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Pharmacy Residency Podcast

Apr 23, 2018

Lindsi Tillo was a P4 with me at the University of Iowa, she's graduating soon and talks about her goals and successes as a pharmacy student and her hopes for the future in community pharmacy practice in Charlotte, North Carolina. 


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Welcome to the pharmacy leaders podcast with your host Tony Guerra the pharmacy leaders podcast is a member of the pharmacy podcast network with interviews and advice on building your professional network brand and a purposeful second income from students residents and innovative professionals welcome to the pharmacy leaders podcast for 24 more hours well graduation is in May but for 24 more hours Lindsay Tillow is a fourth year pharmacy student at the University of Iowa she's had experience working at the University of Iowa Hospital and Clinics as an inpatient pharmacy technician as well as CVS pharmacy and target but she's ultimately decided working directly with patients in a community setting is her passion she starts her pharmacy career in Charlotte North Carolina at CVS Pharmacy inside Target where she hopes to eventually provide clinical services to patients in need Lindsay welcome to the pharmacy leaders podcast Tony thanks for having me okay well we're gonna start with the leadership road everyone's leadership approach is a little bit different tell me a little bit about where pharmacy came into your life how you decided to go to the University of Iowa and then tell us a little bit about your plans for the future I've always been interested in health care and the health care setting my aunt's a pharmacist so I shadowed her and decided that that was the route that I wanted to take I decided that maybe working with patients and getting nitty-gritty with blood and guts was not my thing so I decided to go to the University of Iowa and pursue a career in pharmacy and it ultimately worked out for me I like you said I started working at the University of Iowa Hospital and that's kind of where I got my foot in the door with the pharmacy it was a great experience because I met so many great pharmacists who taught me all sorts of things about pharmacy and about life and it was a great experience but then I started pharmacy school a and had a rotation at Target pharmacy I thought oh this is gonna be awful I don't know if I'm going to like retail I don't want to do this but it ended up being the best thing ever because I will never forget I had a patient who was complaining of muscle cramps and I thought oh I thought everybody just knew that when you had muscle cramps it was because you needed electrolytes like magnesium and so realizing that not everybody knows those little things what was what made me decide that community is where I was needed so then I ended up getting a job in Target pharmacy and I I don't know I just loved it and continued to work there even when we became CVS Pharmacy and we'll continue to work there when I graduate in a month like you said but I will be moving to Charlotte which I'm very excited about okay well tell us a little bit about that curse of knowledge you started off when you you know started off college knew very little about maybe some of the medications and the disease states but now you're at the point where you have to actually take a step back and say oh my gosh I know all this and that's just kind of ingrained in me how do you take it to a patient and get that one-on-one so that you meet them where they are especially with something as simple as electrolytes yeah so it's kind of funny you asked me about that because I will talk to my family and my mom will be like dumb it down for me I don't know what you're talking about and then I'll talk to my aunt and she'll be like on the same page with me just totally agreeing oh I totally get what you're saying and where you're coming from but yeah I just have to take a step back and think about okay where was I you know four years ago when I didn't know well you know all that I know now about medications and pharmacy and I like to think about it like every patient is my family like my mom or my sister and so I like to treat you know just like that and realize that they they don't know all these things that I know and they have other talents and knowledge that I don't so I need to share my knowledge with them but maybe on more of a you know a lower level so that way they get that okay electrolytes is just Gatorade or you know something like that so they kind of can compare the two to every everyday life okay let's talk a little bit about community pharmacy as community pharmacists for a long time I honestly don't feel I should ever be allowed in a hospital unless I go back to pharmacy school and and do that stuff I think that I focus maybe too much on that way but right now it's actually tough to be a community pharmacist because so much of the pressure says you have to do a residency and you have to go to hospital and if you're if you're not in the community you're not working at the top of your license but it sounds like and we'll talk about this in the way that you you worked with the students one on one it sounds like one on one is your best spot can you talk about how you get good at working one-on-one with patients and people yeah so like I said earlier I just really like to think about each patient like my best friend my mom my family and how would I want somebody to talk to them about their health and their medications because like we we just said they don't they don't always know what's going on and they go to the doctor and they're given this new diagnosis and new medications and they're overwhelmed and confused and maybe a little sad or frustrated with their life and so then I like to take a step back and just be their friend but also be there to provide any information that I can