Recent OSU College of Pharmacy graduate and current PGY-1 Pharmacy Resident at the Children’s Hospital & Medical Center of Omaha, NE, Guadalupe Ortiz (’15), was invited to Mexico with the head CT Surgeon, Dr. Hammel. During their time there, they planned to establish a pediatric ICU pharmacy for his foundation “Abriendo Corazones.” As part of her residency project, Ortiz blogged about her experiences in Mexico:
It still rather concerns me that medications are continuing to stay out on the work bench in what seems like a disorganized order left in patient rooms. You can find open vials on the work bench with no idea as to when they were open or if they were used.
Disorganized medications continuing to stay out on the work bench
I found syringes of medications tucked into a container of bicarbonate solution. I can definitely say that safety management is going to be a huge undertaking. I think it would be best to take small steps little by little to ensure there aren’t too many rapid changes at once.
Syringes of medications tucked into a container of bicarbonate solution.
Translating here has been a challenge. The medical terminology is completely foreign to me and similarly my conversational spanish is less than optimal given that I don’t speak the language as often as I should. I’m struggling when talking with the nurses. Luckily, they understand a tiny bit of english. When you combine my bad spanish with their limited english, we get
things done!
The more and more I’ve been inquiring about the role of pharmacy here, the more I’m learning that it is non-existent (aside from Miram). The closest thing they have to a pharmacist here in Mexico is a chemist. However, their version of a pharmacist/chemist works in the industry and not really in the hospitals. So, it’s sort of comical when I introduce myself as a pharmacist and no one really knows what that means here in Mexico.
I spent today chatting a little bit with Srul, one of the Mexican intensivists. I explained why I was here and then asked what his thoughts were on making things safer and more effective from a pharmacy perspective. His response, “We need a central pharmacy!” As I chuckled, he looked at me square in the eyes and said, “I’m not kidding!” Although the idea of a central pharmacy would make everything run more smoothly, it always comes down to money here. I learned that almost 60-80% of the drugs are donated. Not only does this just pose an availability issue, but it also does not ensure that the PICU will consistently have the same amount or concentration of drugs at any given time. We talked a little bit more about how I can help his nursing staff become more comfortable with the medications, but didn’t think that it was met with much response, simply because here the nurses are trained to just take orders from the doctors. They are only starting to assess the patient. So in general, I think the issue is that there is a huge education gap and the culture is definitely different here within the medical team.
things done!
The more and more I’ve been inquiring about the role of pharmacy here, the more I’m learning that it is non-existent (aside from Miram). The closest thing they have to a pharmacist here in Mexico is a chemist. However, their version of a pharmacist/chemist works in the industry and not really in the hospitals. So, it’s sort of comical when I introduce myself as a pharmacist and no one really knows what that means here in Mexico.
I spent today chatting a little bit with Srul, one of the Mexican intensivists. I explained why I was here and then asked what his thoughts were on making things safer and more effective from a pharmacy perspective. His response, “We need a central pharmacy!” As I chuckled, he looked at me square in the eyes and said, “I’m not kidding!” Although the idea of a central pharmacy would make everything run more smoothly, it always comes down to money here. I learned that almost 60-80% of the drugs are donated. Not only does this just pose an availability issue, but it also does not ensure that the PICU will consistently have the same amount or concentration of drugs at any given time. We talked a little bit more about how I can help his nursing staff become more comfortable with the medications, but didn’t think that it was met with much response, simply because here the nurses are trained to just take orders from the doctors. They are only starting to assess the patient. So in general, I think the issue is that there is a huge education gap and the culture is definitely different here within the medical team.
Up Next:
- Keep observing the way these nurses handle and draw up medications
- Understand that education is a barrier and try to develop ideas to help the nurses become more comfortable with more sterile techniques when handling the medications.
There will be a series of 10 posts from Guadalupe. Part 5 in the series will be in the next newsletter.
In related news, this team’s work was covered on KETV Channel 7 Omaha News. Click here to see the video.