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Medical Forum / General / Pharmacy / May 2006

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A pharmacy student's boyfriend's perspective

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rad_google@sustik.com - 04 May 2006 21:36 GMT
My gf is in the last year of pharmacy school, she is doing the
'rotations' (field practice in hospitals, clinics, retail) just prior
to graduation.

One thing that horrifies me about her experience is the hostile
work/study environment she tells about.  For a while I thought
(probably with false preconceptions) that it is just the unavoidable
bitchyness among a lot of women working together and/or being under
immense pressure.  However, more and more I hear and experience of this
I start wondering and have some questions of my own.  I also hope
someone could give me advice on whether this is the norm and how to
deal with the situation.

It is hard to listen >10 minutes of sobbing/crying every day after she
gets home after 6pm.  She starts before 7am, yes that is more than 10
hours a day on a regular basis.  Sometimes she had to be in for 12
hours.  (Not all rotations were this bad of course.)  Last two days she
could not have lunch.  As I understand rules do not allow more than 50
hours a week, but the preceptors (the pharmacists under who the
students train) do not seem to be concerned about this.  Probably,
because they are overworked too?  I am starting to worry: is pharmacy
really a profession one wants to be in at all?  I hoped that we could
both lead a balanced life with other than just work in it.  (I am in
engineering and work/life balance is an important value for our
company, I never heard the pharse 'work/life balance' come up in
pharmacy yet.)

After these long hours she has to do projects and prepare for
presentations at home along with studying the patient profiles and
studying for exams.  I do not know how she handles it.

I thought maybe she is slow in what she is doing or she does not do it
the right way.  I guess that is possible.  Or maybe she is paying too
much attention to details when instead corners should be cut (I heard
some stories about others that may point to this.)  But I suspect that
the preceptors are too busy themselves to show how certain things need
to be done.

>From the 8 or 9 rotations she was happy or at least ok in 2-3 of them.
In the other cases the environment appeared to be very hostile.  What
most bothered me was the way she described the interactions with the
preceptors. A typical conversation goes like this:

student: - Why was the medication changed from A to B for this
patient?/Why was the dosage   adjusted? etc.
preceptor: - Well, what do YOU think this was done for?/Did you not
learn this in school?  Did you look at the patient's
chart/history/sideeffects etc?  Go look this up and tell us why.
student: - <Gives some answer on the drug interactions in question.>
preceptor: - Are you sure?  Go look it up on the computer.

Mind you this appears to be happening EVERY time with some preceptors.
A constant examination if you ask me.  I was under the impression that
students should be encouraged to ask questions; the above is a training
so that you will not.  Furthermore, above I was kind of mild about it,
I am told that some preceptors make a point of making you constantly
feel inadequate or worse: dirt.

She was given an assignment (~2 weeks long) to write a paper on shocks
(cardiac, hypovolemic(?), septic; boy I remembered!!!).  She needs to
cite every sentence and use only recent articles as references, no
textbooks or anything before 2002.  Appears to be a broad topic and
having unreasonable restrictions for the time allotted.  (I have
published 1 journal paper and 1 conference paper.)

My question is: is the above the norm?  You just have to clench your
teeth and get through it?
Maybe she is not cut out to be a pharmacist (kind of late to find out)?
What can I do to help (apart from cooking and listening)?
Dr. Wayne Simon - 05 May 2006 05:14 GMT
> My gf is in the last year of pharmacy school, she is doing the
> 'rotations' (field practice in hospitals, clinics, retail) just prior
[quoted text clipped - 65 lines]
> Maybe she is not cut out to be a pharmacist (kind of late to find out)?
> What can I do to help (apart from cooking and listening)?

The health care field is very demanding.  There is no room for error.  It
sounds like she will be graduating soon.   At least in Pharmacy there are
many options so I hope she chooses one where she can be happy in her career,
and that way when she comes home and you see each other after a long day,
you each can exchange the pleasantries expected after having a rewarding
day.
John Cassara - 05 May 2006 11:38 GMT
>> My gf is in the last year of pharmacy school, she is doing the
>> 'rotations' (field practice in hospitals, clinics, retail) just prior
[quoted text clipped - 72 lines]
> long day, you each can exchange the pleasantries expected after having a
> rewarding day.

Don't bet on it! She'll probably end up with CVS or some other box store
where her supervisor is a 13yo former box boy who will torment her and her
colleges because they make 3 times as much money and can get a way with it.
Oh and don't bother complaining, the management chain is made up of former
box boys and they all belong to the same good old boys club! She's doomed
before she starts! Now is the time for some hard decision making, hospital,
long term care, private retail, nuclear, supermarket or box.
rad_google@sustik.com - 23 May 2006 09:53 GMT
She successfully graduated :-} and will begin a residency in a
hospital/clinic in the fall!
rad_google@sustik.com - 23 May 2006 09:51 GMT
> The health care field is very demanding.  There is no room for error.

