REDEFINING THE FRONT LINES: PART 4 – THE PHARMACIST
Our Civic Life Team has been working hard on a campaign called “Redefining the Front Lines”. We’ve interviewed people who are employed in and out of the medical field, working hard to ensure we’re safe and our basic needs are met. Their stories are an important part of our city’s efforts in COVID response and relief. We are so grateful to our interviewees for sharing their stories. Name: Jahnaya Mann Occupation: Pharmacist
What did your role look like prior to COVID-19? I run a large community pharmacy in Southwest Saskatchewan. I have a team of 12 pharmacists and 10 assistants. My entire staff is about 80 people including the front store, vitamins, post office, coffee shop, etc. We also manage the pharmaceutical services for 5 long-term care facilities in Southwest Saskatchewan. A lot of my day to day prior to Covid-19 is very similar – receiving doctors’ orders, filling orders, monitoring drug interactions, and consulting on any other issues that may influence how their body would react with a medication.depending on the age and health of my patients. A lot of my day to day was very hands on such as injections, checking blood pressure, and medical assessments as well as prescribing medications for minor health conditions. We care for a lot of elderly people and they can be very lonely. Personal connection is key in my role. A lot of time is spent building relationships with our clients. Some people don’t always have that support system and occasionally we are their only support. We would also go into homes and do home visits as some of my patients are not mobile, so they needed us to come to them. We spent a lot of time consulting and collaborating with other healthcare professionals too.
How has your role changed after COVID-19? We have put up plexi-glass at the counters. You know it is there to keep your patients safe but it still puts a barrier there. The biggest thing is we need to maintain privacy, and this is really hard when you have to shout through glass. Because we are not healthcare providers based on Canadian definition, we are not given PPE from the government. Most pharmacies are not stocked with any PPE. I was a pharmacist during the times of SARS and I remember how fast we had to react to access supplies. A lot of the PPE we need now cannot be accessed. Thankfully, the Canadian Pharmacists Association is lobbying for the Government to recognize us as frontline healthcare workers so that we can access the PPE we need to keep ourselves and our clients safe. We cannot hug our clients anymore. There are some professional services that we are not able to do anymore. We cannot do injections unless you have full PPE on. It takes one person about 15 minutes to gown up for just 1 injection and the cost is close to $20 for the PPE and cleaning alone. Up until late-April, we were not able to provide online clinical services but the Saskatchewan Government just started allowing us to provide virtual care for patients. Prior to Covid-19, there were many drug shortages and now we are spending so much time procuring medication to ensure that our patients have the medication they need. Inhalers are critical and in very short supply. You can order only as many based on your prior usage so even though demand has increased significantly for these medications, you can not increase your supply to keep up with it. A lot of the drugs we buy in Canada are not produced in Canada but in places like China or India which have been in lockdown for months. This is worrisome for us because we go to our cupboards and there are shelves that are bare. There are people that need these medications to stay alive. Hospitals get priority over community stores as well. Canada Gov has been very proactive helping prevent this by allowing only a 30 day supply to be dispensed to patients.
What changes has your work made in order to keep its employees safe? We have separated into two teams that never have contact with each other. If one person gets sick, the entire team would isolate and the other team would step in to provide care for our patients. We did this with the front staff and pharmacy. It is expected that they go to work and go home. They do not do anything else. We did this really early in the pandemic and it was key. We increased our routine cleaning processes with hourly cleaning, documenting all sanitizing efforts, and daily check-ins with all staff. We are not doing temperature checks yet but this may come and we ask about symptoms every day. We have PPE in place for when it is needed and had 100 cloth masks donated by a local Hutterite Colony. A few local dentists have donated gloves and masks since they are unable to provide their services. We are lucky that we reacted so early and have such a supportive community. We were able to get a lot of the supplies we needed like hand sanitizer for all of our staff. We introduced a premium for all of our workers. We also offer mental health counselling for everyone on our team so that they have access to talk to someone. We know that people are anxious and nervous to come to work and they may be dealing with things at home like spouses losing their jobs or kids at home. Those who are immunocompromised were given the opportunity to take a leave of absence. Safety for our customers comes at a cost. We offer free delivery to keep our seniors and most vulnerable customers safe. This service has increased by 300% and we fully eat the cost of it. We have implemented debit on delivery and a variety of other services to keep our patients safe but this is all very costly with no government relief programs available or insight for us.
