Hospital pharmacists work closely with doctors and nurses and spend very little time with patients.
Kristin Rogers is a hospital pharmacist—a clinical pharmacist—at Island Hospital in Anacortes, Wa. A typical day is 10:30 a.m. to 9 p.m.
She starts off her day reviewing a list of patients, their medication profiles and a lab report of all their lab values.
“Then we review each patient. We’re looking for optimal therapy and drug-drug interactions. We’re looking for high risk medications and that patients are within the therapeutic range.”
Then she presents her recommendations to the physicians and presents her case. Depending on whether the physicians agree, she then fills the prescriptions. If the doctor disagrees, the pharmacist follows the doctor’s recommendations.
Most of the remainder of the day is spent reviewing the patient profiles, their histories, progress and lab values. Rogers spends quite a bit of time with the patients’ nurses, trying to get a feel for how they’re responding, how they’re doing, in order to get a concise recommendation on medications to present to the doctors so she doesn’t don’t waste their time.
She also takes calls regularly from doctors, asking for information on specific drugs.
Working in a hospital means a pharmacist covers a broader range of disease states than in a retail pharmacy.
“I think you get to use more of your education and I think you get to interact with more of the interdisciplinary fields,” says Rogers. She also has the benefit of working in a smaller hospital; in the larger hospitals there are more pharmacists and they tend to specialize in one area.
The end of Rogers’ day is sometimes spent dispensing, after the dispensing pharmacist has left. She also does the chemotherapy second check—she’s a second set of eyes to ensure these medications are correctly filled.
Each of the pharmacists at Island Hospital has a specialty. Rogers’ specialty is Quality Medication Management (QMM), so she dedicates part of each shift to that. “I review all medication errors to see if we have a process failure and I produce quarterly reports on that. I review the reports that come through. There are errors that come through but don’t make it to the patients.”
She’s also on the blue code team, which means if a patient has a heart attack, she’s on the CPR team. She’s also on the trauma team, so goes to any traumas—such as respiratory or cardiac arrest—that come into the ER.