by Peter Ambrose, Pharm.D. (Doctor of Pharmacy)
as told to Caroline Hatton
If you like helping people, you might love to be a pharmacist.
You may have been inside your neighborhood pharmacy, and seen people distribute medicines and give advice from behind a counter. Some of them are pharmacy technicians. One of them is the pharmacist in charge. Such a pharmacist, who works in the community, is called something very clever… a community pharmacist!
But did you know that some pharmacists work in hospitals?
They also distribute medicines. They advise not only sick people (patients), but also doctors and nurses. This is because pharmacists are experts about medicines: what they are, how they work, and how best to use them to help people by curing disease or making life better.
Hospital pharmacists do a large variety of tasks. What might be one of those tasks? How exactly would it get done? To find out, let’s follow one pharmacist. She joins a doctor and nurse at the bedside of a patient, a teen athlete in pain.
The nurse takes the athlete’s temperature. He has a high fever. His right leg is red and swollen.
The doctor has examined him, ordered a pain killer, reviewed lab tests results, and identified (diagnosed) the problem as
cellulitis (pronounced SELL-u-LIGHT-iss), an infection under the skin. It is caused by bacteria and can spread among athletes.
The boy’s infection is serious, so the doctor decides to treat it with a powerful medicine called an
aminoglycoside (pronounced uh-MEE-no-GLY-coe-side) antibiotic. Like most medicines, it has many effects, some wanted, some not. Giving the patient too much may cause him to go deaf or it may damage his kidneys, which must work properly for him to stay alive and healthy. Too little medicine may not keep the infection from endangering his life.
Someone must take responsibility for figuring out how much medicine the nurse should give the patient. The doctor turns to the pharmacist to ask her to make a plan.
The ball is now in the pharmacist’s court. She knows exactly what to do. First, find out how fast the patient’s body will get rid of the medicine—how well his kidneys are working to remove water, waste, and medicines from his body. A special blood test (serum creatinine concentration) can reveal this.
The pharmacist walks to the pharmacy office closest to this patient’s room. At the computer, she pulls up his personal information (chart) and orders the test. She asks the lab staff to call her as soon as the result is known. A lab team member will come take a blood sample from the patient and bring it back to the lab for testing.
After the pharmacist works on other things for a few hours, her pager beeps: the test result is ready! She reads it in the patient’s chart. She can see his age and weight.
Using a math formula in a computer program she wrote and saved before, she figures out how fast the medicine will flow out through the patient’s kidneys—today. Now the pharmacist can calculate how much medicine to give (the dose) to have, in the patient’s body, the maximum amount that will be safe.
She orders exactly how much the nurse must give and how often, for example “50 milligrams every 8 hours intravenously” (injected in a vein). This is not the same as giving twice as much, half as often, which would not be right for this patient.
The pharmacist also orders more lab tests, to measure the amount of medicine in the blood, at its highest (half an hour after the patient received it) and lowest (half an hour before the next dose). She asks the lab team to take the blood samples at specific times.
For days, ten or more if necessary, the pharmacist follows this boy’s treatment. She keeps adjusting the dose, based on blood levels, kidney function, the nurse’s reports, and the doctor’s lead. Her calculations help the treatment work better so the patient can go home several days earlier.
The pharmacist is a key member of the health team. So is the patient, following orders and maintaining a winning attitude.
This may sound like walking a tightrope, hand in hand with the patient. Team work makes it a thrill and a triumph, every step of the way. And this is only one of many things that pharmacists work on with others.
ABOUT PETER AMBROSE
Peter is a hospital pharmacist, a Doctor of Pharmacy, and a Professor of Clinical Pharmacy at the School of Pharmacy of the University of California at San Francisco. As an enthusiastic teacher, he’s shared his wisdom and experience with students as far as his hometown of Long Beach (California), nearby Los Angeles, and Tokyo. As a sports fan, he’s had adventures that not many pharmacists have experienced:
follow him behind the scenes at the Olympics.
LINKS
* Watch a
video about
hospital and health system pharmacists who LOVE their jobs.
* For more about
what is uniquely exciting about hospital pharmacists’ careers, how they spend their work time, and what they like best and least, read the first two pages of these
survey results.
*
About pharmacists
Hospital pharmacists do what Peter described and much more. They tend to find their work life varied, challenging, and satisfying. Community pharmacists spend most of their time helping patients, making a difference one person at a time. Pharmacists can also choose careers in industry or government, research or business, even sports. Pharmacists have among the highest starting salaries of college graduates in the U.S.
* For a
quick-and-easy overview of
pharmacist careers, click on "Listen to the
podcast..." at the
Sloan Career Cornerstone Center. It’s an introduction to the required schooling, a day-in-the-life of a pharmacist, salary info, where pharmacists work, and the fantastic job market in the years ahead.
* For another friendly
overview, visit
ScienceBuddies.org.
* Is pharmacy right for you? Get help finding the answer at the website, "
Pharmacy is Right for Me".
* Watch
videos of pharmacist Kate James:
- on
why to become a pharmacist (hint: Kate loves science and people)
- on
how much money pharmacists make
- on
how to become a pharmacist
- on the
pros and cons of a pharmacy career
* Read an
interview of a research pharmacist (why she chose her career, her workday, what she likes best and least about work, career goals, hobbies).
* Pharmacist was the
second-best-paid job for women in 2011.
Updated January 18, 2012
