VA Nebraska-Western Iowa Health Care System
PGY-1 Pharmacy Residency Program
The Grand Island VA Medical Center offers a high volume of outpatient primary care and mental health visits to Veterans in rural Nebraska. We have several specialty clinics onsite as well, including: outpatient orthopedic clinic, radiology, respiratory, urology, dermatology, nutrition, eye clinic, wound/foot clinic, dental, nutrition. The Grand Island VA is home to the Community Living Center (CLC) which offers sub-acute and long-term care, as well as palliative/hospice care. We have a 30-day inpatient substance abuse treatment program which provides rehabilitation for Veterans with substance and alcohol abuse disorders. We employ 12 pharmacists (including our site manager, mental health specialist and PACT pharmacist at our North Platte satellite clinic) and 5 technicians, in addition to 8 primary care providers.
Established in 2005, the PGY1 residency program offers a well-rounded clinical pharmacy experience that focuses on ambulatory care and the geriatrics in the long-term care setting. Throughout the course of this one-year program, residents will further develop their skills in drug information, pharmacy administration, time management, organizational skills, as well as polish verbal and written communication skills. In addition to the robust ambulatory care and geriatrics experience, residents will have many opportunities to precept pharmacy students which will foster the transition from pharmacy student to clinical pharmacist or instructor. In addition, residents will be responsible for providing education to patients, nurses, pharmacists and other health care providers. PGY1 residents may apply for early commitment to the PGY2 Ambulatory Care program at the Grand Island VA.
Pharmacy clinical practice at the GIVA goes over 30 years, so the autonomy that pharmacist have is unmatched! Our pharmacist-run ambulatory care clinics are high volume; residents will gain experience working in a fast-paced clinic environment with close relationships with primary care providers. On average 8-14 patients per day are scheduled between face-to-face and phone appointments (video appointments are also available). Unique to the VA, pharmacists have prescriptive authority in areas of expertise. Clinical pharmacists act as mid-level providers, managing a wide variety of chronic diseases, including (but not limited to): anticoagulation, hyperlipidemia, hypertension, diabetes, smoking cessation, congestive heart failure, thyroid disease, anemia, pain management, pharmacokinetics and hospice/palliative care. Residents are included in this opportunity to practice at the top of their license. Given our rural practice, our primary care providers look to the clinical pharmacy team for the latest information from clinical trials and actively seek input from the pharmacy team in managing chronic diseases. Pharmacists, including residents, are responsible for management of the formulary using nationally approved criteria for use and evidence-based medicine. Residents will also experience pharmacy management on multiple levels, both on site management, as well as from the perspective of the Chief and Associate Chief of Pharmacy.
Finally, residents will be required to design, conduct, and complete research or quality improvement project suitable for publishing during the year. We typically use the Inverse Research Model -- residents start out the year with data collection from a project started by the previous year’s resident class. This allows the resident to present a completed project (poster) at ASHP Midyear Clinical meeting. Then while at Midyear, residents can participate in the poster sessions of other residents and take what they have learned about the Grand Island Campus over the first half of the residency year to develop a new research project to start in January. Residents will also present their poster at our VA Nebraska-Western Iowa Pharmacists Retreat (April/May), a PowerPoint presentation at Midwest Pharmacy Residency Conference in Omaha, NE (May) and complete a written manuscript suitable for publication.
In addition to clinical opportunities, residents will gain experience in the inpatient and outpatient pharmacy. Following an initial 4-week rotation, residents will have limited staffing requirements. Residents are required to work every other Tuesday 4:15 to 6:30pm and Saturdays 8am to noon alternating every other month with one Saturday or two Saturdays. Prior to the Saturday shift, residents will staff on Friday, 8:00am to 4:30pm.