Tensions on the rise

Interviews with Australian pharmacists reveal the rise in conflict in pharmacy settings, and the resultant impacts since the pandemic began 

A series of interviews with Australian community pharmacists has revealed the nature and impact of rising levels of conflict within pharmacy settings since the COVID-19 pandemic began in early 2020. 

Analysis of the interviews outlined a growth of conflict levels with patients, as well as rising levels of internal conflict within pharmacies, and a rise in mental health and stress impacts. 

However some of the pharmacists interviewed also expressed the pandemic had led to a growth in their level of resilience and flexibility in their role.

Researchers from the Griffith University School of Pharmacy and Medical Sciences conducted detailed interviews with nine pharmacists, from urban, metropolitan and rural pharmacies, and with a varied demographic mix.  

“Preliminary investigation into the nature of community pharmacy conflict in the context of the COVID-19 pandemic identified seven interrelated themes,” the authors said.

“Relationships between conflict and individuals’ emotional responses to change, and its impacts, were uncovered. Participants also highlighted a lack of clear conflict management protocols in their practice settings.”

Interviewees reported that customer behaviour changes caused conflicts with staff, with reported cases of verbal abuse, physical abuse, and damage to property.

Some speculated that the failure to meet customer needs was a driving force for conflict, the authors said. Others reported COVID-related restrictions such as social distancing, purchase quantity limits, customer capacity limits, and access limitations to pharmacy and other healthcare services due to changes in operating hours and conditions of entry were major contributors to the conflicts experienced.

People often didn’t know and would ask us. Like what treatments would work [for COVID-19] or how do I get it, [there’s] too much unknown. And I think when people don’t know what’s going on they basically tend to freak out. They lose control of the situation and it makes people anxious really, not knowing what’s going on,” one interviewee said. 

Others commented:  “We had customers storm out when the wait time was more than 5 minutes.”

“… under stress, people don’t respond well. So, they take it out on the people on the frontline, which would be me and my staff.” 

“… conflicts happen because what the patient/customer wants – we can’t satisfy their needs.”

All interviewees said the pandemic was unexpected and felt community pharmacies were unprepared to deal with the sudden changes it caused.

Factors reported to contribute to these feelings experienced by participants in the early days of the pandemic included:

  • Disruptions in the supply chain
  • Lack of COVID-19 pandemic protocols or guidance which hindered the usual practice of community pharmacy.
  • Old technologies still being utilised in current workflows (e.g. fax machines);
  • Lack of personal protective equipment (PPE);
  • New legislation and government-imposed restrictions disrupting service delivery and business operations;
  • A large sudden increase in the number of customers due to changes in customer behaviour

The impacts of the pandemic had impacted the mental health and increased the level of work stress for community pharmacists, the participants said.

They also reported that workplace stress stemmed from changes in workflows, legal obligations to comply with new legislation and government-imposed restrictions, trying to maintain services during
the pandemic, and having to deal with an increased influx of customers.

“The usual methods to manage stress were also quite limited due to COVID restrictions which participants thought resulted in stress building up in individuals without any form of release,” the authors said.

One participant commented: “You find that mentally, you’re drained out in many ways because it
takes energy out of you to be able to deal with this disappointment or frustration or anger from customers or unhappy customers because it makes you feel down in many ways.

“It makes you feel as though you haven’t done the right thing. It almost makes you think it’s your fault.”

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  1. (Mary) Kay Dunkley

    Pharmacists and pharmacy staff who have experienced a negative interaction with a customer and need to debrief with someone who understands pharmacy can call the Pharmacists’ Support Service on 1300244910 to talk it over. The service is available every day of the year between 8am and 11pm AEST.

  2. jack7711

    Like every single pharmacy in Australia 2020, we were suddenly overcome with panicked phonecalls, an enormous surge in demand for unavailable items such as Ventolin, Plaquenil and bearing the anger as to why we couldn’t source it, a tenfold increased in faxes (with the associated administration burden) and then an increasingly hostile, demanding public.

    Literally became a punching bag for their uncertainty and stress. Despite our pleading, the non practicing owners smilingly derided our calls for extra help and stopped the practice of customer store limits (before this was mandatory) as they didn’t want profitability to be affected.

    We fronted up day in day out riding this wave while everybody else was in lockdown, doing our absolute best despite the uncertainty and potential risk to our own health and families.

    The end of 2020 was an exhausting record year in sales. Regardless of that, the owners of the pharmacy ‘forgot’ to give us a Christmas party. We were expected to just chug along like robots, pat on the back and get back to it…

    That is when I left community pharmacy….

  3. James

    This article is referencing the interviews presented in this recent research paper: https://www.sciencedirect.com/science/article/pii/S1551741121003211 (https://doi.org/10.1016/j.sapharm.2021.09.002)

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