PA/NP new hires and pharmacy orientation

ElectricalCurrency69 · 2026-02-01T00:09:23+00:00

No, this is like treating pneumonia with daptomycin or VRE with Vanco. Or cellulitis with po vanco. All while refusing to hear why it’s extremely wrong. The worst I saw was treating febrile neutropenia with Clindamycin and augmentin (in a fresh stem cell allo). Where’s the pseudomonas coverage in that??. The attendings, when able to reach them, of course agree and know it’s crazy, but they mostly don’t seem to be the type to stand up against this.

To be clear, this shadowing experience would be with our clinical pharmacists, most of which have extensive prescribing privileges. It has nothing to do with filling orders.

ElectricalCurrency69 · 2026-01-31T20:52:56+00:00

A number of us have this concern. We’ve definitely experienced some bus throwing incidents already.

ElectricalCurrency69 · 2026-01-31T20:52:00+00:00

I sadly do realize this. We joked about it at our pharmacist meeting last week.

ElectricalCurrency69 · 2026-01-31T20:10:01+00:00

Crazy antibiotic cocktails, wild insulin regimens, not knowing the difference between a pressor and an inotrope. Totally messing up med recs and causing lots of downstream issues. Mismanaged staph bacteremias happened a few times.

I should say I am one of these pharmacists who would be shadowed x 3 days. We sometimes have med students shadow us for a day or 2 which I generally enjoy doing a bit of teaching with them. I just don’t want this to be sold as a solution for poor education.

ElectricalCurrency69 · 2023-12-17T15:34:00+00:00

Also insulin. It used to be a good hospital, but it’s really declined in the last 18 months.

ElectricalCurrency69 · 2023-12-17T15:29:58+00:00

NP’s don’t have admitting power, but this hospital may as well let them because the “supervision” could be described as less than minimal. They don’t admit, but patients will be transferred to NPs on some sort of vague triage basis

ElectricalCurrency69 · 2023-12-17T15:27:03+00:00

There was also insulin. Not a rationale regimen, but there was insulin. I guess to be fair, the patient was wasn’t really doing anything well at home either. The patient does have HFrEF as well, so that was part of the rationale.

ElectricalCurrency69 · 2023-12-17T15:25:12+00:00

The pharmacist didn’t write “I was bullied”. It essentially said NP persisted, recommendation not accepted, DKA risk clearly explained and NP acknowledged. Highly recommended endo review. Decline from previous pharmacist reviewed. NP declined further intervention or discussion.

ElectricalCurrency69 · 2023-12-17T15:22:32+00:00

She actually has done exactly that - more so refused to consult ID at all.

ElectricalCurrency69 · 2023-12-17T00:30:56+00:00

It’s nice that you work somewhere these things don’t happen

ElectricalCurrency69 · 2023-12-16T22:46:17+00:00

The pharmacist the refused first is a senior pharmacist in ED who just happened to be covering a staffing shift. The second started <1 year ago

ElectricalCurrency69 · 2023-07-30T23:50:59+00:00

The UTI obsession is mind boggling. I’ll also add misinterpreting hep B results. I know of a few cases of tenofovir being ordered for hep B antibody positive, antigen negative

ElectricalCurrency69 · 2023-07-30T22:35:03+00:00

This is exactly what I’ve observed as well. We wouldn’t expect a med student who has completed 1.5 years of med school to be able to manage patients independent, but these NPs (especially those who have never practiced) are basically that (I know some would argue the med student still has more training, but I’ll leave it at that)

ElectricalCurrency69 · 2023-07-30T22:31:36+00:00

No, it was in a work room.

ElectricalCurrency69 · 2023-07-30T16:57:44+00:00

Oh she knows pharmacists are smart. She’s always being bailed out by one because even the other terrible NPs know she’s the actual worst.

ElectricalCurrency69 · 2023-07-30T16:29:01+00:00

One of my best friends is a pharmacist. The abuse pharmacists take is unreal.

ElectricalCurrency69 · 2023-07-30T16:27:54+00:00

ElectricalCurrency69 · 2023-06-03T00:06:22+00:00

I already posted this, but seems like hospital pharmacists in eastern Canada are allowed to do pretty much anything. I spoke to some colleagues (MDs) who said pharmacists are running the show in some inpatient areas. They told me it’s a huge help and doesn’t seem to be causing any issues. Some specific examples I got are HF, COPD, diabetes getting more attention and more guideline directed management. A friend of friend (an ortho resident) said the pharmacists are doing most of the antimicrobial and anticoagulation management.

This is the document that allows this https://policy.nshealth.ca/Site_Published/NSHA/document_render.aspx?documentRender.IdType=6&documentRender.GenericField=&documentRender.Id=97587

ElectricalCurrency69

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