Preparing for Rotations

Hey guys! I’m writing today to list out how to best prepare to be on your A-Game when you start APPE rotations. Note: This is just what has helped me feel prepared as I go into rotations in May. Other things may work better for different people.

1. First things first, during the first 3 years of pharmacy school, study hard and study well. It is beneficial to work hard to get short-term memory into long-term memory so that you remember all the important stuff for all of the years ahead of you in your career. One of the ways that I do this is to make Quick Disease Fact Sheets after each disease state (or set of disease states) tackled in pharmacy school. I have discussed these before and the link to that blog post is here. You can also do the same thing with specific medications or classes of medications to make sure you remember the BIG, IMPORTANT points.

2. Second, it is important to continue studying, even when you begin rotations. What has been beneficial to me is to buy an RxPrep book (several years old) that was relatively cheap on Amazon. I am going through these topics nightly so that I’m well versed in what I need to know. We do not receive our RxPrep book for the current year until around September/October, so having the older model around before that comes will prove worthwhile.

3. Stay organized. It is very important to remain organized as APPEs are approaching. You should know which rotation is coming up when so you know where to focus your energy in the week or so leading up to that rotation. For example, if your first rotation is a cardiology rotation, it would be a good idea to brush up on the cardiology disease states before heading into that rotation.

4. Be prepared to be wrong or to not know an answer. It is important to be okay with not knowing everything. As pharmacy students, a lot of us are worried about being seen as ignorant. However, the preceptors on rotations understand that it is impossible for us to know everything about the world of pharmacy. A lot of that comes with being in the career field itself. A lot of the time, they aren’t testing our knowledge, but are testing our ability to admit when we don’t know something and our ability to look it up in a reputable source. This is not to say that they don’t expect us to know something… I mean, if they ask you what the brand/generic name or indication is of something… you NEED TO KNOW that.

5. And last but not least, the most important way to prepare for APPE rotations is to just trust yourself and breathe. It will all be okay. You’ve got this. WE’VE GOT THIS. I’m right there with you. If you ever need anything, feel free to reach out.

And as always…

Stay Golden,

Emily

Study Tips: Final Exams in Pharmacy School

In order to best study for final exams, I start studying ~3-4 days BEFORE I EVEN THINK THAT I NEED TO STUDY for an exam. It is critical to give yourself enough time. Here are some tips that I have to make that happen:

Make “Quick Disease Fact Sheets” or “Quick Medication Fact Sheets”

Example Quick Disease Fact Sheets That I’ve Created

I suggest for Disease States to focus on Key Features of the Disease, Pathophysiology, Risk Factors, Medication Management, and Non-Pharmacological Interventions. For Medications, I suggest focusing on Indication, Generic and Brand Names, Side Effects, and Therapeutic Class. It might be helpful to include pictures and charts.

Create a Rough Schedule for Studying

By this, I mean plan out which days leading up to exams that you are going to spend on each subject. For example: Monday: Pharmacotherapy 1, Tuesday: Research and Design, Wednesday: Integrated Pharmaceutical Sciences 1, etc.

Listen to Study Music

Here, I’ve attached a Study Music Playlist that I listen to on Spotify! It may be helpful to create your own.

Avoid Distractions

Put that phone down. Turn off that TV. Go somewhere quiet. Anything to help you avoid distractions.

Use a Timer!

There are lots of Study Timers online. I like the Pomodoro Method of Studying where you have 25 minutes of studying and then a 5 minute break. After an hour, you get a 15 minute break. Here is a useful online timer!

TAKE BREAKS

Going along with the last one, remember to take breaks! Your brain will stop absorbing information after about 20-25 minutes without a break because, as humans, we have a short attention span.

Avoid Cramming

This kinda goes without saying, but I feel like I still have to say it. Don’t wait until the last minute to study.

Make Quizlets or Practice Tests

This one has worked really well for me over the year. Being able to create my own questions with the material gets me thinking about it in different ways. I’ve even been able to anticipate almost the exact question that a professor is going to ask.

Focus on What You Don’t Remember!

If you spend most of your time going over the stuff that you got right on previous tests, you are going to neglect the stuff that you had a hard time with. The point of studying is to get a better grasp on the things that you don’t know or have a hard time remembering.

