Meghan Ross, Senior Associate Editor

Even in a post-apocalyptic world, people still need pharmacists.

Mercer University College of Pharmacy’s video, “I Am Pharmacist,” was nominated for the American Pharmacists Association Academy of Student Pharmacists’ PharmFlix Best Picture Award in 2015.

In the 90-second video, a student pharmacist named Aleks Khapun is not stymied by the lack of civilization in his underserved area. He knows he has a job to do. He transmits over the radio that he is available for health screenings at the underpass “when the sun is highest in the sky.”

He promises to give glucose screenings, blood pressure readings, and medication therapy management.

He also wonders aloud if getting provider status would have prevented the apocalypse.

“The world will always need pharmacists,” he concludes, before waking up to realize it was all a dream.

“I Am Pharmacist” was directed by Heather Corbo and edited by TJ Geers. Aleks Khapun, Lisa Sagardia, and Heather Corbo star in the video.

Are you part pharmacist, part YouTube star? Do you have a favorite pharmacy video that never fails to make you laugh? Send links to your best humorous, pharmacy-related video suggestions to rmarotta@pharmacytimes.com, and your picks may be featured in the next Mental Recess

Articles

Mental Recess: I Am a Pharmacist

Drake University College of Pharmacy & Health Sciences’ emphasis on team-based learning not only ensures that students will be engaged with their peers, it also nurtures more well-rounded pharmacists who will expect to collaborate with other health care providers in their future practice settings.

Renae Chesnut, EdD, MBA, RPh, dean and professor at Drake University College of Pharmacy & Health Sciences, spoke with 

 about the college’s learner-centered teaching, opportunities for diverse experiences, and advice for graduating students.

Q: What is unique about your school/program?

A: One of the college’s values is to be learner-centered. As such, we strive to incorporate content, as well as teaching methods, that maximize student learning. We use a variety of excellent teaching methods that develop knowledgeable and highly skilled graduates who continue to build on the outstanding reputation of our pharmacy program. 

To assist students in adding value to their degree, students are able to focus their education in ways that allow them to pursue their individual career goals. We offer several joint degree options for students to develop skills and knowledge in areas that enhance their pharmacy education, while adding value to the time and financial resources that are being invested into their degree. 

Students can pursue 1 of 5 options for dual degrees: MBA, MPA, MPH, MSLD, and JD. Students also have the option to complete a minor, concentration, or a second major in areas including leadership development, diabetes care, and public health.

We also have unique opportunities for experiential learning, including working with underserved populations and studying abroad, which help to increase our students’ cultural competency and enhance their practice as professionals.

Q: What is the teaching style or philosophy? 

A: Our faculty take an active learning approach to teaching and learning. Courses and lab experiences emphasize patient care, creative thinking, and communication.

Students experience team-based learning in many of their classes, and they are expected to engage with course content in meaningful ways through small group projects, discussions, and in-class activities. This type of learning model promotes collaboration between professionals, which is something health care organizations are now incorporating into the way they approach patient care.

In addition to team-based learning, our faculty also incorporate team-based teaching into the curriculum as a model for how health care is becoming increasingly collaborative. Courses are not always taught by just 1 professor. In the team-based approach, faculty members with an expertise in specific areas of pharmacy teach a class at different times in the semester when the class is covering that particular topic. By harnessing each faculty member's strengths and expertise, students see the value of approaching problems collaboratively, making them more effective members of the health care team.

Q: What are some community outreach activities or programs the school participates in? 

A: Our students participate in neighborhood health fairs; the Iowa Pharmacy Association's Legislative Day; Discover, Prepare, Research, and Explore Pharmacy (D-PREP); STEM Night at the Blank Park Zoo, and Diabetes Tour de Cure.

Students also provide a number of health screenings, which provide a great service for the central Iowa community and allow for a valuable patient care experience.

Q: What opportunities do students have for internships or co-ops?

