Ashley Walus , BScPharm, ACPR
One of my favourite quotations about change is a statement by Harold Wilson, former prime minister of the United Kingdom: “He who rejects change is the architect of decay.” Change is frightening and uncomfortable, but it is a necessity of life. Without change, we experience very little; we don’t learn and we don’t grow.
As fourth-year pharmacy students, my classmates and I were thrown into non-negotiable change—we were graduating. I knew I wanted to work in the hospital setting, but I didn’t know where I wanted to practise. Thus, I opted to do a residency with the Winnipeg Regional Health Authority Pharmacy Program. I assumed that the program would be easy. It would involve work, of course, but I had just spent 4 years in an intense university program, so I was sure I could handle it. School had equipped me with the knowledge and skills a pharmacist needs to practise. After all, I passed the PEBCs,* didn’t I?
Within 2 weeks of starting my residency, however, I felt that university had let me down. Methods for time management, research, and patient care that I had successfully relied on in school failed me miserably in the “real world”. I needed to develop my practical skills and to learn how to cope with the emotional side of patient care:
I did not use an appropriate systematic approach [to the drug info question] and found myself buried in information.—June monthly residency reflection
I was overwhelmed not only by the challenge of caring for a patient with [leukemia] but also by the fact that he was only 2 years older than I am … I did not have the right to be his care provider.—July monthly reflection
As the year went on, I began to change. It wasn’t long before I was referring to myself as a “pharmacist” rather than a “resident”, and I found that I was contributing more to bedside rounds. Yet it was still challenging to change patient care teams each month, constantly having to establish credibility in a short period of time. On occasion, I also witnessed disregard for patients’ privacy and emotions, as well as dysfunctional teams whose members fought more often than they worked together. These experiences strengthened my resolve to build my practice the way I wanted it to be. They also reminded me that my patients are people and my interactions with them are more than just tasks to be completed before the end of the day.
My exposure to numerous preceptors was influential on how I viewed not only my personal practice but also pharmacy practice as a whole. They prepared me to be a leader, regardless of my work environment or position:
Leadership … is being confident in your abilities, knowledge and skills to shape your practice and the practice of the profession. It is about … being proactive in your approach to patient care … [and] setting the practice expectations that will have the best impact on patients.—April monthly reflection
As a whole, a residency program is best described by the cliché of the roller coaster ride: you’re thrown forward into new practice areas at breakneck speeds, twisted and pulled in every direction with the multiple projects, discussions, presentations, and forms that must be completed, on top of patient care. You’re flipped upside down when you realize that processes that worked for you as a student aren’t good enough in real-life practice, and life flashes before your eyes while you have very little sense of what is going on in the world around you. Yet, like every good amusement park ride, no matter how terrifying it is, the residency year always ends too quickly and you realize after it’s over that you just want to hop back on. Was my year challenging? Yes. But was it worth it? More than words can say.
I’ve now been in my workplace for 7 months and have seen the positive effect that my residency training has had on me. Naturally, I still experienced the culture shock of working in a new area, and the learning curve has been steep. But I knew my residency training had been worth it when, on the second day of my clinical training, I felt completely at ease on the ward and on rounds despite being new to the service area.
Would I have had such an easy transition without a residency? I don’t think so. It would have taken me much longer to find my professional identity without the exposure I had during the residency year. I’m very grateful for the residency experience and for all of the preceptors who gave up their time to coach and guide me. All I can say now is, “Change: Bring it on!”
* PEBCs = examinations of the Pharmacy Examining Board of Canada. ( Return to Text )
Competing interests: Ashley Walus is the Manitoba representative on the CSHP 2015 Branch Champions subcommittee.
Canadian Journal of Hospital Pharmacy , VOLUME 66 , NUMBER 2 , March-April 2013