Hi, I’m Shannon!

I’ve had an unusual, winding career path, so I’m creating a thread of it to help highlight some different pharmacist roles, in response to a question posed by @Sarah_Mojarad this weekend.

#TwitteRx, please share what you do in your practice area, too!

1/

PharmD: @UBPharm
PGY1: @URMCPharmRes in the Golisano Children’s Hospital

Which already brings us to the first fun fact...

Pharmacists can do residencies! PGY1 is usually a general year, and PGY2 is for specializing.

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After residency, I started as a pediatric staff pharmacist @MontefioreNYC

Often hospitals have a separate peds “satellite” to handle age and weight based dosing of meds for children. There’s more measuring / compounding of products here than in the main pharmacy.

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My next job was piloting an ER pharmacist role at a community hospital in my hometown.

I’d love for some ER pharmacists to comment, as these roles vary widely.

Most of time was spent confirming home meds - PLEASE everyone carry a list in your wallet or phone!!! - ...

4/

- and checking med orders for accuracy / safety.

I also could probably calculate the dose program an infusion pump to run tPA (for strokes) blindfolded by the end of my time there.

Of all my roles, this is the one where I worked *most* closely w/ nurses.

5/

I loved working w/ @adkats77, but I missed peds, so I moved and took a hybrid role (part staffing, part clinical) at my current institution.

Due to unexpected circumstances, instead general peds, I started in the neonatal ICU (NICU), w/ the teeniest, tiniest patients.

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NICU PharmDs like @NeonatalPharmD are incredible, and I hope she’ll share more!

Some of the coolest parts are how premature or even full term newborns handle meds, and the special ways we prepare those meds for the littlest patients.

7/

Kidneys and livers aren’t fully up-and-running in this age group, and the ratio of body water to fat / muscle is reaaaaally different.

Some NICU PharmDs also determine the babies’ IV nutrition (TPN) needs until they are strong / coordinated enough to eat by mouth.

8/

Inpatient general peds was my happy place.

PharmDs like @ebelarski work w/ the team to determine the med plan, AND get to talk to families about it. This is the setting where I provided the most education to medical residents / students (in addition to my pharmacy learners).

My next role was setting up outpatient pharmacy services for cystic fibrosis (CF) clinics (peds and adults), and a complex lupus clinic (peds).

Seeing patients in clinic and forming relationships over time is wonderful. I do med counseling, and get to focus on adherence more.

I’ve piloted pharmacy services in L&D, which was a good experience. There are not a lot of pharmacists in this practice area!

In the inpatient setting, it can involve guiding the team to antibiotics that were safe to treat an infection (ex. pneumonia) in a pregnant patient.

I know in the outpatient setting, Briggs (of the textbook!) would see patients with gestational diabetes in clinic independently and adjust their insulin regimens, which sounds pretty cool.

And I hope @SallyRafie will share more on PharmD roles in access to contraceptives.

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I currently work in the CF clinic, seeing patients there, and within our #specialtypharmacy supporting other pulm clinics, counseling patients complex, high cost meds, and trying to figure out how to make them affordable.

Specialty pharmacy is a growing area.

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Pharmacists in roles like the ones I described above also do committee work (P&T, med safety, IRB, etc.), teaching / precepting either at a practice site or in the classroom ( #PharmEd), quality improvement / research, and hold other responsibilities at their institutions.

14/

I hope more pharmacists will take a moment to share something about their own roles w/ @Sarah_Mojarad!

I saw a great list from @ConnPharmIntern kicking things off, but we are really just scratching the surface. There are so many places where pharmacists can make an impact!