â€‹A: Students have a variety of opportunities for experiential learning in Des Moines, Iowa, as well as throughout the state of Iowa, across the country, and around the world. We partner with hundreds of experiential sites in the Des Moines area to provide a wide variety of practical experiences that engage students in many areas of pharmacy.

As the capital city of Iowa, Des Moines provides direct connections to the Iowa legislature and Iowa Pharmacy Association, where students can get involved in regulatory affairs, policy making, and health care advocacy.

In the fourth professional year, our students are able to extend their experiential learning to other geographic locations throughout the state of Iowa, across the country, and even outside the United States.  We offer more than 600 experiential sites worldwide each year, which means students have the opportunity to pursue diverse and engaging practical experiences.

Our students are recognized throughout the state of Iowa and across the nation for their commitment to advancing pharmacy practice, supporting their communities, and advocating for their patients and profession.

Q: What advice do you have for students who will graduate this year?

A: It is important to be proactive in the job search process and have unique experiences so that one can be distinctive and stand out from the rest of those who are applying for positions.

Also, take advantage of the various career events and other preparation activities offered through the schools and the professional associations to have the best résumé/CV and interview as possible. 

Following graduation, don’t forget to pay it forward. Most students have some sort of assistance through school, whether it be scholarships or other grants. Typically, those funds come from individuals, rather than corporate donors. It doesn’t have to be a large gift as every little bit helps your alma mater and the profession.

Drake University College of Pharmacy & Health Sciences' emphasis on team-based learning not only ensures that students will be engaged with their peers, it also nurtures more well-rounded pharmacists who will expect to collaborate with other health care providers in their future practice settings.

Drake University College of Pharmacy & Health Sciences

What might student pharmacists expect if they apply for a job with the US Department of Veterans Affairs?

The US Department of Veterans Affairs (VA) offers student pharmacists a unique practice setting that provides a direct patient care role.

Abril S. Atherton, PharmD, BCPS, BCPP, clinical pharmacy specialist in mental health and postgraduate year 2 (PGY-2) mental health residency program director at the VA Salt Lake City Health Care System, told 

 about her career path and what she enjoys most about her job at the VA.

Q: How did you get your job with the VA, and what made you interested in the position?

My career at the VA began with a PGY-1 pharmacy practice residency at the Salt Lake City VA Medical Center. Around the time I was getting ready to graduate, I was offered a position in ambulatory care or mental health. My undergraduate degree involved recreation therapy.

In debating the 2 positions, I realized that mental health would likely be more of a challenge than ambulatory care. It was because of the challenge and my history with recreation therapy that I chose the mental health option. It definitely was the best decision I could have made!

Q: How does this practice setting compare with other jobs you’ve had?

I previously worked in retail and in a home infusion facility. The biggest difference with practice at the VA is the degree of autonomy I have to make clinical decisions regarding patient care. Although I work with a team, there are times when I need to make a clinical decision to assist a patient in their transition from an outside facility back to the VA or to adjust an antidepressant medication dose in our antidepressant follow-up clinic.

The ability to prescribe in the VA allows me to make those adjustments using my scope of practice. I am also able to order appropriate labs and procedures when necessary to provide complete patient care. This direct patient care role is very fulfilling in the VA practice setting.

Q: What does your average day look like at the VA?

I wear several hats at the VA, which include teaching, precepting, and direct patient care. I am 1 of 2 clinical pharmacists on a 21-bed inpatient psychiatric unit.

My day begins with preparing for rounds and conducting admission and discharge medication reconciliations. I attend rounds for around 3 hours with an interprofessional team that includes a psychiatrist, psychiatric residents, medical students, physician assistant, social worker, and a team nurse. We also have a psychologist, psychology interns, nutritionist, occupational therapist, and a recreation therapist. We also have an amazing team of nurses.

All the professions come together to treat patients with a variety of mental health conditions, such as post-traumatic stress disorder, suicidality, schizophrenia, anxiety, and substance use disorders.

