In this article a current pharmacy student discusses how the coronavirus pandemic has impacted her life and professional outlook.
Authored by: Katy Muilenburg, Pharm.D. Candidate 2021
Last updated: 20 April 2020
SARS-CoV-2 is a never-before-seen, worldwide pandemic that has brought about complete remodeling of the lives of people all around the globe. Many working professionals have lost their jobs due to layoffs and business closings while others deemed “essential” effectively put their lives on the line every day.
There have been many articles, posts, tweets, etc. about the various experiences individuals have had throughout this situation and I would like to add to those narratives with my own perspective – the pharmacy student perspective. Below are five considerations from the life of a third-year pharmacy student during this ever-changing state of affairs.
1. Adjusting to virtual learning
The shift to entirely virtual learning has been a challenge for many. There are a variety of learners within our pharmacy curriculum. This transition has been the hardest for those who are traditional learners and prefer the classroom setting. These types of learners often struggle with online courses and self-teaching methods already. Now, this is the sole method available to them. On the other hand, some learners, such as myself, already use lecture recordings and other virtual methods as their principal learning tools. For me, the transition has not been exceedingly difficult as it is not that unlike my previous methods. The hardest aspects of a virtual pharmacy curriculum for me is self-discipline and sticking to self-made deadlines rather than the structured schedule of dedicated class time. Although, I have been fortunate enough to have an amazing, intelligent group of friends with whom I participate in Zoom study sessions before each exam.
In addition to balancing being a student in a brand-new environment, keeping up with emails, assignments, and daily changes in information, some people also have family responsibilities. Many pharmacy students have children that have transitioned to virtual learning too and that can be an added challenge to navigate. This can be especially true for those now providing child care at home in addition to all of their other tasks.
Exams also have new components and for example a strong Wi-Fi connection is essential towards minimizing stress.
2. Uncertainty on the verge of rotations
Our final year of clinical rotations is something that we have both been looking forward to (and maybe dreading a little too) for the past 3 years. I put a significant amount of time and thought into how I ranked my rotations and completely redid the list more than once. While waiting on the results of our final rotation assignments, I thought about it so often that I even had dreams about where I would end up. In one dream, I had a rotation at Disneyland, which would probably not provide extensive clinical training, but I would have definitely enjoyed myself for those six weeks! In the end, I was fortunate to be assigned to many of my top preferences.
However, the current pandemic has led to a state of uncertainty in all aspects of our lives, including our rotations that are scheduled to start on the 26th of May. Many sites have rescinded preceptor availability in order to decrease unnecessary exposure to non-essential personnel for the remainder of the semester. Whether those sites will be available again by May 26th is yet to be determined. As such, the anxiety of rotation changes is ever – looming, again. Even if our rotations remain the same, the environments will be quite different than they would have before all of this. Hopefully, the pandemic will provide new and unique educational experiences that will prepare us as pharmacists should we encounter a similar situation in the future.
3. Maintaining mental health and a self-care routine
A significant factor in persevering through this time is keeping our spirits up through daily routines, maintaining contact with our friends, and a healthy self-care regimen. It is challenging to choose not to lounge around the house all day when there is nowhere to go. Despite this, it is important to remember that a key practice in staying mentally and physically healthy is to create a routine. Wake up at the same time every day and use the time you would have been driving to school to do a 20-minute exercise video or go for a walk. Put on clothes that you would normally wear to school and set times to work on assignments or study. Use either a checklist or calendar to schedule your day, or both.Now, I will admit I personally do not always follow this advise, but on days I do I am much more productive, energized, and focused.
At the same time, this has been an opportunity for a reprieve for those of us who are potentially over-involved in organizations and extracurricular activities. This is a great time to re-balance and ensure that our actions and involvement align with our priorities. In addition, it is equally important to schedule in breaks and activities that are completely unrelated to school such as playing a game, calling a friend or parent, watching television, or developing new independent hobbies. We must emphasize that it is physical distancing, and not social distancing that we must practice. Utilizing our social support is more important now than ever. Creating online study groups and calling friends or family just to catch up have been great sources of stress relief. Also, in an effort to avoid vitamin D deficiency and the potential emotional impact of isolation, I have been trying to go on walks during the afternoons. Feeling the sunlight on my face puts me at peace and helps me forget the quiet chaos that surrounds us.
4. The impact on my passion for the field of ID and ED
Seeing the impact pharmacists have had in the course of the COVID-19 pandemic has further solidified my passion for the field, particularly Emergency Medicine (EM) and Infectious Diseases (ID). These two fields were already my top choices for further specialization after graduation and a post-graduate year 1 (PGY1) pharmacy practice residency, and the fact they are two of the most impactful specialties throughout this global outbreak increases my interest.
