{"http:\/\/dx.doi.org\/10.14288\/1.0437509":{"http:\/\/vivoweb.org\/ontology\/core#departmentOrSchool":[{"value":"Pharmaceutical Sciences, Faculty of","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/dataProvider":[{"value":"DSpace","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/alternative":[{"value":"Our Practice (Podcast). Series 1, episode 5","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/creator":[{"value":"Gobis, Barbara","type":"literal","lang":"en"},{"value":"Domanski, Nicole","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/issued":[{"value":"2023-11-02T21:06:38Z","type":"literal","lang":"en"},{"value":"2021","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/description":[{"value":"Pharmacy practice is continually evolving. From small-scale, iterative changes that happen over time, to revolutionary changes spurred by events such the COVID-19 pandemic, pharmacists need to be adaptive and agile.  \r\n\r\nEarly career pharmacist, Dr. Nikki Domanski, joins us in the studio today to share her thoughts on the changing pharmacy landscape and the skills that enable pharmacists to forge ahead.","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/aggregatedCHO":[{"value":"https:\/\/circle.library.ubc.ca\/rest\/handle\/2429\/86436?expand=metadata","type":"literal","lang":"en"}],"http:\/\/www.w3.org\/2009\/08\/skos-reference\/skos.html#note":[{"value":"Our_Practice_S1E5 (Completed  09\/27\/21)Transcript by Rev.comPage 1 of 7Series 1, Episode 5: Pharmacy Practice ChangeThis transcript was exported on Sep 27, 2021 - view latest version here.Announcer:Welcome to Our Practice, a podcast created to talk candidly about the evolving pharmacy profession, and the challenges and rewards of providing innovative patient care. We aim to inspire and empower you, our pharmacist colleagues, to learn and grow in your own practices.Announcer:This podcast is provided by members of the UBC Pharmacists Clinic and is meant for educational purposes only. There are no associated sponsorships or commercial interests. We acknowledge that UBC, and the Pharmacists Clinic, is situated on the traditional, ancestral, and unceded territory of the Musqueam people.Announcer:Thank you for joining us. And now, here's your host, Barbara Gobis.Barbara Gobis:Hello, and welcome to our final episode of Our Practice, Series One. The idea for a podcast came to life in the spring of 2020 in discussions that we were having about the ever-changing landscape of pharmacy practice in Canada. We're sharing what we do and what we've learned in the hope to inspire others to evolve their practices too. So far, we've talked about the building blocks of patient care and pharmacy practice. From mindset to clinical process, the concept of patient attachment. And what patient centered care looks like in action.Barbara Gobis:Heady stuff. But at the core of it all, is that how a clinical pharmacist thinks, shows up, and behaves is all about caring for the person who is taking medication. Some people call these soft skills, but they really are the critical skills, without which any or expertise is unable to get to and impact the patients we care for. We have a clear role to play, and series one is all about strategies and approaches our team uses to deliver.Barbara Gobis:Today I'm joined in studio by Nikki Domanski, one of our clinical pharmacists at the UBC Pharmacists Clinic. Nikki lived and studied in Waterloo, Ontario, before making the cross Canada trek to BC in 2019 to pursue a new career opportunity, as well as to pursue her love of the mountains. Behind the scenes, Nikki leads the clinic's Our Practice initiatives, which include our newsletter, webinars, and most recently, these podcasts.Barbara Gobis:Today, Nikki is here to share her thoughts on pharmacy practice change and what it's like being an early career pharmacist in these exciting times. Hi, Nikki, and welcome.Nicole (Nikki) Domanski:Hi, Barbara. Thanks for having me on the show. You mentioned I've been working behind the scenes on the podcast for a number of months now, so it's been amazing to watch these episodes come to life and listen to my colleagues' perspectives. Even though we work together closely, and I'm not only familiar with our patient care process, but I practice it every day, listening to my colleagues' episodes that have This transcript was exported on Sep 27, 2021 - view latest version here.Our_Practice_S1E5 (Completed  09\/27\/21)Transcript by Rev.comPage 2 of 7aired so far, I still feel like I'm learning something new, or at least thinking about certain aspects of patient care differently.Barbara Gobis:You're right. I envision it to be like opening a little trap door in the top of somebody's brain and having a chance to peek in and see the inner workings, the behind this scenes. Because it really does start with your head and how you think and approach things.Nicole (Nikki) Domanski:Exactly.Barbara Gobis:So, yeah. Let's take a peek inside your brain, Nikki.Nicole (Nikki) Domanski:Ooh.Barbara Gobis:So how long have you been out of school, Nikki? And what do you know now that you would likely tell yourself as a pharmacy student