just to help them get through it and obviously since the patients come to the pharmacy you know once a month it's a little bit easier to have that long-term conversation with them versus a physician or a pharmacist in the hospital who only sees them when they come in for a visit or are admitted to the hospital so it's easier I think in the community to just sit down with them and take the time to say okay this is but your disease state is and this is what you can do at home to kind of help that you know maybe your diet or exercise or maybe if you just find a friend who has this same diagnosis you guys can get together and talk about it and maybe things will be a little bit better but I like to just encourage them to come to me with any questions - I feel like if you have that relationship with your patients where they feel comfortable with you you'll ultimately get through to them when I first started the first thing that we asked a patient would be are you dropping off or picking up and it seems like you've learned in school or the new wave and we're talking about 20 years later 24 years later from when I started that things are much different so how do you not only engage a patient but how do you keep yourself from being transactional and when a patient comes in saying okay what's your last name or you know what who are you picking up for yeah so I like to approach every patient as how can I help you what can I do to help your day be a little bit better because you're right now everybody's coming in to pick up or drop off a prescription some people just have a question about where's the baby aspirin and so if you take the chewable aspirin low-dose aspirin know there was my parents loved me I know they did but they gave me orange st. joseph´s baby aspirin because that wasn't a thing in the early 70s so it's just and I know we still call it that but yeah that's a that's funny you mention it I didn't mean to derail your train of thought but but how do you how do you let those patients know you care yeah so um I know in school we were taught to and a lot of it was at the community pharmacy practice site but your tie okay if a patient has a question whether it's about their medication or they just want to find a product you go out to the aisle with them and you help them and you ask them open-ended questions so if somebody is asking for their low-dose aspirin you can just say oh you know what are you planning on taking this for or things like that and then if if they say well I really don't know why I'm supposed take this then you can kind of get into that conversation about okay well this could be your diseased state and maybe doing this would also help you and then they kind of feel like oh wow this person really cared about me and they really care about my health so just just starting that conversation instead of just okay how you know are you here to pick up or whatever you know it's sure okay well I'm I'm from the East Coast and my wife has said over and over again how it's not the people in the East Coaster mean it's just they're not as nice or they're just not as you know so bored and and I you know I've learned to wave to people I don't know I've learned to lift the second finger off of my hand off the steering wheel to say hello to people I'm passing but tell me a little bit about how the curriculum at Iowa gets you prepared to talk one-on-one with people and to help them out with the students I'm embarrassed to say this but at many times the students would say yeah I'd rather talk to Lindsay then talk to me and that's both hurtful and wonderful at the same time for you but tell me how did the curriculum or what are the classes or what are the professors that really allowed you to make it so that you're extremely welcoming yeah so I think a big part of that was our lab our ppl is what it's called we did a lot of mock interviews and we had you know actors come in and even interview them and I think preparing for that I would work with the professors and with my friends and we would just kind of think about okay how would I want to be treated in the pharmacy or when I go to the doctor's office and how can I relay that you know in this interview with this pretend patient and really make it as real as possible and I think the University of Iowa did a really good job of making it feel real like you were really in a pharmacy and I think a big part of that to also came from working at the core oval target my pharmacy manager Chris maybe she really told me that you to make it a conversation with the patient instead of just these are the side-effects here's your medication you need to make it open-ended you need to have them respond to you as well as you giving them information and I think she was really the one that shaped me to be more welcoming towards individual patients like that so we're close to the end of you know a lot of people are looking for jobs some people unfortunately didn't match the chances of matching in match two are not the best and then in the Scramble it's about 5% so tell me how did you get a job in what is sometimes a difficult job market well honestly I have always known that I've wanted to go to North Carolina it's just something that has been on my mind for a really long time so I got in contact with my district manager for target a CVS Pharmacy inside Target and just said hey this is what I want and would you have any contact information for somebody there and he gave me an email address for the district manager of Charlotte and so I just emailed him my resume and said you know I'm interested in a position and when I graduate is there any possibility of that and it just went from there when did that happen though when did you send out your resume so I might have done that a little too early I didn't like back in August in September but it works for me I'm just a little bit I like to be prepared well if you know you know