Do you feel you’ve received enough support from the government and your work to feel safe and secure? As an essential business we were mandated to remain open despite the risk and challenges that this places on the team and the business. We knew it was going to take a huge investment for safety to remain open and then also the daily maintenance and cleaning and not to mention the fear factor for our team which can not be underestimated. The Pharmacy Association in Saskatchewan is responsible for representing the interests of pharmacists in our province. The Association advocates for us and they are very supportive and have done a lot of work with the government. The biggest barrier is the access to PPE as pharmacy teams are potentially a huge vector for this disease and are daily exposed to the general public that may be carriers of COVID. The issue is that we are a private business rather than a publicly funded healthcare business. This is why we do not get the PPE from the government. We also have gotten a lot of negative press from the public due to the ministry’s legislation for 30 day dispensing of medications to safeguard medication supply in Canada. Part of this is because most people are not aware of the intense education we have and the critical role we play in the safety of medication use. This crisis has brought pharmacists role to the forefront and our hope is that governments and the general public will be more aware of the role we play in keeping them safe, healthy and free from harm from their prescribed therapies.
Do you feel safe being on the job in the front lines? You have your moments. There are times where, especially in the beginning, when you would hear of the numbers rising or people being tested and it would worry you. When we didn’t have access to hand sanitizer or PPE, we were worried about what would happen when this got bad . Now that we have these essential items, we are more confident. It goes through our minds multiple times a day. You don’t know who is showing up in front of you. You can’t stop anyone from coming in the door. You rely on people’s honesty. You don’t have this guarantee that everyone is taking it seriously. You are at the mercy of people listening and following health official’s direction.
How has this impacted your personal life? (Has your routine or contact changed with your family?) I am a bit of an exception because my children work with me. Many of my workers sanitize themselves before they leave work, then disrobe in the garage when they get home and sanitize again. Most Pharmacists in Canada are women and many of us have little kids that we are going home to. This is heavy for our people because you worry about exposing your family to something.
What does it feel like to be a front-line worker in this crisis? I am really proud of my team. They step up and show up fearless every day. They push all their own fears aside and put the betterment of mankind first. Thank you is not enough to say to those who take a risk for the lives of others. These beautiful people come to work every day with a smile on and a desire to care for this community despite the risk to their health and those they love. We are a family and I am so grateful for each one of them. They still find things to laugh about and celebrate. Their kindness while calming the fears of those who call us for support is outstanding. This is one of the really awesome things that is going to come out of the world – everyone coming together. We have all been challenged to think outside of ourselves – show up to work to keep the vulnerable people safe. They make me proud to be a human. I work with such good people. They are fearless in the face of a terrifying giant.
What do you think the nature of your work will look like once COVID-19 has passed? I think we would all like to know that. We all loved our life before and now we are anxiously waiting to return to what it was like but we know that it likely won’t be the same. I want to know when I can step out and hug my patients. This is what brings tears to my eyes. I have known these patients for 20 years. I can’t give the support I want to give. We know that physical touch is one of the most comforting things. My hope is that we can return to hands on care. This is where the true connection is and where you truly make a difference. Shared empathy for someone. I miss my team. I don’t get to see my night and weekend staff. I can’t get together with my team on the weekend. They are my family – we used to do monthly dinners and we cannot do this.\ I can’t wait until we can celebrate things together again. I will never take that for granted. Our hope is that we will come out as better humans as a result of this challenge and that we remember to treasure time with family and friends.