Wide-ranging research approaches and topics surprised and inspired new PharmD grad throughout her degree
Sasha Roeder Mah - 09 June 2023
Meghan Onushko
Meghan Onushko, ’23 PharmD, grew up dreaming of a career in health care, but it wasn’t till she started exploring the pharmacy profession during her bachelor of science degree that she knew that was the direction she should take. “I didn’t actually realize how broad our scope is and how much on the front lines we are,” she says, and from the moment her degree began until now — as she gets set for graduation — it has continued to surprise her with a range of learning and experiential opportunities she never imagined.
When Onushko embarked on her PharmD, it was the fall of 2019 and the world had yet to hear of COVID-19. But five months later, everything had changed, with classes moving online and very little in-person socializing allowed. These challenges presented a valuable lesson in adaptability and resilience, says Onushko, but she also learned a more important and timely lesson — just how important pharmacists are in the health system. Having begun work in a drugstore before COVID hit, she was still expected to be at work every shift. “I quickly learned that pharmacists were a huge and necessary source of information,” she says, “and I feel like working during the pandemic strengthened my love for caring for people.”
During that first year, while balancing COVID stress, part-time jobs and a heavy academic workload, Onushko still felt something was missing. When she learned pharmacy professor Terri Schindel was doing a study on professional-identity formation in pharmacy students using a writing and drawing exercise, the amateur artist and lover of research was hooked. “I knew right away I wanted to work on that with her,” she says. “It was the perfect fit.”
The study proved invaluable to Onushko not just for the research experience but also for the lesson she has incorporated into her own career journey. “The project showed me how important self-reflection is for understanding and growth,” she says. For her, both research and frontline work bring opportunities for self-reflection, and in her final year, she found a way to marry the two.
The following summer, she worked under Sheri Koshman at the Mazankowski Heart Institute on a novel accelerated medication-optimization stream for heart-failure patients, working part time as part of her fourth-year clinical rotations. During this time, she also completed the groundwork for a systematic review on heart failure and influenza vaccine.
While Onushko was doing her rotation at the Royal Alexandra Hospital pharmacy under the guidance of preceptor Chloe McMillan, the two discovered a shared passion for environmental causes. Out of that came Sustain Pharm, in which Onushko set out to determine how to make a difference to the carbon footprint of the pharmacy profession. “A lot of things I had read had these big, overarching, idealistic concepts, but they didn’t really say how to implement them. I wanted to make sure my project could be realistically implemented.”
She focused her efforts on two areas in the hospital, beginning with the use of aerosol inhalers. Her research had uncovered alarming statistics about the greenhouse gases produced by these inhalers. “Did you know the emissions produced by the use of one inhaler is equal to 320 kilometres driving a car?” she shares. “Since May, just at the hospital pharmacy where I work, they have dispensed more than 11,000 of just one of the many types of aerosol inhalers available — with a carbon footprint equivalent to more than 11 million kilometres in a car.” Onushko sought out alternatives, such as an inhaler that dispenses dry powder rather than a gas, and got to work reinforcing the appropriate use of these medications with the health-providing teams at the hospital.
At the same time, she tackled the problem of single-use plastic bags that clog the system. “In the dispensary, we package every single medication on its own in a plastic bag and then all of those go into a bigger plastic bag that is brought up to the unit, sometimes daily,” she says. “If a person gets 20 medications, they get 20 bags and that can be every day.” That issue is proving a bit harder to tackle, says Onushko, as finding a sterile alternative isn’t simple. She’s exploring the possibility of paper or biodegradable bags instead.
Meanwhile, it’s full steam ahead with her advocacy work around the inhalers. She received positive feedback after presenting her findings to her colleagues at the Royal Alex, and to the pharmacy leadership group in Edmonton. Many have expressed how timely this work is in the wake of the pandemic, which saw a huge increase in waste within the health system with masks, gowns and other sterile equipment needing to be changed and disposed of multiple times a day across many hospitals and clinics. Others are concerned about keeping costs down, since aerosol inhalers are by far the least expensive option. But Onushko has continued to advocate, also giving this talk to the provincewide Alberta Health Services pharmacy team.
When she entered the pharmacy program, Onushko never imagined she’d get the chance to do work that brought together so many of her passions and interests — from creating art to encouraging sustainability practices. Through it all, her love of research has been a constant, and that passion has proven to be infectious. Throughout her degree, she has supported and encouraged many of her friends to give research a try.
Having benefited from the support of mentors throughout her degree, Onushko is clearly keen to pass that gift on to others. After a short break to recharge after graduation, Onushko will be doing just that in a permanent role with the neonatal ICU pharmacy at the Royal Alex, sharing her enthusiasm and knowledge with patients and fellow health professionals alike. “I feel like the more we can bring everyone up around us, the better our profession will be.”