Healthcare: Meet a Pharmacist at Evergreen Health in Bothell, WA

Can you tell us a little bit about yourself, your life and what field of medicine you work in?

My name is Amy Arnold. I am 42 years old, married with 4 kids between the ages of 2 and 26 (the oldest, my step-son, lives on his own now). I was a chemist at an environmental testing company for several years after completing my bachelor's degree, and then went back to school in 2005 to become a pharmacist. I originally worked at an independent pharmacy in a traditional pharmacist role, and also compounded medications (created products in the lab), which is not as common. In 2014 I joined EvergreenHealth, where I manage anticoagulation (blood thinners) and also see patients in the clinic daily to help them manage their diabetes, blood pressure, cholesterol, and other issues. I am able to prescribe medication and order lab tests.

What inspired you to become a doctor?

I enjoyed being a chemist, but after a few years doing that, I realized that I needed to have a "next step" planned. One of my coworkers was applying to pharmacy school and he really talked up the field. I hadn't honestly considered it before then. I liked the allure of working in healthcare without having to take the very big plunge of going to medical school. I already had a family at the time and I couldn't justify the time it would have taken me away from them, and the likelihood of needing to move across the country to perform a residency. Turns out pharmacy school was plenty hard and time consuming, and these days does actually require a residency of 1 - 2 years to work in the type of position I have now.

Where did you attend University and/or pharmacy school? What was the most challenging part?

I completed pharmacy school at the University of Washington. The hardest thing for me was balancing class time, assignments, studying, time spent interning and commuting, with being present for my children. I did a lot of schoolwork in the very early morning hours before everyone else in the house woke up, I would wake up at 2am and start my day! I swear it took me a year after graduation to catch up on my sleep.

"I did a lot of schoolwork in the very early morning hours before everyone else in the house woke up, I would wake up at 2am and start my day! I swear it took me a year after graduation to catch up on my sleep."

Medicine is one of the hardest fields of study to be in, what study advice or general advice do you have for those who are still in the process?

While there is so much to be learned in a classroom setting, I have found that I have learned most by doing, by seeing my own patients and being forced to make my own decisions without a crutch. You are forced to look information up yourself, rather than trying to absorb that information passively while sitting in a class being talked at by a professor. The information sticks much better when you have a reason to be searching for it. I also have colleagues to bounce ideas off, which is an amazing resource to have available. One other piece of advice is to act by the general tenet: "Do right by the patient." It is so simple but really does help when you don't know exactly which way to proceed at times, or have pressures due to cost/insurance issues, etc.

"One other piece of advice is to act by the general tenet: "Do right by the patient." It is so simple but really does help when you don't know exactly which way to proceed at times, or have pressures due to cost/insurance issues, etc."

How has your day to day routine changed as a result of COVID-19? Has it changed at all?

My day to day routine has changed a little due to COVID-19. I am required to have my temperature recorded twice a day at work, and of course wear a mask essentially all day. I was never previously in a role where mask wearing was necessary. Our clinics have definitely been quieter over the last few months with fewer patient visits, so there is a lot of concern over our financial condition as an organization. We are asked to cut costs essentially everywhere, take at least 3 weeks of time off in an effort to avoid laying staff off, etc. We transitioned very quickly to providing virtual visits for our patients, so I have learned to do that too.

How different is the hospital environment as a result of COVID-19?

I don't work in the hospital itself, but when I walk to and from the hospital building, I have noticed for months how empty it feels. It is kind of a sobering reminder that things are not the same as they used to be. In the early weeks of COVID-19, life felt pretty normal at home and I felt a kind of whiplash when I went to work, where we received multiple communications daily about rapidly-changing protocols, infection rates, new symptoms to be watching for, etc.

EvergreenHealth was one of the first hospitals to see a COVID-19 patient in Washington state, how scary was that situation?

The unknown was very scary. Our hospital worked very hard and very quickly to make sure we had space for an influx of very sick patients, in numbers we could only guess at.

"The unknown was very scary. Our hospital worked very hard and very quickly to make sure we had space for an influx of very sick patients, in numbers we could only guess at."

There were serious concerns about not having enough protective gear. We were also worried about not having enough well staff members to continue basic functions, if many of us ended up either sick or quarantined due to exposure. We were worried about caring for our patients. In my clinic, we manage warfarin dosing for a couple thousand patients, which requires a blood test that is usually performed in our clinic with a finger poke. We had to figure out how to keep our patients safe and also convince them to make a trip to what was perceived as the hotbed of COVID-19. It was not easy.

2020 has been a very stressful and crazy year, have you experienced any year like this one before?

No. In my lifetime I have never even imagined a year such as this. COVID-19. Social strife. Economic concerns. And frankly, as we look at the looming start of the 2020 - 2021 school year, the mental health of my children concerns me greatly, since it appears that they will not be going back to school in the traditional sense. For me, the impact of isolating my six-year-old son has been the single most difficult thing to deal with in these last 5 months.

How have you been taking care of your mental health and yourself during these tough times?

I have been making sure I get some form of exercise most days - whether it's a brisk walk at lunch, low budget workout at home, or a run on the school track nearby. I have my low moments, but generally the drive to help my patients and care for my family helps me to find my motivation to keep mentally centered.

"I have my low moments, but generally the drive to help my patients and care for my family helps me to find my motivation to keep mentally centered."

What is one thing you look forward to most when life begins to look “normal” again?

I can't wait to go on vacation again!

You have four kids, two of which are still very young. If they ask about the events of 2020 in the future, what is the biggest lesson you would teach them about this year?

I think the biggest lessons for our family are that we have to make sure that we stay close as a family, support each other, and also prepare in a reasonable fashion for the unknown, (extra water and food, some cash accessible, necessary emergency medication, etc.).

What is one piece of advice, relating to anything, would you give to anyone who is seeking advice?

This may sound silly or cliche, but I really try to treat people the way I would want to be treated, or wish my family members were treated. I think people sometimes forget to just take a step back and do the right thing. It is so easy to get distracted with other concerns, and in medicine in particular we hear a lot about "burnout" which sometimes translates into providers not always doing their job to their best ability. There can be serious ramifications to your patients when you get lazy or don't have the motivation to work hard for them any more.