Embracing the challenges


Western Sydney pharmacists Curtis and Margaret Ruhnau undertook a total rebuild during the pandemic, and survived while retaining their community focus

It’s now cliché that 2020 brought more than its fair share of challenges to pharmacists, as well as their patients.

For Sydney pharmacy owners Curtis and Margaret Ruhnau, and their third business partner, Matthew Quick, the issues around the pandemic were magnified by occurring at the same time as their pharmacy was undergoing a total revamp.

The redesign was forced on them by their suburban shopping being totally remodelled, and the pharmacy owners decided to seize the forced opportunity to remodel their store.

Their pharmacy is located in the western Sydney suburb of Emerton, near the somewhat notorious Mount Druitt area.

The suburb, as with much of the surrounding area, has a lower socio-economic demographic profile, with a sizeable indigenous community and large Pacific Islander community.

Curtis and Margaret overcame initial community, and even staff, scepticism about their staying power in the area. Before they bought the pharmacy in June 2000, it’d had a turnover of owners.

In fact, a long-time staff member, who has now worked in the same pharmacy for 46 years, told Curtis she had “seen off” three previous owners and that she’d be there when he were gone too.

However, after 20 years, their commitment to the community, and the reciprocal respect from their patients, are palpable when visiting the pharmacy.

Curtis is well known to many as a NSW director of Pharmaceutical Defence Ltd (PDL), owner of the AJP. He has been a director since 2013, and has played a leading role in recent efforts to raise awareness of the impact of stress on pharmacists and their staff. He is also focused on helping pharmacists cope with threatening and abusive behaviour from patients.

It all fits into a philosophy that he and Margaret have brought to their pharmacy, and have shared with their patient community: the importance of relationships, and of making your own head and work space a healthy and vibrant one before you try to help others.

Getting to know your people

Speaking of his pharmacy’s catchment area, Curtis describes a community that has its own sets of challenges and issues, and but says that once they embrace you, they are loyal and supportive and welcoming.

“Emerton is within an area which has a very low socio-economic status, and a very diverse range of nationalities (the Blacktown local government area has possibly the country’s most diverse mix of nationalities),” he says.

“We have tried to build up a team of people who all want to help our patients to live happier, healthier lives. They do this by helping them to understand their own health and how their doctors’ and our recommendations can help them achieve this.

“We have spent significant time outside the pharmacy going to meet people where they are. On top of going to local men’s groups and other senior groups, we have volunteered at a local diabetes and weight management service within an Aboriginal Controlled Health Service, been involved in various World No Tobacco Day events, and even been to a local child care centre where we encouraged and helped young parents to quit smoking,” he says.

“And in all of this we have encouraged our staff to get involved too, building their connection with our patients and their understanding of the needs within the area.”

Key pharmacy staff have completed the Centre for Cultural Competence Australia (CCCA) competency course, and while Curtis points out that “it’s been said that you can’t achieve cultural competency in front of a computer”, it does help to explain and demonstrate how Australia’s past has shaped the lived experience of so many of our First Nations People.

Recognising community leaders

I saw firsthand their commitment to their community when I visited the pharmacy to speak to Curtis and Margaret.

Their redesigned pharmacy has three private consult rooms, each of which is named after an important community leader.

One of these distinguished leaders is Aunty Rita Wright, a Muruwari woman from Brewarrina in western NSW and a member of the stolen generation.

Aunty Rita, whose story was featured in the Stolen Generation documentary Servant or Slave, has lived in the Emerton area for many years and is a recognised leader of the indigenous community.

Fortuitously, she visited the pharmacy with one of her grandchildren during my first visit.

She is proud of her life and work, and also of the recognition bestowed on her in the pharmacy, posing for a photograph outside the Aunty Rita Wright consult room, which features a plaque detailing her life.

Aunty Rita says Curtis and Margaret, and their team, are very much part of the community and respected for their advice and work with the locals.

The other two consult rooms are named after:

• Uncle Wes Marne, a now 98-year-old indigenous community leader and storyteller (Bigambul, but has lived on Darug land for more than 40 years), who was involved in establishing the Aboriginal Men’s Shed in western Sydney, and has advocated for his community in many social and health areas.

• Barry Robson, a local man who, since 2003, has been president of the Asbestos Diseases Foundation of Australia. He was also foundation president of the Blacktown Mt Druitt Cardiac Support Group. He still lives in the area and visits the pharmacy.

What a time to rebuild!

A perfect storm of sorts hit the pharmacy early in 2020: demolition of the existing shopping centre commenced in mid-February, and by early March, the pharmacy staff were forced to work with the constant background of jack hammers and other machinery.

