November's almost over

My November rotation that is.

This month has been fast paced, challenging, and a learning experience in more ways than I thought it would be. I know I've learned things, I've certainly spent enough time every night looking up things I didn't know that I must have learned something, but if I had to list them, I couldn't.

Let's see, I'll try:
Zosyn covers Psuedomonas
Cefepime covers practically all gram (-) bacteria
Doctors think about and/or find cancer way more than ever I thought about
Communication issues can kill people
Despite your advice, the doctor's going to dose the drugs however they want to

Anywho, although I can't remember the things I've learned about medicine this month, I think I've learned more about myself. In the two mornings out of this month that I've gone on walking rounds, I have confirmed that I should be a pharmacist and not a doctor. At least not a doctor in a hospital. And maybe not even a pharmacist in a hosptial.

Our Attending physician this week was not very pharmacy friendly. Despite recommendations that "Hey, this guy's kidneys aren't working really well, can we decrease the dose of this antibiotic so it doesn't kill his kidneys, please?" or "This little old 92 year old woman got a dose of digoxin that can get toxic really fast, can we please not load her up on this heart rhythm drug that can increase the toxcity?" Nope, just do it, do it the way I want it or the way consulting physicians want it. They know better. (P.S. the consulting physicians went back and forth on the dosing of the antibiotic based on his kidney function; and the lady's digoxin level got more toxic and her kidney function got worse the next day)

I guess my biggest issue with this rotation is I just don't know how what I've done for 3 weeks really translates into a job. The morning stuff, reviewing the patients and then rounds, makes sense, but our afternoons have been time for projects or topic discussions, that I don't know what a "real" pharmacist would do for that time. I know I learned stuff and would continue to, I know sometimes we might make a difference for the patients, but overall, I don't think this is the job in pharmacy I want. Only 1.5 rotation days left, then home for Thanksgiving and Christmas :)