The Importance of Mentors

The mentors I have had over the years have really helped shape who I am as a student/man today. With each new setting there has been someone that has helped me along on my journey. 

In high school, I had several mentors that provided guidance and direction. My guidance counselor had my best interest in mind and helped me decide to pursue pharmacy at UConn.  It may sound crazy but she helped me with so much more than just the college admission process. She was very helpful in my personal life. She helped me keep things in prospective and formulate a plan of action for every difficult situation I was in. 

My lacrosse coach was another important mentor in my life. He taught me the importance of patience and focus. When I arrived at Bacon Academy high school, there wasn't an established lacrosse program. A group of friends and I worked with my coach to start a club team. We were told we would need to raise money and participation in the sport before the school would grant us varsity status. Over 2 years, under my coach, we raised enough funds and developed a full roster of 50 students. My Junior year of high school we became a varsity sport. All of the hard work and patience had paid off! We received a full coaching staff in addition to school funds. 

Coming to college, I found new mentors. I established relationships with these mentors after joining various organizations on campus. One such group that has given so much to me is Kappa Psi Pharmaceutical Fraternity. Older members of this group have provided invaluable advice and guidance over the years. They were instrumental in helping me get into pharmacy school.

There are a few particular older students who were critical in my decision to pursue a pharmaceutical industry fellowship upon graduation. After completing my retail and institutional IPPE rotation hours, I still wanted to  push the boundaries of what my degree could do. I asked my professors about other non-traditional avenues of pharmacy. They gave me the contacts of several older students who were seeking careers in industry as well as healthcare management companies. Here I was, a P2, reaching out to students who I had never even seen before. Every student I talked to has been more than helpful in helping me get an understanding of their plan and what they currently doing to help them get there. The UConn family really does take care of its students.

I'm blessed to have met so many who have helped me over the years. I would not be the man I am today if it weren't for all my professors, friends, and colleagues who have bent over backwards to help me reach my goals.

Throughout my time at UConn, I have been very mindful of my mentors. I know my life would be different without them and with this in mind, I try my best to pay it back by offering advice to younger students applying to pharmacy school. I was a Resident Assistant in the pre-Pharmacy Learning Community. Sometimes the job was a real headache but it was very rewarding to see students I had talked to about classes and the pharmacy admission process, go on to become P1 students in the program. Now as a P3 student, I try my best to be available and approachable to the younger P1 students.

There are many reasons to be excited about graduating. One thing I look forward to is being in a position to really make a difference in a students life. To act as a resource and help students understand what to expect in the working world. I hope to be a preceptor after graduating and continue to help those who have ambition but just need the tools to fulfill their goals. 

Making Yourself Indispensable

Many employees find themselves hitting a plateau in the workforce. They find they are no longer growing and moving up to more involved leadership roles. These employees may have plenty of experience and positive traits but they often find themselves being surpassed by other employees for new openings. This can be a frustrating and a trying time for many experienced employees.

Strength vs. Weakness Improvement
Naturally you look at your weaknesses and assess how you can do better. However, you should be looking at your strengths. Top level executives have a several outstanding strengths that outweight their weaknesses. Having a couple of outstanding strengths will allow you move up the ladder within an organization. It's more challenging to improve your strengths rather than weaknesses. How do you improve on something that you already do so well? In order to develop and improve your strengths you need to focus on complimentary skills. This is known as "non linear development." Improving a core strength by improving other related skills. There is a synergistic effect of combing two skills. When traits are combined they produce a significant improvement in leadership vs. either skill alone.

Cross-Training
Let's explain this concept another way. The idea of improving complementary skills is how athletes train. Football players can run drills and practice plays. But how do you improve as a player once you have all the plays down? Athletes perform other activities that improve their game. For example they lift weights and run. These skills will allow them to more efficiently execute their plays. Working on their strength and speed will complement their play making. Indirect training to improve an athletes core strength of executing plays.

Strength Building

There are several steps to take when improving your strengths. The first is to identify all your existing strengths. This can be done in several different ways. The best way to discover your strengths is to talk to your peers and co-workers. If possible you should seek a 360 degree evaluation which includes opinions from direct coworkers and other departments. A 360 degree evaluation provides a well rounded view of you leadership style. When you want to be an effective leader, outside opinion of your skills are more important than your own opinion.

