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  • Unwilling, uncooperative staff in a 'race to the bottom'

    I'm struggling as a pharmacist going into their 4th year of practice.


    Ive been a locum and relief pharmacist, and been constantly met with aggressive, furious, overly stressed managers and dispensers in atrocious, messy stores. Some are little more than bullies, while others I have compassion for. Id hate to hold a managerial role, and I dont. I am the RP at a dispensing hub, but not the manager.

    At my current workplace, Ive found the staff have lost their perspective, their true mission to assist in health care, the safe delivery of medicines, and lost their compassion for the patients.

    Now I cant say I blame them, as the pressure is unreal. We all seem to be dashing back and forth at the beck and call of patients and drs, run ragged to accommodate everyone. It is naturally impossible to make everyone happy, so talking down customers from irate to 'ok' or receptive is always a skill I've taken pride in.

    My issue seems to be with staff who - day in, day out - can not seem to snap out of their pessimistic, race to the bottom, corner-cutting behaviours, with an attitude that certain SOPs and safety regulations are "not worth the hassle."

    Ive read many books on communication, leadership, influencing people and encouraging good interpersonal, professional relationships. Some days, the methods work, but for the most part, staff at my current permanent place of work are unwilling to adopt to new systems, or improve policy. They detest learning and will find against doing mandatory training. I am met with quarrels, tears and bickering when Head office hand down a new system, and it's really starting to worry me.

    I feel the staff are in shut down mode.

    I have tried various techniques and followed leadership programs. I've used consistency, bonus incentives, impromptu rewards, friendly competition, careful explanations of why I'm asking them to follow SOPs, educated them of legality and liability, been lavish with sincere praise when it's due etc But they always without pause for breath retort with 'well, we've done it this way for decades and it's been fine.' Even when clearly it hasnt been fine, as errors have occurred, some very dangerous and perfectly avoidable, if they'd only follow the SOPs.

    I have 3 staff who are institutionalised and have been at the site 20 odd years. One is the manager (ACT). This manager will have strange quarrels about my clinical decisions, particularity if it means I'm holding back an RX for safety issues while I investigate further. She has a 'just do it' attitude. They are very pre-occupied with getting the scripts bagged up as fast as possible, with no real pause to think and examine things clinically. Interventions, MURs and NMS actually seem to infuriate this manager, and if I stop do to anything other than tick boxes, they become very exasperated. The manager will try to hide complaints or clinical situations from me, as she fears I will 'make a fuss' and query an interaction with a doctor or the patient. These things take minutes to resolve, but they are minutes too many for her liking.

    There is a tendency for them to make up rules as they go, and if I point out legal problems with their practice, or that they are wide open to issues of liability, they shoot me down: 'we've always done it this way.' I express understanding, but highlights laws change. They continue to argue, then refuse to do as asked. Or do it that one time, but not any time thereafter.

    No matter how much I explain or educate, it is as though they have no value for the patient, and no value for the pharmacist. I catch them making decisions beyond their position, and have to intercept, usually resulting with them furious that I am 'holding them up.'

    Now there is no reward for them to get bags out asap. But there are big penalties for serious errors.

    I do wonder if my young face, small stature and feminine appearance is why I am so readily disregarded. I am one of the youngest looking on the team, even though I am not the youngest. At 2 years service with them, I am still seen as the 'newbie.'

    Now I know I cant expect the same level of professionalism in support staff as I would see in pharmacists, but some of the staff are beyond reproach, petty, rude, gossips, complainers and uncooperative. I appreciate I am auto-hated, as staff see me as the overpaid pharmacist, whilst they are on minimum wage as they "do all the donkey work." They honestly dont know what they dont know, so they arent even sure what a clinical screening is, or what occurs in an MUR/NMS. I understand that resentment. I used to be a counter girl myself, and I thought the pharmacist just ticked boxes. Then I worked up to a disp assit, then an NVQ3 dispenser before going to do the MPharm. Ive met some dreadful, lazy. troublesome locums that I hated. But I was determined not to be that person. I have modelled myself after some of my favourite, most insightful and helpful pharmacists.


    I know I could raise this with HO, but so far, they have not been very supportive, waxing lyrical at me and shrugging it off, saying if it's that bad, I must take out a formal grievance for each person. Now considering none of the staff are going anywhere, I cant see how a grievance will resolve relations, or their work ethic.


    Is there any advice or guidance out there? Or is this situation a dead end, and will I just have to adopt my outlook and perceptions so that I don't go home each day, feeling disrespected, bullied, harassed, and that my patients haven't been given the best deal? This feeling isnt really new to me, and it's the vibe I get within all pharmacies. The tone of pharmacies just seems very stressed and negative no matter where Ive worked.

    But for once, I wanted to be the RP in a place where I could make a positive change for everyone. Yet despite everything, Im making no progress. Help!