Get some SLEEP.

It is extremely important to sleep, especially during this time. It allows you to better retain information and leads to increased performance.

Good luck on your exams!!

Stay Golden,

Emily

I Need Some Serenity

Mirror, Mirror

Sometimes I’m ready to hit publish on one of these posts, BUT something (ahem, Jesus) whispers “no, not yet!” And, of course, He is right every time! Before I could hit submit, I first needed more review on a lesson I thought I already knew by our wonderful, Heavenly Father.

Merriam Webster defines serenity as “the quality or state of being serene.”

It defines serene as “marked by or suggestive of utter calm and unruffled repose or quietude,” and “clear and free of storms or unpleasant change,” and “shining bright and steady.”

Who doesn’t want to be free of storms or unpleasant change? Who wouldn’t want to be steady?

Put me first in line for all that. Yes, please and thank you!

At the start of this academic season, I was sent the serenity prayer over email. I was going through some stuff, as we all do from time to…

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It’s Not the Stress That Kills Us, It’s Our Reaction to It.

To be 100% honest with you guys, this semester hasn’t really been too stressful for me. I’ve been able to do a lot of things that I never would have thought I could during pharmacy school.

However, this week hit me like a ton of bricks. I’m sure a lot of you know exactly where I’m coming from… everything is going well and all of the projects and exams are spaced out and life is good and then all of a sudden it’s like your world was flipped on it’s head.

I know that sounds kinda dramatic, but that’s how I feel. How do you go from one or maybe two things a week to everything being due all at once?

This week I have a pharmacotherapy exam, an NDU (New Drug Utilization) presentation, a Business Plan Proposal, and a SOAP note due. On top of that, I have to read 100 pages for one of my classes and do other little homework assignments along the way.

But the thing is that, I know everything will be okay. I can see the light at the end of the tunnel, and for the first time in my life, I’m handling the stress in a productive way. I’m staying positive, taking deep breaths when I feel overwhelmed, and remembering how blessed I am to be able to have this mess of a life and be in pharmacy school so that I can graduate and do what I love.

One of the biggest things that has helped me deal with my stress is to take time and grow my relationship with God. I try to do a section out of my devotional every night no matter what is going on. This helps me reel in all of the negative feelings and remember all that I have to be thankful for.

We all get a little overwhelmed sometimes, but it will be okay. Everything will work out the way it should, and God’s got this!

Feel free to reach out if you’re feeling overwhelmed, or if you just want to talk. I’m here!

You’re not alone in this crazy thing we call life.

Stay strong and Stay Golden,

Emily

Pharmacy students show Christ’s love through medical mission trip in Egypt — Union Life

Story by Sarah Goff Six Union pharmacy students spent a week this summer as part of a medical mission team that served in Cairo, Egypt. The students — Bailee Esch, Hunter Hanson, Payton Pulse, Firas Quran, Brooke Sanders and Ali Ward — spent four days working in medical clinics, each day in a different local […]

Pharmacy students show Christ’s love through medical mission trip in Egypt — Union Life

To Vaccinate or Not Vaccinate… That is the Question

As a future pharmacist and certified immunizer, I take this topic very seriously and I’m here to discuss the pros and cons of immunizations.

Pros:

  • Protecting yourself and your family from vaccine-preventable diseases.
  • Avoiding complications from vaccine-preventable diseases (i.e. blindness, brain infections, bleeding, paralysis, death).
  • Herd Immunity (When the majority of the population is vaccinated, it is unlikely that an outbreak of the disease will occur. This is incredibly important to protect newborns and infants who are too young to receive certain vaccinations).
  • Saves $$$ by preventing disease (also most insurances cover preventive measures)
  • Protects future children (vaccine-preventable diseases can sometimes cause birth defects)
  • Eradication of Diseases (Small Pox was basically eradicated until the recent ‘anti-vaxer’ movement)
  • Most vaccines contain only harmless ingredients (unless the patient has an allergic reaction to something)

Cons:

  • Vaccines cause Autism (btw this is false). Vaccines have never been proven to cause Autism. The ‘scientific study’ that this myth was based on was proven to be falsified. Even if it did, I feel like this argument is basically saying you’d rather risk your child dying or being paralyzed than risk them being Autistic, and that is cruel.
  • You can get the Flu from the Flu Shot. (FALSE. It is impossible to get the actual Flu from the Flu Shot. It can cause cold symptoms as your body is trying to get used to the shot, but it is not the Flu).
  • Vaccines cause redness, initial pain, and soreness.
  • Vaccines can have significant side effects. This is true, but they occur rarely and the benefits seem to outweigh the risks. (The prevalence of a serious syndrome, called GuillainBarré Syndrome, is estimated to be 6 to 40 cases per 1 million people.)

