“WHAT A DIFFERENCE a day makes”, the song goes. Not many among us would be likely to argue with that sentiment in these, the strangest of days. No more than anyone else, staff in pharmacies the length and breadth of the country now find themselves working every day in an environment that would hardly have seemed credible two months ago. And as is the case for everyone, there really is very little that is normal about the “new normal” in community pharmacy.
Individual pharmacies, in line with the HSE’s guidelines, have had to decide how to best protect patients and staff while remaining operational and open, if not always fully physically so. Some have elected to provide a service from the front of the shop, taking prescriptions and over-the-counter medication requests from customers at the door.
In CarePlus Pharmacy in Kilcock, because of the layout of the shop, we have been able to adopt a one-way system with minimum safe distances clearly marked on the floor with footprint stickers and with doors and windows open to ensure good ventilation.
Hard-won supplies
We have many sanitising gels placed around the store, it is thankfully impossible to forget to regularly “sanitise to save lives”. We’ve all been wearing disposable aprons as well as surgical masks for nearly two months now which, in reality, actually work best to protect patients from staff, should one of us become unknowingly infected.
I should be honest and say that at the start, we did discuss whether keeping our doors open was the right thing to do. Our team is young, fit and healthy, but there were concerns about our extended families and loved ones who might be vulnerable. That probably contributed to our decision that if we were to stay open for the sake of our customers, we’d go all-in on the necessary precautions around PPE. Thankfully, we’ve all managed to stay well so far.
In the early days of the public health alert, we had many examples of people dropping into the pharmacy, who perhaps hadn’t picked up on the scare around Covid-19 and were reporting worrying symptoms. It was scary at times but at the end of the day, they were customers who needed help. Bearing in mind our full PPE policy, I would generally encourage them outside for a chat, where I would advise them on the steps they needed to take. That’s happening less frequently these days.
Pharmacists stepping in
In response to the very real difficulties patients have in seeing GPs or attending surgeries to collect prescriptions the Pharmaceutical Society of Ireland and the Department of Health have been proactive in drafting and introducing emergency legislation to allow us the scope to dispense medication outside the usual parameters.
Where it is safe and in the best interests of the patient, pharmacists can now dispense additional repeats on prescriptions and give longer emergency supplies of medication if needed. GPs can now use a healthcare-specific email service (called “Healthmail” no less) to send prescriptions in advance of patients arriving at the pharmacy.
Day-to-day, much of the pharmacy team’s time is now spent, like so many members of the public, trying to source in-demand items such as sanitising gel, thermometers, masks and disposable gloves. The supply chain for the medications themselves, barring some odd exceptions, has thus far proven to be as reliable and resilient as the government promised us all at the outset.
We have been using our various social media accounts to request that patients order their medication via the phone or better still, the CarePlus App, which also allows us to notify the patient when their script is ready for collection, all of which helps minimise contact time for patients and staff in the pharmacy.
Tense times
That said, rushing people out the door does feel uncomfortably contrary to the traditional role of the pharmacy as the healthcare point of contact offering the greatest ease of accessibility and a “drop-in” kind of informality, particularly at a time when many vulnerable people could benefit from a few kind words of reassurance and comfort.
One of the only silver linings to emerge over the last few weeks has been the way the local community has come so alive in adversity. The Kilcock GAA, the Cardiac First Responders and the local Gardai have all come forward to offer invaluable help with deliveries for those who are unable to collect their medication.
In a less official capacity, neighbours and friends have also begun to materialise on behalf of those now unable to do so themselves. In uncertain times, it’s a real privilege to see so many small acts of kindness.
Some lucky pharmacists may even have had the odd apple tart dropped into them (thank you, Mrs Dooley). Perhaps as a result of all that is going on, the “community “ in “community pharmacy” has never felt more relevant or more important than it does right now.
People are worried about the future
As time goes on, I get the sense that while people were genuinely afraid of getting sick every time they left the house in mid-March, the atmosphere among customers is now changing.
There’s frustration at the ongoing restrictions for sure, but there’s a new fear and agitation about what kind of way of life will emerge after the acute phase of the pandemic has passed.
While putting this piece together I was asked if I worry about my health as the situation continues. I think in the pharmacy we get to see people battling every conceivable situation and we’re well placed to take necessary precautions.
I’m glad we took the comprehensive approach to PPE from the start, and I’m glad we’re getting regular updates from the HSE (sometimes several emails a day), the Irish Pharmaceutical Union and the Pharmaceutical Society of Ireland. It was nice to get a shout out from the Health Minister Simon Harris in public last week so that we don’t feel forgotten.
We can largely control our situation and we’re taking all the necessary steps to protect staff and customers. Our colleagues in clinical settings are facing greater risks and deserve all the praise they get for being right on the frontline of battling Covid-19.
Steve Philips is a pharmacist working at CarePlus Pharmacy in Kilcock, County Kildare.
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