No support: A pharmacy manager has spoken to the AJP about his experiences with multiple robberies over a decade, which eventually resulted in a diagnosis of PTSD
A Victorian pharmacist with nearly 30 years’ experience has spoken out about the lack of support for pharmacy staff who have been involved in a traumatic, violent event in the workplace.
James* has owned two different pharmacies in Melbourne, and for the past 14 years worked as a manager for what he describes as “one of the more violent pharmacies in Victoria”.
“It’s had 10 armed robberies in as many years, I experienced two of those myself where I was the person who was held up, and I was the first on the scene for three others,” he tells AJP.
In both robberies where he was present, James was held up with a knife.
In another where he came on the scene later, a man discharged from a mental unit had come to the pharmacy with a double-barrelled shotgun demanding to get his medications.
“Sometimes responding is worse than actually being there,” says James.
“After a holdup, the store’s shut down, you’re usually in the store for two to three hours talking to the police, the company go and source this corporate psychologist who has to talk to everybody – but they’re usually hopeless.
“I find the whole police aftermath to be just as traumatising as anything else. On one occasion, a policeman said to me: ‘Is anyone hurt?’ And I said, ‘no’. He said, ‘Oh that’s good. With a lot of the holds-ups now, they stab first and ask questions later.’ And you don’t want to hear that.”
James says due to a lack of support for pharmacy staff following traumatic events, violence soon erupted between his staff.
“The big problem we had in our workplace was that when we did have holdups, the organisation did next to nothing to support the staff. The efforts were very, very token and there was no screening done thereafter.
“What I also found in our store is, because we didn’t have any counselling, there became a lot of internal violence where I think people were struggling, not enjoying coming to work and were basically taking it out on each other, verbally, physically…
“We had staff assault [other] staff members, steal thousands of dollars’ worth of product and were caught, and at worst they were given a first and final warning – 12 months later, it would expire and they would do it again.”
He says the staff who were violent to one another had all experienced a holdup “at one stage or another”.
After experiencing his last holdup, James found he couldn’t cope with the experience.
“After the last armed robbery, I didn’t sleep for a few days, I could only sleep for like five or 10 minutes, I’d have a nightmare and then wake up. So I was just wrecked.”
He says he saw a doctor and then a psychiatrist, who down the track diagnosed him with post-traumatic stress disorder (PTSD).
“I was still at work the whole time. A couple of things that popped up during that treatment was that females often get treated early because they tend to let out their emotions. Guys don’t – guys hold it in. So, it’s like the duck swimming on the pond. You see a nice calm duck, but underneath the water the legs are paddling furiously. It’s particularly worrying for males.
“What actually got me in the end were the little things. It’s all the pressure being put on by staged supply, shoplifters, and internal staff issues, that’s the straw that broke the camel’s back.
“About 12 months after the last armed robbery, one weekend I just slept the whole weekend. Lost about six or seven kilos. And my wife just rang the doctor and the doctor said, ‘look, that’s it, you need a couple of weeks off work’.”
In the first months of treatment, “my psychiatrist contacted my HR department several times to try and put forward a return-to-work plan, a care plan – they weren’t interested,” he says.
“The law doesn’t require your employer to act in any good faith at all.”
James was put on WorkCover and, after just over two years on the program, was let go by his employer.
Urged to exercise duty of care
A spokesperson for the Pharmacy Guild of Australia urged all pharmacy owners to exercise a duty of care for their staff, and comply with all workplace and workers compensation requirements.
“We have recently issued guidelines around security issues affecting pharmacies, which include the provision of counselling as required after robberies or other incidents,” said the spokesperson.
The Guild also told the AJP that it recommended the use of outsourced Employee Assistance Programs (EAP), which involves employers providing a counselling and support service to assist employees with their mental health.
James told the AJP that while he attempted to access an EAP, there were too many barriers in the way.
“The silly thing is that, the company I worked for actually had an Employee Assistance Program. And I actually wrote to the company saying ‘I want to access this’.
“I was having lots of nightmares, I was having flashbacks and I was having nightmares about dying. And I thought, it’s time I stopped being a hero and do something about this because this is not right, it’s affecting my sleep which is therefore affecting my work.
“And every time I did they ignored it and said ‘yeah, I’ll get back to you’.
“Once I even rang up the company that they deal with as I had a business card. So I rang up and they said ‘no, no, no, you need to actually get an authorisation number from your HR person’.
“I contacted the HR person by email and said, look this is just what’s happened, can you issue that number?
“Never heard anything. At the time, as a male you think, should I do this? Should I not do it? And if someone doesn’t follow up, you just think it’s not meant to be. And you think, I don’t want to get people offside.
“Pharmacy is very very exposed and we’ve had a lot of people leave the industry having worked in our store, and very little is said, very little is done. There’s a lot of people suffering out there.”
