The Best Prescription for Safety in Pharmacy

The summer of 2016, the year before I graduated pharmacy school, I was working as a student intern. My day started at 7:45 a.m. before the pharmacy opened, and ended after 9 p.m. when the store closed. There were no stools to sit on, meaning my colleagues and I were standing for more than 13 hours, and lunch breaks weren’t common. By the end of the day, we were exhausted, our feet hurt, we didn’t want to talk to anyone, and we could barely keep our eyes open long enough to drive home.

These conditions are tough for any retail position, but we were dispensing medications and consulting with patients about their health — one mistake could be critical. Would you want your patient counseled and their medication filled and dispensed by someone 12 hours into a 13-hour shift? This was the reality. But recently, we’ve started to see some real changes.

October marks the 20th anniversary of American Pharmacists Month, and as I reflect on my own 10 years in pharmacy — as a technician, student intern, pharmacist, and researcher — I’m grateful that concerned frontline staff, management, research, and unionization efforts are finally moving the needle to improve working conditions.

Corporations are implementing mandatory lunch breaks as well as de-emphasizing speed and volume-based metrics. States are passing statutes outlining minimum working conditions. And professional organizations are supporting nationwide efforts and discussions.

My own experiences in pharmacy fueled my passion to pursue graduate school and continue to drive my research on pharmacy fatigue — a major safety issue for staff and their patients. We’ve learned from other professions like surgery, other medical specialties, as well as nursing, that fatigued professionals are at increased risk for mistakes and errors. We like to think that as healthcare professionals we’re super-human, but we’re not.

Throughout my research, which focuses on the need to safeguard patient health by safeguarding the health of those who deliver care, I’ve had the privilege of talking to dozens of pharmacists and technicians about their experiences. They’ve shared with me that their greatest joys come from interacting with patients — clinical consultations, vaccinations, self-care recommendations, or even just pleasant conversations.

Pharmacists and technicians have also shared the stress that comes from working in a retail healthcare profession. One pharmacist told me that when the pharmacy initiated mandatory lunch breaks, patients banged on the gates and called angrily from the drive-through, demanding service. Not to mention, healthcare workers are five times more likely to experience violence at work than other workers; a meta-analysis reported over 50% of pharmacists experienced physical and/or verbal violence in a 12-month span.

Some of the frustration directed at healthcare workers may stem from patient frustration in navigating the healthcare and pharmacy systems. To be sure, pharmacy care should be accessible. Pharmacists take pride in being one of the most accessible healthcare professionals — 89% of Americans live within 5 miles of a pharmacy. But accessible, which is often conflated with fast, can’t compromise safety.

As we look to the future, I am asking patients, policymakers, pharmacy management, and other stakeholders to recognize the value of safe and quality care from community pharmacies and pharmacists.

For prescribers, nurses, and clinical staff, I recommend using electronic forms of communication (like e-prescriptions) when possible, to ensure accurate documentation and handoffs. Help patients plan accordingly for prescription refills (ideally allowing 72 hours), and if starting a new medication, please do not guarantee patients their prescription will be ready by the time they reach the pharmacy. Furthermore, I acknowledge and apologize to prescribers and their staff for long wait times on the phone, especially amidst ever-changing drug formularies and back-orders and humbly request patience as we research new solutions to communicate.

I would like to see pharmacists, doctors, nurses, and patients use their voices to demand corporations and legislators continue to prioritize their safety and high standards of care. And, ultimately, I ask everyone to practice empathy for those in line and behind the counter.

We can and must work together to ensure the best prescription for safety.

Taylor Watterson, PharmD, PhD, is an assistant professor in the Retzky College of Pharmacy at the University of Illinois Chicago. Watterson is a Public Voices fellow of the OpEd Project and the University of Illinois system.

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