Yes, working in the Emergency Room is not the typical route that a pre-pharm would take. We're told that becoming a pharmacy technician is the way to go. Don't get me wrong, becoming a tech before school is a great learning experience...but I learned even more the in the Emergency Room this past year!
Upon graduating in May 2018, I accepted a position in the Emergency Room of a large metropolitan hospital system as a Medical Scribe.
" Medical scribes work alongside healthcare providers to enhance the delivery of care, reduce administrative burden, and improve care team workflow. Scribes serve as a thought partner to leading health systems aiming to bolster efficiency and improve the patient experience. "
I specifically applied and was employed by the company ScribeAmerica. I had come in contact with ScribeAmerica approximately two and a half years prior to when I applied. At that time I was considering careers such as MD, DO or PA. Each required a form of "Patient Care Experience", which are opportunities for one to gain exposure to a wide range of patient problems, diagnoses, and treatment management. I was not interested in the common routes such as CNA, phlebotomy, medical assistant or EMT primarily due to those routes requiring 3-6 months of schooling to receive certification. I was more interested in an entry-level opportunity and ScribeAmerica fit everything I wanted.
Obviously, I decided not pursue the MD, DO or PA route so becoming a medical scribe was no longer a priority . As mentioned in my post Finding Pharmacy, I was forced to take a gap year after finding out I would not be attending graduate school right out of college. I applied to numerous public health internships & fellowships, STEM research programs, laboratory positions and other random positions. After being rejected from just about everything, I realized "I just need money for Pharmacy Applications and Interviews". With that realization I remembered ScribeAmerica. I immediately applied!
Upon making it to the next step of the application process, I was sent 4 to 5 possible sites and chose the hospital where I'm currently employed!
Fun fact: I'm employed at the same hospital I was born at!
With SA you are required to work 1 year full-time or 2 years part time. I chose to pursue a full-time schedule, as I wanted to make as much money as I could for applications, interview travel, and to just enjoy my weekends with my family, boyfriend and friends!
Now Let's get into my experience!
First, I must admit I went into this position terrified that I'd no longer want to go into Pharmacy! Out of my 20+ coworkers between my 2 sites I was the only Pre-pharmacy student. My coworkers ranged from pre-nursing, current nursing school students, pre-PA, and of course pre-med. Let's just say I was the sore thumb.
After I completed the 7 days of classroom training I was finally allowed to be in the emergency room! I met the nurses, PA's, NP's, Respiratory Therapist's, ED tech's, Physicians and then surprisingly.....the ED PHARMACIST'S! At that moment, I knew I had chosen then best route for my Gap year.
My typical shift included making my way through 3 badge check points before reaching the ED, going to the basement to get my work laptop, making my way back to the ED to find a hiding spot for my coffee and place my lunch/dinner in the nook. After that I went to find my provider for the day! Depending on the time of my shift I either floated from multiple care teams (typically with mid-levels) or stayed in one care team the entire 8-10 hours (typically with MD's or DO's). Depending on the care team size meant you'd find me standing most of the time with my laptop on the nurses station, sitting on a stool in the corner with my laptop on my lap or every now and then sitting at the nurses station if that particular care team had one less nurse that day.
Being that I'm in charge of charting for the provider, I saw each patient with them. I'd enter behind them, often times introduced by the provider, and would place my laptop typically on the border of the sink and take my notes! Depending on how complex the case was, it could take 5 to 20 minutes to complete the chart (HPI, ROS, physical examination, past medical history, current medications, and familial medical history).
Aside from the initial encounter, we also documented re-evaluations of the patient, procedures, consultation calls (OBGYN, Ortho, GI, ENT, etc.), and critical care.
Sounds pretty blah, right?!
My FAVORITE aspects where;
Procedures: Joint reductions (typically hips, wrists, ankles), chest tube placement, Incision & drainage, lacerations (Staples or sutures), and of course critical care situations such as respiratory or cardiac arrest.
Learning: Honestly I learned so much about Pharmacy that it surprised me. Yes, I became familiar with the typical drugs for chronic disease management (Lisinopril, Metoprolol, Coumadin,etc.), antibiotics (Amox, diflucan, penicillin, etc.) and pain medications (Ibuprofen, Advil, Tylenol), but those are just a very few used in the ED! We used drugs such as Propofol (typically for joint reductions), Geodon (typically for altered patients at risk of harming themselves and others), Ativan, Dilaudid, Rocephin, Methotrexate, Heparin, Diltiazem and more! This knowledge actually made me stand out during my pharmacy school interview as I wouldn’t have known these drugs in a traditional retail setting.
Relationships: Of course I talked to our ED pharmacists every chance I got! They grew to be great mentors and someone I could bounce ideas off of regarding shadowing, applying for internships and just anything regarding the future of pharmacy. I also developed meaningful relationships with our ED nurses, ED techs, midlevels and our MD/DO’s. Over the 8-10 hours you spend together you’re typically asked about school, your plans after school or what you’re considering specializing in. As you develop these relationships you’re able to update everyone on your accomplishments (good score on entrance exams, passing OCHEM, etc.), discuss how they studied for certain subjects, get advice, connect on social media, and the opportunity to ask for letters of recommendation!
Aside from pharmaceutical knowledge I also learned a lot regarding disease states and medical decision making. I also learned valuable lessons about general health & wellness, life, death, optimism, and making those tough decisions.
Overall, deciding to take the non-traditional route was the best decision I ever made. I don’t regret my gap year one bit.
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