"You probably don't know what you don't know."

One of the pharmacists expressed this quote to my fellow interns and I at orientation, and after my first week in in-patient pharmacy I have a feeling this will be the theme of my summer!

Hello Readers! My name is Kari Horn and I am a P2 at the University of Michigan College of Pharmacy. My internship this summer is right here in Ann Arbor at the University of Michigan Hospital in the In-Patient Pharmacy. Specifically, I will be working in the C.S. Mott Children's Hospital. I hope to give readers a unique insight into the world of hospital pharmacy from the perspective of a pharmacy student.

After a very relaxing week off after final exams, we officially started our internship Monday May 9. The time off was nice, but I actually found myself getting bored with the abundant amount of free time I had, so I was definitely excited to get back to Ann Arbor and start my new position.

Our group of new interns started on Monday with a Michigan Traditions and Values (MTV) Orientation for all new Health Systems employees. It was nice to interact with employees in other areas of the UM Health System, and we learned a lot about the mission, values, and policies to abide by at the hospital. One idea that was stressed in this orientation is doing our best to assist patients and their families. If we see someone who looks lost or confused, we should go out of our way to help them find where they are going. This becomes critical in a hospital system the size of Michigans. Our group of interns determined that in the first few days we might be the ones needing help navigating!

Tuesday and Wednesday, the group of interns went through department-specific orientation with pharmacy services. These days were filled with lots of introductions and information. One thing that our group was very excited about was being about to wear scrubs. I've attached a picture of me and a fellow intern/P2 Erin Dukarski in our new scrubs and pharmacist intern badges.

Thursday and Friday, our group of new interns split up to train in our respective areas. Mine was being the "runner" in Mott Children's Hospital. Mott is connected to University Hospital (as is the Cardiovascular Center and the Cancer Center), so it was easy to find and get acclimated to. The day shift starts promptly at 7am with many tasks to get done right away. The runner first checks the messages. Messages are sent from the different floors to the pharmacy to order IV's and other medications. The runner checks these and relays them to the rest of the pharmacy to fill the order and get it out to the patient. Then, we quickly go on a "run". This happens at the beginning of every hour. "Runs" consist of taking all of the medications to the floors (NICU, 7, 6, 5) and getting them to the proper place. Depending on the floor, the medications might go to different places. One thing I am still in awe of are the giant Omnicells in each of the units. Omnicells are Medication Dispensing Systems that hold a variety of medications. Controlled medications are always kept in Omnicells, and depending on the floor other medications are placed in here too. The Omnicells require a password to unlock and keep a very careful inventory of medications, so there are no mix ups or lost medications. This is critical to reduce medication errors and lost inventory. If medications are not delivered to Omnicells, they might go to patient bins in the medication rooms on the floors, or in the refridgerator if needed.

With the help of my trainer, I quickly developed a system for each run to make the process more efficient. One thing I really enjoy is because we do a run every hour, we get to see the familiar faces of the other healthcare professionals and patients and families.

In between runs, we fill prescriptions that come into the pharmacy. Being a children's hospital, Mott has a lot of unique dosing and dosage forms. The dosage of a diuretic will be infinitely smaller for a neonate than the dosage for a regular 150 pound adult. Many of the doses are also drawn up from oral bulk solutions, so I got to put my compounding skills to the test and make some solutions! I also found out that taste is a factor, so flavoring is also routinely added to oral solutions.

One thing that is very apparent is you are always busy when working in the hospital pharmacy. There was never a time when I had nothing to do! I really enjoy the fast-paced atmosphere of the pharmacy. Before I knew it, my shift was over and it was time to go home. I also really enjoy the fellow technicians and pharmacists working in Mott, which makes coming to work fun.

I learned so much from my first few days of training, and I am excited to continue on Monday. Stay tuned for more updates!