back then?Nicole (Nikki) Domanski:Good question. Okay. Let me think for a second here. So I've been out of school for four years now. And now that I'm saying it out loud, it's hard to believe. In those four years, I certainly feel like pharmacy practice has changed. Sometimes I feel like pharmacy practice changes from one day to the next. I've experienced first hand, how seemingly one day we are talking about the need to access patients lab values, and the next day our team is signing up for CareConnect.Barbara Gobis:Yeah. And for those in the group who aren't familiar, CareConnect is the provincial eHealth viewer that we now, at our clinic and a number of pharmacies across the province, have to access labs, recent hospital discharges, immunization records, and all of those critical pieces that pharmacists have been needing in the past.Nicole (Nikki) Domanski:Yeah. And in hindsight, those changes in practice take years to accomplish. But the point is, I feel like we, all pharmacists, are in a constant state of evolution. There are big changes that have happened, like prescribing authority for pharmacists in certain provinces. There are big changes that are in the process of happening, like the current rollout of the pharmacists in Primary Care Network program in BC, which maybe we can chat a bit about later. And there are big ideas that might have not yet ignited change, but we should know by now, change is on the horizon.Barbara Gobis:Absolutely.This transcript was exported on Sep 27, 2021 - view latest version here.Our_Practice_S1E5 (Completed  09\/27\/21)Transcript by Rev.comPage 3 of 7Nicole (Nikki) Domanski:So to answer your question about what I would tell myself as a pharmacy student, I might say something like, seize opportunities that are new and challenging to sharpen skills beyond just our clinical knowledge. Like adaptability, creative thinking, problem solving, communication, or even risk assessment to name a few.Nicole (Nikki) Domanski:And I would say, Nikki, the practice that awaits you and the patients you encounter will benefit greatly from pharmacy leaders that are not only strong clinically, but also good at adapting to change or even ready to spark change. Oh, and I might say, heads up Nikki, there's going to be a global pandemic.Barbara Gobis:Yeah. And I think at that point you'd both want to clink glasses and have a vodka shot.Nicole (Nikki) Domanski:Yeah. I think you nailed it.Barbara Gobis:So as we think about changes in pharmacy practice, are they exciting or are they daunting?Nicole (Nikki) Domanski:Oh, definitely exciting. But I need to provide a disclaimer for that. I'm a red type personality. For anybody who is familiar with personality tests or personality types, red personalities are high energy, we're task oriented, and we're fast paced thinkers. In a nutshell, we enjoy challenges and changes. When I think about the future of pharmacy practice, I see potential for lots of growth and innovation, and I'm thrilled by it.Nicole (Nikki) Domanski:Like more pharmacists able to independently prescribe Schedule I drugs. Or pharmacists being able to make direct referrals to specialists. Or even having access to one common EMR, shared by a patient's entire healthcare team, that we can have access to. I'm here for it. My first thoughts are, yes. What can I do? And how can I be involved?Barbara Gobis:Right. Bring it on. I'm a red too, Nikki. We're the Git-R-Done gals, right?Nicole (Nikki) Domanski:So you know exactly what I mean?Barbara Gobis:I do, I do.Nicole (Nikki) Domanski:This transcript was exported on Sep 27, 2021 - view latest version here.Our_Practice_S1E5 (Completed  09\/27\/21)Transcript by Rev.comPage 4 of 7But, Barbara, I've come to learn a lot more about the other personality types, and realize that not everyone shares my excitement. And that is perfectly okay. Or they might also share the excitement, but not express it in the same way.Barbara Gobis:Well, as I mentioned, you and I are both extroverts. We're both that action-oriented, Git-R-Done ... perhaps sometimes we're ready, shoot, aim. And we need people around us to help give us all the information so that our energy can be harnessed to propel us forward effectively and efficiently.Nicole (Nikki) Domanski:Exactly. And to that, I learned that my excitement and my red characteristics are not enough to create or drive pharmacy practice change. We need the blues and the greens and all the other colors on the spectrum, a full team effort, to truly make scalable and sustainable changes.Barbara Gobis:Yeah. And just for listeners, so what we're referring to as a green is an analytical type. The person who will be thorough and make sure that we've considered the options so that we're making good choices going forward. And the blue type of personality is the person who makes sure that the people are okay as we move forward and make changes. So the energy, the people, the thought, collectively we move.Barbara Gobis:So now that you've learned this about yourself, Nikki, let's go back to your early career development and how you feel about your journey so far.Nicole (Nikki) Domanski:Ooh, loaded question. Well, I