Once you have a list of strengths, the next step is to choose one to build on. You need to choose a strength that will benefit your organization and you are passionate about. "A strength you have but isn't important to your organization is a hobby. A strength you have that you aren't passionate about but is important to the organization is a chore." (Harvard) Then you need to identify a complementary trait that is also important to your organization. By focusing on improving your complementary trait, there will be an indirect improvement of your main strength.

You should continue to work on your companion trait until you notice a difference upon completing another 360 evaluation. This change will take time and could even be as long as several years but with continued persistence you will grow as a leader. Once you have developed your companion trait, you can look to improve another companion trait. Once your main strength has seen growth, you can start to focus on another main strength and associated companion traits. Extraordinary leaders don't only have one strength.

Below is a chart of 16 Strengths that are related to success along with their complementary traits. 

Overkill?
After you master several strengths, begin to look at the 5 broader categories that the 16 main strengths fall into. Which strengths are underrepresented in the broader categories? Look to improve these ones next!

In Summary:
You may be a well liked person with no real flaws but without ordinary strengths you will not move up the organization ladder! The more outstanding strengths you have, the more indispensable you are. You will become irreplaceable because your strengths will always outweigh your weaknesses. Even starting with one extraordinary strength rather than being well rounded in several strengths will result in leadership development. Companion traits are the way to improve your already existing strengths. Instead of doing what you already do, you are engaging in new ways of skill development that will result in more effective behavior.

Zenger, John, Joseph Folkman, and Scott Edinger. "Making Yourself Indispensable."Harvard Business Review (2011). Print.

Service Learning in the Community Setting

Summer 2014 Service Learning

During the summer, I completed numerous service activities at the Unionville Walgreens. Eric Halpern (a young UConn Alum) was my pharmacy preceptor. The first activity I participated in was Medication Therapy Management. MTM is a preventative approach to prevent negative health outcomes. If a patient’s health and adherence issues can be caught early on, it saves money in the long run and improves patient outcomes.

While at Walgreens I utilized the computer system Mirixa to perform MTM services. Mirixa is a program that alerts the pharmacy to possible patient adherence and regimen issues. The pharmacist then can set up a meeting or make a phone call to the patient to address the alert. Insurance companies pay pharmacies a nominal fee for completing each patient case. Mirixa will raise a flag to any type of drug-drug interaction, inappropriate treatment, and adherence issues. The majority of the cases I worked on were adherence issues. For example, Mirixa would inform the pharmacy that a patient hadn’t refilled their medication on time. Meaning, the patient picked up a one month prescription and it is has been a month since that date without a refill. This would suggest that the patient isn’t taking their medication regularly or as prescribed. I would then call the patient and discuss their medication regimen. These phone calls were both educational and beneficial to the patients. Patients had a chance to learn what their medications were for and I had a chance to drive home the importance of adherence. There were frequent adherence alerts for blood pressure and cholesterol medications. The most important counseling point I made with these medications is that you don’t feel different while taking them. However, it is important to be taking your meds each day to ensure maximal benefits.

While volunteering at Walgreens, I worked with the pharmacist to come up with case solutions. I discussed ways to help patients remember to take their medications. Setting reminders in their phones and using weekly pillboxes were among various solutions discussed. Some cases were more complicated and I needed the pharmacist’s assistance. For example, there was a patient who was on transplant medications. Mirixa raised a drug interaction flag. The patient was on two immunosuppressant drugs, Mycophenolate and Tacrolimus. With the pharmacist, we looked into this interaction and it proved to be a minor interaction. Mycophenolates peak levels were slightly increased when on board with Tacrolimus. Both medications came from the same doctor’s office. I called the doctor’s office and spoke to them about our situation and the doctor assured me the patient was being monitored and that was the correct therapy. The patient had been on this regimen for several months and had yet to experience any issues.

