APPE #5 - Community Pharmacy Rotation

Source:  APPE #5 - Community Pharmacy Rotation    Tag:  tell me about shingles
Ahhhhhhh guuuuys!!!! I am so so so very busy and have been living in survival mode for the past several I am sure you probably figured per my lack of blogging.





Sorry, I will turn my caps lock off now. But I really WAS yelling this stuff in my head.
Because I am too excited. And nervous at the same time. Excited about this light at the end of the tunnel and nervous about the next tunnel that I am voluntarily choosing to enter. The very dark and scary tunnel of residency.

The thought of my pharmacy school graduation is bitter-sweet to me. If you've been following this blog, you know just how hard I have worked throughout pharmacy school and how glad I am to be done and finally be able to move on with my life...start a family etc...but at the same time you know just how much I love education and how much of a nerd I am. So bitter-sweet this shall be.

Ahhh...if someone would just pay me to go to school, I could just do that for the rest of my life.
(I probably don't mean this, but I sure do keep saying it to everyone).'s time to graduate, take the board exams, get licensed, step out onto the battlefield, and GO FORTH AND SAVE LIVES!

So that's that. Now onto the real topic of this blog post.....

Since I have so far posted about every single 4th year pharmacy school clinical / rotation I have had thus comes another post in that series. Here is a quick re-cap of my last rotation (APPE #5)

So my APPE #5 of 6 was a "community" (read: retail) pharmacy rotation. Since I have been working at a retail pharmacy for close to 5 years, there wasn't really anything all that exciting about this rotation to me...nor did I acquire any breakthrough knowledge. Despite saying that, this retail company where I did my rotation is much more clinical services focused (instead of just focusing on the volume of Rx's they sell, they are very involved with providing clinical services to patients, such as diabetes classes, diabetes one-on-one appointments, measuring A1c and lipids, doing medication reconciliation, etc), so I did have a unique experience there with some of their special services.

My regular day usually went like this:
- In the morning, I focused on helping the pharmacists/ technicians with workflow. By this I mean typing up prescriptions, billing insurance, filling prescriptions, dispensing prescriptions, counseling patients about their new medications, providing OTC recommendations, etc.
- In the afternoon, the preceptor assigned me with certain questions or topics for me to research and report back to her on. She gave me time to complete my worksheets and to work on my Health and Disease Prevention project, as well as my patient case presentation.

In addition to regular days, I also shadowed the "Wellness Clinical Pharmacist" a couple of times. She spends her time teaching and driving all over Chicagoland to individual appointments with patients. I participated in a diabetes education class as well as several one-on-one diabetes appointments with patients.

My patient case presentation topic was diabetes - I specifically focused on the effect of alcohol (the different types of alcoholic beverages) on blood sugar, and I made recommendations in regards to what diabetic patients should know and how they should prepare if they know they will be drinking (ex: going on a vacation to Mexico...which is literally what my patient in my patient case did).

My Health and Disease Prevention project was focused on raising awareness about Shingles (Herpes Zoster) and answering questions of the general public about the shingles vaccine. I created an informational poster as well as a trivia game to play. The retired seniors who come into the store every couple of days because they have nothing better to do really enjoyed interacting with me and playing my trivia game. They won prizes that consisted of candy in Rx vials and they also filled out a questionnaire, after which I was able to tell them whether the shingles vaccine is (or is not) recommended for them at this time.

Some of the seniors got so friendly with me that they proceeded to show me their current shingles rash...even when it was on their chest, even though they were in a grocery store, not a doctor's exam room, LOL. I had a lot of good patient interactions, a lot of good stories from patients about themselves, their wives/husbands, and their families going through shingles or having scary post-shingles complications like excruciating nerve pain, blindness, and even brain inflammation (encephalopathy). Some guy, although totally unrelated to my shingles awareness display, proceeded to tell me about his experience of contracting lyme disease from a tick while on a hike, being hospitalized, and going through that disease. I had another old lady asking me super awkward questions that a lady her age probably should not have been asking (lol). My Lord, did I have an adventure while doing this project.

I also did other stuff .....such as creating a pretend medication dose pack by filling it with candy to advertise the pharmacy's "Medication Unit Dose Packing Service." Unit dose packing is basically having the pharmacist arrange all of your pills in a personalized, disposable pillbox every month - putting them in the appropriate "time of day" as well as including all of the Rx Labels on the Unit Dose pack for easy identification and reference. We mostly did this for patients that were in the nursing home. But anyways, to advertise this service, I filled up a mimic dose pack with M&Ms and Jelly Beans. It's funny because a lot of the candies looked like actual medications; for example, the green jelly bean looked like Vitamin D2 50,000 units; the green M&M like Ferrous Gluconate 324mg ; the red jelly bean like Docusate Sodium 100mg.

I had a very nice time at this rotation and the experience was quite different than what I am used to at my retail pharmacy job, but at the end of it all, I realized that RETAIL is RETAIL no matter where you go....and I encountered the same problems and the same nasty people who feel like they're entitled to everything and are smarter than you or their doctor....and realized that although this pharmacy is slower (they fill much less prescriptions than at my job), that it is actually the SAME CRAP, just in SMALLER VOLUME. And I still couldn't  imagine doing it for the rest of my life...and was glad I got into that residency...which I promise I will be writing more about soon. Just as soon as I dig myself out of this hole of projects and things to do before graduation.

IV Infusion of Caffeine is needed STAT