As you can expect by the number of disciplines involved, the VA offers a variety of services for treating mental health. The services I provide include medication education, brief interventions related to substance use disorders, medication education groups, and medication management.

After rounds, I follow up on education requests and complete administrative tasks related to the PGY2 psychiatric residency program I direct. I also precept students and residents when they rotate at my site.

Throughout the year, I teach a course on the use and misuse of psychoactive medications for social work students. I also recently started an elective course on psychoactive medication therapeutics for pharmacy students. I am very involved with our local college of pharmacy and am a member of the curriculum committee and teach a module on schizophrenia in therapeutics.

At any given time, my day could include working on an upcoming lecture or coordinating lectures by my residents. We also recently developed a transition of care program where pharmacists coordinate medication reconciliations from facilities outside of the VA. I spend 1 to 2 days a week assisting patients in their transition back to the VA from outside psychiatric hospitalizations. There is also an antidepressant follow-up clinic that my residents and I run once a week.

Q: What advice would you give to students who want to work for the VA?

If possible, look for the Valor Intern program, which trains pharmacy interns in the VA system. If a student is interested in a VA residency, getting a rotation at a local VA can help orient the student to the VA system and would make them more competitive for a residency.

At this time, all positions involving direct patient care require at least a PGY-1 residency and possibly a PGY2 in a specialty setting, such as psychiatry. Students who are interested in a direct patient care in the VA are encouraged to meet with the residency program directors if a residency program is offered at that facility.

If a student is interested in a career in the distributive side of the VA pharmacy system, there are options in inpatient and outpatient pharmacies. There is also research at most major VA centers, especially if the VA is associated with an academic institution. Pharmacists do everything from clinical trials to outcomes research at the VA.

Q: What’s the best and worst part of the job?

I often feel the challenge of wearing multiple hats. This sometimes prevents me from being able to provide the direct patient care I enjoy the most. When my day is freer, I love to spend as much time as I can with patients. Sometimes that process is hindered by my multiple roles and responsibilities.

The best part of my job is when I have directly or indirectly influenced the trajectory of a patient’s care in a positive direction. I love being able to see a patient who enters our inpatient psychiatry unit in a very rough state improve over the course of their stay. Seeing their hope go from negligible to full of hope for their future is very rewarding. I love to be a part of that by providing motivational interviewing, education, or medication management. I also love to see when my trainees become independent and impact patient care in their own ways.

Life as a VA Pharmacist

You’re finally done pharmacy school. Now what?

New graduates can check pharmacy school off their to-do list, but the next task—finding a good job in pharmacy&mdash;may be just as daunting as getting a PharmD.

One common problem interviewees run into is nerves. Pharmacists can combat anxiety about a job interview by doing copious amounts of research on the company hiring so that they can go into the interview feeling fully prepared. Mediation or prayer can also help calm nerves.

In addition, exercise can reduce stress and improve concentration. Physical exercise can also lead to better sleep, which is important for the nights leading up to the interview.

Pharmacists should also try to get into the right mindset for them prior to the interview. Some people believe that having a positive, optimistic attitude about the interview will ensure success, while others say being a defensive pessimist can help prepare them for obstacles.

If pharmacists are in the position to schedule their own interview, GlassDoor, a job and recruiting site, suggests avoiding first thing Monday morning or at the end of the day Friday.

 Scheduling an interview around lunch time might be problematic too if the interviewer is hoping to skip out early for a meal or is late coming back to the office. Glassdoor suggested that 10:30 AM on Tuesday might be the optimal time for an interview.

One thing pharmacists shouldn’t forget is to consider is if the job would be a good fit for them. Pharmacists may get wrapped up in making a good impression and trying to prove to the interviewer that they are the best candidates for the job, but they should also try to find out more about the job to make sure it’s really what they want to pursue.

If a pharmacist comes out of an interview with a bad feeling about the job and its responsibilities, it might be better to wait for the next job opportunity. Asking the interviewer lots of questions and looking for natural dialogue may help the interviewee get a better sense of the job and its culture, too.

