Sorry not sorry: It's not 2019 anymore and there's no going back

Today a customer told me she had two daughters who were pharmacists: one in community practice, one in hospital. I said, ‘How do they like it . . . since COVID?’ and she tipped her head to the side, raised her eyebrows . . . and before she could say ‘well . . .’ I gave her permission not to answer. CPhA had just posted the key findings of the Canadian Pharmacy Mental Health and Workforce Wellness Survey. Looking it over, I started thinking about how frequently I had said sorry these last two years. How often I had to explain things. How many times the processes, standards, guidelines, drug availability, regulations, distributions, etc. had changed. How, as badly as the public and pharmacy team alike wish it was back to 2019, it isn't. I'm sorry it's not 2019 anymore. —I'm sorry that we (pharmacists, technicians, pharmacy assistants, even cashiers) have taken on NEW roles to make everything more accessible, locally, faster. (For example: rapid tests for travel, PCR tests for surgery, questions about where to get PCR tests done sooner or for travel, distribution of rapid test kits, answering questions about eligibility for vaccines, the who, when and what of it all, why the wait, and where it is available, answering questions about when it's okay to return to work or have visitors etc. after an infection, answering questions about what to do because walk in clinics are still not back in service, helping people locate interim online doctor services (maybe because their doctors retired and no one replaced them; or they moved here and can't find anyone taking new patients), carrying COVID Rx treatment—new drugs which require detailed extensive review of eligibility, interactions and safety data for every Rx, booking vaccine appointments and then administering vaccines first, second, third, fourth and for some fifth doses, making sure the database is up to date with every injection administered so QR codes reflect this right.) NONE of these. NONE. OF. THESE. existed in 2019. (So, if you wonder why the phones are so busy . . .) Read: Time to pull the safety lever: Burnout in pharmacy is not a self-care issue but a workplace problem These tasks have tied up more of our time, and it means other things, like our bread-and-butter dispensing take a bit longer some days. And yes, we could have opted not to take on “all things COVID.” Some pharmacies did. But even if we didn't do it, we’d STILL be fielding calls and inquiries about where to go. And we’d STILL be answering ALL the questions. Because that’s what being accessible means. We can't hide behind closed doors, or "appointments only" or "these hours only." If the store is open, the pharmacist and staff are there. Working. For. You. —I'm sorry there are drug recalls, almost weekly (or I'm sure at least monthly), because of impurities. This hasn't changed. Recalls are not new . . . but some months I feel it's gotten worse. I'm sorry our country hasn't done more to support drug manufacturing in our own country. I'm sorry we have our time taken away to do calls and follow ups with anyone whose received these products. We want them to be aware and not be panicked. These tie up more of our time, and it means other things take a bit longer some days. —I'm sorry these recalls have a whole spin-off cascade: contacting consumers, reaching out to prescribers, getting Rx changed, and hoping that the new option doesn't quickly go on backorder now, too. Backorders have been a continuous bane for at least a decade. Every Rx change takes time. Everyone is unhappy about it, including you and including us. —I'm sorry all the compounding rules changed. Since 2019, coincidentally. I'm sorry that without having access to more equipment, formulas or ingredients, I cannot make the simplest of compounds which we used to make all the time. That we are limited by a whole new set of laws that the college opted to leave every pharmacy to figure out for themselves (I kid you not.). I'm sorry you have to be inconvenienced by finding a pharmacy service, out of town, who will help you. They are good people and they will do right by your Rx, but it will be inconvenient and probably more expensive with shipping added in. I'm sorry. I agree some change was necessary. I didn't change the law. —I'm sorry there are manufacturer shortages of basic non-Rx products that I have no control over. I will STILL talk to you about next best option. It was Metamucil™ at the start of COVID. Currently, it's children's fever medicine. I don't know why. They don't tell me. I'm just as frustrated as you are. Things will change, but not as fast as we want. Can't we all agree we have had to learn this during this pandemic? (And, by the way, in case you hadn’t heard, the pandemic is not over despite relaxed restrictions.) —I'm sorry that we still live with the hassle of the archaic fax machine and that electronic prescribing is complicated by just as many people hoping to make forgeries. And that not all electronic medical record programs know how to communicate . . . electronically . . . with all pharmacy programs. And that we have confirmation that a fax has gone through to a doctor's office; their system does/may not have confirmation to say that their Rx has been received by us. Or that they say they don't receive a fax. I don't know what happened. I know we have proof it went. I cannot speak for the other side of the transmission . . . but I am often asked to try and explain it. —I'm sorry everything Just. Takes. Longer. Drive-thrus take longer some days. Getting groceries takes longer some days. Mail order is not so speedy some days. There are openings for workers EVERYWHERE but it would appear that after CERB offered people a bit of "stay at home and be paid" . . . that perhaps the oomph to get out and get working fizzled? There is so much need for help, ESPECIALLY in the service industry. Why? I'd guess it's because customers just still want it to be 2019. When life was faster, and simpler... And people were generally kinder and more patient. This isn't just a pharmacy phenomenon, not by a long stretch. But if you haven’t been in my little world, maybe the above will explain a little bit of why some days we have to ask a lot more of our customers and a lot more of our staff. Maybe we just need to keep communicating, and stop pretending/wishing for 2019. We in Ontario have now (finally) been approved for minor ailments prescribing starting January 1, which, today, feels like “one more thing” to add to the workflow and, after the pandemic, could be wonderful. Maybe no one will be surprised if I decide to change what I'm doing when I move. Maybe if I stay in this beloved profession I can become the after-hours clinic pharmacist for these ailments . . . as long as OHIP pays enough for us to actually do it. We are doing a lot (see above) for little to no extra compensation. So, forgive me if I am not as excited by this expanded scope of practice as I might have been . . . if it were still 2019. Shelley M. Stepanuik has happily worked within the community pharmacy field for her entire 30+ year career. She's a graduate of USask and has enjoyed work experience in Saskatchewan, Manitoba and Ontario. She currently practices in Strathroy, Ont. with a move to Simcoe in the near future.

Sorry not sorry: It's not 2019 anymore and there's no going back

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