Should Pharmacy Staff Have Optional Breaks?

Pharmacists in Minnesota are fighting for the rights to take breaks and refuse to work more than 12 hours in a row.

Since September 2015, the Minnesota Board of Pharmacy has received more than 80 comments for and against a work conditions rule that would prohibit pharmacies from denying breaks and requiring pharmacy staff to work more than 12 consecutive hours.

The board also recently heard verbal comments on this subject at its regular board meeting on December 16, 2015, executive director Cody Wiberg, PharmD, MS, RPh, told Pharmacy Times.

During the comment period, those opposing the work condition rule tended to be from trade and professional associations, health systems, pharmacy owners, and pharmacy managers.

The National Association of Chain Drug Stores and the Minnesota Retailers Association submitted comments that suggested limitations on hours and uninterrupted breaks could “go against the professional judgment of a pharmacist for certain situations.”

In addition, CVS Health “strongly believes that a pharmacist should continue to manage their own work schedule and not rely on a board rule to dictate work conditions,” a company spokesperson commented.

Others in opposition to the rule said they feared consequences related to their schedule. For example, one commenter said his employer switched his schedule to 6.5-hour shifts instead of 13-hour shifts, which caused him to have to work 6 days a week.

Nearly all those in favor of the rule were pharmacists. One of the affirmative comments, which came from a physician who is married to a pharmacist, read:

My wife is employed as a pharmacist for a major retailer, and over a number of years, I have had the opportunity to observe what I consider to be potentially unsafe workplace practices. Working consecutive 11- to 13-hour shifts with inadequate or nonexistent breaks and being forced to stand during this entire period is by no means conducive to the mental alertness necessary for the competent conduct of the pharmacist’s professional responsibilities. The medical literature is replete with objective documentation of the deleterious effects of prolonged physician work hours on clinical decision-making. The practicing pharmacist is at risk for suffering the same degradation of professional competence in such work situations. These are of course conditions that would be deemed unacceptable to the vast majority of the American workforce charged with far less demanding occupations. Thus, I would vigorously request the board’s considering correction of this egregious and potentially unsafe situation.

Dr. Wiberg told Pharmacy Times that the pharmacy board has been making efforts to implement new rules on breaks and shifts since 2008.

In 2011, the board proposed a work condition rule that was a part of a larger package of rules, but former Minnesota Governor Tim Pawlenty asked the board to strike out the work condition proposal from the package.

Nevertheless, pharmacists have continued to communicate with the board since 2011 about a work condition rule that would address this issue.

It is also worth mentioning that board surveyors have noticed many pharmacies cutting back on staff. This change has amplified the problem, Dr. Wiberg said, and caused many pharmacists to be on duty for 12 to 14 hours with few opportunities for breaks.

“In the judgment of the board, having pharmacy staff work long hours without breaks makes it more likely that errors will occur, possibly leading to adverse events for patients,” Dr. Wiberg said. “So, the board is proposing this rule as a public safety measure.”

Some pharmacists said they saw breaks and limits on hours as an employee benefit, while others viewed the issue more as a way to take care of basic bodily needs, rather than an employee entitlement.

The majority of pharmacists said the work condition rule would increase safety for patients.

“Many of the pharmacists who commented in support of the rule mentioned that, in general, they often work long shifts without breaks and end up feeling stressed and fatigued,” Dr. Wiberg added. “Some mentioned that they ended up feeling shaky, light-headed, less mentally alert, or less able to concentrate.”

The rule that the board has proposed will not mean that pharmacy staff members are forced to take breaks; rather, they would be able to have the opportunity to take breaks.

Dr. Wiberg noted that opponents of the rule have given their own spin on the word “mandatory” to suggest that pharmacists will give up their professional autonomy if they are required to take breaks, but the rule does not mandate staff to take breaks if they do not wish to.

This also applies to shift conditions. Pharmacists should not be forced to work more than 12 hours consecutively, but they can still do so if they choose under the board’s proposed rule.

“In short, the board’s proposed rule is NOT a mandate on pharmacists, pharmacy technicians, or interns,” Dr. Wiberg explained. “The rule would give them more control over their schedule and breaks so that pharmacists, using their professional judgment, could decide if and when to take breaks or to work longer than 12 hours.”

In addition to prohibiting pharmacies from requiring staff to work longer than 12 hours, staff would also be allowed a 30-minute, uninterrupted break if they work more than 6 hours. Also, for every 4 hours worked, pharmacy staff would be allotted a sufficient amount of time to access a nearby bathroom.

Next steps for action on this issue are getting approval from the current governor’s office and then publishing a notice of intent to adopt rules following a hearing. This hearing would be before an administrative law judge, who could give the okay for the board to publish final order adopting rules.

Then, the work condition rule would go into effect 5 days after the publication of the order.

Considering all these next steps, it could take several more months for pharmacists to see change.

Dr. Wiberg added that the board gave him permission at its December 16, 2015, meeting to see through the final steps to get the rule adopted.

“However, it would not surprise me if the opponents of the rule lobbied elected officials in an effort to get them to put pressure on the board to drop the rule,” he said.

One other potential problem that could arise is the administrative law judge seeing a defect in the rule-making process.