Sarah Cummins
@SC_PharmD
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Opioid Stewardship Pharmacist | BCEMP, DEI, SUD, Health Equity, PharmEd | she/her/hers
Sacramento, CA
Joined June 2015
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I said what I said!!
Answer is unequivocally no lol
Stop believing you deserve residents who will sacrifice themselves for your program when the best you offer is a teaching certificate, a few decent acute care rotations, and a poverty level wage.
#twitterx
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Had a patient DoorDash a whole entire crab leg dinner to the ER and I respect it
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This is not a paramedic, it’s a UC Davis PGY2 Emergency Medicine Pharmacy Resident
Sacramento Fire paramedics administer Johnson & Johnson COVID vaccine to homeless.
@CBSSacramento
@GoodDaySac
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The most helpful thing in my workflow as an overnight ER pharmacist is when the nurses call me every 5 minutes to ask me to verify orders that have been in queue <10 minutes. Without these reminders I’m not sure I would remember what my job is. :)
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I’m sad to miss out on
#ASHP2021
but I couldn’t bring myself to pay the registration fee when ASHP is still profiting so much from students and residents for midyear, especially during a pandemic.
*clears throat*
(Pay special attention to the ✨bc they signify my rage)
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Me: Unasyn requires ID approval
MD: ENT said to use Unasyn
Me: you need ID approval
MD: but ENT said…
Me: ENT is not ID
MD: they said they use it all the time
Me: Idk what to say
MD: okay they said use Levoflox instead
Me: Levoflox needs ID approval
🥲 e v e r y d a y
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Hey
#TwitteRx
PGY1s or P4s...DMs are open. If tomorrow isn’t what you hoped, send me a message. Let’s go over your application. Let’s practice some interview scenarios. Let’s find a solution.
And if residency isn’t the solution, let’s just be friends.
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I quit my overnight job in the ED and now work as the Opioid Stewardship/substance use disorder pharmacist at UCD. I am so sad to leave the ED but I already feel so much healthier and happier being able to sleep at night. I also have way more time for my DEI work/research now.
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What is your favorite EPIC login screen and why is it the space alien cow abduction?
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This is also important for physicians to realize: when we argue about a med it’s because we legally have to sign off on it too, we get sued too if it’s wrong and something happens.
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Getting warmer, but,
Hospitals shouldn’t charge anyone to park, period.
Medical students should not have to pay to park at their rotations
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Every day I’m shocked how anyone can go into a patients home med list from 2011 and order all the meds inpatient lol
“Yes those antibiotics for chronic osteomyelitis suppression were for a leg that seems to have been amputated 5 years ago, so we don’t need to reorder them”
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Just want to say I appreciate all of the badass pharmacists who are advocating for our profession and our titles. You guys are awesome. Your tweets are savage. I’m so proud to be a pharmacist and also thoroughly entertained.
Words matter.
In the medical setting, *resident*, *residency*, *fellow*, and *fellowship* belong to physicians ONLY. ⬇️📃
Every EM physician, resident, & student should be paying attention to the battle on scope of practice. 🥼
That’s the tweet.
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I buy oat milk because I don’t think torturing cows is okay.
I use reusable grocery bags so I don’t pollute the earth with plastic bags.
I don’t buy bottled water unless it’s an emergency.
I don’t go to midyear because ASHP exploits pharmacy students and residents for profit.
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As a “poor kid”, as someone who worked multiple jobs through college/APPEs, as someone who has been through this twice now, and as someone who believes this topic is not discussed nearly enough, I wanted to share my advice on how to make the process as affordable as possible....
I don’t think enough is said about how pharmacy graduates, who are riddled with debt, are expected to scrape thousands of dollars together to go to midyear, pay application fees, fly to interviews, pay licensing fees, etc. Really puts those without privilege at a disadvantage
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Just found out I am the recipient of one of the
@ACCP
travel awards and I’m just floored 🙊🙈 To whoever read my application and chose me: thank you for believing in me! See you guys (virtually) in two weeks ACCP members !!!!!
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When the resident tries to shoot their shot at getting zosyn in the ER without a consult 😂💀
#TwitteRx
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During my P1 year, the best “key to success” would have been scholarships to afford my crippling tuition and costs of living so I didn’t have to work multiple low paying jobs while studying for a clinical doctoral degree
For P1s, getting involved with ASHP is key to success – learn about the opportunities and benefits of student membership here:
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I am confused how the board has the power to rescind the invitation but somehow wasn’t involved in selecting him? Clearly you had the power to invite him? Whatever, glad our voices were heard. I’m still not going.
