As the clinical pharmacy coordinator at University Physicians Hospital in Tucson, Kelly Green Boesen has a drug problem.
Her job now includes finding ways to work around the ever-increasing obstacle of drug shortages.
“It's the worst it's been since I’ve been a pharmacist,” she says. “This past year it's been things that you use for every patient, standards of therapy.”
Boesen, College of Pharmacy Class of 2000, cites several reasons drug shortages may occur, none of which are under her control: a lack of raw materials, recalled products, drug companies deciding to discontinue a drug and not giving competitors enough time to ramp up their production. Boesen doesn't know why shortages are so prevalent right now. But quirks in the market won't get her down. She's always up for a challenge.
“It forces you to talk to the physicians and figure out strategies to allocate the use for the correct patients,” she says. “For example, multivitamins can be given to a patient intravenously. But not every patient needs those if they can swallow a pill or take a tablet. With my job, I try to hone in on who needs the multivitamins injected and save those solutions for the people who really can't swallow the pills.”
Boesen's job title comes with a host of behind-the-scenes duties, allowing her to do different tasks every day. In addition to monitoring the hospital's drug selection, she's also busy managing other pharmacists’ clinical activities, representing the pharmacy on hospital committees, developing protocols for her staff and acting as the director for their new pharmacy residency program.
As a preceptor to UA COP students, Boesen manages two rotations in internal medicine and critical care. She often takes two and sometimes three students at a time. A demanding and knowledgable teacher, Boesen is well respected by students and educators alike. The College of Pharmacy named her 2011 Preceptor of the Year.
“She was a very tough preceptor who made me want to do better and learn more,” wrote one of the Class of 2011 students who nominated her. “It was the hardest rotation out of all of them and I loved it the most! She is a very dedicated woman who wants to teach and listen to you.”
During the rotation, Boesen completely immerses the students in the day-to-day life of a clinical pharmacist. This includes working directly with the pharmacists and medical team, speaking to patients and meeting afterwards to reflect.
“We try to focus on issues as they come up with the students' own patients,” Boesen says. “If they have a patient who needs vancomycin, we're going to talk about it that day. We will discuss how to dose it, how to monitor it, and how to optimize therapy for that patient. Then while that patient is on that drug, you can watch what happens and see how it works.”
She continues: “In my rotation, I don't care that much that the students come in with everything memorized. The way that you approach a patient in the hospital setting is much different than the way you approach a patient in an outpatient pharmacy setting. We try to get people thinking that way: what they need to think about when they look at a patient and how to get the information they need to make decisions. Because you can look up anything. You don't really need to know it off the top of your head. That will come, but you need to know how to find it.”
Boesen's team prefers not to call themselves “clinical” pharmacists, because at UPHH, everyone is a clinical pharmacist. Even if you're in the outpatient area, she says, you're still “clinical” because you need to make interventions for the best interest of the patient. Every pharmacist makes recommendations about drug therapy. Everyone works together.
“I really work with a great team of people that make all this happen,” she says. “I can't do all this by myself.”
Well even if she can't, she'll surely give it her best try.