I’ve performed many difficult tasks as a pharmacy manager.  I’ve remodeled a pharmacy, designed a new clean room, and started a chemotherapy program.  I’ve even worked with management to present a new contract to our unionized pharmacy staff.  But the toughest job I’ve found was working with people.

I remember when I first became a pharmacy manager.  I was green.  I wanted to do a good job. My boss had mentored me on how to do many exciting jobs.  Things like: preparing a budget, compiling an antibiotic report, and starting an automated IV program.

But I will always remember when he said that the hardest job that a manager will ever encounter was working with people.  Stuff like the budget, reports, and IV programs were easy. But managing the staff was the toughest job around.

Developing A Multitude Of Schedules

I was always making the schedule.  It never ended— how could it? I would finish a schedule, the time period would pass, and by then I’d have to have another one made.

 It wasn’t like a regular project with a beginning, middle, and end.  Making a schedule went on day after day, week after week, month after month, and year after year.  It went on forever!

I constantly had to come up with a schedule!  I always needed staff.  I had to have people working.  Thus, as one schedule was coming to a close— another had to start up immediately.  There was no lag time.  No overlap.  As one schedule ended another schedule had to begin or else I would have no staff working.

Plus I didn’t just make one schedule— I made several schedules.  I made schedules for the pharmacists, schedules for the technicians, schedules for the other managers, and schedules for the other staff members (secretary, stock clerk).

And these schedules were further broken down by job functions.  Thus, both the pharmacists and technicians had a six month schedule, a weekly assignment schedule, and a daily assignment schedule.  That way everyone would know what their job was each day.

As for the managers, I made a weekly on-call schedule, so they would know where their responsibilities would lie. And finally I made a schedule where I kept track of everyone’s sick call, holidays, and vacation time.

Providing Pharmacy Coverage

Flexibility was a key issue.  Nothing was engraved in stone.  I could make the perfect six week, or weekly, or daily schedule in advance.  And I just knew that there would be sick calls, or switches, or requested vacations that would disrupt my perfect schedule.  I had to be flexible because I was absolutely sure that things would constantly change.

But the schedule always worked out.  Now I’ll admit that there were times when I approached a given week or day and things looked bleak. But miraculously, sometimes even at the last minute, I had enough people to satisfy my schedule.

It might have taken a little manipulating or creative management.  Sometimes I would have to deviate from the norm and divide a shift or pay overtime.  But the schedule always worked out and my pharmacy was properly covered.

Managing My FTEs

In my pharmacy, I had 75 staff members which worked out to 57 full time equivalents (FTEs). So what is an FTE?  If one person works forty hours a week, they count as one person and one FTE.  If two people together work a total of forty hours, they count as two people, but still only one FTE.  If four people together work a total of forty hours, they count as four people, but still only one FTE.

So any combination of people working together to work a total of forty hours, counts as that many people, but only one FTE.

Thus I managed 75 people in the pharmacy which came out to 57 FTEs.

My boss and my vice-president liked to monitor my FTE usage.  Every pay period, they expected me to be as close to 57 FTEs as possible.

With all the data and things to review, I always thought FTEs were a strange statistic for my boss and my vice-president to monitor.  After all, if I was significantly over my FTE limit for a given pay period, it was an easy fix.  First, I’d get yelled at.  Then I’d just watch my overtime on the next pay period and my FTE number would drop to an appropriate number.

However, the big dilemma came if I was under the FTE number.  If I was below my allotted FTE limit on a regular basis— this was a disaster.  It showed that I could consistently run the department with fewer people than I was allowed. Then maybe upper management would jump to the conclusion that I didn’t need 57 FTEs. Then they’d lower my FTE allotment.

It’s to no advantage to be considerably under an FTE budget or any budget for that matter.  I’d rather get yelled at.

Just a side story, my hospital brought in a management consultant group to evaluate our pharmacy department’s efficiency.  They spent three days with us.  They monitored every function and activity that my pharmacy staff did.

After three days of intense observation, they determined that we should have 77 FTEs to ensure our efficiency.  This was twenty more than the 57 that I was allotted.

I found this quite amusing.  Imagine a consulting group telling upper management that I should have more people, more FTEs.

So I approached my vice-president.  I stated that the pharmacy had 57 FTEs and that the management consultants recommended that I should have 77 FTEs.  However, I realized that these were tough times for the hospital.  And the addition of 20 FTEs in the pharmacy would increase the hospital’s overall salary and benefit expenditures.

Thus, I was willing to compromise.  I was willing to meet in the middle.  We had 57 FTEs, the management group recommended 77 FTEs.  I was willing to accept 67 FTEs and call it even. I told my vice-president to give us 10 more FTEs (so we’d be at 67) and I would be happy.

I didn’t get the 67 FTEs.

Accommodating My Staff

When it came to the schedule, I catered to my staff.  I always did the right thing and I never did anything illegal or in violation of any rules. But, I didn’t care what the hospital thought or what other departments did or didn’t do, or even what Human Resources said.  As long as the pharmacy was properly covered, I basically did what the staff wanted.

I devised a plan called “The Shifrin Donut Theory”.  To better illustrate my plan, imagine if I were to go up to a pharmacy staff member and say, “What would you like to eat?”

“I would like a chocolate covered donut,” they might respond.

So I would get the person a chocolate covered donut.  As they were eating their chocolate covered donut, they might see someone else eating a bagel.

“Why are they eating a bagel, while I’m eating a chocolate covered donut?”, they might complain.

