1. What are the responsibilities associated with being a Critical Care Pharmacist?

As a critical care pharmacist, my responsibilities involve daily clinical patient rounding with the interprofessional care team for all patients in the ICU, direct treatment of critically ill patients according to approved institutional protocols, and performance of research projects and medication evaluations relevant to the hospital’s critical care units. I also provide educational in-services and continuing education to the pharmacy and medical/nursing staff and help precept pharmacy students and residents during experiential clinical and research experiences. In my current role as a clinical pharmacy faculty at Memorial Regional Hospital (MRH), I primarily serve in a research/outcomes and quality improvement role, assisting with critical care research projects and providing didactic education to all P4 students on critical care APPEs. From a service perspective, I sit on the residency advisory committees for both the postgraduate year one (PGY1) pharmacy practice and the postgraduate year two (PGY2) critical care pharmacy residency programs at MRH. I am also one of the core program faculty in our hospital’s inaugural resident research certificate program for both PGY1 and PGY2 pharmacy residents.

2. How, if at all, has the COVID-19 pandemic changed the way you practice?

COVID-19 has disproportionately affected ICU providers and practitioners during each wave, as facilities are challenged by medication shortages, personnel burnout, and lack of sufficient support equipment like ventilators. Critical care pharmacy practice has also shifted toward telehealth and remote clinical work, including virtual precepting (which is especially challenging to simulate for a critical care rotation). For me, the pandemic has caused an additional shift away from solely focusing on inpatient practice in the ICU. I was able to actively assist with public health initiatives as a volunteer pharmacist immunizer through the NSU COVID-19 vaccination clinic during spring 2021, which was remarkably satisfying.

3. What do you find most challenging about your job? How do you overcome it?

The biggest challenge I experience in pharmacy academia is, ironically, what I also find the most exciting about it – on any given day, I can function in single or multiple domains of pharmacy practice (clinical work, research, teaching, and leadership/service). The challenge comes in balancing the needs of each of these domains of pharmacy practice and knowing when one domain has to take priority over the others (e.g., during teaching blocks, my primary responsibility is lecturing, so my ability to participate in research/clinical work/service is less than that when I am not actively lecturing). I try to overcome this challenge by blending some of the demands of these different parts of pharmacy practice (e.g., adding a mini-clinical research experience during blocks when I have APPE students on rotation and thus combining precepting/teaching, research, and clinical service).

4. What advice do you have for students for making the most of their pharmacy experience? Especially if they want to specialize in critical care.

Especially when practicing in critical care, active involvement and a calm demeanor in the face of multiple stressors are crucial for success. Burnout rates are highest among critical care practitioners, and it is easy for students to become overwhelmed in the ICU setting, especially during their first experience in this high-stress/fast-paced environment. Trust in your foundational knowledge, and always double-check any recommendation before you make it. Take the extra second to ensure you are aware of the situation and what you are being tasked to do, and then verify your response with evidence from the primary literature. Don’t make it a habit to rely strictly on class notes without knowing the source of that information.

5. In what ways do you believe students can emerge from the crowd and be a standout candidate during residency?

Students have to approach each experience in their education and training as if it were a formal interview. Those who truly “stand out” from the crowd of competitors for residency programs can prove their worth/merit both on paper and in person. Seek out extra opportunities to give yourself new experiences, and mold them into what you desire (e.g., ask a preceptor to complete a formal journal club presentation or research project if your rotation does not originally offer that experience). However, be cautious about coming across as overambitious and then not delivering on your deadlines. Make sure you can accomplish everything you agree to do, and actively seek out help/guidance in a timely manner, when needed.

6. You have published various research papers in the past. How do you think students can become more involved in research?

My passion for research originated from my experiences with different faculty while completing my Pharm.D. degree at the NSU College of Pharmacy. My advice for students considering whether research is a fit for them is to introspect and then explore. Introspection will allow you to determine whether you have the innate curiosity and questioning nature needed to be a successful researcher as well as determine your current (and potentially future) interests. Then, explore the opportunities for research, first among your pharmacy faculty and then among clinical preceptors; experience will allow for a more informed decision regarding which research path is your best fit. As a student, I completed bench/laboratory research during a P1 summer elective, social behavioral research using a secondary database strategy during a P3 winter elective, various clinical projects on antimicrobial stewardship during my P2–P4 years, and a retrospective analysis of antimicrobial prophylactic strategies in liver transplant recipients during my longitudinal APPE block program as a P4. By the time I completed my Pharm.D. education, NSU had well equipped me to be a serious researcher! This diligence for research while at NSU provided me with the opportunity to present multiple posters at local/national conferences and even publication in a peer-reviewed journal by the time I began my first year of residency. These experiences also directly allowed me to successfully balance the deliverables and deadlines of my longitudinal research projects with the additional challenges and rigors of 2 years of residency training.

7. What role has ACCP played in your career development?

I first joined ACCP as a student member in 2014 because it was the professional pharmacy organization most recognized for clinical research. ACCP provided me professional growth at a very early stage in my training and allowed me to develop skills in research conception, execution, and dissemination. I am now an active member of the Critical Care PRN, the Pulmonary PRN, and, most recently, the Health Equity PRN as a charter member. Through my current role as the Pulmonary PRN’s Education, Programming, and Communication Committee (EPC) chair, I have brought critical care issues pertinent to pulmonary medicine into the direct scope of the PRN’s programming and highlighted the intersection of critical care, transitions of care, and ambulatory care pulmonary pharmacy practice. In my involvement with the EPC, I have helped develop our annual PRN focus session topic, leading the charge this year. I have worked with other Pulmonary PRN leaders to develop our PRN newsletter and member needs survey – both charges that our group will continue. In addition, I am actively collaborating on two multi-investigator/multisite research projects and am the lead investigator on a prospective survey-based evaluation of theophylline prescribing practices. Most recently, I was elected as the incoming Pulmonary PRN chair-elect for 2021–2022, to subsequently assume the role of chair in 2022–2023.