Please pass the sodium chloride

April 15, 2013

While not too many bench pharmacists get a lunch hour, creative solutions are still possible. In theory, anyway

In My View

One of the reasons many pharmacists shy away from a career in retail community pharmacy is the fact that there is no true meal break. When a team of pharmacists works together in a long-term care or hospital setting, one of them can break away for a 30-minute lunch break. Not so for pharmacists who choose to work in retail; we know that we are, in most cases, the only license in the store and we cannot lawfully leave the building.

In those circumstances, we are left to decide whether to work through a 12-hour shift without a proper lunch or dinner break and simply munch on snacks throughout the entire day. Some pharmacists wolf down a sandwich between scripts, gambling that customers will not come upon the sight of the healthcare professional eating on the job.

The 30-minute close

One big-box company came up with the idea of closing the pharmacy for 30 minutes at lunchtime. Right in the middle of the busiest time of the day, the pharmacist is required to close the windows of the pharmacy, even if a line of patients is waiting, all with acute symptoms and needing immediate prescription service.

The moment the pharmacy closes, the staff is theoretically “off the clock” and, according to management, not permitted to assist customers, even if they merely ask where a certain OTC drug product can be found. In most cases, by the time the window is finally closed, a good portion of the 30-minute break is gone.

Is it good judgment to close for lunch? I say not. The customers are inconvenienced, and if all they want to do is drop the prescription off for later pickup, they will now be required to make three trips to the pharmacy. Staying open and operational all day is in the best interests of customer service.

The brown-bag solution

You can send your tech out to get you a hamburger at the nearest fast-food enterprise, but in some cases by the time you get the chance to take a few bites, it will be cold and unappetizing and maybe inedible. Most of us will brown-bag it, perhaps bringing in a sandwich from home.

The aroma of peanut butter and jelly on white bread takes me right back to my early days, when I was working for the Thrift Drug Company. I became very skilled at filling five scripts while eating half a sandwich. I often found the rest of an uneaten sandwich on the counter behind eight or nine drug bottles when I was caught up enough to replace the bottles on the shelves.

Available resources

Even though it goes against my own principles to do it - food should not be consumed where prescriptions are prepared - the practice of grabbing a sandwich while filling prescriptions goes way back to when I was a first-year pharmacy student in the mid-1960s, working a four-hour shift in an independent pharmacy. I loved working on Friday nights because that was when the relief pharmacist worked. Tom, the relief pharmacist, was a great storyteller.

Tom had a pharmacist buddy named Barney. One day, while filling prescriptions, Barney got angry because his wife had forgotten to put salt on his chicken-salad sandwich. He ransacked the pharmacy, throwing open every cabinet and drawer, looking for a saltshaker, but struck out. Then it hit him: The pharmacy, like most independent pharmacies in that era, stocked the chemical compounds needed for extemporaneous compounding, all lined up in a uniform row of amber glass bottles. He could just go over to the compounding area and grab the Merck reagent sodium chloride and sprinkle some on the sandwich.

Wonderful idea, right? Only instead of grabbing the sodium chloride, Barney mistakenly reached for the sodium bromide and sprinkled it on his sandwich. Bromides were once used to induce sleep. It wasn’t long before - you guessed it - Barney was snoring away.

I don’t know how true this yarn of Tom’s was, but we all enjoyed listening to his stories. And this one still gives me a sense of continuity every time I find myself eating chicken salad on pumpernickel with NaCl while I count out the hydrochlorothiazide.

Bob Spera is a community pharmacist, a hospital pharmacist, and a writer for pharmacy trade journals. E-mail him at druggist37@verizon.net.