My second IPPE rotation was with Walgreens, and while the hospital rotation went smoothly, my community rotation came with an unexpected twist: Hurricane Beryl made landfall in Texas and caused significant damage and flooding throughout the state. Due to this, the governor declared a state of disaster for our area. Although hurricanes are common here, there is no way to adequately prepare for the turmoil they cause. 

Throughout this time, I kept in touch with my preceptor, Sarah Bui, PharmD, and discovered that the Walgreens location where I would begin my rotation would close due to the storm. During this time, I imagined that pharmacies in the area would face an influx of prescription refills from those trying to secure their medications ahead of the storm, so I looked into this and found that due to the declared state of disaster, the Texas State Board of Pharmacy authorized pharmacists in counties affected by the disaster declaration to dispense up to a 30-day supply of medication (other than a schedule II controlled substance) for patients in the disaster area.

This experience was a unique learning opportunity and gave me a perspective I would not have seen otherwise. After the pharmacy had been closed for two days, power was restored via generator, and  I was able to see pharmacists' role in the aftermath of a natural disaster. Since many pharmacies were closed, there was an increase in patients trying to obtain their medications from other store locations and transfer prescriptions from other chains to our location since it was one of the few open in the area. Many patients, displaced due to evacuations near the coast, came in to transfer their essential prescriptions. This experience showed me how significant the pharmacist's role is and how to address specific issues that patients face in these circumstances, such as being unable to reach their providers. We always hear that pharmacists are the most accessible healthcare providers, and that rang true in this situation. During this time, my preceptor and her team remained adaptable and rose to meet these challenges while showing empathy during a situation that also affected their families. 

In the days following the storm, I learned how pharmacies prepare for these situations and prioritize storing medications that require refrigeration. I learned about temperature-sensitive alarms and the need to relocate medications in some cases before the storm hits, as well as quality checks after the storm to assess the medications and determine if they can still be used safely or if they should be discarded. Despite the delayed schedule, this rotation taught me about the need for flexibility and resilience, which are necessary in community pharmacy; adapting quickly to a changing environment while still providing high-quality patient care is a crucial skill.

During the remainder of my rotation, I integrated with the pharmacy staff and assisted in counseling patients about health issues and symptoms, processing and verifying prescriptions, and providing vaccinations. I also learned company policies and procedures and how to manage staff scheduling changes. I had the opportunity to provide medication therapy management services, where I notified patients of interventions that could optimize their medication therapy and subsequently contacted their providers regarding changes recommended by the pharmacist and followed up as necessary. Additionally, I conducted comprehensive medication reviews to take inventory of the patient's current medication therapy and educate them on their medication action plan moving forward. Overall, this was another excellent rotation experience as I learned more about the profession and how to interact with other healthcare providers, patients, and the excellent team at Walgreens to solve real-world problems. It was undoubtedly an experience that I will never forget.

Aayush Patel, Class of 2025

Mercy Medical Center - Springfield, Massachusetts 

During my APPE rotation at Mercy Medical Center, I had the opportunity to immerse myself in multiple facets of hospital pharmacy, gaining insights across a range of departments. My first week involved learning the pharmacy workflow and observing how various roles—from pharmacists to technicians—operate seamlessly to meet the needs of patients. I shadowed pharmacy technicians to understand how the Pyxis system functions in fulfilling medication orders.

In week two, I focused on anticoagulation management, reviewing patient-specific factors such as kidney function and weight to ensure safe and effective dosing. The next week took me into the ICU, where I shadowed both a nurse and a physician.  The most interesting part of my intensive care experience was witnessing critical procedures, like a lumbar puncture and AV fistula surgery, which highlighted the collaborative role pharmacists play in critical care. They also challenged me to look at patient’s medication list, and asked me to make sure they were on the right medications and the dose.  Additionally, my supervising healthcare team members wanted my input to choose a hypertensive medication that would be correct for the patient. I helped me, a pharmacy intern, to gain experience making a real-life therapeutic decision.

The fourth week was centered around antibiotic stewardship, where I joined daily reviews of vancomycin dosing, monitored trough levels, and adjusted doses based on kidney function to optimize efficacy and reduce resistance. Oncology was the focus of my fifth week.

Through Mercy Medical Center’s connection with Sister Caritas Cancer Center, I shadowed an oncology nurse and saw firsthand the process of initiating a 5FU pump for chemotherapy. Finally, in the sixth week, I explored emergency medicine, observing how nurses and doctors in the ED rapidly assess and treat critical cases. 

This rotation was an invaluable experience, broadening my understanding of hospital pharmacy's dynamic and essential role in patient care.