Introduction
Dr. Stephen Small is a Clinical Pharmacy Specialist in Pediatrics at Denver Health, with a focus on parenteral nutrition, medication safety, and pediatric advocacy. He holds a PharmD from Butler University College of Pharmacy & Health Sciences and completed a PGY-1 residency at Denver Health. As an ambassador for the Board of Pharmacy Specialties, Dr. Small is involved in various organizations and projects related to pediatric care. He enjoys mentoring residents and is passionate about film photography, videography, and outdoor activities. Learn more about his work here.
Why Pharmacy
After my PGY1 residency, I took an open staff pharmacist position in Denver Health’s pediatric satellite pharmacy. The specialist for the team at that time was a fantastic mentor and challenged me to learn a lot on the job every day and provided me great learning resources. Eventually, I gained sufficient experience that I could obtain my three BPS certifications without needing to complete a PGY2 residency. After my mentor’s retirement, I then moved into her specialist role for my team and have continued learning something new every day.
Career Journey
Denver Health is a safety-net, Level I trauma center in downtown Denver. Here, I currently oversee clinical pharmacy services for my institution’s inpatient pediatric, neonatal, and obstetrics units. This includes a NICU and PICU, which adds a lot of excitement to my day. Pediatrics was actually the only specialty I intentionally avoided in pharmacy school due to my fear that I would make a medication error and harm a child. My required pediatrics rotation in my PGY1 residency ant Denver Health opened my eyes to how important pharmacists are for helping this vulnerable population, and I abandoned my initial infectious disease clinical interests to go into pediatrics instead!
Current Role and Responsibilities
Each day, I verify orders for my assigned units and attend rounds in the NICU or Peds/PICU units alongside physicians and nurses. I receive consults where I can prescribe vancomycin, gentamicin, and enoxaparin and I am also responsible for providing parenteral nutrition recommendations to my teams. I also respond to pediatric and neonatal medical emergencies across the hospital including trauma team activations in our pediatric emergency department and emergent deliveries in our labor & delivery unit. When I am not doing patient care, I complete quality improvement projects, write scholarly articles and posters, and teach pharmacy learners. As a clinical assistant professor, I host a pediatrics rotation for local pharmacy students, Denver Health pharmacy residents, and residents from other local hospitals.
Challenges
In pediatrics, we sometimes see unimaginable abuse and deaths in this innocent population. I witness families live their worst nightmare when something tragic happens to their child. Despite this negative side of my position, I am also proud to be part of team that has saved so many lives—sometimes against all odds—and given families healing and hope.
Rewards
Many learners are avoidant or have an intense fear of caring for pediatric patients when they start their rotation with me. The most rewarding thing in my job is to see students gain confidence with this population as they progress throughout their learning. Almost always, students and residents walk away with a better appreciation for this vulnerable population, and they take a newfound drive for patient advocacy that they apply to their future patients.
Advice for Students and Aspiring Professionals
Based on my unique career path, I recommend students explore all possibilities—even options that you may have once thought impossible or unappealing. As a student, pediatrics was the absolute last specialty I would have considered. Now, I can’t see me doing anything else.
My advice includes trying new things as much as possible, explore clinical opportunities as they come your way (even if unexpected), and utilize your mentor’s wisdom to guide you on your lifelong pharmacy career.