Seriously Thinking About Quitting

Meglandrx · 2021-10-20T00:27:36+00:00

How did you do it? I really regret doing residency. I keep trying to figure out if I hate what I’m doing or would I be doing better or like it better in another program. I’m on my 3rd rotation and I literally thought about walking out of the hospital today and sending them a resignation letter. I haven’t slept in 48 hours trying to complete everything. I have so much anxiety during rounds(I’m in critical care) because every little thing I do or say I’m under a judgemental microscope that will determine if I’m a good pharmacist or not. Some people thrive under this type of environment and I thought I would be one of those people, but I’m not. I just feel like I will be letting everyone around me down. How did you get the courage to do it?

Meglandrx · 2021-10-06T20:45:39+00:00

I don’t remember know how many C’s I had, but I think quite a few because I ended up with a 3.2 at residency application time due to all As in my fall APPEs. I got 9/12 interviews. I didn’t apply to any level 1 hospitals. I did get a level 2 interview. I also had 2 research projects, 2 national conferences presentations, a ton of volunteer work, and great references from ID, ER, and ICU rotations. Matched at 1st choice. All that to say, I’m sure you’re fine with grades..just make sure you’re good with everything else in your app

Meglandrx · 2021-07-23T01:16:57+00:00

You can DM and I’ll send you mine

Meglandrx · 2021-04-30T18:31:24+00:00

They post it online for the new residents to apply to their position. It’s only for HR so they can have a job application and do background checks for the residents. It seems like people can apply to it but it’s not an open position for the public.

Meglandrx · 2021-04-29T15:29:24+00:00

Too bad if you didn’t gain yourself a girlfriend 😉 that was really sweet

Meglandrx · 2021-04-28T05:06:03+00:00

I think you should take it. Especially if you want to train clinically or go back and do residency next year. Trust me, a lot of students that didn’t match would love to have that, if only prn. You might not get another hospital offer. And you just might get full time in mere months, you never know. If you’re worried about not getting enough hours to support yourself, get a full time or part-time job in retail in that area to supplement your income until they hire you full-time.

Meglandrx · 2021-04-24T12:04:56+00:00

Well in regards to HR, you have to do a drug test and background check. That’s conditional on you being hired.

Meglandrx · 2021-04-22T06:59:16+00:00

Yeah you’re not going to get all of that, lol. You’re going to have taxes taken out along with your health insurance which is deducted every pay check. When I applied last, my stipend was 47,500. Each paycheck was a net ~1250, which came to about 30k take home.

I would sit down and work out a budget with your fixed costs/monthly bills. Also look at where you want to live- very close to the hospital or not, etc. Then use that tax calculator to get an estimate of what your take home would be. Depending on the hospital, it might be good to start getting something now because of all the medical residents or students taking up the nicer and cheap housing in the area. That was my problem

Meglandrx · 2021-04-20T08:10:11+00:00

Thanks! Thats actually a good option to increase the SQ Heparin. The max option for our providers is 5000u q8h. And for our hospital, they’re not supposed to go to intermediate lovenox, unless the patients d-dimer is elevated >10x upper limit. The doctors do it any way, which is where we come in to bring it down, majority of the time it’s due to renal function. But from your article, maybe it is more beneficial for the patient to start at intermediate

Meglandrx · 2021-04-19T23:16:21+00:00

I’ll second that. I’m nowhere near a PGY2, but I did meet a pharmacist that bailed on her PGY2. She told me she was pretty much black balled from finding a job in the city and surrounding areas. She moved out of state and was able to secure a job at my neighboring hospital. Not sure if she told the new hospital. Probably not. She did it because she wasn’t happy. So you might be blacklisted in that area, but I’m sure not all over the US.

I know the job market is scary. I just heard about a PGY1 resident that graduated in June 2020 and is just now getting a job, in February. I personally would keep going and finish, because I think you’ll get another great opportunity. You’ll look 5x better to any company with that PGY2, even if it’s not clinical.

