COVID-19 and Advanced Pharmacy Practice Experiences: A student’s takeaway

It was approximately 6 AM when “Code Blue Main Tower” was heard on the intercom. That was one of many code blues that day, a day that would never be forgotten.

One of the most significant mile markers on the road to obtaining a Doctorate of Pharmacy is the student progression from the didactic years to Advanced Pharmacy Practice Experiences (APPEs). As incoming APPE students await rotation start dates, varying states of eagerness, anxiety, and uncertainty may loom. Pharmacy schools have prepared students for this transition from a predominantly classroom-centric experience to one that is practice-centric. However, no one was prepared for a global pandemic. Welcome to the first APPE during a pandemic.

Coronavirus disease (COVID-19) swept across the world in 2020 and affected pharmacy practice in numerous ways. As my first APPE rotation started in June 2020, a few pharmacy school colleagues discussed our concerns about going forward. I could feel the uncertainty in conversations with peers as the world’s state became more alarming, and the level of uneasiness rose. As pharmacy students, we had prepared ourselves with clinical knowledge and skills, but not enough schooling could have prepared us for APPEs during a pandemic.

“Code Blue Main Tower” were the 4 words that sank my heart continually that day. That was the sixth code blue called that morning, and being on the front lines gave a different perspective as death and chaos consumed the day. As at many hospitals across the nation, capacity had been reached. Many thoughts ran through my head. What if I contract COVID-19? What if my parents get COVID-19? What if my patient dies? My mind was racing with uncertainty. However, at the same time, I was eager. I wanted to be here and be part of the health care team. I wanted to contribute in any way possible and make a meaningful difference. I wanted to put my best foot forward and lend support. Although up for the challenge, I could not confidently say that I was 100% prepared for what I would encounter.

In pharmacy school, we mostly learn clinical knowledge and skills. Expressing and handling emotions are not emphasized as much, and I had yet to encounter a situation in a professional setting that was emotionally draining. I have always struggled with expressing myself, and I tend to compartmentalize my emotions and carry on. However, one thing I learned quickly is the importance of being human. But how do I cope with emotions that I cannot explain? How can I accept watching someone I have been taking care of die? Is it okay to feel sad, overwhelmed, scared, or numb? Growing up, I was told on several occasions that showing emotions is a sign of weakness or that it is “not tough.” After all, I am human. I was reminded of a reflection written by Jennifer Ku, PharmD.¹ It struck down my emotional barriers and reiterated that yes, it is okay to show emotions and to reach out for assistance, and “Yes, you may cry.”¹ Some days are easier than others. There are good days and not-so-good days. However, we can take comfort from the situation at hand and embrace the uncertainty.

One key takeaway to note is that we can choose how we respond, although we cannot always control what happens. I am still searching to see how I can use this time to get better, grow, and be of service. Witnessing the camaraderie that has arisen in the health care field and the bravery of those serving daily to ensure that their patients receive the best quality care has shown me that we will overcome this pandemic together.

Pharmacists and their teams are vital health care providers. They remain on the front line of public health, serving their patients. No matter what profession or field we are in, we can all be of service in some way, shape, or form. During the COVID-19 pandemic, putting forth our best efforts to serve, love, and care for those around us goes a long way. I have seen the difference it can make, and I want to emphasize to everyone that it is okay to be human, to have feelings, and to express emotions.

“Code Blue Main Tower.” Those 4 words that sank my heart that day have now shown me that it is okay to be human. That the human spirit in all of us will rise, continue to fight, and display courage, justice, and wisdom to be the change force that is needed throughout APPE rotations and beyond. I just have to choose how I respond.

Biography

Kyle Fischer, MBA, Student Pharmacist, Texas A&M Irma Lerma Rangel College of Pharmacy, Kingsville, TX