Basic Life Support (BLS) is a crucial and foundational part of saving lives. As we all know early intervention and high-quality chest compressions are a cornerstone of BLS. However, from a pharmacy perspective, I find that I have the most potential to impact care when Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) algorithms are being executed in the emergency department. As a second-year pharmacy student, I observed the expert skills that the pharmacist employed in code situations to not only dose and draw up medications, but also to do so before the team even called for them. The prior knowledge and skills necessary combined with the attention to detail and anticipation of what would be needed were so impressive to me and I was inspired to become as knowledgeable and skilled as that pharmacist. Now in my final year of pharmacy school, I find myself memorizing doses, practicing algorithms in my head, and telling myself when, where, and how I would produce medications in various emergency scenarios. It is vital that I hone these skills not only because patients’ lives depend on it, but also because my team needs to trust that I will always be there to help and assist with medications, or anything they may need. I constantly strive to be a sharp and efficient drug expert so I can help provide excellent care to patients and support to my team.
Importantly, the emergency department does not consist solely of high acuity codes and traumas. For many patients, a visit to the emergency department may be their only access to healthcare for a very long time. This offers a unique opportunity to make a remarkable difference for many patients. As pharmacists, we utilize that time to provide in-depth patient-centered counseling and education. In order to do so, it is important that we stay well-rounded in many areas of medicine because our patient population is constantly changing and often challenges us with unfamiliar things. In addition, emergency department visits commonly lead to an admission to an acute care or critical care unit. These transitions of care require the team to understand the appropriate type and level of care each specific patient needs. By completing a year of postgraduate residency in general hospital pharmacy, I hope to gain knowledge and understanding of many departments so I can optimize patients’ medications and orders before they reach the unit. After I gain a solid foundation and comprehensive training, I am very excited to complete an additional year of specialty pharmacy residency training in emergency medicine. I can then focus my time and better apply my knowledge to the expert nuances of pharmaceutical care in emergency medicine-focused areas such as stroke and trauma response, emergency preparedness, toxicology, and more.
As a student, preparing oneself mentally, emotionally, and physically is crucial as we begin our careers. Mental preparation is covered largely in didactic learning. I have heard emergency medicine called the “jack of all trades,” the specialty of all the specialties. Staying up to date on algorithms, disease states, and literature is very important. Learning should never come to a stop. There will certainly not be a point where we feel like we know it all, however if we are open to always learning we will be successful for ourselves, our teams, and our patients. The emotional aspect of this field is the most difficult part for many. We regularly see people on their hardest days and we often experience major losses. It is important to see the good in even the worst situations. We must control our emotions for our patients and their families. Because we experience such sadness so frequently, we must find ways to rest and recover in a healthy way. What that looks like is different for each person, but it is essential for our own mental health and to ensure that we can continue to show up and be focused and present for our patients. Ask for advice, learn from others, and always take a moment to self-reflect at the end of each day. Emotions are healthy and appropriate when the time is right.
Physical preparedness ties everything together. Staying current on BLS, ACLS, and PALS trainings are important for practicing to perform life saving techniques for our patients. This, of course, is just the tip of the iceberg. Further practice in specific skills are often what can make the difference between life and death. This looks different for every profession: a nursing student may practice putting a line in quickly even when a patient is severely dehydrated, a medical resident may practice intubating or placing a central line, and of course, from my personal perspective as a pharmacy student, practicing quick and accurate dosing calculations, drug dilutions, and other medication preparation.
All of this requires a high magnitude of mental, emotional, and physical strength. The better we care for ourselves, the better we care for others. There is not a more vulnerable state to be in than the moments between life and death. There is no greater service in this world than saving a life, but there is also nothing as disheartening as losing a life, despite our best efforts. Emergency medicine allows us to use the medical knowledge and experience we have to save lives each day. The better we can perform as individuals, the better we can serve our team and, ultimately, our patients when responding to emergencies. The training is rigorous, challenging, and requires an immense amount of knowledge and excellence. However, once a patient’s life is in your hands, or you tell a family member that their husband, wife, or child survived, you will remember exactly why you worked so hard to have this career.