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“It’s a small world.” People often use this expression when a coincidence happens resulting from people knowing each other or meeting each other in unexpected circumstances. It is often used to denote surprise at how people can be interconnected more deeply than we may recognize on the surface.  Sometimes people play the parlor game “six degrees of separation from Kevin Bacon,” which exploits the small-world-six-degrees-of-separation concept.  In this game, movie fans challenge each other to find the shortest path between any random actor and character actor Kevin Bacon (who apparently has been in an extraordinary amount of films).  Each connection is a degree of separation.  Apparently, every actor you can think of is within six connections (degrees) of being in a film with Kevin Bacon.  (As an aside, Kevin Bacon and his band performed at ASHP Midyear 2009 a few years back.  If you know someone who was at that particular Midyear meeting, you may just be a degree or two closer to Kevin Bacon yourself!)  

From the time we enter pharmacy school, we are told that pharmacy is a small world.  It usually is prefaced in a cautionary way by professors, who are quick to point out:  “Be careful of what you say about others:  Pharmacy is a small world.”  “Be careful of what you do:  Pharmacy is a small world.”  “Be careful of the choices you make:  Pharmacy is a small world.”  In Oregon, where I went to school and also currently practice, we only had one (!) pharmacy school for a long time, so this concept intuitively made sense:  One school = one small pharmacy world.  Since that time, like other states, Oregon has since expanded its pharmacy schools, but the adage still continues to be true.  Despite the growing number of pharmacy schools and increasing pools of graduates entering the job market every year, I am always pleasantly surprised to make connections with people who share my alma mater, residency program, or have similar experiences at the same places I have either interned, done rotations, or worked.   It makes me feel good to make these unanticipated connections with others, as I am constantly discovering new friends in unexpected places.  However, our professors had it right: The interconnectedness of all of our experiences is a wonderful aspect of our profession, but it can also backfire.

As a new practitioner, I am constantly surprised at how the lessons of professionalism we are taught in school (and I think we all intuitively understand by heart), are forgotten when we get out into “the real world.”  Social media doesn’t really help.   I had a colleague at one hospital who told me that a new practitioner she was working with was posting inappropriate things on Facebook about people in the pharmacy department she didn’t like.  (!)  I think most of us realize this is not appropriate behavior.  HR departments do, too.  This, frankly, is a good way to get fired.  At the very least, venting about colleagues on Facebook is not a good way to make positive connections with people with whom you work (who, of course, WILL find out about what you post).  Like my colleague did.  Another friend of mine was recently tapped through a friend of a friend to give information on a person he had worked with at one time who was interviewing for a position in another state.  My friend was torn because, while he felt the person had a strong work ethic and adequate clinical skills on a professional level, he could not recommend the person at all on a personal level because he felt the person was negative and didn’t get along well with others.  He had witnessed the candidate speaking very negatively about other colleagues, having emotional outbursts at work, and being openly hostile to new hires training in the department.   In the end, he was honest with the prospective employer when they asked his opinion, and not surprisingly, the candidate in question was NOT invited to interview.  As another example, all of us have had experience going to pharmacy conferences and witnessing behaviors best left forgotten.  The problem is, before social media, people could forget many of these undesirable things, but now they are all over the internet for everyone to see for all time.  And it isn’t just students who make these errors:  I once went to a pharmacy conference where a young pharmacy professor got very drunk and made some other questionable choices that were immortalized forever on social media by the students she taught (who, themselves, were very embarrassed by how out of control she was).  This was several years ago, but students and residents I know (who are now practicing pharmacists) STILL talk about what this person did.  I can’t imagine that anybody really wants to be remembered for bad choices like that.  Casual choices such as these can become disastrous career limiting obstacles.  The internet has a long (read: infinite) memory. 

So what can we do?  I think one of the biggest mistakes I see students and new practitioners make with respect to professionalism is they forget their own peers in the equation of establishing themselves professionally.  It is easy to give respect to a professor perhaps (because they grade you), a preceptor (because they evaluate you and could be potential references one day), or to a residency director (because they hold the keys to the proverbial kingdom).  But people  often forget that the most influential people of all in helping shape your pharmacy trajectory are not necessarily above you, but beside you—in the classroom (your classmates!) or in the trenches (your colleagues!).  When you are looking at positions, it is these people (who know you best!) who will eventually have the strongest say about whether or not you will be a member of the team where they work and potentially how far you may advance once you get there.  Could you recommend a classmate for a job if your experiences with him/her were he/she rarely came to class and wasn’t reliable in getting things done?  Could you recommend a colleague, even someone who you might like personally, for a job when you know he/she has problems getting along with people and might not do the best work? These are heavy decisions that are not easy ones to make.  I don’t think that anyone wants to be the one to rain on someone’s chances for a new start.  But as practicing pharmacists, we all will find ourselves in this unenviable position one day to either recommend or not recommend someone we know based on our prior experiences with them. 

My advice about this small world we live in, as pertains to professionalism, is simple:  be kind.  Don’t be kind because you are worried about what people can or will do for you.  Do it because it is the right thing to do.  It costs nothing to give kindness or encouragement, and it means so much to the people receiving it.  If you are kind, you will exercise patience with your classmates and colleagues even when you are having a bad day or feel annoyed.  You will make the decision to only post things on Facebook you want the person in question (and your Mom!) to see.  Next tip:  be positive.  If there are things you do not like at your workplace, try to channel your energy to fix those problems without resorting to being negative about everything and everyone.  Recognize that being a team player (“fit”) is a more desirable quality than clinical skills for most employers (because clinical skills can be taught).  If you are positive, you will escape the career-limiting move of being seen as a perennial grumbler.  Negative Nellies tend to sour the work environment for everyone and generally don’t do very well in the promotion department.   And last of all:  be thoughtful.  Try to remember that no matter where you are in your career path (e.g. student or established practitioner), your actions are always on display (even when you think people aren’t paying attention).  You are a role model for the profession, and you need to decide what you want your legacy to be.  If you are thoughtful, you will not put yourself into situations that will tarnish your reputation and make it difficult for other people to respect you.  It is my hope you will choose to be kind, positive, and thoughtful, even when others around you may not make this choice.  In the end, whatever you “give” is what will come back to you.  We cannot escape ourselves or our connections to one another.