Rank List Certified

Last Friday, I had to "certify" my rank list. It's official, I'm going for a residency. Hopefully March 17 will bring good news and I will start making plans to move to Richmond or Columbia. If not, let the job search begin.

This month I'm having a "rural hospital" experience. The hospital I am at has a Critical Access designation meaning not only do they function as a pit stop on the road to bigger hospitals, but they are an integral stop in the healthcare chain that saves a lot of people a longer drive to get care. And there's the money aspect, they also get more reimbursement from CMS (Center for Medicare and Medicaid Services) to help them keep their doors open.

Angel is a small, 25 bed hospital. Yes, you read correctly, 25 beds (babies and long-term OT/PT patients don't count apparently). For reference, the ICU I worked in in January was 14 beds and my inpatient service in November was 17 patients max. This morning, our census was 13, including the babies! Its an adjustment.

I go on rounds in the morning with the Hospitalist. I've met two of them so far and they are very different in teaching styles and patient care, and hopefully I will learn something from them as well as gain confidence in making recommendations and asking for changes. I also monitor 5 - 6 reports each day. I make sure antibiotics are chosen appropriately, I check lab values related to blood thiners and kidney function, I update people's allergies, and if we have someone on IV nutrition I watch those lab values as well. Overall, I stay fairly busy all day long.

I'm finally feeling some moments of coming in to my own. I can recognize certian doses or routes of administration that should be changed with out having to look them up. I can ask a physician to change a dose or order a different medication without being scared of what they will say and also not take it personally if they choose not to follow my recommendation. Yep, in a couple of months I'm going to be a pharmacist. I know I won't feel comfortable with that for many months after getting licensed, but I'm starting to realize that one day I will be comfortable with it, and that's reassuring.