The ACCP Board of Regents has provided an update regarding the choice for the 2023 ACCP Annual Meeting Keynote Address. Please read the update here:
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Nothing like hiking to the top of an 8500 ft mountain at 6am solo to make you feel fortunate to have a healthy body, a healthy mind, and a highly competitive residency that you love 🙌🏼
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I lost both my dogs in a month, unexpectedly and suddenly. I’ve been so, SO sad. But this week we adopted a baby floof and I love her so much already.
Her name is Chowder 🤍
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This has got to be a fucking joke ???
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Had to tell an NP that 1 gram of IV fentanyl was too much for a kid for procedural sedation
The other day i had to explain to an attending the difference between prophylaxis and treatment dose of lovenox
#TwitteRx
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I’ve given several state and national level talks on DEI in residency recruitment and one thing is always true: programs all want the best of the best. The elite applicants. Gladiators. Work horses.
But… does your program deserve them? Are you the best of the best program?
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Any other PGY2s finding themselves CRAWLING to the finish line right now? Someone carry me lol
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Everyone always told me to take bartending off my CV, but, like, do you know how HARD it was to work at Walgreens APPE 7a-4p then go to the bar and work 5p-3a??! If nothing else, putting it on my CV feels like compensation for the chaos I endured
I hear people are advising students to not put non-pharmacy related work or other experiences on the CV and or residency applications. Who are you and why do them that disservice. I love recruiting bartenders and servers for their working in chaos skills
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I’ve been trying to buy a few gift cards each time I go to the store to give to people who are unhoused that are asking for help. I’m bad at keeping cash on me, but this has been easier.
They are paying customers this way so they can use the restrooms/hang out inside/warm up
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The best apixaban allergy to date:
“too much hair growth”
Love it
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Me casually hovering behind EM MD order screens to make sure CTX/azithro is ordered instead of Vosyn for CAP pts not meeting sepsis criteria 🙃
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Here we are again, ordering home med lists from 2011….
The job security is great but I also want to bang my head on the keyboard lol
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Just learned I won the “Best Overall” research presentation/project award out of all the University of California programs/residents and I am 1) shooketh and 2) really proud of myself. I worked so hard on this.
Finished presenting the results of my resident research project at the University of California Collaborative Conference and mannn does it feel good to cross that off the list! Also s/o to my RPD
@cadams_em
for helping me design and execute this project. You aight I guess.
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You’re practically begging me to drag you over this trash take
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1/ As some of you know, I have been working diligently with a multidisciplinary group to bring
#COVID19
vaccines to Sacramento’s unhoused communities. Much of this work is a grassroots effort that is completely voluntary for some, myself included.
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Oh god I already hate it here
I have been informed that
@ASHPOfficial
does in fact have both lobbyists and legislative advocates on the payroll, actively working. The $0 on the tax return is for OUTSIDE lobbying expenses, which does not include internal employees.
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Am I blind or did NABP president Carmen Catizone claim making $900k on tax returns when the next highest paid employee made $8k?
Clerical error, right?
Gotta love that pharmacy org nonprofit life
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Had to argue with a surgery resident about why Levophed was the wrong drug to over for the devastating brain injury patient who needed IV levothyroxine, he made me pull up the protocol bc he didn’t believe me
The other day i had to explain to an attending the difference between prophylaxis and treatment dose of lovenox
#TwitteRx
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Me calling the resident asking if the patient really needs their Ritalin stat at 2:47 am
just because it’s on the home med list doesn’t mean it’s optimal 🥰
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Answer is unequivocally no lol
Stop believing you deserve residents who will sacrifice themselves for your program when the best you offer is a teaching certificate, a few decent acute care rotations, and a poverty level wage.
#twitterx
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Before celebrating my results, I messaged all the preceptors and mentors who helped make my match day happen. Without their instruction and letters of rec, this wouldn’t be possible!
With that said, I’m moving to Cali y’all! Anyone have any tips for this CROSS COUNTRY move? 😂
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We just spent years on the front lines, watching people die en masse, working overtime, wrapping our bodies in plastic and guarding our faces…
…and the organizations that represent us are out here donating to the campaigns of politicians who said covid is a hoax.
#twitterx
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Picked up a new badge reel from a travel nurse selling them in our ER. I feel great about a) supporting small business and b) accurately depicting my internal emotions externally now 🙃
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Should I do a thread on why pharmacy board certification is a money-grabbing scam and expose the various players involved in the financial exploitation of pharmacists?
