The last steps are sometimes the hardest

Its almost done, just 3 more days of rotation, one of which is a half day. It always seems that the last few days of the rotations are the hardest, partly because of the frustration of working for so long for nothing, partly because of excitement about the next step of the journey, and partly because you are one foot out the door. This week was relatively sedate. I spent monday just going through the motions, tuesday and wednesday I was at Tsaile filling in for a contract pharmacist who called in sick. I got to do all the counseling and actually enjoyed myself. I worked with Terry the Navajo pharmacist and had a pretty good time, and was even able to pick up on a few Navajo words. Today was spent working on a few projects only to have a big one dropped in my lap. I have to write a therapeutic review for the hospital's PandT committee by the end of business on monday. I need to do the therapy and cost analysis for anticoagulants on formulary and make my recommendations. It should only be a 7 or 10 page paper, but I need to read through dozens of studies and guidelines to get it done. I wish I had more heads up, but it shouldnt be too bad.

This week I have really gotten frustrated by the waste of the Federal system. I wasnt expecting the federal government to run smoothly, be cost effective, or motivate its workers, but this is just ridiculous. Every day I am shocked at the amount of free drugs just walking out the door. Because there are no costs associated with the treatment there are a lot of patients who dont take a proactive role in their health care, they dont have to worry about the ramifications of their conditions because uncle sam will always be there to step in and pick up the tab. The ineffectiveness of the system would never fly anywhere outside of the federal system. If this hospital was a business venture then it would have gone broke years ago. Patients some times have to wait for hours to get their charts sent over then reviewed, then sent back to get edited by the doctor, then sent back to the pharmacy to be filled, people will seriously wait for 3 hours to get a bottle of baby aspirin. Its pretty embarrassing for me to tell someone this wait when I know that the script could be filled at walgreens in a matter of minutes. The staff isnt very motivated, there are a ton of people in the pharmacy and some of them just seem to be treading water. One staff member actually said to me "I need to slow down before I run out of work for the day". I realize that I am not highly motivated, but this is an unpaid internship, and this is her full time job. I dont want to swear off the federal system for good, because who knows maybe ill be a mercenary contract pharmacist in a few years, but right now it is way to frustrating for me.

Tonight I went out to the chinese place in Chinle with my medstudent roommate Ravi and the med students from next door. It turns out that one guy's parents actually live in Saratoga so it turns out to be a pretty small world after all. The best part of all is that the chinese was actually pretty tasty, I was surpised. I am going to the Chinle flea market (navajo selling stuff place) tomorrow and then I will be relaxing all weekend, getting packed and then getting ready to start the drive home.

-O