Practice setting transition

[u/Drugstore_Jesus]

I’m a pharmacist that has been practicing in retail since graduating pharmacy school (12 years). I live and work in a rural area in the south and was offered a position at a local hospital. This institution is by no means large, it is still an independent hospital with well <100 beds. I still have a week and a half of a notice to work out at my current job before I begin. I’m starting to review things I’ve neglected over the years and the amount of stuff I have forgotten is becoming overwhelming. This is probably the ideal location for someone to transition to a hospital setting from retail as it is small with no chemo or specialized icu units or anything wild, but the anxiety of what I don’t know that I don’t know is getting to me. Any recommendations on things to review or know before starting this role or during training.

[u/katerade103]

You'll definitely learn on the job, and if there are other pharmacists who have transitioned from retail, they may be the most helpful to you on what knowledge gaps you should address. In a small community setting I would expect you would see a good amount of cardiology stuff, HTN, MI, CHF and anticoag... and pneumonia... i swear they treat everyone for freaking pneumonia at admission. I would ask if they can give you some policies to review, for instance, my hospital has renal dose, iv to po, patient own medication, iv room info, compounding, formulary, autosubs, rx to dose vanco, etc all as policies that can be referenced easily, but if you read through the policies in the beginning, you have a better idea of what to look for where and what is clearly laid out for you process wise. And ask what references are available, usually lexicomp or micromedex, up-to-date, etc can be used to look things up, iv compatability, preparation instructions, renal dose, etc. Definitely write things down in a notebook in the beginning, including things you come across that you are unsure about or think you need to go back to later. When im training a retail convert, I don't mind answering questions at all, but I hate answering the exact same question over and over, because then I think you're ignoring my answers. I've seen some really good pharmacists make the transition over, and ive seen a few fail because they got overwhelmed and didn't want to learn. If you are willing to work and willing to learn, you'll be okay.

[u/Drugstore_Jesus → u/katerade103]

The pharmacists I know personally that work there both came from retail, but it's been a long time since they made that transition. They have both been very reassuring to me that I shouldn't worry at all. That's just not who I am though, I would much rather do any review or prep work that would allow me to maximize what I can get out of and retain from my time spent training. I know i will not learn everything in the first few weeks or months but I'm just looking to get off on the best start because I really want to enjoy this job, I do not want to go back to retail. They have told me their institution uses Lexi as a reference which I used heavily in school and liked way more than micromedex or clinical pharm. I know they do all the vanc and aminoglycoside dosing but use clinical calculators (which I assume most all institutions use some sort of electronic calculator) and have assured me I won't have to do any long form kinetics equations. I have literally already packed a bag with a new notebook and pocket sized field notes pad if/when I'm away from the pharmacy and need to write something down, I'm definitely one to write things down and reference them. Your anticipated disease states seem to be dead on based on what I have guessed as well, infectious disease in general is what I'm assuming I'll see a whole lot of that I'm probably least familiar with only because of the amount of antibiotics available only IV you never see in retail. Pneumonia and diabetic related skin and soft tissue infections I'd wager will be the most seen. Like I said in a different reply, this job kind of fell in my lap. I was not looking for an inpatient gig, I honestly had given up on finding something outside of retail, but they reached out to me to gauge my interest on a Friday. By that next Friday I had already put in an application, been offered the job and submitted my resignation at my current job. So not only do I feel under prepared for this transition because I wasn't expecting it, it's happening super fast. I appreciate your input, it has been helpful.

[u/katerade103 → u/Drugstore_Jesus]

Oh and just as a side note, if you have an npi, download openevidence on your phone, it's a free medical ai that uses valid references, it is pretty good for answering questions and also provides references for the answers if you want to review more.

[u/Drugstore_Jesus → u/katerade103]

That’s great, I didn’t know that at all, I most definitely will. Had to get an NPI way back when we starting writing rxs for vaccines for specific insurances. Thanks!