You never know what they've been through...

Recently, my fellow interns and I went to a state-of-the-art simulation center on the Mayo medical campus. The facility was created to help doctors, nurses, and pharmacists practice real life situations in a controlled environment. There are rooms where surgeons can practice surgeries, nurses can practice suturing, and rooms like the one we used where individuals can work on patient counseling.

The exercise we participated in involved speaking with a “patient” who is actually an actor trained to portray certain personality characteristics. This exercise was similar to those done in many of our PCare courses and was a great way for me to improve on the patient counseling skills I have gained through the extensive amount of counseling I’ve done this summer, in addition to what I’ve already learned in school.

The prescriptions I had to counsel on during the simulation were ciprofloxacin and albuterol (thankfully, not too tough). My patient wasn’t as difficult as I expected. She was in a hurry because she was going on a cruise so I had to make sure to relay the important points of her medications in a timely manner to ensure both of us were satisfied with the amount of information shared and the time it took for this interaction to occur.

Although this was a simulation, I can attest to the fact that this is just one of many types of patients that come into the pharmacy every day. In the 8 weeks I’ve spent as an intern this summer, I’ve dealt with yelling patients, crying patients, and MANY who are in a hurry. Realizing that they are probably going through a difficult time and not to take anything personally has helped me deal with the most difficult of patients, although, it’s not all bad. In contrast to the difficult patients, I’ve had individuals who were extremely grateful that I took the time to explain their medications, potential interactions, and possible side effects. Many patients are unaware of the side effects with their medications and have developed symptoms that are actually due to a new medication. They are confused as to why they are experiencing these new symptoms and have a feeling of uneasiness surrounding this. Now when I counsel, I try to point out at least three side effects with each medication. This may seem like a lot but I feel like it’s better for them to know about it and then not get it versus not knowing and then wondering why they’re experiencing sun sensitivity, increased effects of caffeine, or tendonitis (all of which are effects associated with ciprofloxacin).

Working in a pharmacy with no medications...

This summer I am interning at the Mayo Clinic in Rochester, MN. I am an outpatient pharmacy intern and will be rotating through six different outpatient pharmacies during the duration of my program. As a Minnesota native, I have grown up hearing about the Mayo Clinic practically every day but for some of you who aren’t as familiar with this hospital system, here are a few basic facts. The Mayo Clinic is the largest integrated medical center in the world and serves more than 350,000 patients per year. More specifically, the outpatient pharmacies see about 1,000 patients per day and process approximately 4,000 prescriptions daily.

Because of the huge volume of patients seen at the various outpatient pharmacies, the Mayo Clinic utilizes a separate medication filling center, allowing for two of its six outpatient pharmacies to focus their efforts on patient counseling and worry less about the actual counting of prescriptions because there isn’t actually any filling of medications at these two locations.

Let me explain a little bit more about how this process works. Basically, a patient brings a new or refill prescription to our pharmacy where a technician enters it into the computer system. While the prescription is being entered, the pharmacist counsels the patient on their medications and answers any questions they may have. All of the pharmacists I have worked with so far utilize the three question approach we learned in PCare (What did the doctor tell you this medication was for? How did the doctor tell you to take this medication? What side effects did the doctor tell you to expect with this medication?). After the prescription is entered into the computer, it is scanned, verified by a pharmacist, and sent off to the filling center. There, the prescription is filled, checked by a pharmacist, and sent back to our pharmacy through a tube system where the patient can pick it up roughly 30 minutes after dropping it off.

I was very surprised when I first learned that they did not have any medications in the pharmacy but so far the process seems to run very smoothly. It’s great to see the pharmacists spending the majority of their time counseling patients on their medications and less time counting pills and checking orders. It was also very encouraging to see some of the exact same patient counseling techniques we learned in PCare put into practice in the real world and how effective they can be when communicating with patients. Looks like we really will use some of the things we learn in school!