I’m Jewish. I don’t celebrate Christmas. It’s not my holiday. To me, it’s just another day. Now this is a tough concept for someone to grasp who celebrates Christmas. Because for those who celebrate the holiday, Christmas is a big deal.
After all, people adorn their homes with lights, decorations, and even giant inflatables. Some are even quite ornate. In addition, many families not only have a fully decorated Christmas tree, but embellish the inside of their homes with pictures, garland, and Christmas items.
It’s a special time for many families. They gather around the tree and open presents delivered by Santa. Furthermore, many people cook a vast array of food to serve their family members, guests, and companies that visit on Christmas day.
I don’t do any of that. Like I said, I don’t celebrate Christmas. To me, December 25th is just another day.
Dealing With Christmas
I was the manager of my hospital’s pharmacy department. I had 75 employees (pharmacists, pharmacy techs, supervisors, a stock clerk, and a secretary) working in the pharmacy.
Christmas was a major holiday. Many of my employees wanted it off. And I always tried to accommodate as many employees as I could. I was the only Jewish person in the department. But fortunately there were others who were able to work on Christmas Day.
One of the jobs of pharmacists and pharmacy techs was to provide a 24-hour supply of medication for each patient in the hospital. My pharmacy department prepared medication for about 20 nursing units, which translated to approximately 425 patients on a daily basis. Each nursing unit had at least one (some had two or more) unit dose carts. These unit dose carts held individual bins which contained the patients’ medication..
The pharmacists and pharmacy techs used technology to accurately fill each patients’ bins with the correct medication. For those meds not supplied by technology, the pharmacy tech manually added the medication.
After the cart was fully filled, the pharmacist checked the cart for accuracy, before it was delivered to the nursing unit.
The majority of the cart filling process took place on the overnight or 11pm- 7am shift. Minor adjustments were handled in the early morning hours. The carts were delivered by 7:30am.
I was the pharmacy manager of the department. I rarely performed staff work. And, in general, I didn’t work nights (11pm- 7am). But I did have an appreciation for my night staff members. Because, they regularly compounded IV products, supplied the ER and other night areas with medication, and provided emergency medication to patients throughout the hospital. Plus, on a nightly basis, the pharmacists and the pharmacy techs filled and checked medications placed in unit dose carts.
Thus, on Christmas eve, in an effort to give off to as many pharmacy staff members as possible, I worked the night shift. A pharmacy technician and I filled and checked the medications for 425 patients.
Working On The Night Shift
I’ve often referred to my night pharmacy staff people as the unsung heroes of the hospital. Forget about the actual work. The mere fact that they could function on such a high level while working from 9pm at night until 7am in the morning was truly amazing.
There were several things that I noticed about my night pharmacy staff
1) Although rules existed, any rules at night could be modified or even eliminated. From my perspective, as long as the work got done and nobody killed anybody, I was happy. And as long as the night pharmacy people did what they were supposed to when it came to the patient, then I was deeply satisfied with the quality of the work that my night pharmacy people provided.
I had an outstanding night staff in my pharmacy. They were a small group, usually two pharmacists and two pharmacy technicians. They compounded IV medications, handled emergency medication requests, and addressed issues. In addition, they filled and checked all the unit dose cart drugs that were delivered in the morning.
I did not micromanage them. And any high expectations were imposed by them— not me. I was very fortunate. My night pharmacy staff made decisions with the patients’ best interest in mind.
2) When I was in high school, I worked as an orderly in a local hospital over the summer months. Sometimes I worked the day shift (7am- 3:30pm), sometimes I worked the evening shift (2:30pm-11pm), and sometimes I worked the night shift (11pm- 7am). I enjoyed working the night shift the best. I felt that I had the opportunity to learn the most, during the night shift.
For example, when I worked the day shift, there were a plethora of staff members who worked in the hospital. As an orderly, I remember that I had to report to all pacemaker codes or situations where patients were having a heart attack. In fact, nurses, doctors, and residents had to report as well. Thus, during the day shift, there might have been over fifty employees in attendance. Most times, there were so many people that I couldn’t even get near the patient’s room.
