NAREEFA NASRUDEEN
Doctor of Pharmacy Candidate at
University of Waterloo School of Pharmacy
Interested in Smoking Cessation, Immunization, Pharmacy Research
Passion drives Success
Skills Spotlight
Assignment 1:
Communication
An important component of a smoking cessation consultation is using effective communication skills. By practicing attentive listening, effective information gathering and motivational counselling, I am able to assist and support a variety of patients in quitting smoking.
Assignment 2:
Decision Making
When administering injections, it is essential to use good decision making to choose appropriate needle length, site of administration and angle of needle insertion. To make a good decision I gathered information, weighed out pros and cons, used good judgment and involved the patient
Assignment 3:
Teamwork
As a team member, I participated in the a 'Kids and Medicine' presentation to teach children the difference between medicine and candy. I demonstrated my teamwork skills by expressing my ideas, communicating effectively, facilitating exchange of ideas among team members, making suggestions and using the team’s feedback for improvement.
Skills Reflection
Assignment 1 Reflection
This picture illustrates the result of using my decision-making skills. I was able to choose the correct needle length, site of administration and angle of insertion to successfully administer the saline injection.
(i)
(ii)
(iii)
The pictures above illustrate (i) working together as a team to prepare for the "Kids and Medicine" presentation (ii) presenting my part as a team member (iii) team members
Situation/Task:
During my Professional Practice course, I was faced with a standardized patient who presented with number of over the counter smoking cessation medications and was seeking help in choosing an appropriate product. For this activity, my task was to assist the patient in preparing a plan and choosing the appropriate product to quit smoking. I was given the opportunity to demonstrate my oral and written communications skills by directly interacting with the patient using motivational interviewing strategies and documenting the encounter.
Action:
In order to assess the patient’s level of readiness to quit smoking, I attentively observed and listened to the patient. I noted that the patient seemed timid, scared and doubtful from her tone of voice. I also picked up non-verbal cues from her confused facial expression and realized that she was at the stage where she needed guidance and encouragement to help her to quit smoking. I expressed empathy towards the patient by relaying to her that I understand how frustrating it is to quit, however I am here to help, guide and support her in every step. Next, I gathered important information from the patient by asking open-ended questions such as tell me about your previous quit attempts. I also asked the patient to describe the situation when she smokes. This open ended question helped me to identify triggers such as taking breaks with co-workers, which can be avoided. Relevant questions were asked in an organized manner using SCHOLAR-HAMS technique to gather as much information as possible. I also used reflective listening when necessary by repeating what the patient said so that she felt like she is being heard and understood. I was also able to clarify information that was misunderstood. For example, I interpreted that the patient attempted to stop quitting in one attempt using Nicorette gum and lozenges. When I repeated what I understood, the patient clarified that she meant two different quit attempts. After collecting information, in order to encourage the patient to stop smoking, I used the "5 Rs: Relevance, Risk, Rewards, Roadblock and Repetition" to highlight the benefits of quitting in an organized manner. I used patient friendly language to explain the harms of smoking. For example instead of saying quitting smoking decreases your risk of cardiovascular diseases, I said quitting smoking decreases your risk of heart attack and stroke. However, I was careful to recognize resistance so that I can restrict and deliver information in an appropriate way. For example when highlighting the cost of smoking, the patient seemed resistant to talk about the cost of the medication so I did not persist because I did not want to offend the patient in any way. Based on the information gathered from this interaction, I prescribed Zyban since the patient heard about it from a friend and was willing to give it a try. I was able to write a neat, clear and complete prescription for the patient. I also demonstrated my written communication skills by writing a brief, organized, comprehensive SOAP note.
Result:
As a result of implementing great communication skills along with my knowledge of smoking cessation, I was able to successfully create a quit plan for the patient and choose an appropriate medication based on her history and current situation. I am able to use the similar approach when counselling patients on other lifestyle changes such as diet and exercise.
Situation/Task:
As part of my injection training exercises in my Professional Practice course, I administered a saline injection to a classmate who acted as a patient. This task is imperative in developing my practical skills as a future immunizer. I demonstrated my decision-making skills when determining the best methods to use to provide the intra-muscular (IM) and sub-cutaneous (SC) injection based on type of injection and patient characteristics. Specifically, I made decisions about choosing the appropriate length of needle, site of administration and angle of needle insertion. These decisions are important in order to ensure that the vaccine is delivered in the right way for maximal effect and also to reduce pain in the patient.
