Dealing With Challenging Shifts as a Locum Pharmacist

Every locum pharmacist knows the feeling: the mix of anticipation and uncertainty before walking into a new pharmacy. While most shifts are straightforward, the reality of locuming is that you will eventually face a truly challenging day. It could be a chaotic dispensary, inadequate staffing, or difficult patient interactions.

These shifts are a test of your professionalism and resilience. The key isn't to avoid them, but to have a strategy to navigate them effectively, ensuring patient safety and protecting your own well-being. Here’s a practical guide to handling those tough days.

Before the Shift: The Pre-Emptive Strike

Preparation can turn a potentially disastrous day into a manageable one. Setting yourself up for success starts before you even arrive.

• Do Your Homework: If you've never been to the pharmacy before, do a quick search. Check its opening hours and location on Google Maps. If you know other locums, ask if they have any insights. Knowing what to expect is half the battle.

• Confirm Key Details: A quick call or email to the pharmacy manager or your agency can prevent major headaches. Confirm your start/finish times, lunch break arrangements, and, most importantly, the staffing levels. Ask: "Who else will be on duty with me? Will there be an Accuracy Checking Technician (ACT)?"

• Pack Your Survival Kit: Don't rely on the pharmacy having everything you need. Pack your own essentials: a water bottle, some snacks, a reliable black pen, your GPhC number, and a pocket BNF or access to the app on your phone. Having your own tools gives you a small but significant sense of control.

During the Shift: Strategies for Staying Afloat

When you find yourself in the middle of a chaotic shift, your priority must be patient safety. Everything else is secondary.

When Faced with an Overwhelming Workload:

• Triage and Prioritise: You cannot do everything at once. Focus on the essential, safety-critical tasks. This means clinical checks and final accuracy checks on prescriptions for waiting patients take precedence over routine admin, phone calls, or date-checking.

• Communicate with the Team: Be calm, clear, and direct. Say, "Okay team, we're under pressure. Let's focus solely on getting the waiting prescriptions done safely." Delegate tasks clearly and empower your support staff.

• Manage Patient Expectations: Ask your counter staff to give realistic waiting times. An honest 30-minute wait is better than a broken promise of 10 minutes. This single step can prevent the majority of patient complaints on a busy day.

When Faced with Unfamiliar Systems or Unsafe Processes:

• It's Okay to Ask: Never be afraid to ask, "How do you normally process this here?" or "Where can I find your Standard Operating Procedures (SOPs)?" It is a sign of a safe, responsible professional, not a weakness.

• Trust Your Clinical Judgment: If a local process or a colleague's suggestion seems to contradict professional guidance or feels unsafe, do not do it. Your professional judgment and adherence to GPhC standards are your ultimate safeguards. Politely state, "For safety reasons, I'm going to have to do it this way."

When Dealing with Difficult People:

• De-escalate, Don't Engage: Whether it's a frustrated patient or a stressed colleague, remain calm and professional. Don't raise your voice or take it personally. Use neutral language like, "I understand your frustration, let's see what we can do to resolve this."

• Do Not Skip Your Break: This is non-negotiable. Even 15-20 minutes away from the dispensary is essential to de-stress, clear your head, and reduce the risk of making a fatigue-related error. Step away, eat something, and breathe.

After the Shift: Decompress and Follow Up

How you handle the hours after a tough shift is crucial for your long-term resilience.

• Leave Work at Work: Have a routine to decompress. Listen to a podcast on the drive home, go for a walk, or call a friend to talk about something completely unrelated to pharmacy. Consciously draw a line under the day.

• Reflect and Learn: Once you've decompressed, reflect on the shift. What were the key challenges? Were they a one-off, or indicative of systemic issues at that pharmacy? What did you handle well, and what could you do differently next time?

• Provide Professional Feedback: Give factual, constructive feedback to your locum agency or the pharmacy's area manager. Focus on patient safety issues or unsustainable working conditions rather than personal complaints. For example, "The workload was too high for the staffing level provided, which could compromise patient safety."

• Know When to Say "Never Again": You are in control of where you work. If a pharmacy is consistently unsafe, unsupportive, or chaotic, you have the right to politely decline future shifts there. Protecting your GPhC registration and your mental health is paramount.

Challenging shifts are an inevitable part of the job, but they are also an opportunity to prove your mettle. By preparing properly, prioritising safety under pressure, and reflecting afterwards, you can handle anything that comes your way.