A Day in the Life: Jason Seet, Infectious Diseases/Critical Care Pharmacist

Jason Seet is the Infectious Diseases/Critical Care Pharmacist at Sir Charles Gairdner Hospital in Perth, WA. With patients in Intensive Care and the High Dependency Unit at increased risk of hospital-borne infection, Jason shares a day in the life of a clinical pharmacist — a vital intermediary between care teams who ensure all medicines are effective, tolerated and contributing to optimal patient outcomes.

07.30 — I arrive at work and sort through emails, mainly responding to colleagues and collaborators from other hospitals.

08.00 — I join a combined ward round on the Intensive Care Unit (ICU) and the adjunct High Dependency Unit (IDU), which care for people at high risk of infection and clinical deterioration, so managing effective handover is crucial.

08.30 — I look over all patient charts in the ICU and review their medicines: consider overnight observations, check for any adverse drug interactions, ensure each patient is on the right doses of the right treatments and confirm they are on appropriate antimicrobial therapies.

10.00 — I move to the HDU, where patients are still critically unwell but tend to present less complicated disease profiles. Partnering with the medical team, we review medicines and adjust accordingly.

10.45 — I join the PathWest laboratory round with my Infectious Diseases (ID) ‘hat’ on. This is a statewide service through which I can go ‘bench to bench’ looking at new microbiology results, which gives us deeper insight into the pathology of different patients’ diseases and can help inform adjustments to their medicines and treatments.

I respond by email to colleagues from the Infectious Diseases Specialty Group as part of the Society of Hospital Pharmacists of Australia (SHPA).

11.30 — I head back to ICU and prepare ICU and HDU for the ID/ICU microround (there are a lot of acronyms in pharmacy!). I gather the latest results (microbiology and other lab results including PCT, CRP, etc,) and make sure it is clear which patients are on antimicrobial medications and why.

12.00 — The ID/ICU microround starts and the microbiology team meet with the ICU team to discuss each patient and whether to stop, start, adjust or continue these treatments.

Over lunch, our research committee meets to discuss new projects presented to the hospital and whether they will benefit our patients if we take part. I also hook into new funding opportunities through SHPA’s new National Translational Research Collaborative.

13.00 — Still more emails and I check referrals for the afternoon’s antimicrobial stewardship (AMS) round. I am in charge of AMS at Sir Charles Gairdner Hospital, which serves to ensure appropriate use of antimicrobials throughout our hospital. I manage all referrals through our electronic system, eReferrals, which is used by our doctors, nurses and other clinical staff.

13.30 — I review the AMS referrals throughout the hospital and review their charts, gathering key information such as: are they improving? Why did they start on antibiotics? How are they feeling? What are their relevant laboratory and clinical observation results? I’ll see approximately five or six patients in this way per day, summarising an update for an electronic reply to the person who referred them, which they can view instantly, anywhere in the hospital.

14.30 — I meet up with the ID consultant and visit each patient again. The consultant runs over my plans as I summarise each person’s situation, medical background, medicines history and microbiology results. In handing over to the consultant we discuss if we can step down or escalate medicines, whether we should switch from intravenous to oral or vice versa, or perhaps broaden or narrow the scope of their treatments.

This assessment is important as it can lead to cost savings and, more importantly, can improve patient outcomes and their level of comfort while in hospital.

16.30 — I pay a quick visit back to ICU to answer questions and sort out any last minute issues. Along the way, I also drop into the office for another email check, noting new referrals and responding to enquiries.

17.30 — My day usually wraps up by 5 pm, but today I have other appointments to cover and duties as adjunct lecturer at the University of Western Australia, where I provide lectures on immunisation and infectious diseases to postgraduate pharmacy students.