Reaching the Melting Point: My Time Transitioning from a Solid to a Liquid Tumor Pharmacist

Alison Palumbo, PharmD, MPH, BCOP
Clinical Oncology Pharmacist
Oregon Health and Science University

Working in the Community Hematology/Oncology Clinics at Oregon Health and Science University as a clinical oncology pharmacist, you see patients with all different types of cancers, but primarily the focus is solid tumors. This was the ideal practice setting for me as I enjoy being more of a cancer generalist than specialist, however I felt my hematology knowledge was starting to atrophy due lack of exposure. So, in April 2020 when the opportunity came up to cover a coworker’s maternity leave who works in inpatient hematology and bone marrow transplant (BMT), I was excited, if not a little apprehensive, to volunteer to cover her position. Here is what I learned from stepping in to fill her shoes:

When I first arrived on heme/BMT, I received a few days of training. At first it felt like riding a bike – my heme/BMT knowledge was coming back to me rapidly, and I started to feel comfortable enough to staff solo in the evenings. However, I quickly learned that while you may be able to retain a lot of information from residency (it had been 7 years for me), a lot can also change in 7 years. This is where I had to learn to get comfortable with being uncomfortable. This meant both accepting that I would not always have the answers readily available like I did in my role as a solid tumor pharmacist and remembering that taking a few steps back in a new role is perfectly normal. Taking a few steps back for me meant spending a lot of my downtime reading and getting caught up on updates in the heme/BMT world. I also learned to do more listening instead of talking so that I could learn from my peers.

I felt very fortunate to be surrounded by sharp, supportive colleagues who helped me navigate my way through my first few months on service. Some of these colleagues were even my former pharmacy residents who I had not worked with since they transitioned out of residency into their heme/BMT role. I was touched to see just how much these former residents had grown and come into their own as clinical pharmacists. Having this safe, supportive environment was essential for my success, and I am immensely grateful for the support they offered me.

By the end of my 6-month stretch covering heme/BMT, I felt comfortable with the subject matter and had established myself as a resource. I had developed strong relationships with the providers, nurses, and my pharmacist peers on the heme/BMT unit, and I was sad to leave them behind when it was time for me to return to my role at the Community Hematology/Oncology Clinics. Luckily, though this chapter of my life had closed, several months later I was once again given the opportunity to work inpatient heme/BMT to cover staffing shortages. While my primary position is solid tumor clinics, I now regularly staff heme/BMT once every 6 weeks. This provides a perfect balance for me between my interests, and I am grateful my job provides me with the flexibility to do both.

If you are faced with a similar opportunity to try out a new role or fill in for a peer, here are some words of advice:

1. Be prepared to feel out of your depth and maybe a little overwhelmed. Oncology is a field that changes rapidly, so there may be a lot to catch up on. It is easy to feel down on yourself for not feeling as comfortable in your new role as you were in your last, but remember that comfortability takes time, and it is normal to feel growing pains in any kind of transition. Regardless of how it may feel, you belong where you are.
2. Be ready for feedback, both positive and negative. For many of us, constructive feedback may not be something we are used to receiving when we have had a role for a long time, so it may feel uncomfortable at first. Just remember that feedback is how you improve and no one, even the most experienced of us, is free from error.
3. Be grateful to your colleagues, but always respect boundaries. It may be helpful to ask your colleagues in what capacity they are willing to help before relying too heavily on them. For example, you could ask them how often you can reach out and in what capacity before assuming it is acceptable to text someone at home late at night or during off hours.

In summary, doing a complete 180 in your professional life is achievable! You will learn a lot and likely make some wonderful connections along the way. Wishing you the best of luck in whatever new opportunity life brings you!