Patient Aggression

Your pharmacy should feel safe. Not only to your patients, but to you and your staff as well. Unfortunately, patients can get angry, and things can get unruly pretty quickly. Burglaries, crime, and angry behavior in healthcare workplaces. was endemic even before the COVID-19 pandemic and opioid epidemic. But now, bad behavior is even more common.

According to the 2022 Healthcare Workplace Safety Trend Report produced by Stericycle, 71 percent of healthcare providers believe COVID-19 has had a negative impact on their sense of safety in the workplace. A whopping 82 percent of healthcare workers reported experiencing at least one type of workplace violence during the pandemic, and 64percent have been verbally assaulted.

That general data is echoed by the initial findings of the 2022 National Pharmacy Workplace Survey sponsored by the American Pharmacists Association (APhA) and the National Alliance of State Pharmacy Associations (NASPA).

“Workplace issues across pharmacy practice and their relationship to personal well-being and safety continue to be a critical issue,” said Ilisa Bernstein, PharmD, JD, APhA interim executive vice president and CEO. “We are concerned to see the most recent reporting confirms observed trends of pharmacy staff encountering threats and harassment from patients, consumers, and work colleagues.”

Reported experiences included verbal, emotional, and sexual harassment; threatened or actual physical harm; and micro-aggressions. In addition, incidences of threatening emails, social media harassment, and doxxing have also become more common. Doxxing involves the release of personal information online, including contact information or home addresses.

Spalitto’s Pharmacy in Kansas City, Missouri, has survived and thrived through rough times and tough customers since 1929. Anthony Spalitto, pharmacy manager and great-grandson of the pharmacy’s founder, works alongside his father, Pete Spalitto, pharmacy owner, and cousin, Tony Spalitto, PharmD. Anthony said the family-owned business emphasizes empathy.

“My dad always says, ‘Our patients are on medications for a reason,’” he said. “That thought reminds us to sympathize with what they might be facing—they’re sick, they’re worried, they don’t feel well, and more. It helps us stop and listen.”

Rise in robberies

The rise in opioid addiction has resulted in a rise in pharmacies singled out for burglaries or robberies. Not surprisingly, oxymorphone, oxycodone, methadone, Percocet, Xanax, and Valium are the most common drugs to get stolen, according to the Drug Enforcement Administration. Even cough syrup makes the list as it can be used as a party drug and is not classified as a controlled substance.

In the past 10 years, Spalitto’s Pharmacy has been burgled about five times—fortunately, all occurred while the store was closed.

During one break-in, thieves cut all electricity and entered the pharmacy through the roof. Because the electricity was cut, there was no alarm. Burglars were in the pharmacy from late Saturday night to early Monday morning.

“We don’t know of a vulnerability until something happens,” said Spalitto. “Now we have a wireless alarm system with remote monitoring, and we receive notifications via text and phone. We have an attitude of learn and adapt.”

A philosophy of learn and adapt is indicative of community pharmacy as a whole—and it has served Spalitto’s Pharmacy well for 93 years.

Workplace Violence Defined

According to the Occupational Safety and Health Administration, workplace violence is “any act or threat of physical violence, harassment, intimidation, or other threatening, disruptive behavior that occurs at the worksite. It ranges from threats and verbal abuse to physical assaults and even homicide.” Sexual harassment is also considered workplace violence.

What To Do if You Are Robbed

If you’re robbed, it’s easier said than done to avoid panicking . But try to keep in mind this advice from the DEA.

Comply: No matter what, your top priority is the safety of you and your employees. Do exactly as you’re told—nothing more and nothing less.

Move slowly: Sudden movements might provoke an already skittish robber.

Be a good witness: Look for and try to remember as many details as you can. Focus on race, height, weight, build, piercings, tattoos, hair, facial features, clothing, and shoes. Is the robber left- or right-handed? Were there emblems on clothing? Was there an accomplice?

Keep the note: The majority of pharmacy thieves pass notes. If you can hang on to it, do.

Aftermath: Call 9-1-1. Lock the store. Secure the note, the scene, and anything left behind. Do not touch anything. Try to provide a detailed description of what was stolen.

Live, Learn, and Improve

Anthony Spalitto, pharmacy manager of family owned Spalitto’s Pharmacy in Kansas City, Mo., suggests a few hard-won tips to counter robberies.

  • Use a wireless alarm system with remote monitoring. Thieves may cut the electricity.
  • Clearly label all motion sensors and security cameras. “Breakroom door” is much clearer than “Camera-13,” especially if you’re looking at a text message in the middle of the night.
  • Reach out to local police. Response time to one break-in took around a half hour, said Spalitto. He contacted the Kansas City police and discovered pharmacy burglaries weren’t highly prioritized. Once he explained thefts included narcotics and other drugs, the police department raised the priority, quickening response times.

Keeping Calm and Carrying on

While you may not be able to completely cool down a heated situation with a patient or customer, you can avoid raising the temperature by following these four dos and a don’t.

  • Do forgive quickly: Often, your patient will apologize. Even if not, cut them some slack. Smile and shake hands. This helps them recover some respect and shows your professionalism.
  • Do mind body language: Don’t cross your arms, which is a sign of defensiveness. It may be appropriate to smile, but take care not to look patronizing. You want to show you’re concerned because you are concerned.
  • Do mirror verbal language: Listen. Then once your angry patient has simmered down, use their words to reiterate frustration. By maintaining the same language, you show you’ve listened and understood.
  • Do offer options: No matter how maddening the circumstances, alternatives will bubble up. Offer some choices to your patient so they can own the solution and feel more in control.
  • Don’t interrupt: Let your patient let off some steam. You deal with similar problems every day—they don’t. It’s tempting to cut them off and offer a solution. Don’t. Give your patient a reasonable time to vent.

From the Magazine

This article was published in our quarterly print magazine, which covers relevant topics in greater depth featuring leading experts in the industry. Subscribe to receive the quarterly print issue in your mailbox. All registered independent pharmacies in the U.S. are eligible to receive a free subscription.

More articles from the December 2022 issue:

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