MHMHC: Exceptional Hospital Rotation
Each rotation type and even rotation site offers unique opportunities to student pharmacists. As I’ve transitioned from one to the next, it’s been my goal to gain exposure to as many techniques, collaborative settings, and various departments as possible. My APPE 3 rotation at the Memorial Hospital of Martinsville and Henry County (MHMHC) was a wonderful example of what’s possible at an institution setting.
On day 1, I met with my preceptor – pharmacy director, Heather Ashe, PharmD – to discuss her expectations and my areas of interest. As this is a pharmacy rotation, the vast majority of my time would of course be spent working with hospital pharmacists and pharmacy technicians. However, because I was interested in becoming acquainted with MHMHC’s efforts to improve upon its antimicrobial stewardship program (ASP) and interdepartmental communication, we felt it would be especially beneficial for me to spend time in multiple departments during my 6-week rotation.
Cardiac Rehab
During my first week, I was allowed to work with Sharon Perry (above left) and Donna Nash (above right with patient*), coordinators of the cardiac rehabilitation center. This facility offers a variety of state-of-the-art technologies and techniques to patients suffering from cardiovascular disease – from echocardiography and nuclear-stress testing, to pacemaker analysis/monitoring and exercise rehab. In this department, I was able to review medication lists and discuss with patients the importance of adherence as well as progressive exercise programs.
*Patient (unnamed) consented to use of picture
Catheterization Lab
In my second week, I spent time in the catheterization lab, where a team of cardiologist, nurses, and technicians perform procedures such as implementation of balloons and stents to open blocked and/or repair damaged blood vessels of the heart. Again, I was permitted to discuss medications with patients during both pre- and post-operative states. As many of these patients have suffered from valve and peripheral vascular disease as well as heart attacks and strokes, this was a tremendous opportunity to counsel patients, identify various risk factors and potential drug-drug interactions, while hopefully demonstrating the value of pharmacy services.
Microbiology Lab
During my third week, I worked with several microbiologists – including Flo Jackson, supervisor of microbiology, hematology, and cytology – in identifying pathogens and potential antimicrobial treatment options as part of culture & sensitivity testing. Their team was so knowledgeable in studying microbes via methods such as PCR, nucleic acid assays, mass spectrometry, and fluorescence in situ hybridization. There was so much to learn, and luckily their staff showed such an interest in teaching me.
Sterile Parenteral Medication Preparation
Each week I spent a great deal of time performing sterile parenteral medications as well as formulations for oncology patients. The pharmacy staff with which I worked had extensive tenure at this facility and had a great deal of experience with these techniques. The care and diligence with which they approached IV preparations for each patient was truly humbling. And, even so, they were incredibly generous with their time in allowing me to gain experience performing various sterility techniques.
Antimicrobial Stewardship Program
On the final week of my rotation, I presented my findings and recommendations with regard to MHMHC’s antimicrobial stewardship program to members of the pharmacy, microbiology lab, and hospitalist personnel. This was an enormous and intimidating endeavor. But, the members of the ASP team members treated me with respect and viewed the conclusions of my research as a tool for improvement.
There were so many other distinct and rewarding experiences on this rotation – medication reconciliation, pre-screening in the emergency department and surgery wards, pharmacy and therapeutics committee meetings, skills fair, etc. To any ACP student interested in a hospital rotation that offers flexibility, a genuine focus on learning, and a wide range of patient services, I can’t recommend MHMHC highly enough.