Emergency departments (EDs) are often the beginning of the puzzle to optimal patient care with asking the right questions to come up with the best differential diagnosis and treatment options. EM pharmacists are also the front-line for antimicrobial stewardship in ensuring appropriate empiric therapy for inpatients or definitive therapy for those that are able to go home. Being the medication experts, pharmacists are at the forefront of uncovering effective drug therapies for this ever-evolving disease, including if therapy can be deferred in lieu of available clinical trials. Infectious disease experts use their extensive background knowledge of “bugs and drugs” to establish facility-specific standards of therapy based on the most current literature and carefully calculated risk-benefit assessments. This has been exemplified during the COVID-19 pandemic through critical thinking skills to quickly analyze and interpret the consistent influx of literature on SARS-CoV-2 treatment options and the risk of those treatment options causing harm to patients. One of my professional goals is to one day achieve the skillset to be able to solve, as one of our ID professors puts it, any ID puzzle. The resources offered by organizations such as IDstewardship are an enormous help in my path towards this goal.
As a student, one of my biggest struggles has been keeping up with the immense amount of discoveries and therapies associated with treating COVID-19. There are innumerable mediums releasing information daily and it is difficult to differentiate speculation from developing evidence. Even for the literature that is evidence based, it is challenging to stay on top of it all. I have been using resources containing consolidated information such as the COVID-19 Resources for Pharmacists page by IDStewardship, reading review articles such as the one published by local ID pharmacists and an ID physician below, scanning twitter feeds, and following @IDJClub and @ASP_Chat.
5. The expanding role of pharmacists
Recent changes to perspectives regarding the role of the pharmacist has made me feel both proud and hopeful for the future of our profession. The recent approval by the Department of Health and Human Services of pharmacists’ ability to order and provide nasopharyngeal testing for COVID-19 is an enormous step towards expanding consumer access to testing and allowing community pharmacists to expand their scope of practice as one of the most easily accessible healthcare professionals available.
Much of the population has come to see that pharmacists are an integral part of the healthcare team and do not solely count pills as some of the lay public previous thought. Thankfully, accrediting bodies such as The Joint Commission realize the importance of this with requirements for antimicrobial stewardship programs in hospitals since 2017 and in outpatient settings since January of this year. In addition, the Centers for Disease Control and Prevention’s 2019 update to the core element of antimicrobial stewardship programs specifically include pharmacists and indicate that stewardship programs are most successful when a pharmacist co-leads the antimicrobial stewardship program. This is yet another reason I would be proud to be a part of this team.
Final Thoughts
It is my responsibility as a student to learn as much as I can now to become an active clinical pharmacist practicing at the top of their license. I look forward to playing my part in the evidence that pushes pharmacists towards provider status. My long-term career goals include establishing a Post-Graduate Year 2 in Emergency Medicine with an emphasis on antimicrobial stewardship in the Dallas-Fort Worth area as there currently are none. I want to contribute to the expansion of the profession and earn the respect and trust of other practitioners and patients.
While there are many challenges to student life during the global COVID-19 pandemic, it has also been a wonderful opportunity to see the importance of the field I have chosen. It is motivating to be the best student pharmacist we can be so that we can be the best pharmacists we can be and tackle such daunting tasks as a pandemic with grace. This is an opportunity to strengthen our flexibility and resiliency. It has been an honor to see the involvement of pharmacists in both community and institutional healthcare teams. I greatly look forward to the future and to see the transformation of the profession of pharmacy after we emerge from this pandemic.
ABOUT THE AUTHOR
Katy Muilenburg, Pharm.D. Candidate 2021
Originally from Houston, Texas, Katy is a third-year pharmacy student at the University of North Texas System College of Pharmacy in Fort Worth, Texas with an anticipated graduation of May 2021. She plans to pursue both a Post-Graduate Year 1 and 2 (PGY1, PGY2) pharmacy residency program to enhance her clinical skills and be the best practitioner she can be. At this time, she is passionate about Emergency Medicine and Infectious Diseases so she is hoping to do a PGY2 in one of those areas. One of her long-term career goals is to establish the first PGY2 programs in Emergency Medicine with an emphasis on antimicrobial stewardship in the Dallas-Fort Worth area. She wants to contribute to the expansion of the pharmacy profession and earn the respect and trust of other practitioners and patients. Currently, she is the President of our school’s chapter of APhA-ASP, the Vice President of the chapter of Phi Lambda Sigma Pharmacy Leadership Society, and the Co-Chair of Professional Development for Phi Delta Chi Professional Pharmacy Fraternity Delta Beta chapter.
In her free time Katy enjoys cooking (especially Italian dishes and desserts) and traveling. She spends lots of time cuddling with her two German Shepherds Jager and Maggie. She has a BA in Spanish Language from the University of Texas at Arlington and is fascinated by other cultures. She studied abroad in Costa Rica during her undergraduate program and later in Florence, Italy where she became certified to teach English as a foreign language.She looks forward to one day being able to pursue many more global adventures and to experience further cultures firsthand.
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