Well I have a few exciting updates on this blog post, from fine-dining to a productive work week, to suffering from some of the weirdest self-injuries. In terms of the internship, this week, Raniyah and I wrapped up pharmacy, and we will be starting ER hopefully next week. Oh yeah, there’s also a tropical storm headed our way this evening, so hopefully that does not throw things off course for next week. Anyways, let’s get started on what I have to share here…
Ram Luna
We kicked off our weekend by driving all the way up a mountain to Ram Luna, a very fancy restaurant that was suggested by some locals. The vibe of the place was very akin to a fine-dining experience, intertwined with an antique shop; their decorations were interesting dolls, china, and figurines nonetheless. The steak there was pretty good, but the best part (and probably where most of our expenses went) was the location and view of the restaurant. When we were lucky enough, we stepped outside to snap some pictures of the city below, lights twinking on and off as cars meandered through hairpin turns nearby. For dessert, they had this very adorable flower pot (the pot isn’t edible just in case you were wondering like we were) filled with ice cream and cake crumble.
The inside of Ram Luna, which was a cozy wooden building atop a mountain
Our desert is served…in a pot?
The view that Ram Luna had over Costa Rica
Injury 1: The Bruised Leg that Made Me Miss La Chimba
On Sunday, our group had decided previously to go on a hiking excursion to La Chimba. However, I woke up to a terrible feeling in my leg. As I rustled more in bed and tried to investigate what was going on, I noticed a bunch of bruises and scrapes from my foot all the way to my knee. Definitely a rude awakening. There was definitely a lot of swelling, but I had no idea how I sustained these injuries in the first place. My guess is from the sharp edges of the protruding storage boxes on the back top corner of my bottom bunk bed – I must’ve hit my leg pretty badly on it while turning in my sleep. I unfortunately could not go to La Chimba because of the swelling, but I spent the rest of the day chilling and icing my leg, which was pretty great. I knew an injury was bound to come from these Selina beds one day…
Pharmacy
This week, we wrapped up our rotations in the pharmacy department in the hospital. We started in clinical pharmacy, then went to community pharamacy, and then finally hospital pharmacy. Prior to this internship, I never really considered the different sectors of pharamacy within a hospital, so it was very interersting to gain some perspective on how these three parties work together to deliver medications to patients in need of them. The first thing we did on Monday was go to the community pharmacy, which was one of the most customer-facing pharmacies that Clinica Biblica has. It is especially useful for the small clinics, including the Santa Ana branch of Clinica Biblica, who need access to special medications that other locations ight not have. It was sad to hear how some patients have to travel over 5 hours across the country to go to Hospital Clinica Biblica, just to get the medication they need.
On Monday afternoon, we went with the clinical pharmacy student interns to perform quality checks on the contents within shock carts around the hospital. As someone who has worked at Ben Taub Hospital in Houston before, this was something I was vaguely familiar with interacting with these password-protected carts, but this was the first time I could actually see the contents within the carts. As we manually inventoried each cart, I remember seeing how prone to human error some of the process was, from having to count the number of vials of a certian medication, then writing this down on a sheet of paper, to then finding the expiration date of each vial too and again recording this. Raniyah and I were discussing that while shock cart maintenance was important, we are hoping that maybe one day, there is some sort of digital way to record-keep or some sort of machine that could dispense medications so that it would be easier on the pharmacists and nurses in the future.
On Wednedsay, we shadowed the processes in hospital pharmacy, which is the hospital’s main pharmacy that patients interact with when they need to pick up a medicine after a checkup. It is also the primary location where medications are prepared for each floor on the hospita; for example, if Floor 3 (Inpatient) needed refills of a certain medication, then the hospital pharmacy would prepare this, triple check that the prescription followed the correct dosing (doctors place the order), and then they hand it off to a delivery nurse who takes it to the floor. I am actually not sure if this is the process of quality checking prescriptions in the US as well, but I am definitely curious to see what that process is; in hospital pharmacy, we definitely saw there being times where a doctor may have prescribed a certain medication that was not at a standard/traditional amount, so the hospital pharmacy had to call the doctor to triple check the dosage. In the hospital pharmacy, it was overall interesting to see how chaotic the place was; after the desk of medications to be delivered was cleared and quality-checked, it always seemed like new medications would again fill the table.
Our new friends we made at clinical pharmacy!
Injury 2: The Tongue Twister
This one is going to take a while to explain, but I’ll spare you guys and give you all the rundown. So, I think having one injury in a week is already bad enough. But of course, lucky me, I sustained yet another surprising injury this week, which had me ripping off a piece of my tongue. Basically, what happened is that a piece of hair fell into my mouth as I was working on some computer work that occupied my hands. As I struggled to get the hair out, first propelling it out with my tongue, and then finally my hands, I felt a painful pinching sensation, and the hair was stuck! As I went to the bathroom, I noticed that my hair had knotted itself on one of my fugiform papillae – just my luck. I spent the next 15 minutes or so trying to unknot the knot, but alas, nothing had worked. I didn’t want to risk cutting a chunk of my tongue off by mistake if I had used some heavy-duty scissors. So, I had went forward with my next best decision, and yanked the knot off as hard as I could – taking a piece of tastebud off with it. It’s actually just so crazy that this happened to me, especially during this week where my leg had already suffered, but I wanted to document this and share it with you all. Hopefully this never happens to anyone else reading this blog post!
Internship Takeaways:
At the end of this week, we actually met with Dr. Acosta and Dr. Camacho, our supervisors for this internship, to give them updates on our internship. I think the meeting went really well, as we got to share our role in the internship, the needs we identified, and our next steps. Dr. Camacho was even nice enough to help provide us with some low-fidelity prototyping materials and even allowed us to go shadow in Santa Ana for the second half of the internship! Raniyah and I are really looking forward to our last month of this internship here in Biblica.
- Presented our findings from Radiology, Pharmacy, and Microbiology in a joint innovation meeting to share innovation targets
- Noticed some inefficiencies with language barriers in the process of patient intake – would be helpful if whoever has the first encounter with the patient, could write down the language that the patient speaks in the EHR notes
- Built our own prototyping cart!
I’m going to go back to preparing for this tropical cyclone that is ever-so slightly spiraling closer to the Costa Rican border from the Carribean side. I’m sure it will be fine, but I am going to go organize some of my groceries now. Hopefully I survive to write the next blog post! See ya~