If a pharmacist is offered the job, he or she might want to ask to hang around the pharmacy for a few hours to get a better sense of what a normal day in the office looks like.

Here are a few other interview tips from fellow pharmacists and job sites:

 fans on Facebook what advice they had for students trying to land a new job. Here were some of their responses:

		“Be sure to talk about how much you want this job and how committed you are to being the best pharmacist possible. Reserve questions for your prospective employers regarding how much time you will be granted for [vacation] for later, when you’re negotiating an offer.”

		“All communication should be professional.”

		“Find a job in a nontraditional pharmacy field.”

, Donna Kosteva, RPh, MEd, a pharmacist and career counselor, suggested these 7 tips for phone interviews:

		Dress up, even though the interviewer won’t see you, because it will psychologically prepare you.

		Keep a word document open with notes on the company, so you can reference this information during the interview.

		Remember to keep it a 2-way conversation.

		Direct the interviewer to your LinkedIn or pharmacy blog.

CareerBuilder compiled a list of common and less common mistakes to avoid

		Don’t fidget or play with items in your hand or on the table.

		Don’t look at your phone during the interview.

		Don’t be too honest when the interviewer asks what your dream job is (if the position is not truly your dream job).

		Don’t give this as a reason for wanting the position: “My wife/husband/significant other wants me to get a job.”

		5 tips: best times to schedule an interview. Glassdoor website. https://www.glassdoor.com/blog/5-tips-times-schedule-interview/. Published October 5, 2011. Accessed June 15, 2016.

		Common (and not-so-common) interview mistakes to avoid. CareerBuilder website. http://advice.careerbuilder.com/posts/common-and-notsocommon-interview-mistakes-to-avoid. Published January 14, 2016. Access June 15, 2016. 

You're finally done pharmacy school. Now what?

Interview Tips for New Pharmacy Graduates

Jane Doe experiences acute coronary syndrome (ACS), heads to the hospital, and is faced with a barrage of new medical terms she has never heard of, explanations about the ACS event by physicians, plus medications and instructions from the pharmacist. Jane may leave the hospital with 4 or 5 new medications and may not fully understand how to use them or what their purpose is. That is where pharmacists can step in to be proactive about her adherence and to manage her health literacy.

At the ASHP 2016 Summer Meetings, Christopher Betz, PharmD, BCPS, FKSHP, FASHP, a professor at Sullivan University College of Pharmacy, shared with 

  some of the ways pharmacists can use motivational interviewing to improve adherence in ACS patients. According to Dr. Betz, “Adherence is key with outcomes of acute coronary syndrome,” whether it is dual antiplatelet therapy, statins, or beta-blockers. “If they’re not adhering to it, we’re going to have another event.”

Dr. Betz uses the OARS technique to ensure patients understand and follow their medication regimen:

“O” stands for open-ended questions. 

They can help form a partnership between the pharmacist and the patient during motivational interviewing. Dr. Betz suggested that giving patients time to explain what they are thinking can also help the pharmacist gauge their ability to be adherent.

“It’s so much easier to have someone change their behavior if you tell them what they’re doing well first,” Dr. Betz said. “No one likes to be told what they’re doing is wrong.” He suggested starting the conversation by listing what the patient is doing correctly, then focusing on where improvements can be made.

 This is where pharmacists’ empathy comes in. Through reflective listening, pharmacists can better understand what issues the patient is concerned about, and they can also build a stronger connection. One way to show reflective listening is to use a phrase like, “It sounds like X is happening, which I understand can be frustrating. Do I have that right?”

 Dr. Betz pointed out that this can also work as a teach-back strategy to make sure patients understand what they are supposed to be doing with their new treatments and to measure their buy-in to the medication regimen. “If they say they can’t do it, changes can be made before they’re discharged,” he said.