think every person has their own unique career journey. I find it so interesting to hear these stories from pharmacists. I remember in pharmacy school, any time we had a guest lecturer come in, they would spend the first five minutes talking about their career path and how they came to be in their current position. I remember thinking to myself, whoa, that's a twisted trajectory. It's not like one opportunity always led to a better one. Sometimes they had to take a step back in order to move forward. And there were times when people shared how failure, life events, illness, finances, prejudice, or other factors got in the way. But before you knew it, they're five minute ramble was over and they moved on to the lecture topic.Nicole (Nikki) Domanski:But in hearing these stories, and even in talking to my friends and colleagues about their own careers, I've realized that there is this underlying unnamed force or energy that perpetuates career development and ultimately job satisfaction. If I had to put a name to it, I would call it courage. But it's funny, because no one going through the motions, like the experience of accepting new opportunities, changing jobs, moving cities, leaving behind the comfortable or the familiar, calls it courage.Barbara Gobis:Right. And maybe I'll just interject here, because the way I view courage is that I view courage as doing something even though you're scared. You accept the fact that you're uncomfortable, that you're scared. You don't know what's coming. But you put yourself out there. That is courage.This transcript was exported on Sep 27, 2021 - view latest version here.Our_Practice_S1E5 (Completed  09\/27\/21)Transcript by Rev.comPage 5 of 7Barbara Gobis:And at the end of the day, no matter what happens, you either get what you want, you get experience, or you get something that like you said, opens doors and creates an interesting trajectory. So I think you've nailed it. I think courage is the most important thing. And, good on you.Nicole (Nikki) Domanski:Well, thanks, Barbara. And when I talk about this, I realize that I've only been out of school for four years. I'm in the early stages of my career and I still suffer from imposter syndrome, thinking, am I ready for this? Am I good enough for this? But I think that's another whole podcast topic.Barbara Gobis:So what are some of the changes in practice that you've encountered in your long four year career?Nicole (Nikki) Domanski:So we've already mentioned a few of them, such as gaining access to CareConnect, which I highly recommend. And any pharmacist in BC can gain access. But other significant changes would be the expansion of multidisciplinary healthcare teams, the pharmacist role on these teams, and increased patient access to these teams. In Ontario, I did my residency within a family health team where pharmacists were involved in or led a variety of disease specific clinics, like pain, diabetes, memory, anticoagulation, and hypertension.Nicole (Nikki) Domanski:However, access to most of these clinics was limited to patients rostered to the physicians working within the family health team. Later, when I moved to BC, I worked at an outpatient care clinic, serving many different populations. Pharmacists work together with nurse practitioners, dieticians, cardiologists, endocrinologists, and other specialists to provide care to a variety of patients. Like those transitioning out of hospital, patients without a GP, refugees, and those needing access to specialty services.Nicole (Nikki) Domanski:It is exciting to see the growth of interprofessional teams as a model of healthcare delivery. I'm a strong advocate for it, and seeing how much we can accomplish for patients as a team is amazing. I'm also happy to see more and more initiatives aimed at integrating pharmacists on health teams. Which brings me to say how phenomenal it is that the PCN program is underway in BC. And I truly believe the impact of this program for patients and on our healthcare system is going to be far reaching.Barbara Gobis:And just for those who are listening, PCN stands for primary care network, which is British Columbia's equivalent of a family health team or a healthcare network of some sort. And I believe we are slated to talk about that next series.Nicole (Nikki) Domanski:Exciting. We will tune in. There are obviously other aspects of pharmacy practice change that I'm seeing as well. Continued advocacy and action in expanding the pharmacist's scope of practice is probably one on the top of everyone's mind, as well as the expanded scope of practice for pharmacy technicians. But This transcript was exported on Sep 27, 2021 - view latest version here.Our_Practice_S1E5 (Completed  09\/27\/21)Transcript by Rev.comPage 6 of 7I'm also seeing more diverse training opportunities for pharmacy graduates, such as primary care residency programs, masters programs in pharmacy, as well as advanced clinical practice.Nicole (Nikki) Domanski:The pandemic has also clearly changed where we provide care. And I would imagine that virtual care is going to be an increased area of pharmacy practice too. And that's just to name a few.Barbara