When Michelle Rutledge, Pharm.D., heard about the fatal shooting of a hospital pharmacist at Shands Jacksonville hospital in Florida last November, it really hit home. The victim, 37-year-old Shannon McCants, was a fellow graduate of the Florida A&M College of Pharmacy. McCants was shot by a customer who was waiting for a prescription to be filled in the outpatient pharmacy. Rutledge, an associate investigator at the James A. Haley VA Hospital in Tampa, said that e-mails from former student-colleagues began pouring in.
Drug Topics contacted Shands to find out what steps it has taken to prevent a similar incident from occurring in the future, but it declined to comment.
Both the Occupational Safety & Health Administration (OSHA) and The Joint Commission have guidelines in place that address workplace violence and safety. (See box.) But some observers note that there is a delicate balance between protecting pharmacists and making them accessible to patients. "More patient contact is the trend, and you don't want to isolate the pharmacist," said Carmen Catizone, executive director of the National Association of Boards of Pharmacy. He pointed out that once the patient is in the pharmacy, the pharmacist is pretty vulnerable. He posed the question, "If you put the pharmacist behind Plexiglas, will that dis-courage interaction with the patient?"
Bill Balas, R.Ph., assistant director of outpatient pharmacies at Thomas Jefferson University Hospital in Philadelphia, said the issue of safety is a legitimate concern. Balas, a former independent pharmacist, acknowledged that balancing interaction with the patient while at the same time protecting the pharmacist in his or her work environment is a challenge. "How does it look when a patient is coming in for counseling and the most trusted professional is behind bulletproof glass?"
Balas suggested that being aware of the state of mind that some patients may be in after waiting in line for their prescriptions for long periods of time is something pharmacists should take into consideration.
Rutledge believes that there needs to be a greater awareness about workplace violence. "Organizations have to start thinking about this. They have to structure the physical layout of the pharmacy with safety in mind." Industry observers suggest that separating the patient counseling area from the drug storage area is a good start.
"It's an issue of balance between protecting the pharmacist in the work area and fostering a pro-patient counseling agenda," explained Balas. "You have to find a way around those roadblocks."
OSHA recommendations for a safe pharmacy environment