Pharmacists 'stretched thin' amidst pandemic pressures, drug shortages

After working as a pharmacist for eight years, Sheryl Mahar has felt the strain of the past several years, working long days with little time left to spend on her family and herself.

“It’s been quite stressful -- we're stretched pretty thin,” she says in her small office in her community pharmacy in Hatchet Lake. Over her shoulder are two “thank you” cards.

“It's hard because you want to get everyone everything that they need, but you constantly feel like you're treading water because there's so much to do,” she says.

Since the beginning of the COVID-19 pandemic, pharmacists like Mahar worked when many people were under lockdown at home.

Then, they played a key role in the COVID-19 vaccine rollout.

Now, on top of the busy immunization season, they’re also dealing with an ongoing shortage of children's medications and amoxicillin.

In addition, over the past number of years, pharmacists have also been given authority by provinces to diagnose minor ailments, prescribe certain medications, and interpret diagnostic tests.

At the same time, many pharmacists have reported experiencing hostility at the counter.

“We have people protesting, we have people threatening, we have people just generally being rude,” says Allison Bodnar, CEO of the Pharmacy Association of Nova Scotia.

“(They’re) not understanding the volume of services and the things that are changing and evolving in order for pharmacies to serve people better,” says Bodnar.

“We sort of have to have a thick skin back here, unfortunately,” says Mahar. “They just don’t know all the things that we’re doing.”

At the beginning of 2022, the Canadian Pharmacists Association conducted a survey asking pharmacists how they're coping.

Forty-eight per cent reported experiencing abuse/harassment at least weekly; 72 per cent considered leaving the position and/or the profession; and 92 per cent said they were at risk of burnout.

“My fear is that things have gotten worse,” says Zubin Austin, a professor and research chair at the Leslie Dan Faculty of Pharmacy at the University of Toronto.

Austin says the profession has traditionally been undervalued, even though it’s an integral part of the health-care system.

“And when you have fragile, burned out workers in the health-care system, they simply cannot be at their best and provide the best quality of care,” he says.

Austin says the current shortages of children’s acetaminophen and ibuprofen are only exacerbating the situation.

“(It’s) not only increased the amount of work for them, but it’s produced an incredible amount of stress,” he says, “because the idea that you have to turn people away, with children who need help, that is something you take home with you.”

While many of the new duties being carried out by pharmacists were lobbied for by the industry, experts say the systems to support them in their evolving roles aren’t there.

Bodnar cites staffing as an example.

“We have a shortage of (pharmacy) technicians right now, so as much as I would like to tell every pharmacist to stop doing technical work, we're struggling to get technicians, “ she says.

Recruiting more technicians, Bodnar says, would free pharmacists up from some of the technical duties of the job, such as pill counting and labelling.

Austin says pharmacists face technological barriers on the job as well.

“Despite the pivot during COVID-19 to virtual care, so much of communication between pharmacists and doctors is still by the phone, by a fax machine,” he says. “It’s really time consuming and prone to error.”

Austin says developing a “one patient, one record” digital system would improve work flow and communication.

Mahar says, in her experience, how pharmacists are paid is also a barrier.

“What I think would help is if the funding model better reflected the work that goes into all of these services,” she says. “If the funding model better supported the work that goes into those prescribing practices, it would be a lot easier for us to support them, have more staff available, and things like that.”

Mahar says even with all the stress, she still couldn't imagine doing anything else.

Austin urges the public to be patient.

“Thank your pharmacist, please,” he says, “and let them know you understand the struggles they are experiencing.”