Eye on ethics: Dealing with a problem R.Ph.

March 5, 2007

The district manager of your chain pharmacy searched for a new pharmacist for months, and finally hired someone you know casually. You are assigned to train the new pharmacist before he joins the float pool. During his first few weeks, your lead technician has caught several errors made by this professional, and you have intercepted errors yourself. The manager doesn't respond to your e-mails of concern. What do you do?

A. There is an old saying: "Be careful what you wish for; you may get it." As pharmacies open on every corner, the demand for pharmacists has become critical. Even the best managers mutter, "We need to get enough bodies in here." Sometimes it seems that they will hire anyone, whether they are ready to work, or not.

While training the new pharmacist, you should schedule your best technician to work the same hours. Extend the training period if needed, or repeat the training as a refresher for the whole staff, to avoid singling anyone out. If possible, adjust shifts and honor reasonable requests; often, the lead tech is offered a 9:00-to-5:00 schedule while all pharmacists are expected to work 12-hour shifts. Insist on quality counseling on all prescriptions, which also helps prevent errors. Resolve errors immediately, and look for simple changes that could alleviate them.

Treating a co-worker with respect and compassion will make it easier to work through problems that may arise. You may try to talk privately to the pharmacist about his or her performance. Be prepared for any reaction, from anger to fear; the pharmacist may even express relief. Most people know when their performance is not good and are aware of the potential consequences. A pharmacist who is faced with his or her own errors may need some time to reevaluate.

Should you call the manager? If you suspect physical or emotional illness or substance abuse, or if there is any risk of harm to patients, you must talk directly and immediately to your district manager. Never e-mail sensitive information. E-mail is also often skimmed or ignored. The manager may use the software audit trail or other data to help analyze performance.

Technically, it is correct to first call your manager when you have concerns about another employee's performance. However, some large chains use an assembly-line approach to management and training; employees who don't "meet the company standards" may be treated brusquely. Almost every issue of this magazine publishes letters from pharmacists who give patients their best but are deeply disappointed in the unrealistic expectations of the corporations that employ them.