What services are in place?
Pharmaceutical Defence Limited (PDL) says that following a holdup, there are services in place that pharmacies and their staff can access to provide support for their staff.
“The police offer counselling immediately afterwards and pharmacies insured with Guild Insurance also have their staff covered under their insurance policy,” explains PDL Professional Officer John Guy.
“The Guild Insurance for pharmacy is something worth knowing about and should be utilised,” he says.
PDL also encouraged pharmacists struggling after a traumatic workplace event to contact the Pharmacists’ Support Service (PSS).
“That’s staffed by volunteer pharmacists who are understanding and provide a listening ear, and they’ve got some counselling skills as well,” says Mr Guy.
“Unfortunately I’ve seen it before, everyone’s different – some people bounce back after a few [counselling] sessions, and others it can affect for years or all their lives.
“My advice would be to anyone involved in trauma or a holdup to get counselling early, not tough it out. I think the earlier they can get some help the better, because often it’s delayed I believe,” says Mr Guy,
“They think, ‘oh I’m alright, I can go back to work’, and then a few days later they fall in the heap. So early counselling and support would be imperative.”
James says following a traumatic event, pharmacists should look out for the warning signs.
“Sleep disturbance, repetitive nightmares – in terms of the emotion that they cause, the feeling of hopelessness, of death…
“Looking back now, my memory and decision-making was very affected, but I just put it down to stress. What I was basically doing when I was at work was that I would come home from work completely and utterly exhausted emotionally. And I would eat, go to bed, wake up, recharge just enough to get through the day ahead, and then collapse again.
“After a traumatic incident it’s very important for people to see a psychologist, to process the trauma – because if you don’t process it correctly, you [can] end up with PTSD.
“The situation I’m in now, I’m like almost permanently in that fight-or-flight state. People think I’m having a heart attack because I’m unconscious and my heart rate is through the roof, I’m perspiring… so then I end up in intensive care.
“They told me my symptoms are as severe as a Vietnam war veteran.”
He also recommends mental health screening should be done in pharmacies to help those who may fall through the cracks after the first rounds of counselling following a robbery.
“We should probably be doing some sort of screening thing in the pharmacy as well, after stores that go through a traumatic episode,” says James.
“When I speak to other pharmacists, I’m not Robinson Crusoe – there’s other pharmacists that are going through similar scenarios. It’s just no-one’s pulling it all together.”
He’s certainly not alone.
Last year AJP reported on a Tasmanian pharmacy staff member who had been threatened during a hold up.
In her victim impact statement to the court, the staff member said she had feared for her safety during the event, that she was personally threatened with the knife and was terrified that the defendant would use it.
She said that she did not think she “would get out of there”.
The pharmacy staff member was also diagnosed with PTSD, suffering from panic attacks and continued to have flashbacks and difficulty sleeping.
After a violent incident in a pharmacy such as a hold-up it is normal to feel some anxiety about returning to work and to feel a bit “jumpy” if anything happens which prompts thoughts of the event, says Kay Dunkley, Executive Officer of the Pharmacists’ Support Service (PSS).
“For example if someone enters the pharmacy wearing similar clothing to the perpetrator it may put you on edge as you normal stress reaction prepares you for ‘fight or flight’. Other common symptoms include emotional upset, fear, sadness, guilt, anger, sleep disturbance including unusual dreams and appetite disturbance.
“However these symptoms should resolve within a month. When someone has ongoing feelings of anxiety and stress for more than a month after a violent incident in a pharmacy such as a hold-up it is important to seek professional advice.
“Likewise if the symptoms are more severe than those described above and prevent return to work and normal routine professional advice should be sought earlier.
“Immediately after a traumatic event it is normal to want to talk about it and sometimes debriefing of those involved can be helpful, but if you don’t want to talk about it that is fine too,” says Ms Dunkley.
“It is really a personal decision which should be respected by others. However it is not healthy to try to ignore your feelings or to try to dull them with alcohol or other substances.”
Professional Pharmacists’ Australia (PPA) says any pharmacist who has been the subject of a robbery should seek support from the PSS or their treating medical professional “even if they think they are not affected as the impact of robberies and other traumatic experiences sometimes does not become apparent immediately”.
The group also told the AJP that under Occupational Health and Safety (OHS) Acts in each state, employers have a legal obligation to provide a safe workplace for their employees.
“We recommend that all pharmacies introduce a security protocol and have a plan of what to do if someone comes in and threatens them,” says PPA.
“It’s important that all staff know this plan and the protocols that have been put in place. PPA also believe that pharmacies should have a security alert system available for staff to activate if a robbery is in progress so police can be alerted immediately.”
*Name has been changed for privacy reasons
Affected staff can contact the PSS if they need someone to talk to. The organisation’s 1300 244 910 line is available 365 days a year, from 8am-11pm.
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