At night, there were usually about only eight people at the patient’s bedside. I was always one of them. They were all performing tasks to treat the patient with the heart attack. And although the nurses and doctors were taking the lead, I was assisting them. It didn’t matter that I was an orderly with a limited medical background. They needed assistance treating the patient and I was available to help.
It’s the same way with my night pharmacy staff. My pharmacists and pharmacy techs were not always defined by their title or their job description. Instead, they formed a strong bond with their fellow workers and with the rest of the hospital’s night employees. And they acted by doing what’s best for the patient.
3) I saw it happening on the day and evening shifts. There was pettiness. This one was mad at that one. This one didn’t want to work with that one. This one wouldn’t go to lunch if that one was going to be there. And quite often, it was over stupid things.
There was also a great deal of pettiness throughout the entire hospital. I saw it in other departments. I found it between two or more departments. And I knew it occur in my own pharmacy department.
But not on the night shift. There was no pettiness there, or at least I didn’t see it. They didn’t have time for pettiness or the squabbles and arguments that disrupted the other shifts. They needed to work together. They needed to depend upon each other. And they needed to provide coverage and assistance whenever possible. They needed to be there for one another. Because no one else would.
It was the same way with sick calls. My night staff rarely called in sick because it would deeply impact their fellow night workers. Sometimes a day or evening person might call in sick because of an upset stomach, runny nose or scratchy throat. Or they might just want a mental health day. However, that would never occur on the night shift.
My night pharmacy staff would have to be almost dying (and then they’d still come in), if they would even dream of calling in sick. Why? Because my night staff knew that it was virtually impossible to get coverage (on a moment’s notice) for a sick call. And since I couldn’t get coverage, they’d just work short-staffed. This would infuriate the remaining night staff that had to work. They would blame the staff member who called out sick and become angry with them. No one would want to be a victim of their fellow staff members’ wrath. Thus, night pharmacy staff members only called out sick if it was a true emergency.
4) Night staff employees were often overlooked. Parties, activities, even hospital celebrations all took place during the daytime or evening hours. I remember when my hospital was celebrating its 75th anniversary. They decided to honor the various staff members of the facility. For the entire week, there were parties, barbecues, free meals in the employee cafe, and meetings with special presentations. There were even visits by high-ranking hospital administrators to the various hospital departments.
The hospital wanted to have a party for all the night time hospital employees. The party was held in the employee cafe at 2am. Every department manager and vice-president was invited to attend, so they could come and honor their respective staff. Aside from the CEO, who made some opening remarks, only the manager of Human Resources and myself (the pharmacy manager) were in attendance. No one else came for the night staff people.
But it wasn’t only with parties when the night staff was overlooked. Every three years, our hospital prepares for the Joint Commission Survey (JCAHO). It was the task of every department manager and head nurse to educate their staff on the topics that they needed in order to pass the JCAHO survey. (After all, the surveyor would ask the staff members key questions needed to pass the survey.)
As a pharmacy manager, I trained my day, evening, and night pharmacy staff on how to properly answer a wide variety of JCAHO questions. We practiced, rehearsed, and even role played, so my staff would feel comfortable with their responses.
When it came to the actual survey, the hospital’s day and evening staff members were fine. They were very good with answering the surveyor’s questions. But the problem came at 1am, when the surveyors came in to talk to the night staff. It was quite obvious that nobody had been trained, except for my night pharmacy people. Once again, the night staff members were overlooked. And the hospital was lucky that they passed the survey.
Believe me, I couldn’t work nights on a regular basis! As I said, I have a deep respect for night employees. And not just those that work in the pharmacy department. All night hospital workers should be greatly admired. They work a difficult shift and, quite often, with fewer staff members than other shifts. Yet, they are expected to perform as many or even more tasks than the day or evening employees.
Daniel Shifrin, R.P., M.S. is a recently retired pharmacist who enjoys sharing his insights about hospital pharmacy. He is proud to own one of the largest collections of Pharmacy Stamp First Day Covers.