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Lakeview Internal Medicine Pharmacy Services: A Student's Perspective

Written by Adam Price

One might think that helping to start a clinical rotation site might be a little confusing and at times seem overwhelming. Well that’s partly correct. You see I have a little insight on this topic because I am currently on my third week of a brand new rotation at the Lakeview Internal Medicine Clinic. It was apparent after the first couple of days that the start up process can be somewhat puzzling when you are trying to figure out your role as a student. Any time when you are dealing with physicians, nurses and staff along with a faculty pharmacist preceptor you can feel lost. I was lucky that everyone at the office was great. The physicians are very interested in clinical pharmacy and student education. Also the nurses and staff are very friendly. They do not hesitate to provide assistance and are a great resource. This is great, especially because we are brand new to the clinic.

The first week was very interesting. We faced problems ranging from the lack of a computer workstation for myself to not having a working office phone. It may seem that this could lead to a lot of waiting around but, my preceptor, Carrie Koenigsfeld, has found plenty of projects to keep me busy. The first week I spent several mornings rounding with Dr. Archer, one of the physicians from the office, at Methodist hospital. This gave me the opportunity to see many interesting patients and learn about conditions I had never seen before. One example was a patient with a warfarin-induced fever. I have also had the opportunity to be involved with two exciting new patient monitoring programs. The first of which is an INR monitoring program for patients taking warfarin. I have been able to help with the actual development process. I have assisted in creating documentation forms, scheduling patients for appointments, and patient interviews. The interview process has provided valuable patient interaction and given me a chance to assist in the therapeutic monitoring process. In addition to the INR clinic, there is also a brand new smoking cessation program that is currently being developed. This has given me the opportunity to assist in protocol revision. I have also researched nicotine replacement use for smokeless tobacco and cigar use. Another valuable experience has been participating in medication reviews with patients. This has given me a chance to develop my patient interaction skills while reviewing valuable drug information.

As the rotation has progressed, most problems seem to have dissipated. Although small issues still arise, like setting a single day for the coumadin clinic, there does not seem to be anything that impairs my ability to learn. It has been a wonderful learning tool for me to be here at the start of this rotation. I am often exposed to the real world stresses involved in the implementation of pharmacy practice in a clinical environment We often have to create new forms, protocols, and systems while still assisting in the patient care process. It can be very challenging but also exciting at times. Ultimately, this provides great insight into the difficulties faced by many pharmacists striving to develop similar programs.