Won

What specialty area of clinical pharmacy do you practice in and why did you choose that area?

I practice in emergency medicine and critical care. My practice site is at an acute care, community hospital with designations including a level II adult and pediatric trauma center. We are also a cardiac receiving center and comprehensive stroke center and have other designations. My reasons for choosing this area of practice are multifactorial. In the ICU and ED, we take care of many high-acuity patients, which takes an interprofessional health care team approach to really take care of patients to the best of our ability. Especially in critically ill patients, there are many factors to think about regarding changes in pharmacokinetics, how drugs are affecting patients, drug-drug and drug-disease interactions, and so forth. There is a lot of gray area, and I enjoy the challenge of managing these critically ill patients.

I am also an assistant professor in the Department of Pharmacy Practice at Chapman University School of Pharmacy. I enjoy precepting students in the clinical setting because I like helping them apply what they learned in class to real-life patients. It’s always so rewarding and neat to see when the lightbulb in their head goes on.

What has been your involvement in ACCP? How has ACCP influenced your development as a practitioner?

I have been involved in ACCP since I was a second-year pharmacy student and have attended almost every conference since I was a P2. Although there were not yet official student chapters at pharmacy schools, at the University of Colorado, we had an ACCP student organization. I also ran for a national position and was elected as a member-at-large on the ACCP National Student Network Advisory Committee. Now, I am involved with committees as part of the Emergency Medicine and Critical Care PRNs. ACCP has positively influenced my development as a practitioner. I have found the ACCP conferences and participation in the PRNs a great way to build my clinical network; learn from other, more experienced clinicians; stay up to date with the guidelines and literature; and learn what is happening in other institutions or how they are handling certain situations.

What advice would you give to students pursuing careers in clinical pharmacy, particularly in emergency medicine/critical care?

Learn as much as possible while on your rotations. Build your network, and find different mentors for different areas. There is a lot of information that pharmacy school cannot cover, and there are so many different paths you can take in pharmacy. Doing a residency definitely helps you gain knowledge, experience, and confidence.

For those interested in pursuing careers in emergency medicine and/or critical care, I strongly encourage completing a PGY1 residency at a hospital with high-acuity patients. When looking at residency programs, check to see what ICUs they have and other designations (e.g., cardiac receiving, trauma, stroke) and whether they are a tertiary medical center. If possible, complete a PGY2 specializing in critical care and/or emergency medicine. (Some PGY2s offer both specialties, but typically, the focus is on one or the other.)

I also recommend getting involved in clinical organizations like ACCP. Even as a student, joining a PRN helps you learn more and even provides potential mentorship, research, and job opportunities.

Where do you think pharmacists have the most impact in your field of practice?

Research shows that pharmacists in the ED and ICU play a major role in reducing medication errors and time to administration of time-sensitive medications and improving antibiotic selection and de-escalation of therapy, to name a few. Pharmacists also help with dosing and adjusting medications and assist at the bedside for severe conditions such as ST-segment elevation myocardial infarction and trauma. They also serve as drug information consults for different providers. High-acuity patients also often have altered kinetics, so pharmacists play a major role in dosing considerations for patients and assessing the medications. Pharmacists also play a role in education for many types of providers, not only for physicians and nurses. In academic health centers, pharmacists can be seen as attendings to medication residents, which helps facilitate their medication knowledge.

What is the most interesting case you have seen and participated in so far?

That’s difficult – in the ICU and ED, I have seen a lot of interesting cases. I’ve encountered some interesting trauma cases, such as a pedestrian whose leg was amputated by a bus while standing on a corner and a patient who survived after shooting himself in the head. I’ve had some interesting infectious diseases cases, including cystic echinococcosis, mucormycosis, and mycotic aortic aneurysm. When I was a resident, I got to join toxicology rounds and saw some interesting cases with the toxicology fellow, including a stingray injury, a toluene overdose, and a foxglove ingestion.

How would you describe your research and role in advancing interprofessional education?

At the hospital, I work with other health care professionals; it takes an interprofessional team approach to deliver the best care for patients. Interprofessional education (IPE) is a newer concept that continues to develop among all health care professional schools. The idea is to teach IPE to students so that they are more comfortable and better prepared to collaborate with other health professionals in the clinical setting – thus ultimately promoting optimal patient care. However, there are many challenges with creating IPE experiences, including logistical/scheduling issues and being able to bring the health care setting to the students. Many students have limited exposure to the clinical setting, which may prevent them from fully appreciating IPE until they are on their clinical rotations or working as a clinician. My research involves analyzing the effects of IPE and interprofessional simulations.