SHAC Clinic

SHAC stands for "Student Health Action Coalition".

It is a student-led clinic that provides free services to the underserved population of Carrboro and Chapel Hill, NC. Every Wednesday night from 5:30PM until the last patient is seen (generally 11PM), volunteers from the health profession schools run the clinic, including medical, pharmacy, nursing, public health and social work. 

A little bit of info about how it works: 

A patient will arrive at the clinic either by appointment (preferred) or walk-in and will be put into the system by a nursing student. He or she will get vitals checked (blood pressure, height, weight, heart rate, respiration rate) and then the nursing student will go into the room where all of the volunteers are and a pharmacy student will take the chart to see the patient. 

Once the pharmacy student has the chart, he or she will see the patient and ask what the patient's chief complaint is (regular check up, fever, earache, etc.). The pharmacy student will also ask the patient what regular medications he or she is taking, ask about any medical allergies, and ask if he or she would like to get the flu shot (administered by other pharmacy students). 

After that, the pharmacy student leaves the patient and goes back to the room to find a medical student team. The med team assesses the patient and writes a SOAP note. Depending on the situation, a prescription may be needed. 

If a prescription is needed, the med team will confirm with the on-site Attending, and after approval they will have the pharmacy student write the prescription. The Attending signs the script and the pharmacy student goes back to the patient and counsels him or her on how to correctly take the medication. If the medication is part of the SHAC Formulary, then it can be dispensed on site for free (something new this year made possible by a grant the Clinic received). 

Finally the patient is able to go home! 

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Last night was my first time volunteering at the clinic. There are only 6 spots per Wednesday night for pharmacy students, and 3 of them are for PY1's. Needless to say, the sign-up fills up quickly! 

Normally there are 3 PY1's and 3 PY2/PY3's and are put in pairs throughout the night. However, last night 2 of the PY2/PY3's canceled, leaving just 1 veteran volunteer. This gave the PY1's more opportunity to do things on our own. 

I was partnered with a PY2 seeing my first patient and she did all of the talking. The second patient, I spoke but the PY2 was there to watch and make sure that I was hitting all of my points. My third patient, I saw all by myself! It was a great experience to talk to a patient and figure out what he or she was coming in for. I felt like a real pharmacist! 

Along with speaking to the patient for the chief complaint and flu shot, there were a few prescriptions that were written last night as well, and I got to write one! It was hydrochlorothiazide, a diuretic to help control hypertension (high blood pressure) by reducing the total blood volume. I also got to counsel the patient on how to correctly take the medication :)

It may seem simple to counsel, and it generally is, but you just have to make sure you say everything clearly and understandably. 

Just for example, I'll demonstrate: 

Because hydrochlorothiazide is a diuretic, it will make you go to the bathroom more than you do now. It is recommended that you take this in the morning instead of at night so that you're not waking up in the middle of the night to go to the bathroom. This particular script was written "1t po qd", or "Take 1 tablet by mouth once daily". If you miss a dose, take it once you remember, but if you remember close to the time when you would have been taking the next tablet (say, a couple of hours), then just take 1 and keep to your normal schedule (don't double up). 

Your blood pressure should lower after the first couple of days, but you won't be able to feel a change. It's important to regularly monitor your blood pressure either by your own home-machine or you can go to any local pharmacy and they will have monitors there you can use. Because it lowers your blood pressure, you may experience some dizziness if you stand up quickly. This should go away after a couple of weeks, so in the mean time just be sure to be careful standing or sitting up quickly. 

What questions do you have for me (open-ended questions!)?

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Overall, the experience was very valuable. The patients were great and very informative of their issues. Working with the medical students was interesting and I enjoyed the discussions with the Attendings of the patient assessments and prescription recommendations. I also convinced a patient to get her flu shot.

SHAC Clinic was the first of its kind in the country, and from what I hear many schools will visit to try to develop their own type of SHAC. It makes me very proud to be a UNC student to be part of such a great organization! I was able to sign up for a couple more nights this semester, and I can't wait!