Action:
To decide on the most appropriate method to administer injections, I first gathered my information. I used educational resources provided in my professional practice courses about vaccine administration. These include handouts, lecture content, readings and videos. I also researched for additional information on the Internet and gained advice from experienced pharmacists so that I can be fully equipped with the knowledge I need to perform this task. Based on the information collected, I listed all the possible options. For example, the needle lengths include 5⁄8", 1”, 1¼’’ and 1 ½ “; site of administration include arms, thighs, buttocks, biceps muscles, etc. and angle of insertion include 90° and 45°. In order to choose the correct needle length, I also collected patient information such as weight and which injection they are getting. My classmate was not sure of his weight so I used my judgment to estimate if his weight is more or less than 60kg. I also weighed out the pros and cons of choosing each size. Choosing the shorter needle is less pain for the patient but if the patient has a lot of fatty tissue the IM injection may not go into the muscles. My patient was evidently skinnier so I decided to choose the 5/8’’ needle for IM injections and SC injections. There are many sites for IM and SC injections. I considered the patient’s preference and convenience in making this decision. I decided to inject the arm based on accessibility and the limited privacy of a public setting. I used my judgment to decide on the location of the bicep muscle for IM injections and the location of the fatty tissue over the triceps for the SC injection. This was difficult for me as the patient had very little fat. Therefore, I included him in this process by asking him where he feels has the most muscle and fat so that I can make an informed patient-centred decision. Based on the resources and the added benefit of ensuring the delivery is under the skin and into the muscles, I decided to insert the needle at a 45° angle for SC injections and 90° for IM injections.
Result:
My decision-making ability helped me choose the appropriate needle length, site of administration and angle of needle insertion when injecting the patient. As a result, the patient received the injection in comfort with less pain. He also felt satisfied with my technique and appreciated that he was involved in the process. My decision-making skill can be applied to other situations such as choosing the correct medications, risk management strategies and treatment options for patients. This technique can be improved by incorporating my critical thinking, problem solving and effective communication skills when making decisions.
Assignment 3 Reflection
Situation/Task:
During Pharmacists Awareness Month, I volunteered with the Canadian Pharmacists Association to help spread awareness for pharmacists. One of the activities involved visiting Alpine Public School and teaching the Grade 1 students the difference between medicine and candy. During this activity, I worked with a group of classmates where I was able to demonstrate my teamwork skills. Teamwork skills were needed in this situation because we gave presentations as a group therefore we needed to prepare our content and material as a team. As a team member, I expressed my ideas about how we should present by communicating effectively; facilitated exchange of ideas among team members on ways to present the topic to kids; and received as well as used the team’s feedback to improve my presentation techniques. Teaching kids was a challenging task because kids think differently and we need to find ways to simplify concepts for them while keeping them engaged. Everyone on the team had different perspectives and ideas on how we should present to kids. However, working as a team was important because it made the process more efficient and unique by incorporating multiple ideas.
Action:
When preparing for the presentation, the team met to share ideas. In my role as a team member, I shared my idea of making a poster and attaching candy and tablets on it to show the kids what each looks like. I incorporated my communication skills by being precise, clear and specific to explain what I meant. I even illustrated this by drawing out what I meant on paper. In this process, I helped to improve communication among the team members by specifically asking, “What do you think of this idea?” In this way, I was also able to facilitate the exchange of ideas through the discussion that arose from asking for their feedback. For example, my team liked my idea of making a poster but they suggested turning it into a game to make the kids guess if the item is candy or medicine. As a team we also made a script for the presentation. I incorporated a bit of my leadership skills to plan and organize who will present what part. However, as a team member, I made sure I gathered everyone’s input on what part he/she would like to present before finalizing the decision. I was able to delegate tasks to myself and others. I was responsible for presenting the game. I read my script to my teammates and used their feedback to improve my performance. For example, my team said that I was using too many big words that kids might not understand such as the word antibiotics and I should change it to medicine. I accepted their feedback and went back to change all the complicated words to simple words that children could understand. As a team member, I also provided feedback to the ideas of others. For example, someone wanted to demonstrate the importance of shaking medicine before its use by putting sand and water in a clear bottle and demonstrate how to shake it. I loved the idea and suggested using glitters instead of sand to make it more attractive to kids. As a team member, I also assisted the other teammates and contributed my efforts by helping to decorate the posters and prepare other supporting materials for the presentation. I shared some of the expenses as well by paying for some of the materials.
Result:
As a result of facilitating great teamwork skills, my team was successful in delivering a fun and informative presentation to the kids. The kids and the teachers enjoyed it and said that they learnt a lot. My ability to share ideas, communicate effectively, facilitate exchange of ideas, provide and accept feedback and share the workload helped me to improve the presentation techniques for myself as well as for others. My teamwork skills can be applied to situations in the workplace such as preparing group presentations in a nursing home or providing a diabetes presentation for a clinic in the pharmacy in collaboration other pharmacists. This technique can be improved by gathering feedback from others that are not on the team and by incorporating conflict management skills to deal with disagreements that may arise.