“We offer flu shots, but have run out until the middle of next week.”

Unfortunately, my site is far from the only one parroting these words ad nauseam this past weekend:

http://atlantic.ctvnews.ca/n-s-pharmacies-having-a-hard-time-keeping-up-with-flu-shot-demands-1.1637675

In this article, it states that 60,000 people have been shot…er…vaccinated by their pharmacist in Nova Scotia when that number was expected to only be around 20,000. In addition, 435,000 flu shots have been distributed. That number represents 47% of the population, which puts NS in line to be the most vaccinated province in Canada. Those are some impressive numbers.

The first frenzy took place mid-Oct with media advertisements and statements from public health. Due to an administrative hiccup, my site had one pharmacist out of three with the authority to administer injections so we had to be creative with scheduling. Still, we managed to exhaust our initial supply and applied for another distribution. Then, the fever died down (pun intended). Things went quiet over the holidays with only the occasional inquiry. Then we get thrown a curveball from our sister province Alberta:

http://www.cbc.ca/news/canada/calgary/alberta-flu-cases-spike-5-deaths-confirmed-1.2482027

Not exactly a happy New Year to be sure.

Needless to say, this was a scary item to read online or hear on the 5 o’clock news. People reacted and started coming out in droves. When physicians’ offices began running out, pharmacies were the place to go. We had families calling from 45 minutes away to see if we had supply and offered the service. In saying yes, often the following question was “where are you located exactly?” People who had so far resisted getting vaccinated had their minds made up to receive one. Parents were bringing in their kids (5 years and up) and weren’t leaving even if it took a bear hug from mom or dad to control flailing limbs. It was pretty intense at the dispensary last week managing these requests. That is, until we burned through our relatively small supply and started to turn folks away.

Reports indicate that the flu season is only expected to peak in February and we’ve already begun to see a spike in positive influenza tests across the country. The FluWatch report issued by the Public Health Agency of Canada up to Jan 4 notes that cases are being reported in a higher proportion of adults 20-64, which is a change from last year. You can find the full report here:

http://www.phac-aspc.gc.ca/fluwatch/13-14/w01_14/index-eng.php

That last link took me awhile to digest. At least the graphs were varied and pretty-looking.

All in all, I believe we can surmise that pharmacy has strongly impacted awareness and access to the flu vaccine so far in our first season. Now, I say this with the caveat that the season is not over and final vaccination rates are not yet available.  Incorporating an injection service into our current processes is new, and it’s unpredictable, but I have to admit it’s been satisfying. Congratulations to all of my fellow colleagues who took the plunge and are embracing this new public health service with fervor and professionalism. If you’re like me, the overwhelming feedback from patients has been supportive and appreciative.

On that note, a quick story from Friday night…

A family of four from quite a distance away called to ask about having their kids vaccinated. One was 5, the other was 7 and their family doctor had no vaccines left. Once they arrived over the supper hour, I prepared the syringes and laid out the supplies. I had not uncapped the needle when the tantrums started. A boy and a girl were both convicted in the fact that whatever was going on was NOT happening on this night. The parents were worried that supply wouldn’t be there if they had to return and as it stood, I was down to about a half-dozen at that point. There were tears, and kids are slippery when they want to be. However, with a little patience, I was able to follow through without incident even though I wondered about them ever wanting to see me again. Five minutes later, the mom and a now sheepish little girl approached. The conversation went like this:

Mom: “What did you say? Did you want to tell him what you just told me?”

Girl: Hides behind mom

Mom: “She asked that if next year Dr. xxx isn’t able to give the shot again, would she be able to come see you?”

Me (in full blush): “Of course! You did very well.”

I found the rest of the night to be a bit of a blur 🙂

I hope we get our next allotment soon…

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.

Of course this site needs one. 2014 is a new year, and with a clean slate, what better time to evaluate what’s been happening and strive to make those changes that have been put off all year? Getting back to the gym 2-3 times a week, learning how to play the guitar, finally getting the house in order…of course all of these things will happen simply because you received a new calendar for Christmas and can’t wait to hang up the January picture.

Therein lies the rub: heightened expectations mean a bigger fall if we don’t achieve our goals. During smoking cessation sessions, one point that resonates is the dreaded ‘quit date’. After relaxing over the holidays, a lot of folks attempt to turn the page by making a New Years’ resolution that often sets the bar beyond what they have the confidence to achieve.

Practicing pharmacy has some parallels. At first blush it may not seem like it but weening ourselves off technical aspects of our jobs involves training of others, trusting of others and the actual letting go. The exacting nature of what we do makes this troublesome as we are so used to being the centre of the dispensary. Giving up any control at all is uncomfortable. Letting others ‘own’ a responsibility means they first have to be shown all aspects of the job then left to their own devices. If it gets screwy, then that ‘owner’ oversees the cleanup and resolution. I’m not at all suggesting that pharmacists don’t maintain an awareness of what’s going on, but as far as a drug distribution assembly-line is concerned, our role is becoming more and more the beginning (assessing appropriateness of therapy) and end of the process (counseling and follow-up). Anything that occurs in between should be evaluated and adjusted by those who are most directly involved. Occasionally this is a pharmacist, but more often than not, technical assistants are capable of running the show. Since this isn’t happening at my site yet, empowering members of my team to ‘own’ more than they have will be a precursor to any clinical goals I set.

Since a smooth workflow is conducive to a lower-stress day, checking prescriptions remains a priority that we balance with the newer clinical services. One of my resolutions is to avoid seeing patient interactions as ‘interruptions’ to the day-to-day workflow and embrace those opportunities to build relationships. Perhaps I can start with this suggestion from a former pharmacy professor:

https://twitter.com/RxDeanMac/status/416466843600044033

Simple, but the question is open-ended and your time commitment is predicated on the answer you receive. Now, truthfully, will I be able to follow my resolution 100% starting Jan 1st? I seriously doubt it in the sense that my routine for the past 12+ years has been largely technical in nature. Currently, checking and dealing with insurance issues takes up a large part of the day. While both provide a satisfactory service to a vast majority of patients, breaking this cycle is not something that comes naturally to my practice. That said, my goal is to take the initiative to invite a patient into an extended interaction each day (as opposed to waiting for it to happen). If wait times increase slightly from time to time because of this initiative and staff messaging to consumers is well-delivered, we can have the cake, and be able to have a nibble or two. I’m confident that performing within our expanded scope of practice will be sustainable, but also realistic and ultimately rewarding.

Stay tuned. I hope to have some wins to report in the near future. I also can’t wait to hear some of yours 😀

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.