For more information about Vaccine Adverse Events and Vaccine-preventable diseases, click the links below:

Vaccine Adverse Events: Separating Myth from Reality

Vaccine-preventable diseases: signs, symptoms & complications

VACCINE MYTHS DEBUNKED

VACCINES: THE MYTHS AND THE FACTS

Stay Immunized and Stay Golden,

Emily

A Month in my Life: IPPE Hospital Rotation

Hey y’all! It’s been an amazing month in my Hospital IPPE rotation. I’m writing this blog post as an update about what I’ve been up to the past month! Enjoy.

Week 1: Learning about the medication dispensing/ order verifying process in a hospital pharmacy.

This week I learned a lot about how the typical hospital pharmacy might run on a day-to-day basis.

Monday/Tuesday/Wednesday: I spent these days shadowing a pharmacy technician to see what they did on a typical day. We filled orders using the automatic medication carousels, which are basically rotating carousels with bins of medications in them. When you scan an order’s label, the carousel moves to the place the medication should be located in and you just have to pick out how many tablets/capsules that you need and scan the barcode on the medication. Medications in the carousel are all already pre-packaged in unit-doses so that you can just pull out the exact amount of tablets/capsules that you need for a patient’s dose. We also spent some time delivering medications to the different nurses’ stations to put in patients’ bins and also replinished the “pyxis” on each floor. A pyxis is a computerized medication holding device that holdsthe nurses’ floor stock of medications. This allows the nurse to get medications that are used often more quickly than waiting for delivery from the pharmacy.

Thursday/Friday Morning: I spent these days learning about hospital pharmacy inventory. I spent time with the medication buyer, learning from how she ran things. We unpacked and checked in all of the totes that were delivered in the morning on both days. This took quite a bit of time. Our pharmacy is also the delivery site for some of the other departments of the hospital so we went and delivered those totes to the appropriate departments. We took calls from providers trying to get medications that were not on formulary and tried to see if it would be possible for us to purchase the medications. We also prepared the order at the end of each day and made sure that it was complete and ready to be delivered to us the next day.

Friday Afternoon: I spent a lot of this time watching my preceptor (the lead pharmacist and clinical coordinator) verify orders in the main pharmacy and check that IV preparations were made according to their order.

Week 2: Learning about IV preparation in a hospital pharmacy.

Monday/Tuesday: These days were not the most fun I’ve ever had in my life, but they needed to happen for me to be prepared enough to start making IV preparations. On these days, I garbed up in the appropriate PPE and watched the technician draw up and compound IVs.

Wednesday: We spent this day cleaning all of the clean room areas. We spent 4 hours cleaning the clean room, ante room, and chemotherapy room with the appropriate solution and then again with alcohol. When I say clean… I mean CLEAN. We cleaned the walls, floors, ceiling, chairs, etc. Anything that was in the room got cleaned. After I did that, I was actually able to help put “vial-mates” together. Those are devices that allow the IV bag and the medication vial to be attached so that the nurse can wait to mix it all together right before they are about to give the dose. They can be made in advance and we keep a stock of pre-made vial-mates in the pharmacy.

Thursday/Friday: On these days I was actually able to compound IV preparations. I actually drew up volumes of liquid and injected them into IV bags. This was actually really fun. I am super happy that I was able to actually have this experience during my rotation.

Week 3: Learning about medication reconciliation and taking medication histories from a patient (in the Emergency Department) and more IVs (YAY).

