Patient’s care at heart
This past summer 2013, third-year professional student pharmacist Kristy Walker worked in the Veterans Affairs Learning Opportunities Residency (VALOR) program at the Central Texas Veterans Healthcare System in Temple, Texas. She spent most of her time working in the VA’s anticoagulation clinic, which is one of the ambulatory or outpatient clinics.
Walker managed warfarin dosing, adjusting weekly dosing as needed. She gave initial and follow-up counseling for anticoagulation—the hindering of blood clotting— medications, offering more counseling when bridging became necessary.
Although the VALOR program is highly competitive and difficult to get in, Charles Douglas, Ph.D., assistant professor of pharmacy practice at Texas A&M Rangel College of Pharmacy, said Walker would be a great asset for the program even after only completing two years of college.
“Students who excel don’t just do the homework, don’t just get good grades. Kristy proved she was more than that,” Douglas said. “She passed my first test: she knocked on my door one day and asked me, ‘what can I do better?’”
Walker recognized the Texas A&M Rangel College of Pharmacy as a major factor in helping her prepare for the prestigious spot she earned in the VALOR program.
“College helped me prepare for my internship by teaching me how to manage disease states,” Walker said. “Although each hospital has its own policies and protocols for managing therapy, it comes down to basing your treatment options on sound clinical judgment. You work with the patient’s best interests at heart.”
One thing Walker was able to experience was being the head of her own class.
“I was able to teach a patient education class on smoking cessation. The veterans had already set a quit date, so I provided patient counseling on the VA’s formulary and nonformulary medications to help quit smoking,” Walker said. “Some of these medications have contraindications, or a symptom or side effect that makes a particular treatment or procedure inadvisable. Even though it was up to the patient to choose a smoking cessation agent, the pharmacist had to decide which one was best to dispense.”
The time spent in the VALOR program allowed Walker to have many opportunities that she might not have been given otherwise.
She was able to analyze medical profiles and offered suggestions on how to reduce polypharmacy to physicians and patients. Time was also spent changing medications and reducing pill burden using clinical practice guidelines, as well as utilizing the different practices that she had learned during her time at the Texas A&M Rangel College of Pharmacy.
Dr. Douglas, a mentor to Walker, said: “It is not just a regular internship or summer job. The VALOR program allows students the opportunity to earn more than 400 hours of experience. The program is also beneficial because it does not just train students to work as pharmacists; it allows them to see how the VA has pharmacists that also act as clinicians.”
According to Walker, the Texas A&M Rangel College of Pharmacy prepared her for much of her time in the VALOR program, but the program assisted in her learning how to apply the knowledge to real world situations.
“I knew about anticoagulation through my education at the Texas A&M Rangel College of Pharmacy, but this experience at the VA really helped me appreciate the challenges and complexities a clinical pharmacist may come across when managing anticoagulation therapy,” Walker said. “I wrote a patient education brochure on the risks associated with benzodiazepine use in post-traumatic stress disorder (PTSD) patients, providing alternative therapy options to manage and possibly treat PTSD.”
Walker will return to the Central Texas Veterans Healthcare System for a second internship in the summer of 2014.
Story by Arturo Niño, junior English major at Texas A&M University-Kingsville