  • #2
    That is the situation in most multiple pharmacies today where more and more is put upon less and less. I came across this a few times and as I was a free lance locum, just did not return. However, my problems were with very new staff, once or twice I was left with an assistant who said it was their first week in the job and no one had given her any training other than how to work the till. Where there were experienced staff, they would take their breaks together leaving me with the least experienced. Twice I arrived at locums where the regular pharmacist and dispensing assistant had both gone on holiday at the same time. Once I had no idea how the PMR worked and the BNF had been taken by someone. I had to hand write labels until finally I was able to contact another branch for advice. My worst locum was just before Christmas and after. Single handed, the assistant did not know where the CD cupd was and had been instructed to ask every customer if they would like to wait, even with a shop full of impatient customers getting enraged because they thought would only be a couple of minutes.
    You have my sympathy but regret can offer no resolution other than leaving.
    johnep

    Comment


    • #3
      Community pharmacy is a retail job. Run by big corporate soulless companies like Boots, Lloyds, Wells, ASDA, Morrisons, Tescos, Welldrakes and so on. Done on an unsustainable funding model based on dispensing, by a malevolent NHS that wants everything done for free.

      Sure, you sound like a fantastic pharmacist, one I'd like to work with and one the sector really needs, but it's a sick, sick sector, overall. You work in retail, this is how big companies in retail behave and how your staff end up. Once you actually see it in these terms nearly everything that goes on on daily basis actually makes sense.

      20 years in the same place, chuffing hell. You're probably doing really well there. It does take people a year or longer to change bad habits.

      When I as a staff support member have worked in other stores fwiw come across much the same thing. I've met other ray of sunshine locums who were amazing to meet briefly and some of them said that I was a good worker, very intelligent but cynical member of staff for someone who'd worked there such a short time! They ain't seen nothing of how other staff can be and it gets you down.

      It's also an in/out group thing. My first six months in pharmacy I was seen as an unbelievable threat by two other staff members and treated very warily by a third. Oh such a threat, because maybe only one of us would get on the fabled dispensing course and the future career prospects of hanging out in the dispensary, earning a few pence more and maybe one day working in a hospital! It's all quite funny to listen to, but this is how it is.

      You can flag up the interventions to the pharmacist and I can assure you as a support member of staff, that it makes no difference pharmacist or not who says it. Some of the baskets I've taken to the pharmacist the staff are equally as unhappy that there's some major interaction. Oh that's really good the pharmacist says, do you know that 2nd member of staff? Don't care.

      Originally posted by MissAlice View Post

      Now there is no reward for them to get bags out asap. But there are big penalties for serious errors.
      Risk aversion, not reward.

      Often as support staff we get the nasty little digs, the signals, the gestures, the passive aggressive behaviour, all the subtle little things the pharmacists don't tend to get. We've often met the patients five times before where they've acted like this, so there's always a reason why people are doing things a certain way.

      Pharmacists are nice enough to work with, but generally they don't hear some of the wacky stuff that patients say to us out of earshot of the pharmacist. The ones with really good hearing hear a good portion of it, but often they don't care. If pharmacists do care they shrug their shoulders, or raise their eyebrows or smile or laugh. When pharmacists do get the really wacky stuff said to them, they seem to take it much worse than the support staff and do you hear about it then! ​​​​

      I don't think pharmacists understand support staff that well and support staff being retail 'n' all do not understand and are not interested in the stream of nonsense and corporate pressures the pharmacists get from head office and elsewhere.

      Comment


      • #4
        Time to leave and work in a better pharmacy. Anywhere sounds better than this place.

        Comment


        • #5
          Yes get out
          https://youtu.be/ARt9HV9T0w8

          Comment


          • #6
            This attitude seems to be universal in pharmacy.
            Watch this video and a few others:

            https://www.youtube.com/watch?v=sGip7x-sIuo

            johnep

            Comment


            • #7
              Originally posted by MissAlice View Post

              At my current workplace, Ive found the staff have lost their perspective, their true mission to assist in health care, the safe delivery of medicines, and lost their compassion for the patients

              In my many any years of practice I do not think I have worked with anyone who “ had a true Mission !!!! “. I think you are being very optimistic to think that people have a true mission to assist in healthcare when working in healthcare support. It is a nice side effect to be able to - but mission - I don’t think so. I suspect that the goal for most is to pay bills , have a steady job ( never run out of ill people) and hopefully enjoy what they do. Most people according to many surveys like to do their job well but often get frustrated at not having the time or resource to do it to the standard to which they think they should or like to.

              I would certainly have a meeting with the manager to reinforce that while she has operations responsibilities- you have total say over professional matters with no exceptions. Also advise this may overlap her operations responsibility’s should they compromise your RP responsibility’s and yours will always take precedence. It will not be easy but it does have to be made clear.