Monday/Tuesday: I spent these days learning how to take an appropriate medication history from a patient and how to follow up with the patient’s pharmacy or family members if I had any discrepencies. I had a lot of fun interacting with the patients and actually being able to talk to them about their medications. I probably saw about 15-20 patients on both days in the emergency department. I didn’t see anything crazy come through though like I was expecting when I heard that I would be in the ED.

Wednesday: I spent this day back in the IV room preparing IV preparations.

Thursday: July 4th! I didn’t have to go into the hospital this day… I spent it by the pool 🙂

Friday: I presented a presentation to the pharmacy staff on how to take an effective medication history. I also spent some time shadowing my preceptor on her rounds and how she looks at patient charts with a “clinical eye”. I was able to help her counsel a patient on a new diagnosis of heart failure and I was able to change a patient from an IV medication to an oral form by looking at the patient’s chart and seeing that they were already taking all of their other medications by mouth.

Week 4: Learning about clinical pharmacists and their roles in the hospital pharmacy setting.

Monday: On this day, I shadowed another pharmacist on his rounds and helped him prepare for a presentation that he had to present to a group of senior citizens on opioids for osteoarthritis and dependance on opioids.

Tuesday: On Tuesday, I shadowed the pharmacist that I shadowed on Monday. We looked through patient charts to see if there was anything that we could change. For example, there was a patient on IV azithromycin, but they were taking drugs by mouth… we changed their azithromycin to PO (by mouth).

Wednesday: On this day, I shadowed another pharmacist and focused on cardiac patients. I looked in patient charts and determined if they were on the correct anticoagulants and checked INRs, etc. I also gave a presentation on hospital formularies and P&T committees.

Thursday: I shadowed my preceptor, went with her on her rounds, and helped her counsel patients. We had 2 sets of patients to run through this day, so there wasn’t much free time.

Friday: My preceptor and I sat in the ED and verified orders that had been received from the ED. We also looked at culture results for recent ED patients to see if the antibiotics that they were discharged on were actually active against the colonies that grew in their cultures. I also had my evaluation on this day since it was my last day there.

I am truly going to miss the people that work at the pharmacy. I enjoyed my rotation a lot. I’m so happy that I had the opportunity to learn from all of those people.

I hope you all enjoy your rotations if you have some left, if not… I hope you enjoyed reading about my experience and learning about some of the things that pharmacists might do in the hospital setting.

Stay golden,

Emily

A Simple Girl Living in a Complex World

Okay, y’all, this is going to be a really rant-y blog post, but it really needs to be said.

I’m just a simple girl trying to live in this complex world around me. I know what I want. In life, in love, etc. I don’t understand why it’s so difficult for other people to be honest with themselves and others about what it is they truly want.

Here’s a run-down of what I truly want.

Career wise:

I want to graduate with HONORS from High Point University with my PharmD degree.

I want to work in an independent pharmacy and eventually save up enough money to take over and own it myself.

Then, I want to pursue my passion for helping people by making appointments with patients to help them consolidate their medications and manage their disease states.

Family wise:

I want to find the love of my life.

I want to find a passionate love that I know I want for the rest of my life.

I want to be treated well, but have a true partnership.

I want to get married and have kids.

I want a small house, preferably on a little bit of land.

I want a dog or two.

I want to live close enough to see my parents/brother pretty often. I love them very much.

I want to focus on my relationship with God and have Him in my marriage.

Financial wise:

I want to live within my means but make sure to travel when I can.

I want to save money when I can.

I want to be able to be generous with my money.

It wasn’t that hard for me to say all of that, but I know other people have a harder time with it. Although I wonder why things have to be so complex, why we have to be so wishy-washy and confused all the time, I know that it’s just the world that we live in.

My hopes are that this generation learn to be true to themselves and what they want out of life. It is important for the future.

One thing is for sure though, even when I finally get to the point that I have reached all of these goals, I will not stop to make myself a better person.

All I want is to be happy and to truly be the best person that I can be.

So here’s to that.

Stay Golden,

Emily

On May 11th, 2019

As I sit here today watching the class of 2019 walk across the stage, I’m left with my thoughts. The inevitable “what if’s”.

For the past few weeks I’ve been sad. More than I have let on. You see… these are my people. The people that graduated High School when I did, the people that entered college when I did. I’m seeing a lot of the friends I’ve made over the last four years grow up into amazing young men and women and walk across that stage into what feels like the end. 