you know okay all right well let's talk a little bit about teaching so I've learned it's my first time taking ap PE stands for my first year taking ap PE students I had j-term students for a long time and and I wasn't sure if I had enough to give them but I felt comfortable this year doing it and what I've done is in the first 48 hours your live teaching with someone and I thought that's great but maybe I could have done that a little better so tell us a little bit about the experience you had teaching the first time what maybe as a preceptor I could have done a little bit differently to let the other preceptors out there know that hey your student might not give you feedback but I'm certainly willing to take it yeah so my situational is a little unique because I chose this rotation for many reasons but one of the biggest reasons I chose it is because I get a little nervous speaking in front of large groups and so I figured okay I have to do it I might as well just jump in and get as much practice as much feedback as possible so that is why I chose this rotation so when you told me I was going to be lecturing in front of 60 students I just got butterflies in my stomach I was so nervous but ultimately I knew okay these students were once in the position I they are in the position I was once in and how did those professors that I had what did I like that they did and what can I do to kind of make it more comfortable for these students and really help them learn and just kind of sucked up my nerves and I I know you told me that I speak a little bit too fast and I don't think that's something that'll ever change but there are some strategies we've talked about which is writing on the board so it slows you down and or writing in the answer so it slows you down because I'm also a fast talker but I think that their students are pretty forgiving if the next time you come back and you crush it but you also started making sheets that would help them so tell me a little bit about how things really became concrete as okay so I was giving them the information the first time but then the second time around you had at least 25 questions for the whole for the lecture so tell me a little bit about your your change in mindset and your preparation because it wasn't just okay I've got to really know the stuff you knew the stuff that wasn't the issue it was how do I make it like I would want it to be yeah so I remember I had a professor dr. Slagle who he would create handouts instead of powerpoints and I really liked that process so I decided to go ahead and recreate that and have a handout instead of a PowerPoint for these students and I made a whatnot eight or nine page handout and you're like there's no way you're gonna get through this in 90 minutes but I did and I did it in like an hour so after that I decided okay I've got to do something to engage the students a little bit better and to slow myself down and I figured okay what's the best way to do that but ask questions to lead into the next thought and the next idea and so I just started coming up with these questions based on the material I was giving them and thought okay this is a great way for them to really learn and become engaged in the in the class okay let's talk about some of the specific tips maybe we can give another student who might be going on an academic rotation or something like that tell me how you pause to wait for someone to answer because how do you deal with that silence when you ask a question and nobody immediately responds that was the worst our pharmacy class is known as the quiet class because literally no one will answer and so when the professor's all say oh you are the quiet class now I get it I get their pain and they would through I man I can be inpatient sometimes so when I asked a question I was expecting an immediate response and then I remembered okay I didn't like to answer questions because I was a little nervous about being wrong and I was nervous about being put on the spot so then I just remembered okay and you just take a step back and let these students think about the question for a second let them really like you know think about it and look up the answer if they need to and then eventually somebody will answer because they'll be so uncomfortable as well yeah the book says forty-three seconds is how long you're supposed to wait and that that seems like an eternity and and you you really as a student you get knocked if you do answer or you don't answer so if you do answer and get it right people are like Oh show off yeah and if you do answer and get it wrong then you've got of you getting it wrong so there's no win really for the student except when it becomes so uncomfortable too quiet like I'm just gonna answer it because I just can't so that's that's tough and then you handled that well well let's talk about your you're also your bread and butter which is students love you one-on-one they love to have you there have you next to them tell me a little bit about how you've worked with students one-on-one yeah so I had a lot of students especially in your chemistry class that would come up to me for questions on their homework problem and I remember thinking I haven't done chemistry for like six years I don't know if I'm gonna know how to answer these questions but it all came back to me in an instant so I was thankful for that but I just when I was in college I obviously went to the University of Iowa and so I had a big class and you didn't get that one-on-one work unless you went and asked for help and so I didn't always go and ask for help but when I did I the TA wouldn't always be much help for me because they would be speaking over my head so it kind of goes back to talking to the patients about you know on their level and so I would talk to the students on their level and try to just okay I need to go back to the very first step and why am I doing this and how