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Pharmacy and attitudes PDF Print E-mail
Written by Nigel Brunsdon   
Tuesday, 09 February 2010 13:52

Pharmacy NSPI’ve had a couple of conversations this week about the way some people feel they are treated in pharmacies when they collect needles. This is something that comes up from time to time, both when I’m talking to injectors and also when I’m talking to pharmacy staff.

It’s even something I cover when I’m training pharmacy staff, and I think it comes from a lack of understanding by some people on both sides.

Pharmacies are an incredibly important aspect of needle distribution in the UK. And they have been ever since needle programmes started back in the 80’s.  One of the first was Boots the Chemist in Sheffield which started distributing free needles in 1986.

There are now around 2000 pharmacy programmes, they outnumber formal NSPs by about 3 to 1, and without them we wouldn’t have even a fraction of the coverage we need to get clean equipment out there.

Attitudes

So what is the whole issue with attitudes? Well, from conversations I’d had with injectors they often complain that they are treated with suspicion, mistrust, fear or even disgust by some pharmacy staff. But on the flip side I’ve also spoken to pharmacy staff who say they are treated with aggression and anger by injectors.

As I’ve said, this is something I talk about when training pharmacy staff and when talking to injectors in NSP. Both sides have the following expectations and attitudes:

 

Pharmacy staff 
 Injectors

Fear (of aggression)
Mistrust (shoplifting, lying)
Lack of confidence in their own knowledge

Fear (of aggression)
Mistrust (who will they tell)
Expecting to be questioned
Lack of confidence in staff knowledge

 
As you can see the expectations on both sides are mostly the same and these expectations colour the way people react to each other. If you go into a situation expecting a fight then you are going to be hyper defensive. As we already know, heroin users are more likely to be able to identify signs of disgust and anger in others (Study 1, Study 2), so is it any surprise that they are defensive when they enter a pharmacy? Of course there may be many reasons for the reaction they are getting; the worker may just be having a bad day, be tired, be busy, or they could be reacting because of a bad experience they have had in the past. What both sides actually want from the situation is the following:
 Pharmacy staff
Injectors

Respect/polite
Positive/friendly
Open
Confident (in their own knowledge)

Respect/polite
Positive/friendly
Open
Confident (in the workers ability)

 
Again it’s clear that both groups want the same thing. So, how can we achieve it?

I think when it comes to the confidence issues that this is a training need for pharmacy staff. Pharmacies tend to have a quite high turnover of staff and it’s usual for some of the bigger chains to have locum pharmacists who will only spend a short time in each branch, so training needs to be regularly repeated. It’s also important for all training to have a strong focus on attitudes as well as knowledge.

But most of it can be changed by people in both groups taking time to think what it is like for the other person and to realise that even if someone appears to be in a mood with them then it’s even more important to be polite, friendly and open.

Everyone is different

Of course in the same way that it’s not every heroin injector that shoplifts and gets aggressive in a pharmacy, not every pharmacy worker treats injectors with mistrust and suspicion. If anything the bulk of them are doing their best in a busy job, and in some cases they are fantastically supportive. Those pharmacies that are the most supportive also seem to be the ones who have very few problems with shoplifting and aggression – cause and effect?

Related links

For any pharmacy staff who feel they need more support running a needle programme can join the pharmacy discussion list, which is part of the National Needle Exchange Forum.

The recent NICE NSP guidance which talks about the need to move focus away from strict one to one exchange, which was historically one of the biggest causes of conflict in pharmacy provision.

Last Updated on Tuesday, 09 February 2010 14:24
 
Comments
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hn5226  - good article   |2010-03-02 05:44:18
avatar good article.

when i used to teach drug related info in a college and when i worked in a service that provided N/X i used to encourage students/ staff/ volunteers to go and get an exchange from a pharmacy posing as a drug user of there choice..

for those that tried it it really opened there eyes to the situation and some of the discrimination encoutered by IDU.

without fail those that did were more empathetic in there work.

worth a thought for training/ induction.
Nigel Brunsdon   |2010-03-02 05:55:10
avatar As I mentioned in the article there can be misunderstandings on both sides and this increases the effect of the possible discrimination.

Pharmacy provision is an essential part of the NSP system, and when its done well it can be great.

I recently developed some training for pharmacy workers (which received a NICE award) and when we ran it it became obvious that pharmacy staff are often really pushed for time and lack confidence, our training was only 2x 2hr sessions and I'm still being told a year later how helpful it was.

We have to remember that most times its young counter staff that have to deal with clients and that the situation as a whole is intimidating for everyone concerned.

I do like the idea of using it as training/induction though. I'm planning to write some secret shopper guidance soon.
hn5226   |2010-03-03 06:32:35
avatar yes, i'm not particulalrly calling out the Pharmacies on my previous comment and I agree that they are needed as part of a larger system of support for IDU's.

i agree with you and anecdotally can say that most pharmacies i came into contact with in previous roles lacked training/ support & governance. though some had particular probelems around attitude specific to the people they employed.

that said most pharmacies arent really set up for drug users, coming into contact with drug users tends to be a by product of the service they offer.

theres a bigger problem than attitude for me in Pharmcy NX historically, in that the lack technical knowledge they retained on IDU but again that brings us back to the points raised above.

would be intrested to read the mystery shopper guidance as i am also invovled in a small chartiy that delivers mystery shopper audits for daats.

cheers.
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