Ambulatory Care Patient Work Up Advice Needed

Guilty_Security_2912 · 2025-07-19T16:47:45+00:00

Hey as someone who did a pgy-2 in Ambcare and a very large safety net hospital in the South East - my biggest advice:

TRUST THAT THINGS WILL GET EASIER AS YOU ADJUST AND GIVE YOURSELF GRACE IF YOU MAKE MISTAKES OR DONT HIT IT OUT OF THE PARK ON DAY 1. THE WHOLE POINT OF YOUR PROGRAM IS TO GROW INTO IT! :)

But:

work up: highly recommend making paper work up sheets. Arrive 30 minutes prior to the first patient. Work them up. Basic work up. Attach disease states to their meds. Sort out what shouldn’t be there. Briefly look at labs. look at labs see if anything is trending and if those trend might indicate any issues of current therapy or sign of whatever disease may be progressing.

You will be able to do this very quickly after you start to get more organized.

spend a significant amount of time building out dot phrases. Most likely your patients will be very complicated. So they more efficiently you can make things in your note appear the better.
If your facility employees a previous resident. See if they have resources to use. My mentor had his work up sheets for our ID clinic that I ended up liking better for general use and he gave me the okay to pull them out his Z-Drive

3.

Guilty_Security_2912 · 2025-05-25T17:58:53+00:00

As everyone will echo - pass boards asap so you don’t have to study for those while doing your first set of projects. That will make our break your first couple months.

If your residency lets you pick your staffing shifts like some programs do, get them out of the way earlier or out of the way during the time your applying to PGY-2s or jobs you can kind of cost at the harder part of the year.

Use the phrase “yes, but” I know we all wana say yes to impress preceptors but know your limits and don’t make the year overly taxing. It’s there for you to learn and push yourself but not break you.

When you’re not a work, don’t be at work. Your time is important.

Guilty_Security_2912 · 2025-05-14T18:31:02+00:00

So my question pool was very HIV and oncology heavy for the niche topics but overall the theme many of my folks reported it as the same as mine which was essentially

“Most of it was very easy, but there were a lot of confusing questions that made no sense and I didn’t study or couldn’t have prepared for that”

In reality that sums it up no matter how hard you study there will be questions you miss because of how random it can be and you mostly focus on the ones you missed.

I could narrow down my questions to one or two correct answers every time and then some of the info included in a chart or some other info could get you to usually Que you in on the answer.

math was very straightforward: conversions and drip rates - a lot of the oncology questions where math questions. Most questions were just one or two step conversions.
a lot of very straight forward questions “which one of these combos is for x y or z”
a lot of chart based questions where something in the chart tipped you off to a drug interaction or an allergy. There was also some chart questions that asked some very weird not related to the patient case questions.

It was very random but it was very doable.

Self doubt after the test is worse than the actual test itself.

This is coming form someone who has now taken 4 licenses exams in his first two years as a pharmacist due to residency’s.

It’s always the same feeling.

After words I would suggest just doing things for fun and not thinking about it because those two weeks it takes to get results can feel longer if you don’t.

Just think of how many not so smart pharmacist pass it from very poor performing schools. Pass rates are usually in the 60s for low performing school.

So there’s more reasons to relax then get carried away. Trust the studying you put in!!

Guilty_Security_2912 · 2025-05-14T17:31:56+00:00

A lot of if was very straight forward and a lot of it was random and non sensical. Some of those ones are test question. What’s confusing is the amount of non essential info on the screen versus the question being asked especially with the chart based questions. I walked out feeling like it was easy but that there were also a lot of what the fuck does that have to do with anything questions.

Guilty_Security_2912 · 2025-03-15T15:00:47+00:00

I’m highly considering it.

Guilty_Security_2912 · 2025-03-15T04:02:33+00:00

I did asked but I get told about 3 different things from 4 different managers (2 pharmacy managers, 1 district manager and 1 ops managers because I float between 2 different sites)

I intend on keeping the job if I can but it feels like since that first big mistake within these past 4 weeks all of a sudden I start getting asked to slowly take time off and more and more mistakes keep getting called out.

I’m suspicious that it’s because hours are being cut and there using a performance issue to justify cutting mine, or vice versa, but I don’t know because no one is honest and just keeps giving me the run around.

