RJ LaCoursiere

EM pharmacist into all things FOAMy/EBM, tox, and service to the vulnerable. Trying to be better every day.

[RJ LaCoursiere @Crofabulous]

@littlecheee https://t.co/nRVzKwVhpf

[RJ LaCoursiere @Crofabulous]

@amcrlsn Stay strong sister. I feel you. To top it off, we have TJC here. I'm sure the dept would be on actual fire if you weren't there.

[RJ LaCoursiere @Crofabulous]

@AjvictoryMD @MatthewBower2 Gender bias is 100% alive and thriving. I'm a pharmacist but I get EMS and residents presenting patients to me instead of the qualified physician standing at the head or foot of the bed solely bc I'm the male in the room (with a few gray hairs). I correct them but its not cool.

[RJ LaCoursiere @Crofabulous]

@AndreaSikora Order placed. Congratulations!! I can't wait to read it!

[Andrea Sikora @AndreaSikora]

My experiences as a mentee & a mentor have been a continuous source of inspiration, motivation, deliberation, and always gratitude.

The culmination is this book:

Pay It Forward:A Map to Mentorship in Medicine

https://t.co/uEaycKELnq

#TwitteRx #AcademicTwitter #payitforward

[Christy Forehand @CForehand84]

We @Crofabulous @kkeats_ describe our DP/MC 🚨 longitudinal LE for our PGY2CC resident. Also make the argument that experiences like this would be valuable for other areas of practice (e.g., HSPAL) too! #TwitteRx #PharmICU https://t.co/56QEoj1GvW @ASHPOfficial @AU_UGAPharmRes

[RJ LaCoursiere @Crofabulous]

@amcrlsn @grumpypharm I usually go with "what fresh new hell are you about to rain down on me?" 😅

[Bryan D Hayes PharmD @PharmERToxGuy]

Fellow EM clinician colleagues, can we collectively agree to minimize prescribing of tramadol in our EDs?

https://t.co/PcIGulbzme

@petermullins @LNelsonMD @JMPerroneMD @DrJessePines @DavidJuurlink

[RJ LaCoursiere @Crofabulous]

@PharmERToxGuy @petermullins @LNelsonMD @JMPerroneMD @DrJessePines @DavidJuurlink Done. 👏👏👏🙏

[RJ LaCoursiere @Crofabulous]

@PharmD_intheED PGY1 only but have been EM pharmacist since for 3ish years now

[RJ LaCoursiere @Crofabulous]

@ASHP_EMPharm RJ LaCoursiere - EM pharmacist in Augusta, GA

[RJ LaCoursiere @Crofabulous]

@ASHP_EMPharm A9- co-chairing acute pain subcommittee of the pain steering committee, looking at tx agreements, checking opioid script/order reports for outliers (not punitive/judgey), updating order sets to ensure multimodal analgesia included, edu edu edu

[RJ LaCoursiere @Crofabulous]

@ASHP_EMPharm A8 cont- Organization and management have been very supportive of my recovery and my willingness to share it. Not every place would want that advertised but my team, docs, and rx dept have never been anything but supportive

[RJ LaCoursiere @Crofabulous]

@ASHP_EMPharm A8- step 1- earn trust and respect of nursing and provider staff.
Step 2- out myself as an EM pharmacist in long term recovery.
Step 3- teach EM lecture on OUD.
Step 4- (pharmacist-driven) bupe induction protocol

[RJ LaCoursiere @Crofabulous]

@ASHP_EMPharm A7- in a working group that's setting up a same-day/next-day follow-up clinic for new MAT starts. Working with psych, ED, addiction med providers. Intake process was originally 2 week minimum but cut through a lot of red tape and it looks like we might pull this off. Stay tuned

[RJ LaCoursiere @Crofabulous]

@ASHP_EMPharm A6- sloooowly edu-ing about change to outpt Rx rules and letting people know they can prescribe bupe outside the ED now. Getting more and more residents/attendings to fill out the NOI on the SAMHSA website. Same day follow up clinic will be clutch once it goes live

[RJ LaCoursiere @Crofabulous]

@ASHP_EMPharm A5- same as @EMPoisonPharmD and developed ED bupe induction order set to ease in protocol adherence/ease of induction.

[RJ LaCoursiere @Crofabulous]

@ASHP_EMPharm A4- same as @EMPoisonPharmD , also docs often specifically ask us to walk them, the nurses, and pt through the process since the EM pharm team set up the process and protocol. We also try to make sure they get narcan/edu, working on SOP to dispense from drug cabinet in ED

[RJ LaCoursiere @Crofabulous]

@ASHP_EMPharm A3- mostly bupe, but we will continue maintenance methadone. Started methadone on a few folks but def prefer bupe whenever feasible. ED naltrexone isn't a popular option due to not being able to confirm an opioid-free washout period. UDS can't catch all the synthetics out there

[RJ LaCoursiere @Crofabulous]

@ASHP_EMPharm A2- there was a lot of stigma even just a few yrs ago about OUD and that has been a significant barrier but we found kindred spirits and have won over lots of hearts and minds. It helps getting to the new EM residents early and showing them a protocol to follow, NO X WAIVER YAY!