Nikki Domanski is a Clinical Pharmacist and Lecturer at the Pharmacists Clinic – UBC Faculty of Pharmaceutical Sciences. She is also the first graduate of the University of Waterloo/Centre for Family Medicine Ambulatory Care Residency program.
Where They're Working
Though it’s only been a few years since she graduated, Nikki’s post-grad life has been busy. The Waterloo native was the first learner admitted to the unique Ambulatory Care Residency Program co-ordinated by Profs. Jeff Nagge and Barb Coulston and hosted by Waterloo Pharmacy and the Centre for Family Medicine (CFFM).
“The residency program aligned perfectly with my passion to continue learning and working in primary care,” she says, reflecting on her decision to apply to the brand new program. “The variety of clinical rotations, working on a highly-integrated multidisciplinary team, and opportunities to teach – these were all aspects of the program that interested me.”
As a resident, Nikki refined her clinical and leadership skills through work placements in diverse ambulatory care clinics. These opportunities helped her land the role of clinical pharmacist at the Jim Pattison Outpatient Care and Surgery Centre in Surrey, BC.
“I’ve lived in Waterloo my whole life, so it felt like a momentous decision to move away from family and friends, but the job lined up with my passions and career goals. I would be able to continue working in outpatient care clinics, similar to the ambulatory environment I’d experienced at CFFM, and there was lots of opportunity for interprofessional collaboration.”
The five clinics Nikki supported were anticoagulation, heart failure, pain, diabetes, and primary care which involved collaborating closely with nurse practitioners.
“I rotated through all the clinics weekly and every work day looked different. I loved the fast-paced environment, the opportunity to work closely with a wide range of clinicians, and being able to establish relationships with my patients through ongoing follow-up.”
Reflections
on
the
Program
“The PharmD rotation lottery did not work out in my favour, and I ended up being relocated to my 13th choice – Sault Ste. Marie, ON. My first reaction was not positive, to say the least. Eight hours from my family and friends in a city I’d never been before. But it ended up being the BEST learning experience I had in pharmacy school, probably all of university. Again, this circles back to my previous advice about getting out of your comfort zone. It’s usually the challenges that make us grow and learn the most, and I certainly think I thrived as a learner during that rotation.
The anticoagulation clinic presented especially interesting experiences for Nikki.
“I think this is as close to acute care as I’ll get in an ambulatory environment. We saw patients immediately following diagnosis or discharge for bridging, INR monitoring, and teaching.”
Often, Nikki provided extensive education for how patients manage their care outside of the hospital.
“Some patients in the clinic presented to the hospital with leg pain and ended up leaving with a life-changing diagnosis such as cancer. I was often the first primary care provider to work with these patients post-diagnosis. Navigating through difficult conversations filled with lots of emotion and anxiety was challenging, but also very rewarding. I also felt proud to represent pharmacy, because patients always seemed so impressed and grateful for the knowledge and support that we could provide.”
Nikki thrived on the team at the Pattison Centre, but after ten months another job opportunity arose.
“I had been following the Pharmacists Clinic at UBC since undergrad – I’d seen a couple of the clinic pharmacists present at conferences and heard amazing things about their work. When I saw they were hiring, I knew I had to apply.”
Nikki applied and was hired for one of two Clinical Pharmacist and Lecturer positions. The role, which she began in November 2019, has her splitting her time between seeing patients for comprehensive medication management and working on projects that concentrate on increasing access to best-practice care. The Pharmacists Clinic, uniquely located within the Pharmaceutical Sciences building at UBC, provides the clinic team with a multitude of teaching and mentoring opportunities.
Nikki credits some of her success to the residency program and the incredible mentors she had at Waterloo Pharmacy.
“The mentors I’ve had at Waterloo modelled the kind of practitioner I want to become. Seeing faculty, like Jeff and Barb, who are such incredible and effective clinicians devote their time to not only teaching but also mentoring students is inspiring. I am so fortunate to have had role models like these early in my education. Learning from them and other faculty has helped shape me into the professional I am today.”
Alumni Answers
UW: What inspired you to pursue the unique job opportunities you’ve had?
ND: I felt like there was a lot of pressure early in school to figure out what area of pharmacy I’m going to work in. For me, choosing between community and hospital pharmacy seemed daunting, because I didn’t feel a strong connection with either of these practices. But slowly, year after year, co-op after co-op, I was finally able to identify aspects of pharmacy that I was really passionate about. By the end of pharmacy, I did not have it all figured out – instead I thought about what I valued most in a practice setting and what kind of patient interactions were most rewarding for me. Ultimately, I was able to define my passion for working with patients in ambulatory care clinics. If you feel uncertain about your own career path, or have a passion for something nontraditional, that’s totally okay! I challenge you to explore that! Pursue unique opportunities, get out of your comfort zone and don’t be afraid of being different. That is a motivation I had throughout school and ultimately what inspired me to pursue these unique and wonderful opportunities.
UW: What advice do you have for those considering a residency opportunity?
ND: The first step is identifying exactly why you want a residency and narrowing down the search to programs that meet your goals, ambitions and interests. If you are planning to apply to as many programs as possible because your goal is simply an ACPR title then I encourage you to stop and reassess right away! The interview panel can tell whether a candidate is truly passionate about their program, if they can describe what makes the program unique and why they would be a good fit for that. In my case, I only applied to one residency, the ambulatory care program, which was certainly risky but I didn’t just want a residency, I wanted THAT residency. Bottom line, in terms of applications, it’s about quality over quantity!
Non-Pharm Fun
