Jason Poquette is the director for outpatient pharmacy services at Saint Vincent Hospital in Worcester, Mass., and an APPE preceptor for the Massachusetts College of Pharmacy. Contact him at Jason.firstname.lastname@example.org.
It's something every pharmacist knows well-the long shift. Here's how to make it a little more bearable.
We should have seen this coming. Working a 12-hour shift in a retail pharmacy is not exactly like a long day in any other job. The stress and physical demands of a 12-hour work day were a bit much. Schools were getting complaints from employers that their grads couldn’t handle the rigors of these marathons.
And so, academia responded. All the 6th year pharmacy students had to complete a month-long rotation at Gold’s Gym before graduation. Lectures on medications declined. They were replaced with motivational TED talks, and lectures from military survival experts and long-distance running coaches. Usain Bolt was asked to deliver the commencement address.
Sure, corporate executives, consultants, and other healthcare professionals may work late. But a 12-hour, always-standing, busy, break-free, distracting environment which demands 100% focus because patient lives demand it is becoming par for the pharmacy course today.
The following are a few tips from someone who has worked his fair share of 12-hour shifts himself.
I suggest following general marathon running guidelines in preparation for your 12-hour shift. No, a long day on the bench isn’t exactly like running a marathon. But since a marathon is among the most physically and mentally challenging tests of endurance we know, it was the closest thing I could imagine.
Focus on carbs, consuming them 4-hours pre-shift to maximize your liver glycogen reserves. Rumor has it that several clever pharmacy students are currently working on an app that will predict your exact caloric requirements based on anticipated prescription volume, immunization season, a drive-through window, and tech staffing.
Mental acuity is a concern on these 12-hour shifts. Your brain must be ready to check prescriptions and simultaneously give a flu vaccine, counsel patients, un-jam the printer, double-count your narcotics and explain the atenolol shortage to the doctor’s secretary, all while on hold with your patient’s PBM.
We all start the day sharp. But about the 400th time we explain to a patient that we cannot control when their refill request is returned, the mental fog starts to settle in. I have personally found that mental exercises help. Try memorizing the phone numbers of the top 20 pharmacy help desks and the exact aisle and location of the cat food to keep the brain strong for these long days.
No amount of preparation can substitute for sufficient caffeinating, so drink up! This beautiful little chemical has been helping pharmacist survive these long days for decades. Tell your doctor if you are concerned about the cardiovascular repercussions of high caffeine intake.
As pharmacists, we understand that a good dose of caffeine will still only last 6 hours. Therefore, even the Starbucks Venti Blonde Roast with an estimated 475mg of caffeine is unlikely to get you past 3 pm. Continuous IV infusion is impractical and a 12-hour caffeine patch has not been developed just yet. For now, plan on asking your 3 pm tech to bring you in coffee on their way to work.
They say that fatigue begins in the feet. For that reason, preparing for your 12-hour shift involves investing in the proper shoes to support you as you get ready to go all day without ever sitting down. Ever. Don’t go cheap here. You spent $200K or more getting licensed so you could stand up longer than the half-life of amiodarone.
Buy a good quality, light-weight, shoe with good laces and Olympic-quality insoles. Compression socks are good to keep all that coffee from pooling around your ankles. Oh, and plan on replacing your shoes every 20,000 prescriptions or so.
Finally, we must address the most complicated facet of the 12-hour shift: hydration. Lack of proper fluid intake can lead to exhaustion, make you prone to infections by weakening your immune system, cause a headache, palpitations, kidney failure, or death.
However, fluid intake will require bathroom breaks which are incompatible with many 12-hour shifts. So what should you do? Some would say these are just the risks associated with the profession. Personally, I suggest sneaking in your bathroom breaks while on hold with a pharmacy help desk. That should allow you plenty of time.
Working a 12-hour pharmacy shift can be intimidating to new pharmacists. Pace yourself. At 9 am the finish line seems light-years away. But don’t give up. Only 720 more minutes to go. Keep these tips in mind. And don’t forget the most important tool: a good sense of humor. With that and a strong back, you should do just fine. Good luck.