While volunteering, Eric had me set up and run blood pressure clinics. I sat at the front of the store and asked patients if they wanted their blood pressure taken. I took any willing patients to a private screening room and measured their blood pressure using an electronic blood pressure monitor cuff. I discussed blood pressure goals/targets with these patients. Furthermore, I inquired about any medications there were currently taking and if their doctor was aware of their blood pressure. When working with these patients, I made sure they were aware of lifestyle changes that would positively affect their blood pressure. I did my best to empower my patients and give them the knowledge to make healthy life decisions.

Eric worked with me on several other projects. I answered patient inquires at the pharmacy. A patient asked when was the best time to get the influenza vaccine. The CDC recommends that the pharmacist start giving the flu vaccine as soon as the vaccine becomes readily available in their pharmacy. The patient’s concern was if they got the flu shot in July would the effects of the shot wear off before the end of the flu season. I called the CDC to ask about this question. I talked to a specialist who still recommended giving the flu shot as early as possible. He discussed that only children could receive two flu shots in one season to ensure they were protected.

During my time at Walgreens, I also participated in a medication reconciliation meeting with Eric and a patient. An elderly woman was overwhelmed by all of her medications and had questions for the pharmacist. One afternoon, Eric and I sat down with her and discussed what each of her meds was used for. We made recommendations for meds that could be consolidated to combination dosage forms. Finally we discussed OTC products she was taking and their efficacy. We helped the patient gain confidence and control of her therapy. Eric also had me go onto the floor with patients to answer their OTC medication questions. Several patients came up to the counter to ask about which pain medication to use and I assisted them with their decision. Eric quizzed me on OTC products and their active ingredients.  

I learned a lot from this experience. I was able to successfully complete MTM cases and work with patients to improve their adherence and health. I gained experience working with other health agencies. I learned on how to research drug related questions. I was beneficial to the pharmacy because I engaged their patient population. My volunteering allowed for certain tasks to be conducted that the pharmacist otherwise wouldn’t have been able to perform.

I would highly recommend Eric Halpern as a preceptor. He did his upmost best to ensure I wasn’t there to dispense and fill drugs. I didn’t count out one prescription the entire time I was with Walgreens. He is very compassionate about pharmacy and is very patient with his students.

Family and Pharmacy

My name is Robert MacKnight Guarino. I am a 22-year-old pharmacy student who is starting the fifth year of my program at the University of Connecticut.  I come from a close-knit family. In fact, my family that is one of the reasons that I chose to go into pharmacy.

Let’s start off by introducing you to my family.  My dad is an engineer and my mom is a nurse. My older brother, Matt, is my Irish twin.  We are the same age for a week every year because my birthday is 8 days before Matt's. He has his associate’s degree and is now pursing a Bachelor's degree at UConn.  Being this close in age has made us fast friends. My younger brother, Zach, is two years younger than me and is a sophomore at UConn working towards a geography degree.  My mother's family lives 20 minutes away.  We see them all the time. My dad's parents live in Buffalo, which is 400 miles away so we would only see them 2, or 3 times a year.  Although we didn't see Pa and Grandmother a lot growing up, we have a great family history. My dad would tell us stories about Pa and his persistence in accomplishing things that would benefit the family. 

Unfortunately, Grandmother started to develop Alzheimer's in her mid to late 60s.  Pa was her sole caretaker.  Hard of hearing, stooped with age but full of determination, Pa decided that he and Grandmother would beat Alzheimer’s.  He read everything he could about the disease. He took her to doctor's appointments, took control of her medications and devised an exercise program for her.  He was responsible for all her care.  As a teenager, I would hear the phone conversations between my dad and Pa as dad would call everyday to see how things were going.  I could hear how difficult it was for Pa to understand what the doctors were telling him. I could feel his frustration as Grandmother continued a slow decline.  But he never gave up!  Just before she died, he said; "we were finally starting to beat it."  This battle with Alzheimer’s lasted at least 15 years with the last 5 being the most difficult. 

Inspired by Pa, I entered the pharmacy program at UConn.  I am a people person and I look forward to providing empathetic compassionate care to the elderly population who struggle with various chronic illnesses. As a pharmacist, I will be able to teach the patients about their medications and ensure they receive the maximum benefits from their regimens.

