In this episode, I’ll discuss 6 ways to develop a clinical pharmacist’s mindset.
When it comes to having a positive impact on patient care, how a pharmacist thinks can be as important as their knowledge base. This episode is a collection of 6 mindset techniques that I have found useful in my practice as a clinical pharmacist.
1. Make it a point to “know what you don’t know”
Develop a robust self-awareness of what you don’t know, and a determination to close that knowledge gap before giving a recommendation to another clinician. It is daunting to admit when you don’t know the answer to a question. But your credibility will be permanently damaged if another clinician thinks you made up an answer to avoid saying “I don’t know.” Once you recognize that you don’t know an answer to a question, call upon resources – other clinicians, reference material, etc… – to close your knowledge gap.
2. Memorize pathophysiology of disease and mechanism of action of medications, and look up the rest in a reference
Experienced clinicians seem to have a natural ability to apply their knowledge to any patient scenario, no matter how complex. This is actually a skill that can be practiced and developed. The key is to focus on connecting the mechanism of action of medications to the pathophysiology of diseases. By learning in this manner, you will develop the ability to:
1. Anticipate indications and contraindications for new medications.
2. Correctly apply pharmacotherapy principles to any patient case, even if you have never encountered a particular combination of disease states before.
3. Remember what you have learned and apply it to the next patient without having to look it up every time.
I’ve found that focusing on this method is actually is much easier than memorizing lists of facts in the long run.
3. Focus on getting the routine tasks done as early as possible in the shift
I use the formula “One minute before 9 am = 2 minutes after noon” to prioritize my day. This means completing routine work early to free up time later in the day to spend on unexpected events or important follow-up care.
For example, work on pre-rounding, monitoring, and report reviewing before answering emails, updating policies or protocols, completing a medication use evaluation, or conversing with colleagues.
If you use this formula to guide the start to your day, expect to be more efficient, have less stress at the end of the day, and have more time for unexpected events and learning opportunities as they come up throughout the day.
4. Spend as much of your day as possible on the nursing unit, elbow-to-elbow with patients and the care team
Use your time off the unit for activities that require a quiet space to work such as creating an in-service / presentation, or drafting a policy / procedure.
When you spend most of your time on the unit, 3 things tend to happen:
-You become more efficient by observing / interacting with the patient:
-You have more Interaction with the care team:
-You have more learning opportunities in your interactions with other clinicians
5. Structure your verbal communication with physicians in the same manner they think about patients
When you approach a physician with a recommendation, they are usually occupied with another task. To have the best chance for acceptance of your recommendation, you need to focus the physician’s attention on your patient. To do this, present your recommendation in the same manner they are used to thinking about patients – like a case study. Earlier in my career I would plan ahead of time to succinctly phrase and communicate the recommendation using a structured tool called ISBAR:
Introduction (if they don’t know you already)
Situation
Background
Assessment
Recommendation
Presenting your thoughts using this format allows the physician to follow your decision making process so that you can agree on a plan of action. With enough practice, I was able to naturally structure my verbal communication this way and no longer need to plan it out ahead of time.
6. Be intentional about developing professional relationships with physicians and nurses
It is essential to deliberately cultivate relationships with physicians and nurses. This can be done simply by following up with them on patients that you have cared for together. Asking “How is Mrs. Smith doing with her new gabapentin dose?” or “Did that patient’s tremor stop that we discussed last week?” lets the physician or nurse know that you are there to help them take care of the patient.
The relationships that you develop can be leveraged to help you better care for patients, learn new information and skills, and improve your future interactions with physicians and nurses.
Members of my Hospital Pharmacy Academy have access to my Clinical Pharmacist Mindset training that offers practical advice with examples on all 6 of the points that I covered in this episode. Members also get access to the entire training library covering critical care, emergency medicine, infectious disease, and general hospital pharmacy, plus many more resources to help you in your practice. Get all the details and join today at pharmacyjoe.com/academy.
If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies.
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