‘They feel powerless.’

More than 60% of health workers have experienced poor mental health due to work, a new survey has found – and pharmacists are no exception

A new report by the Australian Council of Trade Unions, Work Shouldn’t Hurt, has found that 80% of working people have been injured, or become ill, or both as a result of their work.

The survey included more than 26,000 people, of whom 4,050 worked in the health sector, though the ACTU’s statistics did not include a breakdown between health professions.

 It found that 78% of respondents had been physically or psychologically injured or ill as a result of their work; 78% of respondents knew someone who had been seriously injured or ill as a result of their work; and 16% of respondents knew someone who was killed at work, or died from a work-related disease.

It also showed that in the last 12 months 47% of respondents were exposed to traumatic events, distressing situations or distressed or aggressive clients/customers; 66% of respondents experienced high workloads; and 31% of respondents had experienced occupational violence (abuse, threats, or assault at work by clients, customers, the public, or co-workers).

In the health sector, 59% of respondents were aware of current safety issues in their workplaces.

Seventy-nine per cent of health workers knew somebody who had been seriously injured or become ill due to work; 24% had suffered psychological injury, 16% physical injury and 40% both.

In addition, 62% said that they had experienced poor mental health due to work, and 66% said their employer did not know how to address workplace mental health.

Commenting on the report, Sydney pharmacy owner and PDL director for NSW Curtis Ruhnau told the AJP that PDL is regularly contacted by members concerned about workloads and aggressive customer behaviour.

“We do hear, from our members, that some of them are working with higher workloads than they feel comfortable with – and they’re unsure who to approach to talk to about it,” Mr Ruhnau said.

“They feel powerless, because they don’t feel that they can just change jobs if where they are working isn’t suitable for them.

“We know that people who are under stress don’t always make the best decisions, and that sometimes, if they feel they have no-one to turn to, they may make decisions hastily.

“That may contribute to an increased error rate, or at least an increased stress level for the pharmacist who is worried that they may make more errors.”

He said that recent member feedback, particularly noticeable over the last few years, indicated an increase in difficult interactions with patients.

“There would seem to be an increase in aggression from members of the public towards pharmacists,” Mr Ruhnau said. “Sometimes it’s simply somebody trying to intimidate a younger pharmacist, or attempting to intimidate somebody, particularly if they are younger, or female, or smaller.”

He encouraged PDL members to get in touch with the organisation if they have concerns about issues such as workload.

Speaking not as a PDL representative but in his own experience, Mr Ruhnau added that part of the problem is that pharmacists are not routinely taught self care concepts in the same way some other professionals are.

“In a previous position I was a tutor for first and second year med students – and they were taught, in the first semester of their first year, about mental health self care, peer support, workload, and how to deal with being low on the ‘totem pole’,” he said.

“I’m not aware of pharmacy students being taught any of this in anything like as comprehensive a manner as med students have been getting for years.”

The Pharmacist Support Service’s Kay Dunkley told the AJP that there were “definitely” messages in the ACTU report for pharmacy.

“Certainly, there are hazards in the workplace in pharmacy, and particularly exposure to psychological stress from difficult interactions with customers or patients, difficult interactions with other health professionals such as doctors, and there’s also a lot of people who are now more willing to be violent or abusive when they don’t get what they want from a pharmacist,” Ms Dunkley said.

“Pharmacists have a right to say no, and there are some people who don’t want to accept ‘no’ for an answer.

“There are physical hazards in a pharmacy workplace. They spend a lot of time standing up, they’re on their feet all day – that can put a strain on their back, their feet, their legs. It’s very common for pharmacists to experience varicose veins, for instance, and foot problems towards the end of their career if they’ve spent a lot of time standing in the dispensary.”

Ms Dunkley said that in severe cases, pharmacists may be physically attacked, such as in the recent South Australian case where a doctor, aggrieved that a pharmacist had reported concerns about his prescribing practices, attacked her with a knife.

She said that the hazards are also not restricted to the community pharmacy setting, but were also apparent in hospital pharmacy, and that pharmacists visiting people in their place of residence may also face danger.

“Psychological stress also applies in the hospital environment,” she said. “They’re dealing with life, death and trauma on a daily basis, as well as the pressure of work, and the throughput in hospitals can impact pharmacists in terms of workload. They may be particularly subject to psychological stress.

“There are also issues for people going into both nursing homes and private homes – sometimes people with dementia can be violent, and when you’re visiting someone in their personal home, precautions like making sure someone knows where you are and how long you’re going to spend, being aware of the exit points, are important.”

A pharmacist visiting a home for an HMR or to deliver medication may be vulnerable to attack from unsecured pets, for example; they also face hazards while travelling between locations.

Ms Dunkley encouraged pharmacists to be aware of occupational health and safety guidelines, such as the Pharmacy Board’s Guidelines for dispensing of medicines, which suggests that if script volumes reach 150 to 200 a day, resources such as interns or dispensary assistants be brought in to help the pharmacist; above 200 additional pharmacists may be required.

She encouraged self care strategies such as taking breaks during the work day, staying nourished with healthy snacks and water, and taking time to debrief or calm down following a difficult patient interaction.

She also suggested making use of the PSS’ resource “Managing Stress in Pharmacy,” available here, as did a spokesperson for Professional Pharmacists Australia.

“Our pharmacy members are the most accessible health professionals and play a vital role in managing medication safety and providing equitable access to medicines across the country,” said the PPA spokesperson.

“As the ACTU report has shown they, like other health sector workers, face risk to their physical and mental health through their work for the community. This is supported by 2017 pharmacy specific research by Monash University.

“Members of the pharmacy workforce currently report more perceived stress than has been reported for the Australian population as a whole but this appears to be no greater, or only marginally greater, than what has been reported for other health professions in Australia, or to what has been reported in other parts of the world.”

PDL members can contact PDL on 1300 854 838.

Readers who are distressed can contact the Pharmacists’ Support Service on 1300 244 910.

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