Leadership Tract-Public Speaking Course

UConn Pharmacy Leaders Tract-Public Speaking Course

The UConn Pharmacy Leaders Tract is composed of pharmacy students from all years P1-P4. There are currently 15 tract students as we enter our second year as a program. Dr. Schlesselman is the faculty advisor and oversees our individual tract projects.

This past semester was the first time we incorporated a public speaking class as requirement of the tract.  The public speaking course was an idea that was brought up by Paul Ahearn, who is also a returning tract member. This public speaking course became Paul’s leadership project. Dr. S and Paul worked together to form a syllabus and conduct the class each week.To be completely honest, the idea of an additional class was stressful to me. As pharmacy students we all have other commitments. Whether it be the full class load, IPPE hours, professional organizations, or work there is always something you need to be doing. So another class was the last thing I wanted to think about. However as the semester comes to a close I have grown to really appreciate this class and actually look forward to it each week. This class has forced me out of my comfort zone and made me a more effective public speaker.

Paul created three different speech assignments. The first assignment was an elevator speech, which to me, proved to be the most difficult speech. For this assignment I had to physically be riding up and down in an elevator while giving my speech. I found it very difficult to keep my tone and train of thought as people came on and off the elevator.The second assignment was an instructional speech. I tried my best to think of something that would be both entertaining and useful for college students. I decided on teaching my fellow tract members how to iron a dress shirt. The funny thing is I had to first teach myself how to properly iron. Before this assignment, I had never ironed an article of clothing in my life. I brought in a mini ironing board along with an iron and physically demonstrated proper ironing technique. The speech went well and I received praise for my use of props during my presentation.

The last assignment was a presentation on a topic of our choice. I chose to present on why you should purchase UConn basketball season tickets. This is a topic that I am very involved and interested in. I have purchased season tickets for the past 4 years! To start off my presentation I took off my sweatshirt and sweat pants to reveal my complete UConn basketball uniform. This got my fellow tract members laughing and it was a great way to start my presentation.

Over the course of the semester, Dr. S helped me recognize and work on my weaknesses and at the same time taught me to play up my strengths. For example, I do a good job of proper posture and gestures while I give presentations but I struggle with getting my audience involved. Dr. S offered constructive criticism after my presentations that allowed me to engage my audience while presenting.

This semester has flown by but I can proudly say I have developed new skills and have become an effective public speaker! Dr. S and Paul’s hard work have really paid off and I look forward to seeing the direction of this curriculum as the years go on!

NACDS RxIMPACT Day on Capital Hill

RxIMPACT Day on Capitol Hill

           My name is Robert Guarino and I’m a second professional year pharmacy student at the University of Connecticut. Last week I traveled to Washington D.C. to participate in RxIMPACT Day on Capital Hill. RxIMPACT day is a program that is put on by the National Association of Chain Drug Stores (NACDS) and it brings together CEOs, CFOs, pharmacy operators, pharmacists, pharmacy school Deans, student pharmacists and executives to educate Members of Congress and their staff about the services pharmacists provide. As a team we discuss the importance of pro-patient, pro-pharmacy policy and key issues affecting healthcare.

            RxIMPACT is two day event. The first day the student pharmacists learn about leadership and advocacy. Cynthia Boyle (PharmD) explained how to incorporate proper leadership into our practice after graduating. Additionally, she informed the participants how to become involved with advocating as a student. The main idea behind her presentation was to keep looking for improvement. Whether it be improving our leadership skills or the profession, there is room for “improvement in the status quo.”

            Deputy Chief of Staff James Paluskiewicz also attended our orientation meeting. He works in the office of Micheal C.  Burgess (R-Tx26). James gave us a view from the other side of the table. We would eventually go on to talk to staff members like James about the profession of pharmacy and various bills. James gave the audience the inside scoop on how to effectively advocate to the Congress members and their staffs. He informed us to make any “asks” for the congressmen to be easily understood so that they don’t misconstrue your message. James discussed his experiences with other advocators and about effective techniques of communication that ensure policy makers hear your message.

