Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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Taking care of pharmacists’ health – what is it worth?

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

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Kay Dunkley is a pharmacist who has worked in hospital and organisational pharmacy for over 20 years.  She has a broad experience working in public hospitals and in providing support to health professionals through government funded bodies and professional organisations.  Kay also has a strong interest in the health and well being of health professionals and especially the role of peer support.  Kay first became involved as a volunteer with the Pharmacists’ Support Service, a group which has been providing telephone support for pharmacists in Victoria since 1995.  In 2005 Kay became the Program Coordinator for the Pharmacists’ Support Service and has assisted the service to become an independent organisation which is currently seeking to expand to provide support to pharmacists throughout Australia.  In 2007, when AMA Victoria approached the Pharmaceutical Society of Australia (Victorian Branch) with a view to establishing their own Peer Support Service; Kay accepted an invitation to assist.  The AMA Victoria Peer Support Service commenced operation in February 2008.  Kay currently coordinates both of these services and also works part-time as a consultant pharmacist in Residential Care Facilities.

How much are you willing to pay for services to support health and well-being?
The working environment for many pharmacists is not ideal.
In both hospital and community settings pharmacists often experience many of the following: long periods of standing, non-ergonomic computers, minimal opportunity to take a break including visiting the toilet or eating lunch, constant demands and the expectation of working quickly without making a mistake, dealing with distressed or difficult people, working extended and sometimes unsociable hours and being a victim of hold-ups and threats of violence.

The pressures can also be significant for pharmacists with ethical dilemmas, red tape and procedural demands, legal requirements and extensive regulation, policy changes, CPD requirements and the need to keep up-to-date, financial concerns, demands from patients and prescribers as well as the risk of litigation if you do not take due care and give the wrong advice or make a dispensing error. Can you identify with this? How often do you go to bed thinking about an incident that occurred at work or wake up after a nightmare about dispensing?

The most common reason that pharmacists call the Pharmacists’ Support Service (PSS) is stress followed by workplace and workload issues. Complaints of bullying seem to be increasing. More recently the service has received an increased number of calls from pharmacists who are experiencing difficulties finding employment. The environment and the pressures on pharmacists can lead to health issues including mental health and substance abuse as well as pharmacists leaving the profession.

Unfortunately there has been little research on the impact of the working environment and policy change on the health and well being of Australian pharmacists and on workforce retention. In comparison in the United Kingdom, a team of researchers at the Centre for Pharmacy Workforce Studies at the University of Manchester under the direction of Professor Karen Hasell, have undertaken research on the workforce, the labour market, and on organisational change and development within the pharmacy profession. We need similar Australian research to guide the profession and to inform future workforce planning.

In comparison although doctors may not face the same physical and environmental stresses as pharmacists it is well recognised that they work in a stressful environment. Callers to the AMA Victoria Peer Support Service, which operates in a similar fashion to PSS providing a listening ear and telephone triage, also report stress as the most common reason for calling. Career issues and training pathways feature as the next most common reason. Personal affairs and mental health issues also feature significantly as does bullying, all at a higher rate than among the pharmacist callers to PSS.

There has been a lot of research undertaken on the topic of doctors’ health and well being in addition to workforce planning and lots of publicity. At present there is a large longitudinal study known as the MABEL (Medicine in Australia: Balancing Employment and Life) study underway and this will continue until 2016. Also there have also been many campaigns by medical groups addressing doctors’ working hours such as the AMA Safe Hours campaign for doctors working in hospitals. Doctors in private practice are also able to regulate the number of patients they see through appointment systems and are able to close their books to new patients or have waiting periods before an appointment is available. Doctors do however face many pressures associated with life and death decisions and are more likely to face complaints and litigation.

PSS is the only pharmacist specific support service available to pharmacists in Australia and is available to any pharmacist and pharmacy students and interns who wish to call. The service offers the opportunity to speak with another pharmacist who is trained in telephone counselling. The benefit of this is to be able to speak to someone with a good understanding of pharmacy and to be able to access to pharmacist specific information and resources. PSS originated in Victoria in 1995 and now operates independently. PSS has expanded to Tasmania, South Australia and Northern Territory. If funding can be secured PSS aims to become a national service and develop a website to broaden the outreach of its services. Australian pharmacy organisations provide assistance to members but apart from PSS none are solely concerned with the health and well being of pharmacists. PSS offers anonymity and confidentiality (unless there is a risk of harm) to callers to enable open and honest discussion without fear of recognition and to avoid mandatory reporting requirements. The pharmacy profession is relatively small in some parts of Australia and so the Victorian base for PSS enables pharmacists from smaller states to contact the service without concern that they will be speaking with a close colleague.

Australian doctors are well serviced with a range of support services. Many of these services provide support over the phone including the AMA Victoria Peer Support Service which is available to Victorian and Tasmanian doctors and medical students, the NSW Doctors’ Health Advisory Service, the Queensland Doctors’ Health Advisory Service (which is also available to pharmacists), the South Australian Doctors’ Health Advisory Service and Colleague of First Contact in Western Australia and in ACT. There are also Benevolent Associations for doctors in Victoria and NSW. The RACGP GP Support Program provides both telephone and face-to-face counselling services. Face to face medical assessment and treatment is available through the Victorian Doctors Health Program (VDHP) and there are a few GP clinics which specifically treat doctors. I am only aware of the latter being available in Melbourne and Adelaide. The VDHP has the most well developed model of service in Australia and includes ongoing support groups for recovering doctors and back to work programs.

I believe that the Australian pharmacy profession can learn from the attention our medical colleagues pay to their own health and well being and to their workplace stress and pressures. We can also learn from the services available in the United Kingdom as described in my previous contributions to i2P. Profession-specific health and support services for doctors and pharmacists are very valuable in that they are able to address specific issues in relation to the practice of the health professional.

The Medical Board is currently undertaking consultation with doctors by asking if they are willing to pay an additional levy on their registration to fund doctors’ health programs, like VDHP, around Australia. If the Australian medical profession supports this proposal a precedent will be set which could be applied to the pharmacy profession, with a levy added to pharmacist registration fees to fund expansion and further development of PSS. I am interested to hear if you would be willing to support the work of PSS through a higher registration fee and if so how much you as a pharmacist are willing to pay. I invite your comments and look forward to your feedback.

In the interim the pharmacy profession can assist PSS through tax deductible donations. If you wish to support the work of PSS send your donation to Pharmacists’ Support Service c/o 381 Royal Pde, Parkville 3052. Donations can also be made over the phone using a credit card through the PSA (Victorian Branch) office on (03) 9389 4000 or by direct deposit into the Pharmacists’ Support Service bank account BSB 083155 and account number 481820199 (include name and contact details so that a receipt can be issued).

I recommend that you take a moment to put the PSS phone number in your phone’s contact list as you never know when you may need it. Pharmacists and pharmacy students and interns requiring assistance can contact PSS for anonymous and discreet support on 1300 244 910 between 8.00 am and 11.00 pm every day of the year.

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