And of course, the World Health Organisation declared a pandemic on 12 March, just as this demolition was beginning in earnest.

As a result, not only were the staff working in already extremely difficult circumstances, they now faced the same run on medications, hand sanitisers, sanitary products, etc, as other pharmacies.

And on top of this, flu vaccinations started to arrive—all this in one week, with regulatory restrictions on children’s Panadol and other products soon to follow.

So serious did the situation become, Margaret told dispensary staff to slow down and work at a safer pace to reduce their stress, and reduce the possibility of errors.

While all this was going on, preparations began for the move and rebuild. They began to move stock on 24 March, and they closed early to move the dispensary five days later.

Curtis says the stress levels in the pharmacy were so high that they enfored shorter working hours, including on weekends.

It was all worth it

Now that the dust has settled, and everything is operational in a shiny new premises, which re-opened on 9 September, Curtis, Margaret and their team seem very pleased with their new-look pharmacy.

There are three consult rooms, two larger and one smaller, each feature soundproof walls and the smaller with louvre windows to allow for privacy, but also visibility. This room also contains a safe disposal chute.

A spacious dispensary, with a new automated dispensing system behind it, allows for a smooth and efficient workflow.

And to show their adaptability to changing circumstances, Margaret added hand sanitising stations into the design mix while construction was ongoing. Two of these are now installed in the pharmacy for patients, with another in the staff room.

The pharmacy focuses on a range of professional services, offering blood pressure checks and sleep apnoea testing, as well as others.

“We also offer methadone, with a focus on that and on the space being both safe and discreet for our methadone patients. We also do needle exchange (through the Pharmacy Guild) and sharps return (through Blacktown Council)—and all are done in the Aunty Rita room,” Curtis says.

“We also focus on diabetes, a huge and growing need in our area, compression garments and, yes, BP and sleep as well as dose administration aids.”

Curtis emphasises that for DAA services they charge a fee “among the highest in the area, in line with the service provided by our dedicated DAA pharmacist and the system we have built to make this as rewarding as possible for the patients, their carers and our pharmacists”.

In fact, Curtis emphasises the importance of their DAA service: “The DAA room… with a dedicated area for dispensing and patient profile maintenance, as well as an area for DAA preparation, underpins our belief that personalised medication management is a core part of what Community Pharmacy should, and can, be providing”.

All about the people

“It has taken years to get here but we have an amazing group of people working with us,” Curtis says.

“They are empathetic, friendly, open, and although many may be young in years, their commitment to our people and their impact on the health of the population cannot be understated. Without them we couldn’t possibly achieve what we have.

“I have been asked why we have such a diverse racial mix within our staff. My answer was simple; we hire the best people for the job.”

Margaret says, “We want to be a Best Practice pharmacy regardless of our patients’ demographics. No matter where we were, our practice would be the same. We would meet them where they are and take the time to give them the best we can. They deserve no less.”

“In short, we haven’t changed our practice. It’s just a reflection of the pharmacists we want to be.”

Learning to cope

Curtis has become very active as an advocate for pharmacists learning to look after themselves first.

During a webinar hosted by the AJP, Curtis described the stress he himself experienced in 2020, and how learnt to confront and deal with this.

“We pharmacists don’t always understand that it’s OK to seek help, that there are times in our lives when the situation becomes overwhelming, and feeling bad is a response to that. And that it’s OK to feel bad and to then seek support and advice,” he says.

“This year I’ve needed to seek some professional help to cope with everything 2020 has thrown our way.”
“The tools in my mental health kit simply weren’t getting the job done and the realisation came at a time when something went wrong in the pharmacy and my reaction to it was out of proportion to the situation,” he says.

“Don’t get me wrong, it was a serious problem. I couldn’t sleep properly, I was running over and over the situation in my head and could feel myself spiralling.

“It’s a hard thing to admit… but I knew that I needed to speak to someone to get a few more tools in the toolkit. I sought help,” he says.

Curtis says pharmacists must learn to “normalise those feelings that we’ve all had, and allow ourselves to listen to people talk about some coping strategies that they’ve learned and recommend, and to understand that we are all feeling those feelings. We’re all in the same boat”.

Emerton + Amcal Pharmacy Key Statistics

  • Size: 260m²
  • Special features: three consult rooms, one of 10m², two others each of 11m²
  • Staff: 17, plus Curtis and Margaret
  • Number of pharmacists: seven, plus two interns and three pharmacy students
  • Patient comments: “A friendly family Chemist with old fashion service, and advice.”
  • “A chemist you can trust. Great customer service from all staff.”

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