Before beginning my geriatric consulting pharmacy rotation at Wright Geriatric Consulting, I was unsure of what to expect. Although I had gained experience in various pharmacy settings, I had limited exposure to the roles and responsibilities of pharmacists working in long-term care facilities. However, after reviewing the rotation expectations syllabus on the first day, I became excited about the opportunity to explore an unfamiliar area of pharmacy practice. I was also grateful to be among the first pharmacy students to complete a rotation with Wright Geriatric Consulting alongside my rotation partner.  

During the first week, my rotation partner and I shadowed Dr. Wright as we visited various long-term care facilities. Our daily responsibilities included assisting with medication destruction, conducting medication cart and medication room audits, and observing medication administration audits. Through these experiences, I gained a better understanding of the regulations and procedures that help ensure medication safety in long-term care settings.  

One of the most valuable aspects of these activities was learning how to identify potential medication safety concerns and ensure compliance with facility regulations. For example, during medication cart audits, we checked for expired medications, appropriate storage conditions, and proper separation of oral and topical medications. Although these tasks may seem routine, I came to recognize their importance in maintaining a safe environment for residents. 

Beyond learning the technical aspects of medication audits, I also developed my communication skills through daily interactions with nurses and medication aides. Conducting audits required us to approach facility staff, explain our responsibilities, and communicate our findings. At times, discussing areas that needed improvement was challenging, particularly when staff members were not receptive to feedback. However, these experiences taught me the importance of approaching conversations with professionalism and respect. Over time, I became more comfortable communicating concerns constructively while maintaining positive working relationships with facility staff. 

Another important component of consultant pharmacy practice that I had the opportunity to explore was medication regiment review. Consultant pharmacists regularly evaluate residents’ medication regimens, including those of newly admitted residents, to identify potential medication related problems and provide recommendations to doctors and nurses. As a student pharmacist, I had opportunities to review patient cases, develop recommendations, and discuss my clinical reasoning with Dr. Wright and my rotation partner.  

These discussions helped me better understand the unique considerations involved in medication management for older adults. For example, I frequently encountered residents receiving long-term proton pump inhibitor therapy without a clear ongoing indication or potentially duplicative medications for sleep disorders. Reviewing these cases encouraged me to consider the risks and benefits of medications more carefully, particularly in a population that may be more vulnerable to adverse drug effects. Most importantly, I gained a greater appreciation for the meaningful impact consultant pharmacists can have through ongoing medication reviews and thoughtful clinical recommendations. 

I also had the opportunity to observe gradual dose reduction (GDR) meetings with nursing staff at long-term care facilities. During these meetings, the consultant pharmacist and nursing staff reviewed residents’ medications, particularly psychotropic medications such as antipsychotics and antidepressants, to evaluate whether dose reductions or discontinuation might be clinically appropriate. Observing these discussions helped me understand the importance of balancing medication safety with each resident’s individual needs. It was also a valuable opportunity to see how pharmacists collaborate with other healthcare professionals to make patient-centered decisions. 

In addition to these responsibilities, I had the opportunity to administer flu vaccinations to residents at the facilities. Interacting directly with older adults was especially meaningful, as it reminded me that behind every medication regimen and clinical recommendation is an individual with unique healthcare needs and personal priorities.  

Another valuable learning experience during this rotation was completing the American Society of Consultant Pharmacists (ASCP) Age-Friendly Care Certificate program. Through this program, I learned about the 4Ms Framework: What Matters, Medication, Mentation, and Mobility. This framework emphasizes a holistic approach to caring for older adults by considering not only their medications and medical conditions but also their personal goals, cognitive health, and functional abilities. It reinforced the importance of individualized, patient-centered care, and I hope to incorporate these principles into my future pharmacy practice.  

Looking back, this rotation was a valuable and rewarding experience that broadened my understanding of the pharmacist’s role beyond traditional pharmacy settings. I entered the rotation with limited knowledge of geriatric consultant pharmacy, but I now have a greater appreciation for the clinical expertise, attention to detail, and communication skills. 

I am grateful to Dr. Wright and Wright Geriatric Consulting for providing me with the opportunity to explore this area of pharmacy practice and learn through hands-on experiences. This rotation not only strengthened my clinical and professional skills but also reminded me of the important role pharmacists play in improving medication safety and quality of care for older adults. The knowledge and experiences I gained will continue to influence my approach to patient care as I progress in my pharmacy career.