Drug Topics - October 8, 2007 - (Page 41)

41 found himself confused, disoriented, and without his discharge medications. The pharmacist tracked down the man’s psychiatrist, ascertained his medication regimen, and coordinated with local physicians so that the man was able to resume psychotropic treatment. Within days the man was stabilized. Not only was he grateful for the pharmacist’s help, but so too were the shelter staff (who had been concerned that his psychiatric decompensation could have potentially disrupted shelter operations). Pharmacists serving as first responders should also expect to encounter victims who have psychological reactions that involve medications. Some victims respond to stress by attempting to self-medicate, perhaps because they are confusing psychological stress with medical symptoms or because they are “attached” to their medications. For example, an observant pharmacist noticed that a cheery, friendly elderly woman seemed to be chewing two tablets of cephalexin. The woman reported, “I found these red pills, and they keep my spirits up.” The pharmacist gently but persistently intervened and learned that the woman was hoarding a full bottle of cephalexin. By intervening, it is likely that this pharmacist saved the woman’s life, or at least spared her from a dangerous overdose. While difficult to imagine, such unusual cases do occur in the aftermath of largescale disasters—in the days and weeks following the disaster event, the environment is typically disorganized and even obviously dangerous situations can be overlooked or fall through the cracks. It is important for all first responders to recognize that psychological reactions to disasters merit attention. Every first responder in a disaster will encounter victims who are compromised by stress, and, furthermore, all first responders are susceptible to experiencing stress reactions of their own. Psychological precautions First responders are not immune to stress reactions secondary to their relief efforts. A critical incident describes a situation where a first responder is at risk for being overwhelmed by his or her experiences. The Substance Abuse & Mental Health Services Administration (SAMHSA) suggests that first responders follow guidelines to minimize their risk. These guidelines can be adapted for pharmacists who are serving as impromptu first responders in disasters within their local area. First, it is essential for pharmacists to have their own disaster plan. This plan should be designed for use by the pharmacist and his or her family and loved ones. In addition to having emergency supplies (several days’ worth of food and water, a radio, batteries, etc.) on hand, the disaster plan should address different sce- narios, such as: “If we are separated at the time of the disaster, where should we plan to meet?” “Who would pick up the children if they were not with us?” and even “Will the local shelter accept pets or do we need to make arrangements with our veterinarian?” The overarching point of having a disaster plan is that a pharmacist-first responder should ensure the safety of himself or herself and his or her loved ones first. After all, if health professionals are to serve as local, impromptu first responders, they must be safe before they can help others. Next, it is advisable that first responders discuss with colleagues and employers their intentions to serve as first responders. If, for example, they may be away from work while volunteering as a first responder, it is important to have this understood beforehand. It can be stressful to return to work after serving as a volunteer, only to find that one’s absence was confused as a “vacation” or that colleagues were unprepared to cover the workload during a time when they themselves were strained by the disaster. Of course, some pharmacists’ occupational environments may already have plans for responding to a local disaster. If a pharmacist were to also commit to being a first responder, it would be important to avoid conflicts in responsibilities or overextending one’s efforts. In most areas, there are opportunities to join volunteer relief organizations, but usually this is only possible before a disaster. The American Red Cross (ARC), local emergency management teams, and the like not only coordinate relief efforts but often offer advanced training. When R.Ph.s are serving as part of a team of first responders, it is best that they have a clear organizational structure. Decision-making authority needs to be mutually understood, and team members should be aware of one another’s roles and responsibilities. This organizational structure greatly reduces stress during relief operations. Working in a disaster environment is obviously difficult and has the potential to strain interactions among first responders. Advanced training and practice is desirable, so that team members can work together as cohesively and smoothly as possible. First responders will likely be called upon to perform tasks unrelated to pharmacy or even health care—supplies need to be moved, meals needs to be prepared, etc. Flexibility is essential, and, as the saying goes, “There is no room for egos in a disaster.” Team strain can be minimized or avoided when members respect and trust one another. An important recommendation from SAMHSA is that teams use a “buddy system” to monitor for stress fatigue. First responders should not function in isolation. There are two responsibilities in being a “buddy.” First, buddies are responsible for monitoring how their colleagues are coping with the stress, and they should

Table of Contents Feed for the Digital Edition of Drug Topics - October 8, 2007

Drug Topics - October 8, 2007 Latebreakers Latebreakers in Depth Letters Rx Care Community Practice JP at Large 150 Years of American Pharmacy Hospital Practice Are You Getting Pharmacy's Message Across? Self-Care Government and Law Legal Q&A The Pharmacist as First Responder in Disaster Relief Technology Update New Products Advertisers Index Statement of Ownership Classified Viewpoint

Drug Topics - October 8, 2007

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.