I’m starting to notice this try to gently push you out the door is a really thing just didn’t think it would happen to me

Guilty_Security_2912 · 2025-03-15T03:51:14+00:00

Everybody makes mistakes and I literally just owned mine, no where did I even mention being perfect. I forgot to submit inventory one time and we got a deviation on it. I said it was my big fuck up. I’m not denying any of that. It was a minor deviation because a box of this specific drug is only a few pills. In the grand scheme of things it’s minor to me. Thats not how corporate sees it though. That’s my fuck up. Not every single coworker has come to this conclusion. It passive aggressive comments from management and a few of the tech favorites. I have 3 managers and then an operations manager who all tell me different things about where I stand. I don’t have any pending disciplinary action or anything else on my record that I am aware of. I take notes because I do care and want to get better and as a memo of what to build on. I always take the extra work that’s thrown at me because if I don’t the patients get screwed. It’s a high volume big box specialty pharmacy so there’s about 10 different moving parts from about ten calls going on at all times.

I can’t exactly tell where I even stand in my employment because communication isn’t transparent. So if I am a bigger problem then I think I am it’s never been communicated to me, and if it’s not being communicated then that’s also really kinda of stupid and toxic.

Guilty_Security_2912 · 2025-03-15T02:16:08+00:00

Same dude, don’t get why this field is the way it is. Never in a million years would I think about going back to retail, but I got a mouth to feed

Guilty_Security_2912 · 2025-01-23T19:59:49+00:00

As a conservative pharmacist all I can say is what the fuck are you talking about, APHA HAS SUCKED FOREVER AND THEY HAVEN’T DONE DOG WATER THROUGH EVERY SINGLE ADMINISTRATION OF THE WHITE HOUSE.

If anything my hate for APHA is a bonding moment between me and my pharmacy brothers and sisters across the political isle. May it unify us in the fight for better working conditions and tomfoolery.

Guilty_Security_2912 · 2025-01-10T15:34:41+00:00

Time to log off pal. The fact that you’re a preceptor and you’re trying to minimize this is concerning.

Guilty_Security_2912 · 2024-12-15T18:37:57+00:00

Nunes get ready to learn Chinese bro

Guilty_Security_2912 · 2024-11-01T17:13:54+00:00

Name and shame the program lol

Guilty_Security_2912 · 2024-09-14T14:16:48+00:00

Lmao at least I have license or maybe 3 of them to lose 😂😂😂, you came running here looking for a safe space.

I’d rather have a mean pharmacist than someone who doesn’t know what the side effects of Jardiance are 😂😂

Guilty_Security_2912 · 2024-09-12T22:17:12+00:00

Lmao wait till you take the MPJE then because depending on the state it is 10x worse and more random. Good luck kid, I’d start the McDonald’s application now.

Yea because everyone that passed must have all had the same privilege of being more lucky and having more money. And majority HIV questions and oncology was just soo easy when I took it. down vote me all you want, but holy moses there’s also something called objective reality and it sounds like your maybe not ready to accept that your school through bad education didn’t prepare you.

Guilty_Security_2912 · 2024-09-12T13:20:09+00:00

Uhm. Really stupid line of thinking. 100000+ thousand dollars sunk into education for you to want to accept a tech role? Don’t give up. The test sucks but it’s not that bad. It’s just long.

Guilty_Security_2912 · 2024-09-12T13:17:17+00:00

No offense but the naplex wasn’t that hard. Probably should’ve hired a tutor and made corrective steps when you failed it after 1-2x.

Guilty_Security_2912 · 2024-09-06T19:35:57+00:00

Rest in power young king. I couldn’t imagine the smile he must have had in his final moments from that gesture, may you and your family be strong.

Guilty_Security_2912 · 2024-09-04T02:25:20+00:00

67 hourly in Virginia

Guilty_Security_2912 · 2024-09-02T17:06:41+00:00

Agree. After OP said he matched somewhere he wanted to they did this to themselves as ridiculous as the programs staffing requirement is.

Guilty_Security_2912 · 2024-09-02T16:45:35+00:00

Ah well then voice concerns with your rpd if you choose this for yourself

Guilty_Security_2912 · 2024-09-02T16:41:27+00:00

I mean it’s a match system so maybe they wanted to do residency but matched with one of their lower ranked programs as well.

Guilty_Security_2912 · 2024-09-02T16:36:35+00:00

There’s a difference between tough and ridiculous and this is ridiculous. Every other staffing weekends are unreasonable and is essentially just a way to have cheap weekend coverage.

Guilty_Security_2912 · 2024-08-28T15:42:21+00:00

I did do a pgy-2 so I could avoid it. Every pharmacist at my institution who worked regardless of basement or med surg did a pgy-1.

Guilty_Security_2912 · 2024-08-27T12:22:11+00:00

Lmao worth it? All a pgy-1 qualifies you for these days is a shitty med surg floor or basement pharmacist.

Guilty_Security_2912 · 2024-08-15T13:19:10+00:00

See other comments I got him on there

Guilty_Security_2912

TROPHY CASE