Ultan Molloy tries to take the positives from having the 18-to-34 vaccination age group sprung on him

What a surprise we got a few weeks back. Would you go into work at all if you thought your day was going to be a case of fielding hundreds of phone calls you weren’t expecting about a vaccination service you didn’t know you’d be doing? It has been great to get involved in order to help out a cohort who have probably had the most difficult time mentally through our Covid experience, who have little opportunity to get a mortgage and house anytime soon the way the market is, and who have been left until toward the end of the vaccination programme.

Now, I know there’s some logic in leaving them until the end, and indeed much science to support this approach. All the while, other countries have managed the vaccine roll-out, and lockdowns, or indeed the lack of them, very differently.

So, yes, about the vaccine clinics. I admit, I totally underestimated the disruption, and bookings management, cancellations, spreadsheets, emails, texts and everything else involved. At the same time, it’s been hugely inspiring to see how our team has stepped up, taken on vaccination clinics, as well as administration work, out-of-hours. Any spare time I’ve had in recent days I’ve used to reflect on the value of having really good people around us.

Pros and Cons

Second-dose Pfizer vaccines are starting to land in the middle of holiday time now with people off, including myself, in that I was supposed to be on holiday. We’ll have additional income from the vaccinations of course, but it’s a little difficult to capacity plan, when:

1) We didn’t know we would have three patient cohorts 18-to-34 sprung on us overnight; 2) we don’t know when, or how many, vaccines we will be receiving week-to-week; and 3) we do not know when the relentless phone calls, asking questions you do not have the answer to, will stop. No, it’s not a perfect situation presently, but you don’t need to think these things through when you’re the Minister for Health. The impact of an announcement, without regard for the fall-out, can be someone else’s problem. Maybe the ones who have had FEMPI since 2010, increasing prescription dispensing volumes annually, and a public service contract that is outdated, and remains unfit for purpose.

Any spare time I’ve had in recent days I’ve used to reflect on the value of having really good people around us

Necessity has been the mother of invention, mind you. Google Drive, patient communication management, running focused mass vaccination clinics, additional computing investment, and translation support for foreign nationals have all served us well for this. Our flu vaccination clinics will also be better organised on foot of this, and streamlined this year. We’re learning more from pressure and running down dead-ends than we would have done without this recent squeeze.

PharmaVax

So when we have a GP hub and pharmacy hub on the HSE website, someone thought it would be a good idea to also have PharmaVax, and I’d assume Covax, separate to these. We don’t have any auto population facility, even though when we put in a PPS number on the pharmacy suite, we have two-thirds of the information we’re presently paying staff to input into PharmaVax, again, into another system for the HSE. Jesus, man, how disjointed can the thinking on these things be? Does no-one sit down for 10 minutes and think, ‘what have we in place at the moment that we can integrate with, or draw data from?’ S

ome very clever people no doubt, but no-one with the mandate to call bullshit and have something done that will work for patients and for pharmacies. To minimise admin and maximise efficiency, communication and impact.
‘Would you mind getting terribly sick between 9 and 5pm, but not on Thursday, Saturday or Sunday please?’

GP surgeries are closed on Thursdays in Ballyhaunis, for administrative reasons. The kind of stuff you might be presently working through out-of-hours. Good to have the weekends off too. Perhaps I’m a bit jealous! Saturdays are a shorter day for us, thankfully. It’s still a less popular day for our staff to work, though. It’s retail though, and at least we’re not working Sundays in the wild west.

Anyway, so, our four-year-old, Neillí, had a severe croup attack at 3am in Roundstone last week. She woke crying uncontrollably and struggling severely to breathe. So we rang WestDoc. We got a very polite nurse who asked questions like Neillís date of birth and all those important things one needs to know when a child is struggling to breathe. Spoke to the doctor on call in Clifden, who rang us back to say: “The doctor said you’ll have to bring her to A&E in Galway.” I don’t think I responded, as I was in shock.

Twenty minutes to Clifden where the doctor was, or one hour and 20 minutes to Galway to A&E with a child that is distressed and struggling to breathe. ‘Off you go there now, daddy.’ No conversation with the doctor. No empathy or clinical engagement. A convenient, corporate degree of separation through having a nurse receptionist ask a few questions to manage patient engagement. What do you think?

What about, ‘come to Clifden and we’ll give her some steroids and assess her as you’re just down the road’, or ‘I’m a bit tired and don’t know you as a person with a child crying and struggling to breathe in your arms, so off you go to Galway’. All I can say now to them as I write this is, ‘just f@*k off, whoever you are. You’re in the wrong job!’ I’m still in shock as I write this, and more than a little pissed off.

I see Community Healthcare West has a delivery plan underpinned by the values of Care, Compassion, Trust and Learning. Well, aren’t they just doing a fantastic job of bringing them to life through individual behaviours when patent facing, or rather avoiding, in Westdoc, Clifden.

As it turned out, our home was closer than Galway. We managed to settle her on the journey and got some prednesol steroids into her when we got home an hour later. Our precious Neillí. Steroids will be closer to hand in future. I’ve heard it said by customers that it would be easier to get a vet. Maybe I’ll try a vet the next time one of us are inconveniently sick out of hours.

So many good ones…

And yes, there are so many good GPs, and hopefully the majority are looking after people very well. Like pharmacists too. So many good ones. Some next to useless ones too, but that’s life, isn’t it? We get the full spectrum of abilities, fits, and misfits. Not all people in the same role are equal in terms of their competence and effectiveness by any stretch of the imagination. To my earlier point, again, I am thankful for the team we have and how they look after our patients and customers.

I’ll just count my blessings on that front at the moment, consider how I can support our team to be better, and consider how we can better bring our own values to life through these stressful times.

Ultan Molloy
Ultan Molloy

Ultan Molloy is a business and professional performance coach, pharmacist, facilitator and development specialist. He works with other pharmacists, business owners and third parties to develop business strategies.