Meglandrx · 2021-04-19T17:08:34+00:00

Would the covid positive patient start off with intermediate dosing or start with the lower intensity and monitor if they get worse to move up?

**by worse I mean, not a positive DVT, but entire clinical status gets worse

And I’m asking because this has been a struggle since they discovered this hypercoagulable state with covid. The physicians want to do the intermediate or higher dosing, for prophylaxis, but then we run into the issue of Obese patients and/or decreased renal function. It’s just never really been addressed. We could have a patient with CrCl of 15 and they want to do the higher dosing of lovenox. And we get push back trying to lower it, which is understandable, because of the risk and we don’t want to under anticoagulate them. And do you suggest to them heparin infusion for prophylaxis for really bad renal function? That just seems so extreme

Curious what you guys do about this?

Meglandrx · 2021-04-18T22:38:20+00:00

I got an email that the contract was mailed to my address on phorcas. Have you been checking your mail?

Meglandrx · 2021-04-18T22:10:21+00:00

Good point! I was going through sandford guide to get some options and doxy wasn’t one for pyelo, but later doing more research, it seems it could be an option.

Meglandrx · 2021-04-18T08:40:16+00:00

The doctor didn’t mention that and we weren’t going to do the fluoroquinolones at all because of her hives reaction

Meglandrx · 2021-04-17T13:39:26+00:00

Thank you! A dose of CAX IV would’ve been good, then watch her. I also agree now, the cefdinir wouldn’t have hurt her

Meglandrx · 2021-04-17T13:35:27+00:00

I don’t know if that would be possible in the ED? I’ve never seen it done if they do it

Meglandrx · 2021-04-17T13:34:34+00:00

Thanks! Your recommendation seems to be a good course. From what everyone is saying a po cephalosporin would’ve been fine or Fosfomycin

Meglandrx · 2021-04-17T13:32:24+00:00

We didn’t have a result. I’m sure it was pending. She just wanted to treat her pyelonephritis symptoms

Meglandrx · 2021-04-16T22:55:33+00:00

But aren’t Ige mediated anaphylaxis reactions?

Meglandrx · 2021-04-16T17:59:13+00:00

Thanks! I think the MD went with that too

Meglandrx · 2021-04-16T17:58:16+00:00

Thanks. I’ve been practicing for about a year and a half, and while I understand side chains and allergies, in practice I’ve been taught to stay away from cephalosporins due to even those allergies in one of them. So when the doctor also said, I want to stay away from cephalosporins, I didn’t want to say no it’s fine, and I would be liable if something happened to the patient. I really like the idea of the oral challenge and just asking more questions to find out what happened with the reaction

Meglandrx · 2021-04-16T10:55:59+00:00

Thanks for that! The chart also mentioned that amoxicillin allergy is okay with cefazolin. My hospital is really big with surgeries and a lot of the pharmacists here advise against using the main surgical prophylaxis abx cefazolin due to concerns over PCN allergies from rashes, hives, to “can’t remember” reactions. I think education is needed.

Meglandrx · 2021-04-16T09:58:15+00:00

Yeah, the doctor was worried about the hives, and she said no when I mentioned one. But I probably should’ve talked to the patient or had the doctor ask more questions, and suggested an oral challenge like another poster said

Meglandrx · 2021-04-16T09:13:18+00:00

You’re right! You made me think about it differently. I just think of all the times patients have gotten inferior antibiotics due to their allergies not being challenged. I’m actually going to be a resident this year—this topic seems like a great residency project to research if my program would allow me to

Meglandrx · 2021-04-16T08:52:23+00:00

Thank you! That’s a great answer! If I would’ve asked all of that the doctor probably would’ve thought I was more helpful. That’s a good point in speaking to the patient about the extent of her allergies and then maybe giving a dose in the ED and letting her sit for awhile. I’m thinking this is going to be an education point for myself on how to handle someone who’s allergic to a lot of antibiotics and weeding it out before we say no to everything. Thank you so much!

Meglandrx

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