But it’s not the end. It’s not the end of our friendships…of the times we’ve spent together. It’s just the beginning. Now we won’t just be 5 minutes away, but miles and miles apart. But there’s good in that. Now is the time to visit one another. To take trips together. To live.

With that being said… I’m so incredibly proud of each and every one of you. Whether I know your name or not. Whether you’re graduating on time or not. You are my people and I love you dearly. Congratulations to the class of 2019.

Now back to the what if’s… like I said, these are my people. But at the same time they aren’t. You see some of us take a little bit longer to get to our destination. God intended for me to graduate college in 6 years, not 4. But with that, comes more responsibility. I’ll be a doctor. I’ll be a medical professional. I’ll be a PHARMACIST. And that is my calling. 

If you knew me when I was younger, you’d know. I’ve always wanted to be a pharmacist. So here we go. I may be sad now, but my time will come and it will be much deserved and much awaited. 

So here’s to us: the doctoral class of 2021. Here’s to our true calling. We got this!! 

And to those of you taking a little bit longer, don’t forget that your time will come and that beautiful things are awaiting you at YOUR finish line. Keep pushing through. 

Stay Golden, 

Emily

I Refuse to Let IT Control Me.

For at least 10 years, I have been controlled by the demon inside of me. I’ve let it dictate my actions. I’ve let it dictate what I say. I refuse to let this anxiety cripple me anymore.

I’m writing this because I’m finally ready to let it all out. Sure, I’ve written blog posts about anxiety before, but I’m finally ready to lay out all the dirty details.

I’m not sure where exactly my anxiety stems from, but I do remember that in middle school I was bullied for being too skinny. People constantly asking me if I’m anorexic or if I need something to eat. People telling me to go eat a burger or 2. I started being self-conscious. I started feeling anxious every time that I was around new people. I felt like everyone was judging me. That’s the first time in my life that I remember the voices coming. “Nobody likes you,” “you’re too skinny,” “you look weird,” “you’re a failure.” Constant voices in my head that never go away. I’m not sure if the anxiety started there, but that’s the first thing that I can remember from my childhood.

It also could have been because of the fact that in high school I got physically and mentally abused by people who I thought were my best friends before that. The fact that I was never good at picking friends and never really understood why I felt so alone.

Then there’s, of course, the fact that I hate being in big crowds… I hate meeting new people because there’s this constant nagging feeling.

The constant feeling that everyone is watching me and judging me didn’t stop there. I’ve always felt that way. I can’t even go to class without feeling anxious because someone is judging me. I can’t raise my hand and answer a question I know the answer to because I don’t want to draw attention. I can’t make eye contact with people that I don’t know because I don’t want them to notice me. I want to be invisible. I need to be invisible. The worst part is that I KNOW that isn’t the truth. I know that not everyone I meet is judging me, but I can’t get that thought out of my head.

Of course, there’s also the academic part of it. People call me Type A and an overachiever, but I don’t want to be an overachiever. I HAVE to be. Those little voices in my head tell me that I’m not good enough and that I’m never going to be good enough. So I work as hard as I possibly can in hopes I can finally be good enough for the voices to leave me alone.

But anxiety isn’t just about being scared of what people think… it’s not wanting to leave the house. It’s constantly being exhausted and wanting nothing more than to lay in bed all day for the rest of your life. It’s sometimes not wanting to eat or wanting to eat too much. It’s being needy to those that you have let into your life because you need to feel wanted. It’s acting like everything is okay when all you want to do is scream. It’s panic attacks over the tiny stuff that shouldn’t matter.

But I refuse to let it rule my life any longer. I don’t care if you think I’m weak… I’m not. I’m strong for asking for help when I know I can’t do it on my own.

I’m also asking God to take my problems and give me peace. I’m strengthening my relationship with Him the only way that I know how. By talking to Him. By reading His Word.

It’s time I start fighting back against this demon inside of me. It’s time to WIN.

I’m writing this mainly to get it all off of my chest, but I hope that along the way it helps someone understand that they’re not alone.

You’re never alone. Even in the hardest times.

Stay Golden,

Emily