for her involvement in their care.

I think, that many times in a hospital setting, we can lose sight of the fact that even though you don’t touch a patient directly, you can still make a tremendous difference in patient care.  Although we may not care for patients directly, like a nurse or physician, pharmacists can have a profound effect on patient care by building caring relationships with one another and with the healthcare team.  These relationships become the foundation for the quality of patient care that is provided to all the patients we serve. 

So, yes, we should arm ourselves with all the latest and greatest references.  But if you leave your peripheral brain or mobile device at home one day, don’t panic.  These are not the essential things which make us true practitioners.  We become true practitioners by choosing 1) to be kind even when the person on the other end of the conversation is NOT making that choice 2) to be helpful even when the help you are giving is unappreciated/ unnoticed, and 3) to care when it would be easier to let things slide.  Wherever you practice, I hope you will choose to practice pharmacy at the top of your license not only by practicing from the guidelines but also by practicing from your heart.