- Samantha Boaterfield studied and worked as a clinical pharmacist for eight years.
- She didn't realize how much family time she was missing until a medical surgery left her bedridden.
This as-told-to essay is based on a conversation with Samantha Boaterfield, a 32-year-old former pharmacist from Phoenix, Arizona, about leaving her career after five years. Insider has verified her previous income with documentation. The following has been edited for length and clarity.
Before I started my online business, I worked as a pharmacist for five years. I loved my job and never thought I'd ever leave, but when a medical procedure gone wrong left me on disability, I realized my career just wasn't worth the sacrifices I'd have to continue making.
I went to Arizona State University and got my degree in biochemistry with a minor in business. At that time, I worked as a pharmacy technician in a retail location for two years. That job got me interested in becoming a pharmacist.
Despite my six-figure income I was living paycheck to paycheck. The most I made in a year was almost $125,000.
Though I was provided a great education, I'll spend the rest of my life paying off the loans
When it was time to apply to pharmacy school, I didn't want to separate from my husband for three to four years. We were high-school sweethearts, and his job was in Phoenix. Luckily, I got into the one pharmacy school I applied to in the area and got my PharmD — a doctorate of pharmacy. I used student loans to pay for pharmacy school, and because my school was private, I had to take out as much loans as a dentist or a physician, but my pharmacist salary was only a fraction of what they make.
The program was accelerated, so I went to school for three full years with minimal breaks.
After I graduated, I did a hospital residency
Pharmacists can choose to do a year or two of residency to get more clinical positions, and I chose to do an acute-care residency in Phoenix. Acute care is very different from traditional retail.
The acute-care residency gives a pharmacist the opportunity to advance their skills and knowledge within a hospital setting, from emergency medicine and critical care to transplant pharmacology. This year of residency helps pharmacist become competent in everything involved with medication management for an inpatient population.
During my last year of school, I did rotations in different settings, and I just loved hospital pharmacy — in retail, you don't have access to labs or patient records. Having access to medical labs and records allowed me to ensure a medication dosage was optimized and adjusted for the patient. If a patient had a deteriorating kidney function, for example, they'd need the dose of a medication reduced to avoid accumulation. I found it rewarding to be part of the patient-care team, be able to make improvements to a patient's regimen, and improve clinical outcomes.
I needed to keep myself updated with the latest evidence and literature
Every hospital is different in the way they're structured, but often there are "central" pharmacists that verify prescriptions before the nurse can remove them from the medication machines. These pharmacists are also vital in verifying intravenous medications before they're sent up to the patients to ensure they're the correct dose and compounded correctly. It's an acute, critical environment that kept me on my toes.
Oftentimes you may have a patient that's in a more critical condition, where you need to be able to quickly dose and accurately dispense a medication safely. You're always learning something new, and it keeps you practicing at the best of your license. Also, infectious diseases are always evolving and can become resistant to our antimicrobials. Therefore, our treatment strategies have to change with them.
Pharmacists can take many clinical roles in a hospital
There are infectious-disease pharmacists, cardiology pharmacists, transplant pharmacists, and critical-care pharmacists. These pharmacists actually work on the floors of these departments. They'll look at all their patients, just like the physicians do, and go through all of the patient's medications to see what they can do to optimize the patient's regimen.
Clinical pharmacists ask pertinent questions like: "Does the patient need this medication?" "Why aren't we using this medication instead of a current one?" and "Can we optimize this dose better?"
As a clinical pharmacist, I'd do rounds with the physicians in the morning, weighing in on the drug regimens the patients were on. That was my favorite part of my job.
I worked in central pharmacy, but I often did pharmacy coverage in the ER, too
In the emergency room, I'd get medications to trauma patients so the nurses could stay by the patient's side. I preferred ER pharmacy over working centrally because I never knew what the day would bring or what patient would come in.
I'm someone who doesn't enjoy doing the same thing every day. If I'm not learning or facing a new challenge every day, I just don't do as well. I thrive under pressure.
A big part of my role was anticipating what the medical team would need in a crisis. If we had a code situation, I'd handle the crash cart, a mobile unit that contains the medications and devices needed to perform a code. Pharmacists are taught to anticipate the patient's immediate pharmacological needs and help prepare or facilitate the medication to bedside quickly, such as those needed for resuscitation, seizure prophylaxis, or antimicrobial treatment. Having things prepped and ready to go was crucial for creating the best possible outcomes for patients.
As my family grew, I needed to change how I worked
The ER was primarily nights and weekends. That didn't work with a growing family. Hospital pharmacists usually need to work every other weekend. Acute care was minimum 40 hours per week with overtime offered if needed. Hospitals are not Monday through Friday, 9 to 5 establishments; they're 24/7. Unfortunately, it also means working holidays.
When I got pregnant and had my daughter, I didn't realize how much holidays, weekends, and being truly present meant to me. I missed my daughter's first steps while I was at work, and before I had kids, I missed two Christmases in a row. As much as I loved my job, I loved being a mom more.
That's when I transitioned to becoming an ambulatory-care pharmacist, which is a clinical pharmacist. I worked at a primary-care clinic with about five or six physicians. The doctors would often send over patients with diabetes or high cholesterol, or that were on blood thinners, and I'd help manage those conditions. I had prescribing authority underneath the doctor, but the doctors had to approve everything I did, so I would send over my treatment plan for the physicians to sign off on.
This setting was great because I had a lot of one-on-one time with the patients that physicians don't have — the initial consults were an hour long. Being able to share that much education with a patient was rewarding because I could see them improving from appointment to appointment.
I didn't realize how much I was missing until a lumbar puncture gone wrong landed me bedridden
Once I changed positions from the hospital to the primary-care clinic, after my first child was born, the commute was brutal. It was almost two hours long, round trip. I had my second child after making the transition to the clinic, so this meant I was away from my children for about 12 hours on any given day, at least five days a week, and I'd often have to take work home with me. Combine that with paying for daycare and student loans, even while living well below my means, my family's income barely covered our expenses.
The lumbar puncture never closed. When I'm upright, my spinal fluid leaks and creates immense amounts of pressure in my head. Sitting and standing doesn't work for me. I have to lay down most of the time.
While I've been on disability, I've opened up an online affiliate-marketing business, where I share the most cutting-edge tools to create efficient systems that automate the mundane tasks and help people work smarter not harder. I learned SEO and started blogging, and it's been my way to help cover some of my medical expenses. It's also allowed me to have more time with my children.
Overall, I loved my time in pharmacy, but in the end it just wasn't worth it.