Blogs

One participant in the ASHP Foundation Critical Care Traineeship shares what she’s learning

This is my fourth day of training at UC Health –University Hospital in Cincinnati, Ohio, under Dr. Eric Mueller. I have been working this week in a 34-bed surgical ICU rounding with a team of resident physicians, nurses, a respiratory therapist and other disciplines, as they get involved.

My day begins around 7 a.m., when I meet Dr. Mueller and discuss the day’s activities as well as the patients I will work on in the unit. I pre-round in the unit and work up the patients using a systems-based approach. We reconvene at 8:15 a.m. to review the patients and discuss potential interventions and/or recommendations to improve patient care. We round with the team at 8:30 a.m. under the attending physician.

Rounds have been exciting, with one of the resident physicians leading and reviewing the patient while the rest of the team chimes in with questions, concerns and recommendations to improve patient outcomes.

There have been many teaching moments during rounds, with the attending physician asking questions related to pathophysiology, mechanisms of actions and most appropriate treatment based on current guidelines and medical literature.

For example I needed to research and describe the pathophysiology as well as risks versus benefits of corticosteroid therapy in a renal transplant patient in the ICU. With another patient, s/p MVA with chest trauma with pulmonary contusions and hypotension, the attending physician discussed the indications for a Swan Ganz catheter in order to monitor fluid status, cardiac output and filling pressures.

My afternoons have been spent with my preceptor, other clinical pharmacy specialists and another awesome ASHP clinical trainee, Dr. Malar Narayanan from Texas, with whom I have become friends. We have topic discussions of selected disease states such as arrhythmias and traumatic brain injury. So far, magnificent!

 Dr. Mueller and, in particular, Dr. Neil Ernst have provided us with excellent teaching sessions and learning points we can take back to our hospitals and really utilize in our practice. They and other clinical pharmacists have been awesome in teaching us how to approach different complicated medical scenarios and real situations. In addition, they have shared their protocols and relevant literature supporting current guidelines and evidence-based practice.

I am thrilled to have this opportunity to learn critical care medicine from Dr. Mueller and to share great information with such a talented group of clinical pharmacists. Can’t wait for tomorrow!!


Look for my next post, "Day Six," which will be posted on Aug. 19th! See "Day One," which was posted on Aug. 12th.