              Best of luck.

              Comment


              • #8
                I must say that in the only pharmacy in the small town where I live I see nothing that's anything like the situations often described here.Over the years there have been several pharmacist managers and only one of them has seemed to me to be any sort of pressure. It's not a indie, either; it's a branch of a medium sized multiple. I've only once seem any 'pressure' and then was on aSaturday, with a locus and one of the two rostered staff hadn't turned up. The locus had been late, too, IIRC.

                If I get wind of the pharmacist. leaving I'll post a note on here! Don't know what the salary is like, but I think that those who have left have gone to other branches, not different firms.

                Comment


                • #9
                  Being on time was a thing drummed into me by my parents. I was only late once being held up on the M1, I phoned the branch on my mobile and no problem. At multiple bookings often had two and two or three times, three of us turned up. I was always the first but would concede to the others who had sometimes driven long distances. I thus had a day off (unpaid of course).
                  johnep

                  Comment


                  • #10
                    Originally posted by Merlyn View Post
                    I must say that in the only pharmacy in the small town where I live I see nothing that's anything like the situations often described here.
                    I've worked in a small number of chilled out other branches that never had any problems. Chilled out patients. Very little silly stuff. Few scripts. Nice staff. Cushy.

                    The only problem was they weren't profitable and lost thousands a month and of those other branches have closed or are in the process of closing (one is closing in a month's time), or sometime in the next year or two will likely close.

                    Comment


                    • #11
                      Originally posted by johnep View Post
                      Being on time was a thing drummed into me by my parents. I was only late once being held up on the M1, I phoned the branch on my mobile and no problem. At multiple bookings often had two and two or three times, three of us turned up. I was always the first but would concede to the others who had sometimes driven long distances. I thus had a day off (unpaid of course).
                      johnep
                      +++1 very similar experiences.

                      Comment


                      • #12
                        Originally posted by MissAlice View Post
                        I'm struggling as a pharmacist going into their 4th year of practice.


                        Ive been a locum and relief pharmacist, and been constantly met with aggressive, furious, overly stressed managers and dispensers in atrocious, messy stores. Some are little more than bullies, while others I have compassion for. Id hate to hold a managerial role, and I dont. I am the RP at a dispensing hub, but not the manager.

                        At my current workplace, Ive found the staff have lost their perspective, their true mission to assist in health care, the safe delivery of medicines, and lost their compassion for the patients.

                        Now I cant say I blame them, as the pressure is unreal. We all seem to be dashing back and forth at the beck and call of patients and drs, run ragged to accommodate everyone. It is naturally impossible to make everyone happy, so talking down customers from irate to 'ok' or receptive is always a skill I've taken pride in.

                        My issue seems to be with staff who - day in, day out - can not seem to snap out of their pessimistic, race to the bottom, corner-cutting behaviours, with an attitude that certain SOPs and safety regulations are "not worth the hassle."

                        Ive read many books on communication, leadership, influencing people and encouraging good interpersonal, professional relationships. Some days, the methods work, but for the most part, staff at my current permanent place of work are unwilling to adopt to new systems, or improve policy. They detest learning and will find against doing mandatory training. I am met with quarrels, tears and bickering when Head office hand down a new system, and it's really starting to worry me.

                        I feel the staff are in shut down mode.

                        I have tried various techniques and followed leadership programs. I've used consistency, bonus incentives, impromptu rewards, friendly competition, careful explanations of why I'm asking them to follow SOPs, educated them of legality and liability, been lavish with sincere praise when it's due etc But they always without pause for breath retort with 'well, we've done it this way for decades and it's been fine.' Even when clearly it hasnt been fine, as errors have occurred, some very dangerous and perfectly avoidable, if they'd only follow the SOPs.

                        I have 3 staff who are institutionalised and have been at the site 20 odd years. One is the manager (ACT). This manager will have strange quarrels about my clinical decisions, particularity if it means I'm holding back an RX for safety issues while I investigate further. She has a 'just do it' attitude. They are very pre-occupied with getting the scripts bagged up as fast as possible, with no real pause to think and examine things clinically. Interventions, MURs and NMS actually seem to infuriate this manager, and if I stop do to anything other than tick boxes, they become very exasperated. The manager will try to hide complaints or clinical situations from me, as she fears I will 'make a fuss' and query an interaction with a doctor or the patient. These things take minutes to resolve, but they are minutes too many for her liking.

                        There is a tendency for them to make up rules as they go, and if I point out legal problems with their practice, or that they are wide open to issues of liability, they shoot me down: 'we've always done it this way.' I express understanding, but highlights laws change. They continue to argue, then refuse to do as asked. Or do it that one time, but not any time thereafter.

