Pharmacist - John D. Dingle VAMC (Department of Veterans Affairs Hospital of Detroit) - Detroit, Michigan
(2008-10)
Clinical evaluation of prescribed medication for patients for various disease states, dosage, directions for use; among these include schedule II narcotics prescribed from the pain clinic prescribers.
- Worked in the Pain Clinic with the Pain Clinic 1a providers (Anesthesiologist/Interventionalist and Nurse Practitioner)
- Responsible for reviewing medical charts for patients with chronic pain who were referred to the pain clinic by their primary care providers.
- Reviewed current and past medications and worked collaboratively with the Pain Clinic team to develop an appropriate pain management regimen for the patient.
- Responsible for the approval or denial of non-formulary medication prescribed by physicians or nurse practitioners which must meet certain criteria based on national VA formulary guidelines.
- Worked with the Pain Clinic Team. Evaluated pain management regimens for patients with chronic pain issues and discussed them with the Pain Clinic team to determine their final treatment plans.
- Certified as a Battlefield Acupuncturist (BFA) provider and educator for the treatment of patients with chronic pain.
- Currently treating an average of 15 veterans a week with BFA at the Detroit VA and about 4 veterans a week at the Macomb County Vet Center once a week.
- Worked in the Anticoagulation Clinic. Evaluated patients with hypercoagulable states and determine the appropriate anticoagulation therapy for them (using Coumadin, low molecular weight heparin, etc.) to help them maintain a therapeutic INR.
- Worked in Home Based Primary Care (HBPC) with nursing staff.
- Chart reviews (MTM) for patients enrolled in this program were completed each month (average of 60 charts per month). Reviewed medication regimen, appropriateness for the drug and disease state is evaluated, along with the dosage, directions for use, refills, drug/drug interactions, non-compliance, pertinent labs, etc.
- Traveled with HBPC nurses to home-bound veterans' homes for administration of COVID-19 vaccinations.
- Work in the Tobacco Treatment Clinic for nicotine dependent patients who wish to quit smoking. Review patients' profiles and initiate/prescribe various NRTs and other tobacco treatment pharmaceutical aids for the patients.
- Prescribe nicotine replacement therapy (NRT) for the veterans in the Tobacco Treatment Clinic.
- Gave a formal presentation to the physician and nursing staff of the Mental Health and Primary Care Departments about nicotine replacement therapy (NRT) and appropriate prescribing of them. Precept pharmacy students and residents for tobacco treatment.
- Prescriber for the three Tobacco Treatment Clinics. Participate in this clinic on an average of about three days a week that meet both virtually and in person.
- Member of the Naloxone Committee as of October, 2014.
- Lead pharmacist for OEND (Opioid Education and Naloxone Distribution) for patients diagnosed with OUD (Opioid Use Disorder) and/or SUD (stimulant use disorder).
- Veterans are contacted, counseled on Narcan (purpose for its use and its appropriate administration), and a Narcan kit is prescribed and dispensed to that patient. An average number of 40 veterans a week are contacted for OEND counseling.
Pharmacist - Rite Aid Pharmacy - Birmingham, Michigan
(2003-01 - 2008-10)
- Efficient and accurate evaluation, processing, and quality analysis of prescriptions.
- Ordering needed medications from the distribution center daily.
- Daily counseling of patients about their prescribed and/or over the counter medication.
- Weekly cycle counts of formulary medications in the pharmacy to help maintain stock accuracy.
- Accurate documentation of Schedule II controlled substances with monthly inventory counts.
Clinical Pharmacy Rotation - Emergency Department Medicine - Detroit Receiving Hospital - Detroit, Michigan
(2004-04 - 2004-04)
Witnessed the prompt and efficient triage of patients in the emergency room several times a day. Patients were treated for motor vehicle accidents, cerebrovascular accidents (strokes), drug overdose, etc.
- Gave an average of four presentations a week to Dr. Delgado and the pharmacy interns who I rotated with regarding the medications that were used to triage patients who I saw in the emergency room.
- Gave an informative presentation about rapid sequence intubation (RSI) and the various medications that are commonly used in the emergency room before the pharmacy staff.
- Attended daily case presentations each morning given by the emergency department physician residents regarding select patients that they triaged recently.
Clinical Pharmacy Rotation - Geriatric Medicine - Lutheran Memorial Hospital of Indiana - Fort Wayne, Indiana
(2004-03 - 2004-03)
Gained Knowledge about the effects that some medications may have on the physiology of the geriatric patient population. Experience of the proper medication dosage adjustments based on different pharmacokinetics and pharmacology of the geriatric patient were reinforced. Witnessed cardiac mitral valve replacement surgery on a geriatric patient.
- Counseled an average of four patients a day on Coumadin and its use, including its risks and dietary restrictions for patients who were newly prescribed to.
Clinical Pharmacy Rotation - Substance Abuse - University Hospital Family Practice - Cleveland, Ohio
(2004-02 - 2004-02)
Gained knowledge about the many kinds of substances, both prescription and non-prescription drugs, that are commonly abused by patients.
- Worked with Dr. William Fiegenschuh, Substance Abuse Fellow, at the Harbor Lite Detoxification Center on an average of four times a week.
