“I started having work-related stress dreams”: What it’s like to be a pharmacist during the Covid surge

Richard Sigesmund is a pharmacist in Toronto’s east end. Here, he describes how the Omicron surge, staffing shortages and the overstretched health care system are affecting his work.

—As told to Isabel B. Slone

“I work at a small pharmacy in the east end. There are only three employees: me, another pharmacist and a pharmacy technician. We have a niche patient base, including a large number of low-income patients from the neighbourhood. Many of them require a lot of attention and have difficult medication regimens that need to be managed—some of our patients are on 15-plus medications and live in assisted-living complexes near our pharmacy. These people really need the pharmacy to go the extra mile for them, to make sure they continue to take their medication, and to understand why the meds are important for them to take. As pharmacists, we wear a lot of hats. We are general health care advisors, patient confidantes, sometimes social workers. Now we’ve had to put on an extra hat to make sure we continue to give patients the care they need.

“Omicron didn’t creep up on us. It was just suddenly here. My fear back in December was the possibility that our entire staff could be wiped out with Omicron and all three of us would be sick at the same time. The loss of even one staff member would put a strain on the others and potentially decrease the quality of patient care. I started to work on a contingency plan to bring in more staff, putting together a list of names of people who might be able to work for us with zero notice (as if they’re sitting around at home, waiting for a phone call), but it was just a hope and a prayer. Everyone’s in the same boat—pharmacist shortages due to Christmas, New Year’s and Omicron—and it’s just an exercise in futility.

“By the end of December, our pharmacy technician had Covid, so we lost a third of our staff. She’s the glue that holds the pharmacy together. She knows every patient’s individual needs, manages all the little things to ensure that our patients never run out of medication. Our other pharmacist, meanwhile, had taken a week of vacation, so I was completely on my own.

“The end of December is always a busy period in pharmacy. Traditionally, that’s when people start coming down with winter illnesses, physicians’ offices are closed, and patients suddenly remember they need to pick up their medication before New Year’s. The first day I was on my own, December 29, was one of the craziest days I’ve ever worked in my 23 years of being a pharmacist. It was almost impossible to take care of patients’ needs in a safe and sane manner. Even with all three of us it would have been an incredibly busy day, but being alone I didn’t know whether to scream or cry. The whole day was a hazy blur. I was doing my best imitation of an octopus—answering phones, checking orders, working with the clinic physicians to help answer questions they have, trying to keep up with the prescriptions that were coming into the pharmacy. At around 11 a.m., a physician came into the pharmacy to ask me a medication question, but the frazzled look on my face was enough for him to realize that he should slowly back away and try again later. For the first time in my career, I had to close the pharmacy gate so I could sit down for 10 minutes, have something to eat and drink and recompose myself.

“When you go see a physician, you book an appointment. In a pharmacy, it’s all walk-ins or call-ins. And when patients’ prescriptions run out, you can’t tell them to come back tomorrow. When I was in the pharmacy alone, the phone was ringing all day with patients needing prescriptions. I was preparing everything, responding to people asking if we sell rapid tests—we don’t—and playing mask police, monitoring every patient that comes through the door to make sure they’re wearing a mask. (Most days, I have to ask at least three patients to put a mask on and another half dozen to fix their masks so they’re over their nose and mouth.) The stress had me struggling to take a breath. With the constant volume of work, I didn’t have time to go to the bathroom, let alone take a break and refocus. The patients were understanding about the long waits, but that still didn’t ease the workload. I was completely despondent.

“Normally I work three days a week in the pharmacy and I spend the rest of the week as a volunteer, inoculating people at a pop-up vaccine clinic in the Durham region. But as the only person available, I worked six days that week—three of them nine-hour days all by myself at the pharmacy. It was exhausting. When I got home from work, my back was killing me, and I was getting tension headaches from the straps of my N95 mask. I started having work-related stress dreams where I was at the pharmacy, frantically trying to serve people who needed prescriptions. I feel like the experience aged me five years.

“The pharmacy technician is now back to work after 10 days of isolation, and we’re still playing catch-up. But the biggest issue is one that started before Omicron. Because it’s harder to see a physician right now, there are now serious gaps in health care, and a lot of patients are coming to us instead of their doctors. People usually turn to pharmacists for general medical advice, and, when we can’t answer it, we tell them who to see. Since the start of Covid, we’ve been fielding a lot of questions from patients who are unable to get medical help. I used to get asked, ‘Should I see a doctor for this?’ Now it’s, ‘I can’t see a doctor, what should I do?’ At the beginning of the wave, I was sending people to the hospital to get simple things addressed because family physicians and walk-in clinics were all too busy. The stress that community pharmacists face is not going away any time soon.

“What keeps me coming back is my sense of duty. My patients need me. I’ve been a pharmacist for over two decades, and this is the craziest it’s ever been. After having to work alone, I sure appreciate the job my co-workers do, taking care of the little things needed to keep a pharmacy running. I think in a month and a half, things will be much better. That’s what keeps me positive.”