Every human makes errors.

http://www.fda.gov/cder/drug/MedErrors/patientsafety.htm

In my experience, there is a natural tendency for human's not willing
to admit when they err.  It is hard for me to admit making an error,
but when I have done that, it always improved the outcome in the end.
In fact it seems that is the first crucial step in avoiding similar
errors in the future.

Advocating "no error" over "minimize error (as state of the art and
circumstances allow) and prepare for and mitigate errors (when they
occur)" is the kind of pressure that makes it even harder for the
people involved to do the right thing.

IMHO overworking and increasing the pressure on those working in the
medical field is not the way to optimize their peformance.
Bill - 05 May 2006 17:19 GMT
The book "The Making of a Woman Surgeon" by Elizabeth Morgan M.D. (out of
print) is an excellent book on what people go through in medical school.

Medical school is brutal. At one point Dr. Morgan worked in an emergency
room three days straight without sleep as I recall.

It is not fair. They are unreasonable. But perhaps this is all a "vetting"
process to weed out those who will not be able to hack it.

I would suggest not causing any trouble for your gf while she is going
through this. Just say "yes dear" and be as supportive as possible. When I
am under a lot of stress, peace, quiet, an absence of problems, and solitude
are all gifts from heaven!

Medical doctors are under a lot of stress and some of them treat co-workers
like dirt. Some yell at people and can be quite nasty. But other "big bucks"
careers are like this as well. So half a dozen of one and six of another.

You may find that book at your library or you can get used and out of print
books here...
http://used.addall.com

<rad_google@sustik.com> wrote in message
> My gf is in the last year of pharmacy school, she is doing the
> 'rotations' (field practice in hospitals, clinics, retail) just prior
[quoted text clipped - 65 lines]
> Maybe she is not cut out to be a pharmacist (kind of late to find out)?
> What can I do to help (apart from cooking and listening)?
P T - 06 May 2006 14:29 GMT
The standard advice for you is either to be empathetic: hold her hand
and say "you poor baby;" or, be directive and try to ameliorate her
suffering.  Since she has chosen her path, you can't do much along those
lines except to try to help her rationalize her pain: "this will pass,
do the best you can, your preceptor is a bitch."

Interestingly, in a sense, you mirror  exactly what you describe in your
gf. You say - - - her preceptors are very unpleasant to be with and she
is not enjoying the experience - - - your gf is very unpleasant to be
with and you are not enjoying the experience.

Please advise, whether you desire a type 1 approach (sympathy) or type 2
(intellectualizing.)
John Cassara - 08 May 2006 12:16 GMT
> The standard advice for you is either to be empathetic: hold her hand
> and say "you poor baby;" or, be directive and try to ameliorate her
[quoted text clipped - 9 lines]
> Please advise, whether you desire a type 1 approach (sympathy) or type 2
> (intellectualizing.)

You forgot option 3.

Remove yourself from the relationship and no longer deal with the problem,
her and her work.
P T - 13 May 2006 16:28 GMT
John C  wrote

>You forgot option 3.
>Remove yourself from the relationship
>and no longer deal with the problem,
>her and her work.

I went to see a psychiatrist.
I told him, "Doc, you gotta help me! My uncle thinks he's a chicken."
He said, "That's no problem, bring him in, we can cure that."
I said, "Doc, you don't understand. We need the eggs."

:-\
rad_google@sustik.com - 23 May 2006 10:09 GMT
She did it!  She graduated and will start a residency ijn the fall.

>Interestingly, in a sense, you mirror  exactly what you describe in your
>gf. You say - - - her preceptors are very unpleasant to be with and she
>is not enjoying the experience - - - your gf is very unpleasant to be
>with and you are not enjoying the experience.

I would not compare her suffering to mine though.  I managed to do
reading for pleasure and keeping up with exercise (while meeting my
obligations and cooking, shoping etc. for her).
rad_google@sustik.com - 23 May 2006 10:05 GMT
I can see that some "vetting out" is needed.  It may be indeed
necessary to stand ground for > 24 hours in emergency situations (I am
thing disasters like Katrina).

However I am troubled by the overworking of the people in medical
professions.  Do you want your doctor evaluate/diagnose/treat etc. you
in his 11th work hour that day?

My girlfriend succesfully graduated.  She became visibly happier and
prettier with every day after the ordeal of the last rotation was over.
She is really bluming!  She will do a residency in a hospital/clinic,
I hope that she will do her best without burning out.

My advice and plea to pharmacy students:  Try to bring

WORK, LIFE BALANCE

to your profession.  As a start: talk about it amongst yourselves, talk
about it on social meetings, talk about it in the classroom, talk about
it in research papers, one day it may make it into the curriculum...
 
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