I am the type of person who plans everything. When I started pharmacy school in 2008, I immediately formulated my game plan, which focused on pursuing a clinical residency after graduation and establishing my career in the field. I never imagined that life would throw me a curveball and I would not match with a residency program. In the aftermath of the match, I found myself humbled, with a shattered game plan and with no “Plan B.”
Fortunately there was an opportunity back home at the Guam Memorial Hospital. It seemed that my humble beginnings as a pharmacist were predestined — I was meant to return to my island, my people and the hospital with which I grew up. I never dreamed that I would have so many opportunities to make a personal impact on the patient care on Guam.
I started working at the Guam Memorial Hospital in September 2012 and was asked to undertake the huge project of establishing an Antimicrobial Stewardship Program. The goal of this program is promote the appropriate use of antibiotics while maximizing our patient outcomes and minimizing toxicity and bacterial resistance. In the next month, I researched the literature on developing a program, presented the proposal to the Internal Medicine Department and the Medical Executive Committee and recruited various members of our healthcare team to form GMH’s first Antimicrobial Stewardship Program Committee.
Since its launch in October 2012, I devote two days of my workweek to perform a retrospective review of patients on our broadest spectrum antibiotics, tracking labs and cultures, tailoring antibiotic therapy to patient parameters and contacting physicians with recommendations and interventions. I analyze hospital-wide antibiotic usage trends and track pharmacy antibiotic interventions on a monthly basis. I have facilitated the acquisition of new antibiotics to our formulary for use in multidrug resistant infections. I have also had the opportunity to present in-services to our pharmacy staff, provide continuing education services to our nursing staff and meet with JCAHO surveyors to present our Antibiotic Stewardship Program initiatives. In addition to my antimicrobial stewardship duties, I supervise the hospital pharmacy workflow, process daily medication and TPN orders and provide support to our nurses and physicians regarding patient care. Outside the pharmacy walls, I participate in brown bag events, diabetes fairs and give career day presentations at our local high schools.
The patient population on Guam is a kaleidoscope of ethnicities — we serve our local Chamorro population, as well as people from Asia, the Marianas Islands, the Federated States of Micronesia and the U.S. Mainland. With our diverse patient population and geographic isolation, we have a unique opportunity to set the standard for patient care in the Pacific region. Our patients are afflicted with chronic diseases, such as diabetes, hypertension and heart disease — diseases where their effects are more pronounced due to our small size and varied population. With that, there is a great need for health care professionals — especially for pharmacists. I am so grateful for the opportunity to come home to Guam and give back to the community that helped mold the individual I am today.
It’s funny how age-old clichés ring true to one’s life story. My personal cliché is “when one door closes, another one opens.” Within a year of graduating with my PharmD, I have gained knowledge and experience that would normally take years to get under my pharmacist belt. As it has played out, my life after graduation didn’t go according to the game plan. But I’ve learned that life doesn’t always happen that way and you have to roll with the punches. And this “punch,” namely Guam Memorial Hospital, has given me more than I can ever repay. It has allowed me the freedom to pursue my love for clinical pharmacy and encouraged my professional growth. I truly feel lucky to say that I love my job! I am so grateful for the constant support and encouragement from my preceptors, from the UH Hilo administration and the Guam Memorial Hospital. I don’t know what the next few years have in store but I’m armed with this wealth of experience and a newfound confidence, excited to take the on whatever comes my way.
For more news from the Daniel K. Inouye College of Pharmacy, browse past issues of Kāwili Lā‘au.