can I explain this in a way that's going to make sense to them so that way they can replicate this same problem for the exam yeah and I I have people I have students teach chemistry and pharmacology and it's what students have says it's nice to have something that you can if you need to you know refresh or pick up again but you know maybe in a second-round critical-care rotation where you're there for 12 to 14 hours you never get that feeling of I got it I've got it down with these students and then you know you you had that you know you say five or six years ago and then you had you know pharmaceutical Kim and all those things I feel like tell me a little bit about how being able to be an expert on something improves your confidence and maybe not just in the classroom but your confidence as you go out and become a pharmacist yeah so I like to think about this as if I prepare for a class I'm going to know what I want to say and what I want to do and then I'm going to come off as confident and the students are going to really truly believe what I'm saying the same thing goes for pharmacy practice so if I tell a patient oh you know you shouldn't give your your child aspirin but I'm like oh maybe you shouldn't give it to them they probably aren't going to believe me and they're gonna think that I don't know what I'm talking about so if you just really make sure you look up or you know what the answers are and you come across confident you know everybody's gonna believe you although with that being said you also especially in the healthcare profession need to know when you don't know something so if you aren't 100% confident you need to say mmm I'm not sure let me look that one up for you know that those are the three toughest words as a healthcare professional to say I don't know and I'll have to look up for you well um one other thing I wanted to go over so you're you're going to Charlotte and you know you said you wanted to do this for a long time tell me a little bit about what you're hoping for in the future you did get to talk to someone who is working in Charlotte now tell me a little bit about what your future looks like well I'm really excited to go to Charlotte for several reasons obviously the weather and the environment is kind of what drew me there but I also really like how progressive they are with pharmacy practices so pharmacists can become providers in the state of North Carolina and I really like the idea of doing that to help provide patients with clinical services you know so maybe monitoring their blood sugars and helping them adjust their doses of insulin if they need it or their hypertension medications I just like being able to do little things like that and I feel like then the patient really truly appreciates your help because they don't have to make an extra doctor's appointment or they don't need to you know worry about oh no I have a no duck appointment for a year I can't get a refill so being able to provide those services could be a huge step for a pharmacist and I really want to be a part of that so I'm really excited to learn how to how to really change the pharmacy practice and I feel like North Carolina is a good place to do that well so I this is the other Iowa school at Drake where Anna Shields picked you picked her residency because of the state's laws and I've heard that that's more common where you feel like you're going to learn more because the state allows you to do more and so when you say top of your license I didn't think about that until just now that that means something completely different in two different states so what are some of the other things I'm guessing that you've already started looking at the pharmacy because you knew where you were going tell me a little bit more about picking a state based on those kinds of things the the ability to do more things than you would at another yeah so I think it's important to you know before you decide where you want to end up especially right out of school you need to consider those Pharmacy laws because if they're doing something that you're not interested in or you don't want to do then that's probably not a good place for you to go I think what really actually helped me and this was kind of after I got the job and everything but I I talked to Jessica in North Carolina for your podcast and she gave me a lot of really good information and a lot of good advice so I think reaching out trying to find somebody who's in a similar position that you're in it's a really great way to learn more about the state and see if whether you think it's a good match or not for you and obviously always going to shadow the pharmacy or talking to the district manager about the differences from state to state might be a good idea as well well I've asked you a lot of questions do you have anything else you want to say here the day before you're done with the pharmacy school especially to those people behind you and the classes behind you I guess what I do want to say to especially those p3s out there I remember my first day as a p4 student on rotation and I remember thinking I do not know anything I'm going to fail this is gonna be awful but I you know when I was asked as tough questions it all came flooding back to me and I knew what I was doing so just be confident and don't be afraid to ask questions okay well thanks not only for being on the pharmacy podcast but thanks for helping the students that you have helped over this last semester thanks Tony support for this episode comes from the audio book memorizing pharmacology a relaxed approach with over 9,000 sales in the United States United Kingdom and Australia it's the go-to resource to ease the pharmacology challenge available on audible iTunes and in print ebook and audiobook thank you for listening to the pharmacy leaders podcast with your host Tony Guerra be sure to share the show with a hashtag hash pharmacy leaders