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! 

First week of school!

Well, the first week of school has come and gone already!

Let's go day-by-day...

Day 1: Wednesday
According to any older student I spoke to, the seat you get in the first week or so is the seat you'll have for the rest of the year (and some say for all 3 years!) Consequently, that means you have to get to class VERY EARLY. Taking this literally, a few others joined me in arriving at the building at 6:50AM. Waking up before the sunrise is not fun when you've been sleeping until 3AM every night of the summer...

I got the seat I wanted! Third row, where there is a stair for my height issues, and not too close to the center to be in direct vision of the professor, but not so far to the side that I can't see the board.

[8:00-9:15AM] First class is Basic Pharmaceutics 1 with Dr. Moo Cho. He's a petite Asian man with a thick accent, but he seems nice. This class is what I'm afraid of most, so I'm guessing I won't like him for long. I shouldn't jinx myself, though!

[9:30-10:45AM] Then comes Biochemistry... which apparently will be exactly like BCH4024 at UF. Doesn't mean it will be any easier, but at least I'll have been exposed. The first few lectures are orgo reviews... fun!

[11-11:50AM] Third, is Physiology. Three years ago, it was taught in conjunction with the medical school across the street, but then the pharmacy school decided to bring it "in-house" and now it's taught by a UF Alumnus! Dr. Andrew Persky is super awesome (obviously, my adjective handbag has thinned out a bit).

Common hour is 12-1PM. No classes or review sessions are allowed to be scheduled at this time. These are usually when meetings are for organizations... quite convenient! On this day, there was an informational session/lunch provided with Kappa Epsilon, the all-female pharmacy fraternity. Met some great girls and seriously considering pledging :)

[1-2:50PM] FINALLY, came Health Systems. Besides scientific courses, part of the curriculum are courses that teach you about the other aspects of health care. This particular class will teach some practical things, including: structure of the US health "system" (in quotes because ours is so fragmented, it can be hardly called a system... ask me about it!), Medicaid/Medicare, health reform, medication therapy management (MTM), and public policy.

Despite the class being right after lunch and the end of a long day, the discussion-driven style keeps you awake, plus it's refreshing to talk about things that have real-life applications.

Wednesdays are the LONGEST day for PY1's. Schedules aren't regular (MWF, TR) so this just happened to be the day that all classes meet. It was nice to experience that first so that the initial exposure was rough and all you can go is up!

Day 2: Thursday
Since Day 1 was so long and started early, I was able to sleep early again but there was no need because my first course didn't start until 1PM!

[1-5PM] Pharmaceutical Care Lab. I think I'm really going to enjoy this lab. It's structured into Medical Terminology, Top 200 Drug List, Compounding, and Self Care. Each we we'll have lists of terms and drugs to learn and be quizzed on. Some days we will compound, and others we will have presentations of assigned over-the-counter/herbal remedies. We will also learn how to use blood glucose monitors and how to check blood pressures so that when our patients ask us, we can instruct.

We also must dress professionally to each lab. Love dressing up! Although this means I will have to buy some new wardrobe...

That night was another KE event, a dinner with the girls. Met even more great people!

Day 3: Friday
Fridays vary in length because some classes are canceled and the others are optional review sessions. This particular Friday, it was just a physiology review on the renal system.

During Common Hour, Senate sponsored a lunch to have with our mentors. My mentor is amazing! But I won't get into too many details :)

That evening was the CAPS Back-to-School Picnic where interested students got to see what they are all about. I'm stoked to be a part of it and all that they do. Among many things, they have numerous patient care projects including: Generation Rx, Operation Immunization, Diabetes, Women's Health, etc. It's a great way to be involved in the community and in campus.

Overall, great week! Can't wait to get into the meat of the classes next week and experience a full week plus work.

Cheers!

Orientation Day #2/First Dose of Franklin

Second day of Orientation was on Friday and was much shorter (9AM-12:30PM). Met a lot more great fellow classmates :) I think my favorite part was listening to the presentation about "Getting Involved" from 2 school leaders. It both inspired and intimidated me; I'm not sure if I could ever follow in the footsteps of those guys!

Afterwards, I treated Errol to lunch for dropping me off/picking me up from both days of Orientation. Thank goodness for his GPS on his handy-dandy Droid because we can just type in what we're craving and it will lead us there. I was craving some pad thai noodles, so we were led to Thai Palace on Raleigh St.

It was very delicious! I had my usual (always try out the noodles every Thai restaurant I go to) with thai iced tea and Errol had some curry with rice noodles. Not the biggest fan of curry, so I didn't try his plate, but mine was so good! The portions weren't large; we finished both of our meals (which is very rare for me) and the prices were very reasonable.

That night was the first Dose of Franklin at The Library on Franklin St. The "Doses" are sponsored by Student Senate as a social/fundraiser ($3 cover before 11PM went to Senate). Beforehand, a fellow PY1, Errol, and I joined in on some pre-gaming with PY2's. Had some delicious shots and was introduced to the games, "Boom" and "Last Word".

The Library was a lot of fun! It was packed with fellow students and it seemed like I could approach anyone and just introduce myself. Had some Rx Shooters, Washington Apples, Apple Sauce, and another one I don't remember. But all were yummy! Met a lot of new people and hung out with ones I met at Orientation.

Overall, great day!

Orientation Day #1

I survived my 40-hour work schedule last week with only minor injuries to my sleep cycle. Woo!

Then, at the end of the week we had visitors from Michael (Errol's roommate for 3 years) and his girlfriend. They were visiting his grandparents in Burlington and stayed with us for 3 nights.

We spent those days exploring restaurants like Allen and Sons (best BBQ around, apparently). Carolina BBQ is supposedly a very serious discussion between Western and Eastern Carolina. East vs. West, tomato-based sauce vs. vinegar-based sauce, etc. etc. There are even historical books about Carolina BBQ! It's very important up here.

Then my roommate of 3 years, Stu,  joined us on Sunday on his way back from his summer internship in Rochester, NY. It was such a great reunion, even though he just stayed for a few hours! We went to Top of the Hill, which I like to compare to The Swamp in Gainesville. What's cool about Top of the Hill is that they brew their own beer! I don't like beer, but it was a cool site.

Literally at the same time Mike and Lauren left Tuesday morning, we received our final visitor! An adorable 9-month-old, pug-retriever named: Codeine.

It was my first experience taking care of a dog, and I must say it was a great one! It was just for 24 hours but I already miss him now that he's gone. He was potty-trained, didn't bite, didn't lick, and stayed where he was supposed to be (aka out of the bedroom). He was so great!

Having all of the visitors was perfect timing because I'm very impatient and it was good to have all of the wonderful distractions while waiting for Orientation.

Speeeeaking of Orientation (Day 1)...

It was a great day! Albeit long (10AM-5PM), it was a great first interaction with the PY1 class and older student organization leaders. At the end, there was an organization fair where I got to indulge in what all 14 groups had to offer. I'm so excited to get involved; I'm very, very ready!

Day 2 tomorrow will be shorter (9AM-2PM), but I'm just as excited!

Cheers!