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VERY yes
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No you needa chill
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I had my ride along with the flight crew yesterday and it was SO MUCH FUN! Flying over San Francisco at sunset wasn’t bad either 🤷🏻♀️
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In case anyone is curious (and awake), I’m currently transitioning for my first night as a 7-on, 7-off overnight EM pharmacist tomorrow
All good vibes appreciated
Also why WOULDNT I spend my time advocating for ASHP to cancel registration fees, like, do you know me at all? 😂🤷🏻♀️
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I’ve been going down a DEI-hole on residency recruitment: one concept I keep ruminating on is “fit”. Majority of programs tout “fit” as one of the highest defining factors in a rank list.
But do we want applicants that are already exactly like us? Does this increase diversity?
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Honored to be asked to give this lecture - a topic I can’t ever talk about enough
We are very excited for our upcoming virtual April CE: "How the Poor Stay Poor - Barriers to Overcoming Financially Disadvantaged Backgrounds & Pursuing Higher Education" by the talented
@SC_PharmD
Free for MSHP members
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Quite possibly one of the most dangerous manufacturing errors possible
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My hospital plays the Rocky theme every time a
#COVID19
patient is discharged from the hospital. If that’s not the most Philadelphia thing you’ve ever heard, I’d love to know what is 😂
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Just a very (un)friendly PSA: history of IV drug use is NOT a reason to withhold starting an IV in an incarcerated patient with multiple stab wounds
Bias can substantially delay care and prevent us from being able to quickly perform life-saving procedures
Check yoself
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The real issue here is that programs want perfect applicants because 1. they are lazy and don’t want to put any effort into teach and just want cheap labor to fill staffing holes or 2. Don’t actually know HOW to teach and end up frustrating everyone involved
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My very first publication from the work I did as a student at Purdue is finally online and I’m SO EXCITED to see my name in print!
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For those of you confused about the commotion, here are the receipts:
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The contrast is staggering. Well done
@ASHPOfficial
Just announced: ASHP's 2023 Midyear Clinical Meeting & Exhibition to feature a conversation with Viola Davis.
#ASHP23
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Actually 1 mg is still tenfold higher than the appropriate dose for this kid, which was in the ballpark of 100 mcg total procedural dose
The point is that pharmacists are vital
@SC_PharmD
Are you sure you don’t mean 1 mg. A gram of IV fentanyl would be 200 ml at the standard concentration of 50 mcg/ml and enough to do at least 15 to 25 adult open heart cases.
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Residents heading into interviews:
I want you to ask programs what kind of resident they are looking for. And if they answer with a synonym of “perfection”, I want you to look that person in the face and ask:
“What does your program do to deserve that?”
I’ve given several state and national level talks on DEI in residency recruitment and one thing is always true: programs all want the best of the best. The elite applicants. Gladiators. Work horses.
But… does your program deserve them? Are you the best of the best program?
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Called out torsades de point on the EKG monitor while two physicians debated whether the patient was having an MI and started CPR within 5 seconds of losing pulses
The other day i had to explain to an attending the difference between prophylaxis and treatment dose of lovenox
#TwitteRx
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Y’all better get your emotionally abusive preceptors and 10 bed ICU tfoh
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Requiring perfect grammar (or subtracting points for imperfect grammar) on residency applications doesn’t select for higher quality candidates, it selects against English as a second language candidates.
Last time I checked I don’t need perfect grammar to do my job well
#ISWIS
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We have a system at our hospital where if we do something really great (save a life, catch a lethal dose, etc) we get a “best award”, which is basically a $25 gift card to an establishment of your choice.
Guess whose been bagging Buffalo Wild Wings gift cards left and right?!
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As
#TwitteRx
residency recruitment season starts up, I hope programs are all updating their rubrics/scoring strategies to recruit diverse candidates according to the NIH underrepresented minority (URM) criteria. Many programs may not realize there are multiple criteria for URM 🧵
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EMS: “Based on the color of her blood, she’s probably on blood thinners”
Me: “…pardon?”
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So, this happened.
I’m STOKED to be chosen for this committee!! I’ve been following the
@ASHP_EMPharm
since before I started PGY1 and I can’t believe I’m part of it now 😭
#careergoal
✅
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Like this tweet if you spend ENTIRELY too much time stressing about what your CV font “says about you”
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Please enjoy this video of me struggling to pronounce the word “collaboratively” on camera while trying to create a virtual tour video for our interviewees.
