Pharmacist Working A 16-Hour Shift Misfills Prescription For Psychiatric Medication
27 Jul 2007
Delaware, N.C. - A Wilmington pharmacist working a 16-hour shift dispensed the wrong psychiatric medication to a customer. The N.C. Board of Pharmacy decided to act.
It disciplined the pharmacist, but also decided to discipline an industry it says has ratcheted up workloads. The board tried to ban pharmacies from requiring pharmacists to work more than a 12-hour day.
The board also proposed that pharmacists get a 30-minute meal break after six hours, and an additional 15-minute break.
But the state's Rules Review Commission rejected the board's new rules, saying it has no authority to regulate pharmacy owners that way. The commission's action had nothing to do with the merits of the proposal, according to a member of its staff.
The Rules Review Commission is an eight-member group, appointed by the legislature, with wide-ranging power to kill rules and regulations adopted by other state boards and agencies.
David Work, executive director of the pharmacy board, says the board is determined to get the rules on the books. It will ask the commission to reconsider, and is prepared to go to court.
"We believe it's a safety issue,'' Work said. "We've had reports for years that pharmacists are just exhausted working 12-hour days. And that's common for pharmacists now.''
A variety of forces are combining to push drugstores to work their pharmacists harder. Demand for drugs is up as the pharmaceutical industry produces more drugs to treat more conditions, in some cases advertising directly to consumers. An aging population needs more drugs.
The way pharmacies get paid also has changed.
Prescription-drug benefits are now a common part of health-insurance plans. Those plans negotiate discounts with pharmacies, meaning the pharmacy makes a lower profit on each prescription filled.
The discount deals sometimes force pharmacists to act as interpreters of drug-benefit rules for doctors and their patients, a time-consuming job.
The demanding working conditions also create a catch-22: It's more difficult to recruit pharmacists to retail stores than to other settings, such as hospitals. So retail jobs go unfilled, putting even more demands on pharmacists in the stores.
The Wilmington error, which occurred in December 1997, involved an Eckerd Corp. pharmacist who gave a customer a drug for depression instead of the proper drug, which treats anxiety. The customer blamed the dispensing error for causing her to fall and hit her head during a party.
When the case came before the pharmacy board last May, the pharmacist testified that she made the mistake on a day when she was the only pharmacist on duty from 8 a.m. to midnight.
In disciplining the pharmacist, the board ordered her not to work more than 12 hours a day for the next two years. The board also ordered Eckerd not to require any pharmacists to work more than a 12-hour day at that location.
Presumably, a misfilled prescription is less likely to occur if a pharmacist works no more than 12 hours a day. Would an 8 hour day, worked by most Americans, even reduce the risk further?