So I would respond, “Did you ask for a chocolate covered donut?  Did I get you a chocolate covered donut?  So don’t be jealous if someone else asked for a bagel and I got it for them to eat!!”

In other words if a staff member doesn’t want to be assigned to the IV room on their weekend to work I can probably manipulate the schedule so that staff member won’t be in the IV room on their weekend to work.  However, don’t complain if another staff member works 7AM to 3:30 PM on Tuesdays so they can pick their child up at daycare.

  Everyone had their requests. I would accommodate everybody.  And my staff knew it and would rarely complain.

Implementing A Unique Schedule

Of all the schedules within my department, I felt that my night pharmacists had the best schedule.  My night pharmacists worked 7on- 7off.

People generally work a 40 hour work week.  This constitutes 80 hours per two weeks or 80 hours per pay period.

Normally a night shift (in any job category or department) has always been a difficult shift to fill.  It’s very difficult to get people to work the overnight shift.  Therefore, many employers give perks or additional monies to entice people to work the overnight shift.

To attract pharmacists to work the overnight shift, I implemented a 7on- 7off schedule. Here is how it worked:

I hired four pharmacists to work the overnight shift.  Pharmacists A and B would start their shift on Sunday night and work the following schedule:

• Sunday 9 PM- Monday 7 AM
• Monday 9 PM- Tuesday 7 AM
• Tuesday 9 PM- Wednesday 7AM
• Wednesday 9 PM- Thursday 7 AM
• Thursday 9 PM- Friday 7 AM
• Friday 9 PM- Saturday 7 AM
• Saturday 9 PM- Sunday 7 AM

During the week while Pharmacists A and B were working, Pharmacists C and D would be off.  At the conclusion of the week that Pharmacists A and B worked, Pharmacist C and D would work the following schedule:

• Sunday 9 PM- Monday 7 AM
• Monday 9 PM- Tuesday 7 AM
• Tuesday 9 PM- Wednesday 7AM
• Wednesday 9 PM- Thursday 7 AM
• Thursday 9 PM- Friday 7 AM
• Friday 9 PM- Saturday 7 AM
• Saturday 9 PM- Sunday 7 AM

Meanwhile, Pharmacists A and B would be off.

Thus, the two teams of pharmacists would flip flop.  Two of the pharmacists would work for seven days while the other two pharmacists would be off for seven days. They’d alternate back and forth to provide adequate coverage for the overnight shift.

Two things that should be noted were

1. A pharmacist working 7on- 7off  was only working 70 hours (instead of the normal 80 hours) per pay period.   Nonetheless, this was one of the enticements in which a pharmacist worked 70 hours, but was paid for 80 hours.
2. Overtime generally occurred when a person worked more than 40 hours in a given week. But in this case, although the night pharmacist worked 7 days in a row, no overtime was paid because the night pharmacist was working their normal 70 hour shift.  Instead, overtime was only paid if the night pharmacist exceeded their normal 70 hour shift or was working a holiday and was paid time and a half.

Like other departmental employees, the night pharmacists were entitled to holiday time off and vacation time off.  It was nearly impossible to arrange coverage for the night pharmacists. So sometimes they covered for one another to accommodate each other’s time off.  Thus, the additional hours (at time and a half) plus the regular 70 hours were quite appealing to the night pharmacists.

But the biggest perk was the vacation scheduling. Since the pharmacists worked a 7on- 7off schedule.  It was not unusual for the night pharmacists to schedule their vacation during the time in which they were scheduled work 7 on.  Thus, the night pharmacist would be off for seven days. Then have seven days vacation time off (where they would have normally been scheduled to work). And then be off for seven days.  This works out to a three week vacation!

I always tried to accommodate the night pharmacist. And the money, overtime, and vacation enticements were outstanding.

But remember, it was the overnight shift.  It was from 9 PM at night to 7AM the next morning.  And even though the seven days off in a row was wonderful, the pharmacists were scheduled to work seven ten-hour shifts. As appealing as this may seem, it should be remembered that it’s very difficult to change one’s lifestyle and body’s time clock in order to work the overnight shift.

Establishing The Rules

In order for my schedules to work out, they had to have rules.  My schedules were governed by three rules:

1. Staff members could make any changes they wanted as long as I had coverage.  My staff members were constantly making switches with one another when it came to days, shifts, or weekends.  I did not mind these changes as long as the pharmacy had proper coverage.  Even switches that resulted in overtime didn’t upset me— since my overtime numbers and FTEs levels were outstanding.
2. If you don’t like the results of a switch, don’t switch.  When I first began the chemotherapy program, I stated that I would not schedule a pharmacist to prepare chemo for more than two days in a row.  One of my pharmacists made a switch with another person.  As a result, the pharmacist was now mixing chemotherapy medication three days in a row.  The pharmacist complained to me.I felt that I scheduled the pharmacist to prepare chemotherapy medication for two days in a row.  It was as a result of his switch, that he was now scheduled to mix chemotherapy medications for three days in a row.  So I told him that if he doesn’t like the switch, don’t switch.
3. If you make a switch which results in an inconvenient schedule (six or more days in a row, a late shift immediately followed by an early shift, two or more double shifts in a given week, etc.), you can’t call in sick in order to get out of it.  After many years of schedule making, I was very adept at noticing these things. And I made sure that the person was aware of them prior to the switch.

Final Thoughts

With all the difficult tasks that I needed to accomplish, making the various schedules was the toughest.  I needed to follow certain rules.  I need to make the schedule process easy for me.  I need to make my staff happy.

I succeeded in accomplishing all three of these things.