Wednesday, July 23, 2014

H-IPPE: Clinical Generalist

Clinical generalists work on the floor within the medical team
During our experience, each student had at least one evening shift and mine was on the Clinical Generalist day.  As opposed to a distribution pharmacist in the inpatient pharmacy, the clinical generalist works on the floor with a specific service.  The major responsibility of the clinical generalist is to verify the medication orders put into the computer by the doctors.  Most was accomplished sitting at a desk in the crowded work area.  Using EPIC, she kept up with the new orders on her floor, but they also watched hospital wide to quickly verify high-priority orders.

Because I was on the evening shift, there really wasn't much to see other than order verification.  She went incredibly fast clicking away as they came in.  Several warnings would pop up on orders that she would override.  She explained that our clinical judgement allows us to get past some warnings when the benefits outweigh the risks.  Some medications are hazardous with serious potential complications, but if it cures an infection quickly, it would be worth it.  A few times, the clinical generalist calculated Creatinine Clearance (CrCl) to determine a patient's kidney function which would result in an adjustment of the dosage.  Had I seen a day shift, my experience would have included rounding with the medical team as the generalist makes dosage suggestions.

Usually, a clinical generalist completed one year of residency training.  I enjoyed the experience and would not mind falling into that type of position.  While I may not know all the clinical information yet, you do seem to work towards the peak of your certification making judgement calls and having a potentially active role in patient care on the floor.  Nurses would stop by and ask questions or we would search out doctors to make suggestions. Most importantly, the clinical generalist on the floor helps catch medication errors and optimize patient care.

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