Pharmacists aren’t just pill-pushers; faculty from the School of Pharmacy often have off-campus jobs where they work in a variety of settings.
Clinical pharmacists work in hospital settings and can be involved in mental health, cancer care and even poison control. Some clinical pharmacists choose to specialize, leading to occupations like those mentioned above. These are areas of work that a general clinical pharmacist may not be called upon for since specialized pharmacists have honed their skills into a specific area.
Kelly Gable is a professor in the School of Pharmacy and teaches courses directed towards the mental health side of pharmacy.
“I teach a first-year pharmacy class in patient-centered communication,” Gable said. “And I teach in the third professional year in integrated therapeutics psychiatry topics, like treatment and clinical management of depression, schizophrenia, psychosis, bipolar disorder and anxiety disorders.”
Gable said the School of Pharmacy offers an elective specifically targeted toward education about psychological disorders and their treatment for prospective pharmacists.
“[It] really just focuses on going beyond the pharmacology and clinical use of the medications, and allows the students to think about things from the patient’s perspective, from the health care system’s perspective, related to mental health,” Gable said. “So we do a lot of active learning and discussions, we watch some documentaries surrounding mental health disorders, and we have some discussions about them.”
Off-campus, Gable works in the psychiatric field in St. Louis providing services to underserved communities alongside a psychiatrist.
“Since 2016, I’ve been working as a behavioral health consultant at a federally-qualified health center in St. Louis,” Gable said. “We provide psychiatric medication, assistance or guidance for primary care providers, [and] we work with a team of social workers, psychologists and peer specialists to offer behavioral health resources and treatment focuses for our patients that receive care at these clinics.”
Gable said she typically sees 15 to 20 patients per day and advises them based on where they are at with their mental health.
“From 8:30 to 5 I’ll have a 30-minute slot with a patient I’m seeing for behavioral health focus,” Gable said. “I spend that 30 minutes meeting with the patient, discussing their behavioral health concerns, and trying to really focus in on how we can better help them manage their symptoms. Sometimes that’s starting a medication, stopping a medication, getting them connected to resources in the community [or] getting them connected to therapy.”
Lisa Lubsch, a clinical professor with the School of Pharmacy, also works at Cardinal Glennon Children’s Hospital with children who have cystic fibrosis or asthma. Lubsch, a pulmonary pediatric pharmacist, said her father was also a pharmacist, so she grew up familiar with the ins and outs of the job.
Lubsch said she sees patients and their families after they have been seen by the physician, so it’s her job to explain medicinal therapy to her patients. Lubsch said she typically does this by way of analogy.
“We have a medicine that came out in February of 2019 – it’s been a literal lifesaver – called Trikafta, tri because it has three medicines in it,” Lubsch said. “I teach them that those three medicines work together like a doorway. It works on their chloride channels to open the door – or to open the channel – to bring more people through the door, so that chloride can move through the door to make their body process chloride better. In turn, that means they process sodium and water better.”
Lubsch said she tries to use analogies that kids can relate to and more readily understand, such as the video game Fruit Ninja, a game where the player has to slice fruit that appears on the screen.
“There’s a drug called Pulmozyme that they inhale, and it works by cutting the DNA bonds, so that it’s less sticky, less viscous,” Lubsch said. “To teach the family those terminologies I tell them about Fruit Ninja and how you chop up the fruit into smaller pieces. I’m not saying that it chops up their lungs; it chops up the snot in their lungs into little pieces so they can exhale it or cough it out easier.”
Lubsch said she feels her role in therapeutic education is important, especially for parents who may be reluctant to give their children medicine.
“Besides vaccine hesitancy … I don’t run into hesitancy otherwise, once education is provided,” Lubsch said. “If parents are on the fence, I try to instill the importance of the medicine for the child. I think what’s more difficult for my adult provider peers is they’re able to make decisions for themselves, instead of who I’m working with, they’re making decisions for their child.”
Keith Hecht, an associate professor of pharmacy practice, also works at Mercy Hospital as a specialist in hematology and oncology, which focuses on blood and cancer care.
“I work with a multidisciplinary team that includes nurses and social workers to help people recover from whatever reason got them into the hospital,” Hecht said. “For cancer patients, that’s a lot of things like infections, pain, nausea, vomiting and other side-effects that they may have experienced from their chemotherapy, so it’s a lot of helping make recommendations on how to treat those problems, as well as recommend adjustments to their chemotherapy regimens to decrease the likelihood of those scenarios happening again, and educating patients about medications and especially their chemotherapy.”
Hecht said for cancer patients, and patients in general, he and his team try to get them well enough so they can continue their treatment on their own at home.
“The goal is to get them well enough so they can finish their healing process at home, where it’s more comfortable and they’re surrounded by things that they like and people that they love.”
Like Lubsch, Hecht said he emphasizes patient-provider communication. Hecht said this is a key component for any pharmacist, regardless of the setting.
“We could be super knowledgeable and know exactly what we’re talking about, but if we can’t convey it accurately to a patient so they can understand it, they won’t be able to process that information,” Hecht said. “For me, the way I keep that in mind is I think of trying to explain technology to my mother. I’m sure most students at SIUE can probably relate to trying to explain Snapchat to your parents.”
Gable, Lubsch and Hecht also oversee rotations towards the end of pharmacy school, in a student’s fourth professional year, where aspiring pharmacists work in a variety of settings to get experience in the field and figure out where they want to go with their career.
While we can’t go behind the counter, we can do things to be respectful of the myriad duties of pharmacists and other health care professionals.
“Right now is a very hard year for all the children because of all the viruses around, because we’ve masked up for the last two years. My plea to everyone reading would be to use the best hygiene, get vaccinated, so that you can help take care of everyone, not just the advanced age folks,” Lubsch said.
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