Beyond the OARS method, pharmacists can help their patients with ACS by assessing their health literacy. Dr. Betz pointed out that most patients will probably have some difficulty reading the materials they are sent home with. Often, a health literacy assessment may not be done because the focus is on solving the cardiovascular problem, and it is easy to forget to assess the patient’s ability to understand the information related to the care of the heart. “These patients are scared,” he said. “Their ability to comprehend what’s going on is going to be diminished anyway because they had a life-changing event.”

One technique Dr. Betz suggested was the single-item literacy screener (SILS), which he likes because the pharmacist can ask it once and quickly get a response, even if the patient is angling to get out of the room or leave the counter. The SILS involves asking the patient, “How often does somebody have to help you read and understand materials given to you by your doctor or pharmacist?”

Dr. Betz posited that if the patient says “never” or “seldom,” the pharmacist can provide normal counselling. However, if the patient says “often” or “always,” the pharmacist knows to be more concerned about the patient’s ability to comprehend the materials they are receiving. With this knowledge, the pharmacist can better tailor the counseling.

Dr. Betz offered other tips for offering more targeted counseling to those with low health literacy:

		Try to refrain from using complicated medical terminology (eg, angiotensin-converting-enzyme inhibitor).

		Avoid multiple-syllable words if possible.

		Aim for around 3 “need to knows.”		

				If the patient needs more information than those 3 pieces, Dr. Betz suggested scheduling a follow-up visit or engaging other family members to help explain the medication regimen.

Watch Dr. Betz detail more ways health-system pharmacists can improve adherence in patients with ACS at 

pharmacytimes.com/conferences/ashp-summer-2016

At the ASHP 2016 Summer Meetings, Christopher Betz, PharmD, BCPS, FKSHP, FASHP, shared some of the ways pharmacists can use motivational interviewing to improve adherence in ACS patients.

How Health-System Pharmacists Can Improve Adherence in Patients with Acute Coronary Syndrome

Over a 3-day period in July, 130 individuals overdosed on K2 in New York City. 

Health and law enforcement officials told 

 that they believe the hike in overdoses was linked to a tainted batch of the synthetic compound, rather than an actual increase in users. However, the CDC reported last year that it was seeing an increase in calls to poison centers that were related to synthetic cannabinoid use. The most common complaints were agitation, tachycardia, lethargy, vomiting, and confusion, and among the nearly 3000 calls, 11.3% involved a major adverse event that could be life threatening. 

For pharmacists who aren’t too familiar with K2, the following are 5 facts to know about it:

The blend is often sprayed with a synthetic compound that’s similar to THC, which are the psychoactive components of marijuana. It may be presented in small, silvery plastic bags and could be marketed as “incense that can be smoked,” according to the Drug Enforcement Administration (DEA). Some believe it looks like potpourri. 

K2 also may contain an herb called damiana, which can be found in Central America, Mexico, and the Caribbean. 

2. You can find it in head shops, bodegas, tobacco shops, some retail stores, and on the Internet. 

The DEA noted in a drug data sheet that purchasing K2 online is especially dangerous because it’s harder to track where the ingredients came from and how much chemical is used on the product. 

The DEA noted that K2 may also be referred to as spice, bliss, black mamba, Bombay blue, fake weed, genie, and Zohal. Others refer to cigarettes rolled up with K2 as sticks, 

The DEA stated that K2 is usually smoked in joints or pipes, but others consume it like it’s tea, or simply ingest it. 

5. K2 can have detrimental effects on both the mind and body. 

Users may experience paranoia and panic attacks, as well as giddiness. It can also increase heart rate and blood pressure and cause tremors, numbness, seizures, and vomiting. 

In some Brooklyn neighborhoods, residents told 

 that they saw K2 users disrobe and jump into traffic while screaming. 

The DEA compared its effects with marijuana, but New York Police Department Assistant Deputy Commissioner for Civil Enforcement Robert Messner told 

“It appears to be stored in the body for long periods of time, and therefore the long-term effects on humans are not fully known,” the DEA stated. 

 reported that 10 deaths were linked to K2 in 2015, according to the city’s health department. None have been reported thus far in 2016. 