By: Addolorata Ciccone, Student Copy Editor
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As a fifth-year pharmacy student researching and ranking advanced pharmacy practice experience (APPE) sites, I felt excited at the prospect of taking the knowledge and skills I obtained in the classroom and applying it to real world patients and scenarios. My years of work in community pharmacies were beneficial in learning not only about medications, but also about properly interacting with patients and other health care professionals; however, I had an unsatisfied urge to be on the front lines of medication therapy in the critical care setting. During my introductory pharmacy practice experiences (IPPEs), I felt most interested and motivated when on the floors viewing actual patient charts and trying to identify what is wrong with a specific patient and how to help that specific patient get better; it inspired me to become more competent in the clinical setting. I wanted to fully immerse myself in the inpatient setting and gain clinical experience. I wanted to push myself to learn about as many different aspects of pharmacy as possible during this year of internships as you only get one APPE year and you only get out what you put in. Upon hearing about NewYork-Presbyterian’s (NYP) special five-month bundle of APPEs offered to St. John’s University’s Doctor of Pharmacy students, I recognized this as a once-in-a-lifetime opportunity, and as quickly and surely as I did with studying abroad, I felt a strong need to take advantage of this unique learning experience. The prospect of learning from and interacting with the best in their fields among a wide range of specialties all in one institution at such a reputably high level is unique and excited me.
My months at NYP allowed me to grow professionally at a quick pace. Spending five consecutive months in one institution rather than in five different settings allowed me to take the first few weeks to get comfortable with the hospital setting, electronic medical records, and basic inpatient policies and procedures, and then spend the rest of my time at NYP to focus on patient care and learning and applying evidence-based medicine rather than learning new systems monthly. Throughout my five rotations at NYP learning the role of a clinical pharmacist, patient care always came first. At this large institution, I was exposed to a variety of different patient populations, rounding on neonates, children, adults, and the elderly throughout my time there. It was interesting to go to work in the morning not knowing exactly what to expect and working with diverse patient cases.
My rotations at NYP included Key Concepts in the Provision of Pharmacist-Delivered Care, General Inpatient Care, and three electives in Critical Care: Cardiac Intensive Care Unit (ICU), Critical Care: Neonatal ICU, and Specialized Nutrition Support. My classmates’ elective options included: critical care, pediatrics, geriatrics, transplant (lung, kidney, heart, or pancreas), oncology, research, and drug information. New electives were also created for students to better suite their interests, such as nuclear pharmacy, administration, and ambulatory care. There really is something for everyone at NYP, and no matter the elective, it is sure to be a great learning experience as you are working with knowledgeable professionals in their fields.
No matter the rotation, I was involved in daily rounds and learned what being an active part of the health care team making care plans for patients is like. I realized that Pharmacists are hard-wired as drug information specialists (focusing four years on studying medications rather than the one semester medical students get of pharmacology in their rigorous curriculum) and take on that role within the health care team. Pharmacists are able to tap into a solid drug information foundation and apply pertinent facts along with clinical experiential knowledge to an individual’s case, interacting with both the doctors and the patient, and thus make a difference in that patient’s life; being able to think and apply myself this way everyday was satisfying. There were numerous opportunities to make medical interventions and provide in-services to the medical team on rounds.
Besides daily patient care activities, common experiential rotation projects at NYP include: journal clubs, topic discussions, drug information questions, drug monographs, and optional research projects. Student Common Hours are organized for presentations to fellow students and preceptor pharmacists. Student Seminars are also scheduled for pharmacist presentations in various pharmacy specialties, for example: presenting skills, SOAPing, CV writing, literature evaluation, mentoring, networking, residency training, research, publication, public health, anticoagulation, antibiotics, pain management, and drug shortages. Students are also able to attend hospital Grand Rounds that usually highlight innovative topics such as extracorporeal membrane oxygenation (ECMO), continuous positive airway pressure (CPAP) in pediatrics, controlled substance regulation, bariatric surgery for Diabetes Mellitus treatment, pain management in pediatrics, and delirium in the ICU. Having long-term and short-term goals, schedules, and assignments improved my time management skills.
Although I had a daily commute of about three hours and my rotations were work-intensive at times, my time at NYP was so worth it as a hopeful future pharmacy resident. I was rewarded greatly in taking initiatives by being involved in relevant projects in clinical research, including writing up a case report for journal submission and performing a longitudinal medication use evaluation research project. My Curriculum Vitae (CV) was really able to blossom through my activities performed through NYP. I also had networking opportunities within the “small world” that is the Pharmacy profession. I was exposed to post-graduate year one (PGY-1) and post-graduate year two (PGY-2) residents, seeing their responsibilities first-hand and utilizing them as resources for advice.
I had wonderful learning opportunities and experiences with each one of my preceptors at NYP. They were all great role models in their own way and some became mentors to me and facilitated the great strides I made in five short months. I enjoyed my time learning and growing with each of these pharmacists. My preceptors were all readily available as coaches and facilitators. They arranged learning opportunities to meet my individual objectives (i.e. observing an interventional procedure, visiting relevant outside facilities, scheduling common hours for presentations). They regularly gave feedback to help improve my clinical skills and showed great enthusiasm and dedication to teaching and displayed interest in me as a student.
Reflecting back on my time at NYP, I feel indebted to this top-notch institutional program for the myriad of aspects of pharmacy I was exposed to. As Oliver Wendell Holmes, Jr. once said: “A mind that is stretched by a new experience can never go back to its old dimensions.” This great program did just this for me; it challenged me to grow each day and permanently changed me for the better as a health care professional; it stretched me closer to achieving my potential as not only an excellent clinical pharmacist, but also a more well-rounded individual. I witnessed first-hand as advertised on commercials, billboards, and banners that “amazing things are happening here [at NYP].” I feel honored and grateful for my chance to learn and grow during my time at NYP.
I wholeheartedly recommend this program to upcoming APPE interns and am more than happy to answer any readers’ questions about interning at NYP. Feel free to email me at: [email protected].