            Nick Dorich (PharmD) went on to give the audience a crash course in advocating. Some important ideas we discussed overlapped with ones we learn at UConn; such as, don’t assume everyone knows what you are talking about. Just because your advocacy team knows the importance of a pharmacist to the healthcare team, this doesn’t mean a policy maker will. It is essential to know your audience before giving any type or presentation or having a discussion. Another rule of thumb we went over, if you don’t know the answer to a question don’t lie! It is important to keep your facts straight. You need to be honest and tell someone you don’t know the answer to their question. You will get back to them after looking up the answer. The final point Nick drove home was how essential it is to follow up with the people we would go on to meet on the Hill. Follow up can be as simple as a thank you card and can include answers or information that Members of Congress and their staffs were seeking. Congressmen have a lot going on and by following up with your discussion they know you take your stance seriously and you won’t simply go away. Following up is what separates a good advocator from a great advocator.

            On the second day, I was matched up with several pharmacists and fellow UConn pharmacy students to form Team Connecticut.  We were scheduled to visit six different offices of various Connecticut House of Representatives and Senators.  We discussed three bills with the staffers of the offices. The first “ask” we had for the offices was for them to sign a congressional letter to the HHS secretary requesting a one year transition for state implementation of Average Manufacture Price (AMP)-based Federal Upper Limits (FULs). Our group didn’t have any opposition to the program, we just believe the States need more time to properly implement the new reimbursement standards. Having another year would allow States to conduct dispensing studies to ensure pharmacies are fairly reimbursed.

            The second “ask” involved the pharmacists expanding their role and gaining a provider status. We asked for the support of HR 4190, which would allow pharmacies to bill Medicare Part B for medically necessary services and preventative services. All the services are already in the scope of practice of a pharmacist. This bill would allow third party payors to recognize pharmacists as providers and thus would expand the types and number of services provided. Pharmacists would be able to perform at their full capability and would allow underserved populations to have access proper care.

            The last “ask” was for the offices to sign  a Congressional letter to urging CMS to finalize key pharmacy provisions in the proposed Medicare Part D regulation. Specific provisions in the proposed rule by CMS would lead to improved health outcomes at lower program costs. These Provisions would give pharmacies the option to participate in a Plan’s network and provide preferred cost sharing rates. This provision would empower the patient and would allow them to chose which pharmacy they go to. This increases the accessibility of healthcare to patient and allows for better more consistent care. When a patient is forced to go to another pharmacy, this leads to “gaps” in healthcare. The new pharmacy doesn’t know the patient like the original pharmacists does. The original pharmacist knows the patient history and social factors present. When a patient is uprooted and goes to a new pharmacy, there is a lack of patient history in the computer system. The new pharmacist has to start at square one and doesn’t know what to expect with each patient.

            Team Connecticut spoke to different staffers for most of the day. The highlight of the day occurred during our last meeting. I was a little disappointed that my team and I hadn’t met any congress members. This is when Joe Courtney walked into his office the same time we did! Mr. Courtney invited us into his office to discuss our ideas. Mr. Courtney seemed very receptive to our ideas and recognizing pharmacists as providers. He had to step out of our meeting a little early so he could attend a vote. However, he snapped a picture with Team Connecticut before taking off. It was very exciting to meet the Representative of my district and discuss my profession with him! This was great way to end a long day with my team.

            RxIMPACT was an eye-opening experience that allowed me to feel connected to my profession. I felt empowered and that my voice made a difference. It was interesting to see yet another way in which you can utilize your pharmD. This program educated me on how the Hill works and how to be an efficient advocator. RxIMPACT day allowed me to grow as a leader and meet with some of our professional and national leaders. I met pharmacy students from all over the country and have developed new friendships. This was a rewarding experience and I would highly recommend anyone attend RxIMPACT day. It is crucial to have students participating because we are the future. Our advocacy will influence our development as a profession and our role as part of the  health care team. This a breath of fresh air and allows you to utilize your leadership skills. It is important to do things outside of the classroom and RxIMPACT day is a great way to get involved. NACDS showed me that I have the power to make a positive change in the profession of pharmacy.

 Above-Part of Team CT and Congressman Joe Courtney

Below-Brody McConnell, Jon Lee, and myself in front of the Capital Building

 

Team CT office visit schedule ^^                                              Key "asks" for Capital Hill meetings ^^

For more information on RxIMPACT Day and NACDS visit http://www.rximpact.org/nacds/home/index