I’m doing my best to find times of laughter amidst the insanity of our reality.
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The fact that the email went out just lets me know that complaining on social media is in fact an excellent way to communicate with our organizations lol seems like we are being heard loud and clear!
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Taking a break in between residency and starting work full time to focus on my physical, mental, and emotional fitness. This week I hiked Half Dome in Yosemite with my cousin! I was terrified of this hike, but needed to prove to myself I could do it.
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Clearly, I’m not in finance or nonprofit management. There are probably many factors I’m missing and don’t understand.
But what I do know is how hard it is to afford to become a clinical pharmacist, and I don’t see ASHP throwing all their weight at alleviating that burden
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I’ve been working in my ER long enough that I know many of our sickle cell pts by name, so I can just badabingbadaboom through those orders and preemptively correct them if their regimen isn’t optimized. One small step to reduce those disparities.
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My co-residents have resorted to trading each other produce, meats, toiletries because we can’t find all the items we need to sustain our health
When I was told “lean on your co-residents during residency, they will be your rocks,” I didn’t realize it would be like this
#COVID19
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Check out our new publication that we poured our whole hearts into:
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Something my RPD told me this week it is to jump in and help whenever I can. Grab tubing, end tidal monitors, extra channels, warm blankets, help move the patient, etc. The more often everyone sees you being a team player, the more they will realize how vital you are to the team!
ER pharmacy rant
#312
:
Get to know where all non-pharmacy supplies are (ET tubes, fluids, tourniquets, ultrasound ect..)
“ Sorry, I’m just pharmacy “ should never be said imo
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I know you guys have already seen tons of
#vaccination
posts, but I’ve been waiting for this for so long 😭😭 I am a true frontline ER worker that watches hundreds get diagnosed with, suffer from, and die from
#COVID19
. With this vaccine, I will not be one of them!
#TwitteRx
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Had to explain that you can’t give IV magnesium to the myasthenia gravis patient with pneumonia
The other day i had to explain to an attending the difference between prophylaxis and treatment dose of lovenox
#TwitteRx
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Is there no one there that can spell check? This is frustrating and feels like a bot.
@BPSweb
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SUPER proud of my mentee Byron for graduating his PGY2 in Cardiology! He will be heading to Chicago to be a CTICU pharmacist at Northwestern this summer.
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Maybe I should create a 60-minute free presentation to give at the same time as VP and make it open to all attendees
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My preceptor page is live on our institution website and I just…🥲
…I made it y’all 🥲🥲
#twitterx
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I’m sure ASHP just simply wouldn’t have it in the budget
Yay for conferences with Covid measures! 17,000 people registered for COP15. Each gets two boxes of masks and 3 boxes of rapid tests. Masks and a daily negative covid test are required on site.
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I really wish ASHP would release an expense report for midyear so we can see if it is TRULY NECESSARY to profit off the backs of students and residents during midyear. I can’t find these specific financials anywhere.
And honestly, until I do, it’s a no from me dawg
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Let’s not mince words
Hospitals should not charge parking for ANYONE. Patients, families, employees, etc. Their greedy pizza-party asses do not need yet another avenue of financial exploitation.
Parents and caregivers should not have to pay for parking when their children are hospitalized. I can’t believe I even have to say that.
#medtwitter
#neotwitter
#PedsPharm
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Also want to add that the Western standard of “professionalism” is rooted in the identity of the white cisheteronormative male
So, naturally, I don’t give a rats ass about what is traditionally defined as “professional” or not
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Please withdraw your support for
@RepBuddyCarter
Today, our Board of Directors approved a new policy (introduced during our 2022 Summer Meetings) asserting patients’ rights to access comprehensive reproductive healthcare services:
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After all the incredible sessions, posters, and networking today at midyear I finally have a moment to sit down and miss my dad, who died one year ago today. He would have been SO proud of who I am and who I am becoming.
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15f. And guess what, I matched there!! Being “poor” sucks, not gonna sugar coat it. But it can teach you SKILLS and give you STRENGTH that more privileged individuals won’t have.
Stay gritty. Be organized. Plan ahead. Do the best you can. And ROCK this shit. 👊🏼
#TwitteRx
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Locked and loaded with stats on crime, poverty, race, and policy today
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Absolutely salivating thinking about getting my hands on the new tax returns of our favorite pharmacy orgs
Is it April yet??
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Checking in once again from California, a place where my work pays for us to do things like this 🏳️⚧️🏳️🌈
#Pride2023
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