The peculiar experiences of a floater pharmacist

May 24, 2011

No matter how lofty his aims, and notwithstanding his professional carriage and comportment, a floater pharmacist will encounter a very unique and trying experience in each location. Here are a few scenarios one may deal with.

Community pharmacy practice in most U.S. cities today presents peculiar challenges for the practitioners. Public perception of the role of a pharmacist is somewhat distorted, especially when examined beside the pharmacist's expectation of how he desires to be seen by patients. The pharmacist hopes to be seen as a:

  • Provider of genuine, safe, affordable and effective medicinal products

  • Source of valuable drug information

  • Counselor on side effects, adverse events, and drug-drug and/or drug-food interactions

  • Source of potent vitamins, minerals, herbs, and safe medical appliances

  • Community contributor to public health issues

  • Society's gatekeeper of prescriptions and poisons

  • Controller of a potentially hazardous mass-circulation of dangerous drug substances

However, most members of the public wrongly perceive the pharmacist as a profiteering Shylock who is out to skin them of their meager earnings through a continual increase in the price of medications. Their angry posture at the pharmacy drop-off window speaks volumes about their traditional resentment. They display grimaces, clenched fists, red faces, sweaty brows, and monosyllabic responses to the pharmacist's questions.

Many are weary and wary of the long wait times at the pharmacy. They imagine that prices may go up between the drop-off and the half-hour it takes to pick up their medications. It is not unusual to hear such queries as "Why does it have to take so long?" "Aren’t you just counting those pills?" "It’s just a cream, isn’t it already in a tube?"

In the skewed perceptions of such patients, the pharmacist is reduced to a mere counting or labeling machine that must not be allowed to unnecessarily delay their collection of those scarce drugs.

Some patients may ocasionally attempt to help by suggesting to the floater pharmacist, "Just give me the container of meds. I don’t need all those bags and papers … They know me here; I guess you must be new.”

The floater pharmacist, otherwise known as the relief pharmacist, is a pharmacist who moves from one store location to another, filling in during weeks of annual vacations, emergency callouts, maternity leaves, workplace overlaps, and other HR necessities that arise frequently on any annual workplace calender. Most big corporations in the pharmaceuticals retailing sector employ pharmacists, fulltime or otherwise, who work in floater positions year-round.

The floater pharmacist is no less competent than his locally based colleague. However, the peculiar challenges of working almost daily in different locations plus the attendant demands of driving far distances may alter the possibilities of follow-up on certain in-progress services that a floater might have initiated at any one location.

Now juxtapose this scenario and circumstance with the fate of a floater pharmacist who is new to a particular location and whose plight it is to serve for 12 hours in that new place for 5 consecutive days. The floater is unfamiliar with the mannerisms of the patients in that environment and must deal with each case individually to the best of his ability within any given time frame. No matter how lofty his aims, and notwithstanding his professional carriage and comportment, a floater pharmacist will encounter a very unique and trying experience in each location.

When the floater fills and verifies prescriptions, he doesn’t know which patient's pills must be triple-counted. He doesn’t know which family of patients always picks up controlled substances for one another. No one informs him in advance that "Mrs Fox" wants her OCPs taken out of the satchet/packet and placed right or left in the plastic dispenser case. How could he know that "only Mrs Green is allowed to walk her dog to the pharmacy check-out counter"? Patients rarely exhibit their characteristics on their faces, so he may not know that the tempestuous “Ms. Yaba” customarily creates a scene just for the public attention whenever she comes to the drop-off window.

His flexibility in handling human relations, his ability to manage damage control, his dexterity at intervening in every potentially flammable customer-staff altercation will all be sorely tested. And these are apart from the innuendos, deliberate subversive activities, and unimaginable acts of sabotage originating from the internal staff of the pharmacy.

In addition to contending with the challenges of driving long distances and working from town to town, the floater pharmacist must be creative in his management of the different pharmacy staff he meets in each location. There are the unappreciative pharmacy managers, the chronic latecomers, the pharmacy gossips and politicians, and the sleazy and indolent. Then there are those light-fingered pharmacy mice. Such circumstances can traumatize a less-than-adaptive personality.

The following examples are plausible scenarios that are peculiar to the typical workplace experience of a floater pharmacist.

  • The pharmacy manager got married and is on leave of absence for a 6-week honeymoon. No one else knows where she kept the monthly staff schedule.
  • The happy-go-lucky, chronic latecomer technician now has a field day of call-outs since the substantive manager is away.
  • The chief technician recently threatened to fire the floater for daring to correct his typographical error of chlorpromazine instead of chlorpropramide at the drop-off. ("Who does he think he is? He’s just a floater! How dare he tell us what to do here in our store!” etc.)
  • Sales have been going down because the main cashier in the pharmacy just lost her 90-year-old mom and is out, and no one else wants to check out clients at the pickup station. The only other junior technician, a recent college graduate with a degree in anthropology, considers the job of cashier beneath his dignity. He is evasive and dodgy whenever a customer shows up at the checkout counter. In 1 day alone, he makes 7 trips to the restroom just to escape ringing out sales.
  • There was a noticeable shortage in the nicotine-gum inventory (for example). The floater is concerned about this; is a ghost entering the pharmacy afterhours? Or there is a mouse in the pharmacy that suddenly develops an appetite for gum each night after all the crew have left. Is it the front-end overnight shift? His imagination is running beserk and ruins a good night's sleep.
  • A patient complained the other day that "I was told my medication is not covered by the insurance … What do you mean by ‘NDC-not-covered’?" Both the floater and the patient are unsure about the third-party rejection message. Why are some NDCs covered and others not when all NDCs are registered with the FDA? Questions and more questions for the helpless floater. Another patient asks, "Why are my wife's lorazepam covered on her plan, and mine are not covered, when we have the same plan?" The floater attempts to explain the third-party message "Medication not appropriate for patient's age." The 80-year-old patient is further infuriated. He storms out amid a plethora of unprintable words, shouting, "That boy does not know what he is doing! Where is the regular pharmacist?”

Because the floater attempted to issue suggestions to staff members on how to effectively operate in their respective workstations, the staff members suddenly adopt a tight-lipped attitude toward work, retarding productivity and generally portraying a morbid, gloomy atmosphere in the pharmacy in spite of every spirited effort made by the hapless floater to encourage all.

I can testify from many years of serving in the capacity of floater pharmacist that such scenarios are not uncommon. Since most employees only respect those who have power over their schedule and work hours, they may visit on the floater what they would never do to their pharmacy manager.

My intention is more than to recite a tale of woe. It is to acknowledge the problem of the poor work ethic and sabotage so commonly seen by floater pharmacists. The floater pharmacist genuinely desires to serve. However, his expectation of willing, patient, and attentive clients whom he wishes to educate and assist is constantly rebuffed. His hope for a cooperative, productive, and dedicated staff of co-workers is too often dashed. For the floater, the best strategy at work may well be just to try to keep his head above water until 9 p.m.

At this time, there is undoubtedly very little job satisfacton for many pharmacists working as floaters in large urban areas in the United States. The environment of practice today offers very little motivation for any extensive pharmacist–patient interaction and pharmacist–coworker cooperation. Neither the patients nor the average pharmacy staffers are willing to receive the best professional services that a floater pharmacist desires to offer.

Oluwole Williamslives in Glenside, Pa., where he works as a relief pharmacist.