Gobis:Wow. And that's ... I mean, those are big things that have been going on. Which really gets me thinking about what change is typically like. I mean, for the most part, we think of it as being evolutionary, happening in small scale actions and goals. And then every once in a while, bam, a revolutionary change like COVID. So we've experienced, and we, I guess are continuing to experience both evolutionary and revolutionary change. What do you think of this?Nicole (Nikki) Domanski:I have seen firsthand how small changes, like optimizing the function and security of our clinic's video conferencing platform, can impact patient care. This impact then leads to knowledge translation, which can induce larger scale practice change. For example, in this case, after optimizing the way we run virtual appointments during the pandemic, we hosted a webinar for pharmacists across Canada about our experiences with virtual care and the ways they can incorporate it in their practice.Barbara Gobis:Right. Yeah. A webinar on how to do webinars and how to communicate virtually. Which I will just let listeners know, our webinars are archived on the Pharmacists Clinic website under Our Practice. So go and check it out.Nicole (Nikki) Domanski:And we need to remember, like you said, evolutionary change is an iterative and gradual process, which requires a mindset that is grounded in patience, practice, scalability, and accepting failure. At the clinic, I think we have this mindset that if something doesn't work, we ask why, and how can we fix it? If something doesn't work as well as it can, we ask, what can we do differently, and how can it be optimized? And even if something works well, we acknowledge that it should be monitored, just like a patient care plan. And when should we follow up on things?Nicole (Nikki) Domanski:I think, Barbara, to conclude here with everything, practice changes start with daily changes.It's the small ways to think or do differently. If I had to give pharmacy student Nikki one more piece of advice, I would say, keep an open and curious mindset. Don't settle. Be courageous, challenge ideas, and be ready for change because it's going to come at you in one way or another. So brace yourself. Surround yourself with the right people, and jump in.Barbara Gobis:Well, Nikki, you've really, I think hit some keywords for us to remember. Be open, be curious, be courageous, go forth and prosper. I love that attitude. And really, that's the way to just ride the waves and get the most out of these exciting and interesting times that we're in. And I will just put in another This transcript was exported on Sep 27, 2021 - view latest version here.Our_Practice_S1E5 (Completed  09\/27\/21)Transcript by Rev.comPage 7 of 7plug, that we have written up our experience with CareConnect and the impact on patient care in our practice and published it in our September 2021 feature article for the Our Practice newsletter. Go to our website and check it out.Barbara Gobis:So thank you again, Nikki, for sharing your thoughts and your enthusiasm and that red energy. It really fires me up and I want to go out and change something right now. It's also a great setup for series number two, which is going to be coming out soon. Where we're going to talk about how we as pharmacists show up every day to make an impact on our patients, our profession, and for our team.Barbara Gobis:So thank you to our listeners for joining us in series one in our inaugural venture into podcasts. We really appreciate your thoughts, we look forward to hearing from you, and we'll talk to you again soon.Announcer:That's it for today. For more information on the Pharmacists Clinic, please check out our website, where you can access more practical information, including our newsletter, archive webinars, and practice resources. From our practice to yours, thank you for listening.","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/hasType":[{"value":"Other","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/isShownAt":[{"value":"10.14288\/1.0437509","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/language":[{"value":"eng","type":"literal","lang":"en"}],"https:\/\/open.library.ubc.ca\/terms#peerReviewStatus":[{"value":"Unreviewed","type":"literal","lang":"en"}],"http:\/\/www.europeana.eu\/schemas\/edm\/provider":[{"value":"Vancouver : University of British Columbia Library","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/rights":[{"value":"Attribution-NonCommercial-NoDerivatives 4.0 International","type":"literal","lang":"*"}],"https:\/\/open.library.ubc.ca\/terms#rightsURI":[{"value":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/","type":"literal","lang":"*"}],"https:\/\/open.library.ubc.ca\/terms#scholarLevel":[{"value":"Faculty","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/title":[{"value":"Pharmacy Practice Change","type":"literal","lang":"en"}],"http:\/\/purl.org\/dc\/terms\/type":[{"value":"Text","type":"literal","lang":"en"},{"value":"Sound","type":"literal","lang":"en"}],"https:\/\/open.library.ubc.ca\/terms#identifierURI":[{"value":"http:\/\/hdl.handle.net\/2429\/86436","type":"literal","lang":"en"}]}}