My name is Phoenix Riley, and I am a dual degree pharmacy and clinical research student at Campbell University. May 2021 was the start of my first APPE rotation as a P4 student. I completed my Advanced Hospital rotation at Duke University Hospital in pediatrics with Dr. Tara Bell, assistant professor of Pharmacy Practice at Campbell. Arriving on site the first day consisted of an APPE orientation that involved getting our parking passes and a detailed tour of the campus. As soon as orientation was finished, we jumped right into working up patients and rounding with the medical team, which consisted of a medical attendee, medical residents and students, and a nurse.
The preceptor allowed us to quickly observe how she worked up patients before rounds. Throughout rounds we were allowed to ask questions as she discussed and made interventions with the medical team. She also asked us pertinent questions as the discussions were being held to ensure we were continuously learning throughout our first day of rounds. From then on, we knew what Dr. Bell expected from us each day before rounds, and we started our next day at 6:15 a.m. to efficiently prepare so we were able to discuss patients with her at 8:15 a.m. before 9 a.m. rounds.
The sole reason I pursued a pharmacy career was not only to help my patients, but to be a part of the major innovations in the medical field and medication therapy.
Each morning Jasmine Roberts, a fellow P4, and I would each have about 10 patients to work up before discussing the patients with our preceptor. Some days when our medical team was on call we had a longer list of patients so we had to plan accordingly. The process of working up a patient varies based on preceptor. Overall, we focused on prioritizing the patient’s problems and assessing associated lab values. Discussing our patient recommendations during rounds was an opportunity for us to learn unique clinical pearls through not only the lens of a pharmacist but of a physician, as well. Throughout the rotation, there were projects, case presentations, and topic discussions where we were able to further discuss these clinical pearls as a group in more of a learning environment where questions were encouraged to ensure we understood the reason why we made certain decisions.
By the end of rotation, Jasmine and I were able to attend rounds independently to make our recommendations after discussing them with Dr. Bell. We were also allowed to do our own medication reconciliations with cystic fibrosis (CF) patients in the CF outpatient clinic at Duke with observation. The CF clinic was an opportunity for us to experience outpatient clinic medication counseling which we do not get as much in the inpatient setting. I also got the opportunity to participate in rounds with the neonatal ICU and hematology/oncology medical teams based on my personal interest.
The most important thing I learned in terms of making the most out of my APPE rotation was to set goals for myself at the beginning of the rotation and throughout the rotation based on the preceptor’s midpoint feedback. Setting these goals earlier allowed me to focus on my weaknesses within the clinical field as well as polish my strengths. This first rotation proved to me that even after three long years of studying, that my passion for pharmacy still lies within me. The sole reason I pursued a pharmacy career was not only to help my patients, but to be a part of the major innovations in the medical field and medication therapy. Through this rotation, I got to see where pharmacists stand in making these changes and continuing the growth within medicine through interprofessional opportunities. I am excited to further develop my passion, knowledge, and skills as I begin my next rotation!