Outpatient pharmacist: “we’re approaching outright collapse!”

Max

Last Tuesday, on the shuttle back to the lot the driver said to us: “You guys know that after today all shuttles are cancelled?” All of us voiced assent (though I personally hadn’t heard before; I didn’t want to stand out at that moment). Then, pulling up to the shelter the driver opened the door: “God be with you all,” she said, and we were discharged into the rain.

I work at the University Hospital in the outpatient pharmacy. Last week Monday and Tuesday discharges were expedited to clear as many rooms as possible for anticipated demand. Between those two days, myself and four other technicians filled nearly 600 prescriptions.

On Wednesday the leadership team announced that the oncology pharmacy and children’s pharmacy would be combined into the outpatient pharmacy, and staff from those pharmacies would be amalgamated together. In addition, our respective patients would all be filtered through one pharmacy on their way out of the hospital.

I emailed the head of the pharmacy department expressing my concern over unnecessarily exposing oncology patients (who are already immunocompromised) to other discharge patients who might well be contagious. While initially downplaying my concerns I brought the issue back up again the following day during a specially convened meeting regarding the situation. Thankfully by the end of the meeting it was resolved that the nursing students would deliver medications to the oncology patients instead of having the patients come to the pharmacy.

This was a small victory.

For pharmacy employees, we are not allotted masks or other protective gear. We are down to 12 bottles of hand sanitizer to last us an indefinite period of time. We have some 30-ish bottles of isopropyl alcohol to make up the deficit, but we have no ability to get any more once those are exhausted. After that we’ll be forced to make do with a limited stash of hydrogen peroxide, and after those are used up, we’ll have no method of sterilization.

We are running out of alcohol prep pads for diabetic supplies. Steroidal inhalers are on shortage as are certain nebulizer solutions. Hydroxychloriquine and chloroquine, two critical drugs for transplant patients without any substitute, are entirely unavailable, and the limited supply we have has been consolidated for those in most need. Thermometers, masks, gloves, and probe covers are entirely unavailable. Despite this, nurses, doctors, assistants, and techs are required to monitor their temperature before going to work. Acetaminophen is even running low.

Even in the best of times hospital work runs about an inch away from chaos at any given time. Between burnout and critical shortages, we’re approaching outright collapse, and a further influx of patients is all that’s needed to push our pharmacies past that point.