I truly feel like an almost-new practitioner

ON ROTATION DIARY

To speak honestly and openly with you, I write this column anonymously under the name “Veronica.” It is my hope to provide you with insights about rotations and the many pharmacy opportunities I encounter.


As I begin the second half of rotations and my final year as a student pharmacist, thoughts about graduation, “What’s next?” and “Am I really ready to be a new practitioner?” are almost daily occurrences. That last question was especially prominent as I started my first inpatient rotation experience. 


My rotation schedule wound up being fairly back-loaded, with all of my more clinically-focused, inpatient experiences in the last few months of the spring semester. While I was excited to finally experience pharmacy life in this setting, I was definitely nervous. Preceptors expect more from their APPE students as the year progresses because we should be increasing in both skill and confidence. I was nervous because although I have completed half of my rotations, I was still behind the curve in this type of setting. 


I wanted to do well in the inpatient setting, not only for a good grade, but also because this is the type of environment I was leaning toward pursuing after graduation. What if I hated it? What if it overwhelmed me more than invigorated me? I guess I would just have to find out. 


Rough start


During the didactic portion of pharmacy school, I found myself drawn toward subjects that posed some sort of problem to fix or question to answer. I am a problem-solver by nature, so modules like infectious disease and oncology were particularly appealing. In January, I completed an infectious diseases rotation with the Antimicrobial Stewardship Program team at a nearby facility. It meant that not only was this my first foray into the clinical service realm, but it was also a very specialized rotation. 


To be honest, the first week was a little rough. Things like topic discussions and working through patients took much longer than I anticipated. Speaking up on rounds made my palms sweat and my knees shake. That first Wednesday, I was so overwhelmed because I felt so far behind. It had been almost 2 years since I was really immersed in this subject and it was taking more time than I liked to dust the cobwebs off the infectious disease shelf in my memory. I can be my own worst critic, so feeling like I was farther behind than I wanted to be was so defeating.


Positive preceptor


Thankfully, this preceptor was the exactly the type of mentor I needed for this time of the year. He knew that this was my first clinical rotation and approached the month with the perfect mix of challenge and encouragement. While rotations are great for helping decide a future practice setting, they also provide the opportunity to observe other practitioners and learn from their examples, both positive and negative. Regardless of where I find myself in a few months from now, I know that precepting students will be one of my priorities. This rotation and preceptor has positively influenced how I want to interact with my future preceptees and mentees. 


I know that giving and receiving feedback can be an awkward exchange. No one likes to hear criticism, no matter how constructively it is framed. However, this was one of the first instances where I really looked forward to those discussions. My preceptor applauded areas of strength while guiding me in specific areas of growth. As someone who can be highly self-critical, this rotation allowed me to see feedback as a way to continue to grow personally and professionally, and to be a little less fearful of the evaluation process. 


That first week was rough, yes, but thankfully rotations allow you to grow during your time at the site. By the second week, anti-pseudomonal agents were easier to remember, I was whizzing through patient lists before rounds, and making recommendations like it was the best thing ever. Actually, those were the best things ever! This rotation was one of the first times that I truly felt like an almost-new practitioner. My preceptor even said to me one day, “You’re taking a lot of joy out of writing that chart note.” Why yes, yes I am! 


Many fantastic firsts


It may sound silly, but I can distinctly remember how great it felt the first time a physician accepted one of my therapeutic recommendations and made a change to their patient’s medication regimen. This rotation was full of many firsts that I know will be important for the future: first patient case, first class lecture, and first staff education on a controversial topic. More importantly, it was the first time I really had to push myself to self-learn, to trust what I know, and to be confident in my contributions to an interdisciplinary team.