- Witnessed how Dr. Fiegenschuh counseled several patients with substance abuse problems and the plans that he made to help detoxify them.
- Worked with Dr. Sybil Marsh at University Hospital and witnessed how Dr. Marsh counseled her substance abuse patients and the plans that were made to help with their recovery.
- Gave an average of three presentations a week before Dr. Hulisz and the pharmacy interns who I rotated with about the patients that I encountered and the medications that were used to assist them.
Clinical Pharmacy Rotation - Ambulatory Care - Sinai/Grace Hospital - Detroit, Michigan
(2004-01 - 2004-01)
- Counseled outpatients about their medicine, including cardiovascular medication, antihypertensives, and especially Coumadin.
- Gave an informal presentation about cholesterol medication to a group of outpatients.
- A one-on-one counseling session with these patients took place afterwards to educate them about the side effects, adverse drug reactions, and dietary restrictions regarding their prescribed drugs.
- Gave an informative presentation to the staff pharmacists about various types of antiarrhythmic medications used for the outpatient with cardiac disease.
Clinical Pharmacy Rotation - General Medicine - John D. Dingle VAMC - Detroit, Michigan
(2003-11 - 2003-11)
Worked with the anticoagulation pharmacy specialist and gained much knowledge about the various types of anticoagulants used in both hospital and especially on the outpatient basis.
- Witnessed how Coumadin doses were altered based on the patients' INR levels and what types of lifestyle modifications (especially dietary modifications) that the anticoagulation specialist recommended to help stabilize these levels.
- Attended the P and T Committee meetings with Mr. Maher and witnessed what types of changes were made in the hospital's formulary.
- Helped to organize a patient satisfaction survey with the pharmacist that worked in the dialysis unit.
Clinical Pharmacy Rotation - Community Pharmacy - Harry's Pharmacy - Carey, Ohio
(2003-10 - 2003-10)
Dictated prescriptions from doctors' offices several times a day. Gained much experience with patient counseling (an average of forty patients a day were counseled by me).
- The Indian Health System (HIS) method of patient counseling was used to counsel patients about their medication.
- Reviewed patients' medication profiles on computer daily with my preceptor to evaluate patients' progress with their disease state(s).
- Appropriateness of each prescribed medication, drug strength, frequency, and duration of therapy were all assessed.
- Compounded topical cream and ointment medication for patients.
- Monitored for and documented all prescription drug errors from doctors' offices on 'Rph Care Claim Forms.'
Clinical Pharmacy Rotation - Cardiology - Wyandot Memorial Hospital - Upper Sandusky, Ohio
(2003-09 - 2003-09)
Gained experience on how to interpret an electrocardiogram (EKG) graph.
- Rounded with the cardiologist on several occasions and witnessed the kinds of modifications, if any, were made to the cardiovascular regimens of the patients.
- Reviewed medical charts with my preceptor for patients with heart disease and evaluated medications they were using for appropriateness of the disease state(s), dosage, etc.
- Witnessed cardiac catheterizations on two occasions.
- Counseled an average number of six patients a day with various forms of heart disease about their medications.
- Provided a review about the different forms of cardiac disease states and the kinds of medications that are commonly used for their treatment to the pharmacy and nursing staff.
- Witnessed several Adenoscan stress tests during this rotation that helped to determine the severity of cardiac disease in the patients.
Clinical Pharmacy Rotation - Hospital Pharmacy - Wyandot Memorial Hospital - Upper Sandusky, Ohio
(2003-08 - 2003-08)
- Worked with the clinical pharmacist on a daily basis reviewing patients' medical charts.
- Witnessed the successful surgical excision of cancer on a patient.
- Assisted the pharmacy department director in developing monthly utilization reports for the dialysis department.
- Attended the P&T Committee meeting and participated in the discussion.
- Nursing home residents' disease states, the medication that they were currently taking, and their progress were all discussed.
Clinical Pharmacy Rotation - Pediatrics/Neonatology - Sinai/Grace Hospital - Detroit, Michigan
(2003-07 - 2003-07)
Worked with the neonatologist and nurse practitioners to determine the treatment and management of common disease states in neonates.
- Prepared sterile intravenous medications for neonates.
- Rounded daily with the pediatricians and Dr. Macdonald and reviewed patients' charts to assess their progress.
- Reviewed appropriateness of prescribed medications and their benefits and/or adverse drug reaction profiles for each patient.
- Assisted in ordering total parenteral nutrition (TPN) medication daily and checked the calculations for the doses of the various electrolytes, protein, and lipid content of each preparation.
- Provided a review (twice a week) to the pharmacy staff about the patients that I helped to work up and the medication that was involved in their treatment.
- Gave a journal club presentation to the pharmacy staff.
Pharmacy Intern - Sinai/Grace Hospital - Detroit, Michigan
(1996-09 - 2003-08)
- Prompt filling and delivery of Pyxis machines with the correct drugs.
- Compounding intravenous medication in a class 100 IV room using aseptic technique.
- Rounded with the clinical pharmacists during vacations from school for my training experiences.
- Patients' medical charts were reviewed and training took place in the dialysis, critical care, telemetry, rehabilitation, and step-down units.
