The dangers of burnout and stress


An “isolated, depressed” rural pharmacist has been suspended after supplying restricted drugs to customers without scripts and falsifying dispensing records over two years

In early 2010, the pharmacist in charge at a rural Queensland pharmacy was approached by two customers who requested Schedule 4 restricted drugs (predominantly steroids and other drugs associated with body building) without a script.

One of the customers claimed he was being treated for ongoing hormonal deficiencies, and sometimes the two customers attended the pharmacy together to request medication.

The pharmacist, who was also the proprietor of the pharmacy, admitted he felt physically intimidated by the customers and took the path of least resistance, supplying the medication requested.

Once he had dispensed the medication the first time, the pharmacist found it increasingly difficult to be assertive with the customers and say “no”, the Queensland Civil and Administrative Tribunal heard.

Between 2010 and 2012, the pharmacist supplied Schedule 4 restricted drugs to the two customers without a prescription, 94 times over 66 supply episodes with an approximate retail value of $8,442.72.

He also generated false electronic dispensing records in the pharmacy’s database, recording that the restricted drugs had been dispensed in accordance with a valid prescription.

During two hearings late last year, the tribunal heard that the pharmacist had been suffering from anxiety, depression and undiagnosed hypogonadism at the time of the conduct.

It accepted these conditions would have had some impact on the pharmacist’s assertiveness and decision making capacities.

In addition, the pharmacist was found to have worked very long hours and often worked as the only pharmacist in a remote, isolated community in a mining town.

He and his wife were described as isolated from close family and social support networks.

“He was relatively young and his wife was experiencing a difficult first pregnancy,” said the tribunal.

“These facts, together with the fact that he was suffering from depression, anxiety and undiagnosed hypogonadism, meant that he found his work and home life very stressful.”

The pharmacist eventually moved on from the rural pharmacy and found a new job as a clinical pharmacist at a major private hospital.

However his conduct caught up with him, and he was formally notified by AHPRA in late 2014.

In response, the respondent made full admissions to the alleged conduct.

The tribunal found the respondent understood the impact of his actions and was found to have made positive changes in his work life.

“[The pharmacist’s] level of insight has enabled him to find his preferred work environment in a hospital setting where there is greater collegiate support, stability and more regular working hours,” it said.

“He is now acutely aware of the dangers of burnout and stress. He was very aware of the impact of his misconduct on his family and of the need to ensure he has in place strategies to avoid burnout and stress in the future; the things which he feels contributed to his poor decision-making.”

The pharmacist was found to have acted in a way that constitutes professional misconduct.

Taking into account mitigating factors, the tribunal decided a one-month suspension of the pharmacist’s registration, starting from 1 February, was appropriate in achieving general deterrence.

While the respondent and Health Ombudsman agreed to a fine of $20,000, the tribunal did not consider it necessary or appropriate to impose a fine.

However in addition to the suspension, the tribunal ordered the pharmacist to abide by the following conditions, with an opportunity to review them after 12 months:

  • Practice only in an approved position;
  • Undergo a period of mentoring, with a focus on ethical decision making and dispensing, and strategies to resist pressure to dispense;
  • Complete an education course in ethical decision making; and
  • Complete an education course on appropriate dispensing of medicines.

Are  you feeling stressed, anxious or overworked? Contact the Pharmacists’ Support Service on 1300 244 910 (8am to 11pm) to speak with a volunteer pharmacist counsellor.

A free PSS manual, Managing Stress in Pharmacy, is available here.

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