With a new lockdown now in place, Fintan Moore considers how ‘battle fatigue’ is setting in for a lot of people
So we’re now seven months into Ireland’s pandemic crisis, and we pharmacists are still on the frontline. At the time of writing, the daily positive rate is clocking-in at about 1,000 people, so there may well be a level 5 lockdown in place as you read this. Some things have changed for the better since March, in that pharmacies now have screens in place, sanitiser is available, and numbers admitted at any one time are controlled. Patients are mostly masked, as in most of them have masks, but often they completely miss the point of why and pull the masks down to talk to you. And you have to love the people who step in the door of the pharmacy, realise they have forgotten their mask and shout at the top of their voice to ask, ‘is it okay to come in?’
But some aspects of life are getting tougher, and a form of battle fatigue is setting in for a lot of people. The sense of national solidarity with clapping on the doorsteps for the health workers seems like a distant memory. The effect of this protracted crisis on the mental health of pharmacists and staff is something to be aware of. Paradoxically, the people who are characteristically upbeat and positive can be the ones to be most worried about. This was observed by an American soldier called James Stockdale — a veteran who survived almost eight years in a Vietnamese POW camp who was asked if the people who didn’t make it had anything in common, and he said this:
“Oh, that’s easy, the optimists. Oh, they were the ones who said, ‘We’re going to be out by Christmas.’ And Christmas would come, and Christmas would go. Then they’d say, ‘We’re going to be out by Easter.’ And Easter would come, and Easter would go. And then Thanksgiving, and then it would be Christmas again. And they died of a broken heart.”
So, let’s all keep an eye out for one another, and keep an eye on yourself too. Just because you’ve been alright up to now doesn’t mean you’re going to stay that way, so don’t be afraid to admit that it’s hard to keep coping. Talk to a friend, or a friendly colleague or to a support service, but be sure to talk to somebody. All this will pass, but not by Christmas.
Until this year, I had never got involved in the flu vaccination service. In my opinion, the fee offered wasn’t sufficient to justify the cost and time required for training, let alone the running costs of providing the service. The time spent with the patient giving the vaccine is probably less than the time involved in the relevant paperwork and on the vaccination website, so the overall time commitment per vaccine is higher than might be expected. However, the improved fee structure this year should make it economically viable, except for the inability to get enough vaccines. I’m not alone in feeling short-changed and other pharmacists have had the same problem.
There has been a definite weighting of supplies towards pharmacies that have ordered in previous years, although some of them have also struggled to get orders. Given that the preferential supply of stock to existing customers is putting new entrants to this market at a disadvantage, I wonder what the Competition and Consumer Protection Commission would make of the situation. If enough pharmacists get left out in the cold, or
more accurately left out of the cold-chain, after investing hundreds of euro in training costs, it’s pretty likely that somebody will make a complaint.
Scheming and Screaming
We’re all grimly aware of the ludicrous number of patient schemes that we have to deal with every day, each with its own individual rules and idiosyncrasies. A lot of patients end up getting their various medications on different schemes, and to complicate life even further, the ordering path for the medications can be less than straightforward. I’ll now present to you the details of the single most ‘labour intensive’ patient that I have:
This guy gets three straightforward items on the GMS, but it’s all downhill from there. He gets one high-tech medication requiring ordering on the hub, and the high-tech docket needs attached to the relevant claim form.
He gets Fampyra on the LTI scheme, which (bizarrely) can only be ordered by phone from the special Fampyra ordering service. He also gets a ULM on LTI, which needs to be ordered on the wholesaler website, and a photocopy of the invoice needs to be attached to the LTI form. He also has an OTC item approved for him on LTI, so the invoice for that also needs to be attached to the LTI form. That’s my current record-holder, although I’m sure there are ones out there who can beat it.