                        No matter how much I explain or educate, it is as though they have no value for the patient, and no value for the pharmacist. I catch them making decisions beyond their position, and have to intercept, usually resulting with them furious that I am 'holding them up.'

                        Now there is no reward for them to get bags out asap. But there are big penalties for serious errors.

                        I do wonder if my young face, small stature and feminine appearance is why I am so readily disregarded. I am one of the youngest looking on the team, even though I am not the youngest. At 2 years service with them, I am still seen as the 'newbie.'

                        Now I know I cant expect the same level of professionalism in support staff as I would see in pharmacists, but some of the staff are beyond reproach, petty, rude, gossips, complainers and uncooperative. I appreciate I am auto-hated, as staff see me as the overpaid pharmacist, whilst they are on minimum wage as they "do all the donkey work." They honestly dont know what they dont know, so they arent even sure what a clinical screening is, or what occurs in an MUR/NMS. I understand that resentment. I used to be a counter girl myself, and I thought the pharmacist just ticked boxes. Then I worked up to a disp assit, then an NVQ3 dispenser before going to do the MPharm. Ive met some dreadful, lazy. troublesome locums that I hated. But I was determined not to be that person. I have modelled myself after some of my favourite, most insightful and helpful pharmacists.


                        I know I could raise this with HO, but so far, they have not been very supportive, waxing lyrical at me and shrugging it off, saying if it's that bad, I must take out a formal grievance for each person. Now considering none of the staff are going anywhere, I cant see how a grievance will resolve relations, or their work ethic.


                        Is there any advice or guidance out there? Or is this situation a dead end, and will I just have to adopt my outlook and perceptions so that I don't go home each day, feeling disrespected, bullied, harassed, and that my patients haven't been given the best deal? This feeling isnt really new to me, and it's the vibe I get within all pharmacies. The tone of pharmacies just seems very stressed and negative no matter where Ive worked.

                        But for once, I wanted to be the RP in a place where I could make a positive change for everyone. Yet despite everything, Im making no progress. Help!
                        I made a career out of putting up with this type of cr*p. Sincere and heartfelt congratulations on your efforts to put up with it, you have done all that I ever did and more. My honest and I hope not too paranoid opinion is that multiples resent having to employ graduate pharmacists and so make sure that you get a rough ride. If it comes to a disciplinary complaint rarely, if ever, is the pharmacist supported. The net outcome is that in community pharmacy we are faced with a negative authority gradient.

                        What to do about it? as other posters have mentioned OUT is probably the best solution but please get professional career and other advice before you make a move.

                        The PDA might be able to help (are you a member?) but its major fault is that it was started 40 years too late.

                        Once more; congratulations. You have shown yourself to be a strong character in being able to put up with this nonsense.

                        Comment


                        • #13
                          Originally posted by mcitr View Post

                          I've worked in a small number of chilled out other branches that never had any problems. Chilled out patients. Very little silly stuff. Few scripts. Nice staff. Cushy.

                          The only problem was they weren't profitable and lost thousands a month and of those other branches have closed or are in the process of closing (one is closing in a month's time), or sometime in the next year or two will likely close.
                          While I don't know how many scripts it actually does, I've no reason to think it can be described as 'few'. It's the only pharmacy in a small town with probably 4000 prescribing patients, a significant proportion of whom are elderly. So probably 3-4000 per month.

                          And, I agree with Mutley's last two sentences.

                          Comment


                          • #14
                            Originally posted by Merlyn View Post

                            While I don't know how many scripts it actually does, I've no reason to think it can be described as 'few'. It's the only pharmacy in a small town with probably 4000 prescribing patients, a significant proportion of whom are elderly. So probably 3-4000 per month.

                            And, I agree with Mutley's last two sentences.
                            I have no idea what your local pharmacy does and not meaning to tell people how it is where they are.

                            However it is interesting you say 3000 as that is the number at one of the other stores that I am referring to as 'few'. That is few to me. Whatever I think this is the territory of figures that the chains are eyeing up to close, based on other factors. As the one you are talking about is the only one in town I am guessing it'll survive and long may it continue. There is a rumour around one of the big chains that around 5500 is a number below which possible closure could be a consequence.

                            I agree with mutleys comments too. Although I don't think the PDA are an effective union it is better than none and others are available. The flaw with the PDA is that it's pharmacists only. Employment law deals primarily with policies in the company, in actual fact a pharmacist has far more in common with others in their chain than they do with other pharmacists in other chains. Big flaw in a union.

                            Comment


                            • #15
                              There seems to be confusion in this thread as to the status of dispensers and medicine counter assistants. The assumption is that they see themselves as health care professionals. Many, if not most of them, don’t, they see themselves as retail assistants and conduct themselves accordingly. Educate them to an appropriate level, and pay them a professional wage and you might see a difference. I’m not holding my breath.

                              Comment

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