The First Week of PAIN (Management)

If you have ever been to a Ben and Jerry’s ice cream store, you will understand the daunting task of choosing 6 rotation sites out of 640 options. A requirement of the selection process was to write a personal statement summarizing my professional goals and principles in an attempt to guide my choices. My opening statement read as follows:

“…[I believe] in the potential of pharmacists to optimize patient care…to treat patients efficaciously and as comfortably as possible via consideration of specific patient characteristics and anticipation of potential side effects. We meet people at a vulnerable point in their lives …it is part of our responsibility to show empathy and understanding.”

This statement foreshadowed my experience at the Stratton VA pain clinic. There is a stigma associated with persons on chronic pain therapy particularly those being treated with opioids. But at the pain clinic, complaints of pain are acknowledged as true and the goal is to restore patients to an acceptable level of functionality.  It is a great example of achieving that balance between humanistic and clinical care.

What I did not expect was how much I did not know! Even though this is my first APPE, I anticipated that after 5 years of nothing but drugs and disease states, I would be a quasi-expert! But being asked questions on the spot is so much more daunting that I had expected; I am so much more nervous than I anticipated. But from shadowing my preceptor as he interacts with other practitioners, I have realized that the profession requires the ability to respond to drug related queries, confidently and accurately, and often instantaneously.  We should be the drug information experts; having that knowledge off-hand is one of the ways that we can help to develop a trusting relationship between physicians, pharmacists, and an array of healthcare providers.  If my response is going to be, “let me look that up and get back to you” well, the physician could do that himself. In one of our discussions about how I could become a successful clinical pharmacist, I was advised that the key is to provide a unique vital service that cannot be imparted by other team members; any one on the team can look up the same resources that I can.  Of course one advantage we do have if research is necessary, is that a pharmacist’s interpretation of that data will likely be distinctive.

I am grateful that I started my APPE with this rotation because I am developing strong principles of practice that I will carry to my subsequent rotations. I feel like I am starting my final year with great momentum and my goal is to garner as much knowledge and advice as I can from the pain rotation.  At the end of the first week, I am hopeful about the contribution that I can provide to a patient care team as I am witnessing and participating in pharmacy practice at its best.  It has set the expectations for my own career very high.