Garrett Sims

Garrett Sims

Garrett Sims

LCDR J. Garrett Sims

PharmD, BCPS, NCPS, U.S. Public Health Service Pharmacy Officer, Advanced Practice Pharmacist for the Indian Health Service, Northern Navajo Medical Center

LCDR J. Garrett Sims graduated from the UW in 2009 and currently lives in New Mexico.

What drew you to Pharmacy?

I was interested in Biology and Chemistry so I thought about biochemical engineering as a potential career path. I was interested in making medicine. I discussed this with a career counselor and she mentioned pharmacy as a potential career path, where you could also become involved in the pharmaceutical industry and make medicine. After researching the profession of pharmacy a little further, I realized pharmacy would be a better fit for me than biochemical engineering. I decided to go the route of direct patient care rather than industry after experiencing the joy of providing care by volunteering at pharmacies and through experiences at the University of Washington.

Describe your current position

Well… I wear a lot of hats. I am a pharmacy officer with the United States Public Health Service (USPHS) and I work for the Indian Health Service (IHS) agency as an Advanced Practice Pharmacist. The USPHS is one of the seven uniformed services (Army, Navy, etc.), and we respond to the health needs of the Nation. There are only 6,500 officers in the USPHS. As a USPHS officer, I may be called upon to deploy to health disasters domestically and internationally. However, my day-to-day job is with the IHS. The IHS provides health care to Native Americans and Alaska Natives from federally recognized tribes.

At Northern Navajo Medical Center (NNMC), we primarily serve patients from the Navajo Nation. Our pharmacy department is made up of 31 pharmacists. I work in many different aspects of our pharmacy department, with my role often changing daily. I may work in the outpatient pharmacy, the inpatient pharmacy, or provide direct patient care in a pharmacy involved clinic.

As an outpatient pharmacist I may be a screener, a checker, and/or a counselor. Screeners screen patients’ charts in the electronic health record, ensuring appropriateness of medications ordered by checking labs, reading notes, etc. Screening takes place in the main pharmacy and in satellite locations in the patients’ medical home, directly interacting with the prescribers.

Checkers check that the prescription was filled appropriately and matches the prescriber’s intention. Counselors counsel patients in counseling rooms by using the show-and-tell method and the 3 “golden” questions, ensuring that patients understand what their medication is used for, how to take it and what side effects they might expect. Every position is expected to make interventions as needed.

As an inpatient pharmacist, we monitor patients’ labs, reconcile patients’ medications on admit, transfer, and discharge, and dose vancomycin, gentamicin, Coumadin and anything else the doctors request. We also work with nurses to help clarify medication orders, saving the doctors time. We also are working on creating formalized procedures for monitoring specific disease states, for example, congestive heart failure.

We have eight pharmacy-run or pharmacy-involved clinics. I manage the pharmacy services provided in the Epilepsy Clinic. In the Epilepsy Clinic, pharmacists see patients with a neurologist or independently. In this clinic, I have prescriptive authority to order medications and labs. I perform neurological exams as well. I also am involved in the Asthma Clinic and in the past I was a provider in the Coumadin Clinic. We are currently looking at further expanding our roles as advanced practice pharmacists through pharmacist clinician certification and creation of a PGY2 residency.

Other roles I fill include student preceptor, Infectious Disease Residency preceptor, USP 797 compliance officer, Antibiotic Stewardship committee member, and lead for the Compensation for Pharmacist Provided Services Initiative.

What do you enjoy most about your current work?

I love serving people and the Navajo are great people to serve.

We have a great relationship with the other healthcare providers, and we are considered a valued member of the medical team. There are no shortage of opportunities. It is an exciting place to work because we are always looking at ways of expanding, trying to do more, be better and reach our potential as a department.

What is the most challenging?

Balancing the opportunities at work with personal and family life. All the opportunities can take all of your free time if you allow it.

Tell us a few fun facts about yourself.

I have been married to a wonderful woman for nearly 9 years. We have three great children. I enjoy disc golf, ultimate frisbee and video games.

I served 6 years in the Army National Guard as a paralegal before transferring to the USPHS.

I served a mission for my church in Norway for two years.

What would you like to share with students considering a career path similar to yours?

The IHS is a great place to work and is always looking for enthusiastic pharmacists. The best way to currently become an USPHS commissioned officer in the IHS is by doing a residency or through a program called Senior CoSTEP, which you commit to before your last year of pharmacy school.

Residency was a great way to spring board my career in IHS, but it isn’t required. However, BCPS should be a goal of any advanced practice pharmacist in the USPHS. You don’t have to be top of your class to be selected for an IHS residency, but we value life experience. If you haven’t spent time in another culture, I would recommend doing volunteer work in a different country for a summer, or do a summer internship with the IHS (called a Junior CoSTEP).

I think it is easy to view graduation as the end of a long race, but really it is just the first leg of a long journey. Pharmacists who have no interest in building their career after graduation quickly get burned out. When you choose what you want to do, put the most weight on the type of practice you want to work in and less weight on things like location and salary. Focus on what type of pharmacist you want to be and how you want to practice. By building your career on the type of pharmacy you want to practice, you may be able to eventually practice what you want, where you want.