Olivia McPherson stands outside a room at Grand River Hospital’s Intensive Care Unit, holding a phone to her ear as she meets the eyes of the patient on the other side of the glass.
“What medications do you take regularly?”
She takes meticulous notes as the patient inside answers.
“Has that changed in the last few months? What pharmacy do you go to?”
Olivia, a second-year pharmacy student, is conducting a best possible medication history (BMPH) and every detail she records informs decisions about patient care. Normally, a BMPH takes place at the patient’s bedside. But they are just one of many procedures at the hospital that changed in the wake of COVID-19.
Olivia is one of 226 pharmacy students who worked in community pharmacies, hospitals, family health teams and long-term care facilities across the province during the winter term. As the School of Pharmacy enters spring term, pharmacy students are heading out on more work terms and placements. These students provide much needed support for Canadians at a time when other frontline healthcare workers have been redeployed and community pharmacies are often one of the only primary care sites left for patients.
Supporting teams in hospitals
In hospitals, co-op students like Olivia help ensure care teams have accurate information for decision-making and support tasks like recommending appropriate antibiotics, suggesting dose adjustments and monitoring lab results and patient symptoms.
“BMPHs involve detective work,” Olivia says. “In many cases, patients in the Intensive Care Unit (ICU) may be unable to answer questions directly, so I spent a lot of time on the phone with family members, doctors’ offices and community pharmacies piecing the information we needed together.”
She began her work term in January and supported the ICU team as they prepared for COVID-19.
“My supervisor Sue Bryden-Cromwell was on the COVID-19 strategy group for the ICU, and I got to sit in and see how many factors need to be considered in pandemic planning. The complexity of the process is beyond what I could have ever imagined.”
By mid-March, the severity of the pandemic became clear for many Canadians, and Olivia, working in a frontline role at the Kitchener hospital, was not immune to the stress and worry COVID-19 causes.
“The anxiety of the situation was tough at times,” she reflects. “I had to have discussions with my roommates to clearly say ‘hey, these are the precautions I’m taking. I’m being extra careful to not bring anything home with me.’ But the ICU team is so supportive of each other and it was inspiring to be a part of that. I also was sure to reach out to the social support system I already had in place.”
Though her work term is now complete, Olivia has already taken a part-time job with the hospital’s Emergency Department.
Providing care for Ontarians in communities across the province
The pandemic has strained health-care providers of all types and community pharmacists are no exception. Joey Champigny is a fourth-year pharmacy student completing his patient-care rotation in the London region. These rotations are a requirement for senior pharmacy students; typically, students are assigned to one of fourteen regions throughout the province, completing six months of work across various health care sites.
COVID-19 necessitated changes in the structure and operations of these hospitals and community pharmacies and Waterloo pharmacy students on placement were affected as a result. 44 of the 120 fourth-year students had to be assigned to different locations and many experienced a dramatic shift in job duties as the sites pivoted to respond to what their patients needed.
Joey Champigny saw those changes unfold on his rotation at a Pharmasave in Ingersoll. Before COVID-19 struck, Joey split his time between medication dispensing and counselling and clinical tasks like sitting with patients to review their medications or discuss options for quitting smoking.
As the pandemic unfolded, services were altered to reflect the new necessities of physical distancing.
“Initially we encouraged patients to have their medications delivered. Some services, like vaccinations, had to be deferred so we did research on how best to do that,” Joey says. "It took some time, but eventually we received a shipment of PPE (personal protective equipment) so we could have appropriate safety gear. Plexiglass barriers were installed over the pharmacy counter, and later we decided to move to curbside pickup options.”
Throughout all this, pharmacy saw an increase in traffic — not just in patients with prescriptions and refills, but also in customers purchasing supplies for loved ones or simply looking for more information. The result was busy days for the pharmacy team and an increased pressure to serve as many needs as possible.
“There’s a certain amount of stress you carry simply being in a frontline environment,” Joey reflects. “If I was providing a patient with information in the aisles of the pharmacy, I’d put on the appropriate PPE, head beyond the plexiglass barriers and remind them about the importance of maintaining a safe distance,” Joey says. “Often, people just have concerns and want to talk to someone. There are lots of mixed messages out there and I’m grateful for the fantastic pharmacy community that has worked hard to ensure we have the latest information. Those resources helped me get patients the facts.”
Joey has now moved to his second rotation site in Stratford. He carries the advice of Ben Austin, one of his preceptors and an alumnus of the School of Pharmacy, with him.
“Ben said the pharmacist is like the quarterback of the pharmacy. The one who fields the questions and reinforces the team as a whole. In a time like this, where there are so many concerns and inconsistencies, I grew into that role, tackling those difficult conversations and questions.”
Olivia and Joey are just two of the hundreds of brave Waterloo pharmacy students rising to the challenge of COVID-19. The virus has changed everything, drastically altering what the students expected when they started co-op and rotations. It’s tested them, but it’s also made them stronger. In the last two months, pharmacists and pharmacy students have shown Canadians the critical role their profession plays supporting health from the frontlines.