Pharmacists across the province took notice when a province-wide state of emergency was declared July 8, 2017. As key health-care providers, they knew that the people being evacuated would need a pharmacist’s expertise. Many patients turned up in Kamloops after being evacuated from Clinton and surrounding areas.
Kamloops pharmacist and BCPhA board member, Julie Ford, knew she could help. “I was in Williams Lake in 2010 when the Cariboo was evacuated and remember how anxious and upset people were about missing their medication. I knew that this time I could coordinate a group of Kamloops pharmacists to help these people out.”
On July 9, pharmacists began arriving at the evacuation centre at Thompson Rivers University. One of the first volunteers on the scene was Marcie Decker, a recent UBC grad working at Shoppers Drug Mart #0261 in Kamloops.
Decker welcomed evacuees, answered questions and helped patients get emergency fills of prescriptions. “Anxiety was running high,” Decker says of the patients coming in. “We were counselling them on what they should be doing.”
Many of the evacuees left home without their medications, or they were running out of medications and didn’t know how to get a refill. Still others needed glucose strips or inhalers to deal with the smoke.
One woman told Decker that her cancer medication was being shipped to her home, and wasn’t sure how she was going to get it. “How awful. She was worried about getting her cancer medications while her house was burning down,” says Decker.
Using emergency powers
After consulting members, the College of Pharmacists of BC, the Ministry of Health, and private payers about the wildfire, the BC Pharmacy Association issued a reminder of two important College policies: Professional Practice Policy-31: Emergency Refill Prescriptions and Professional Practice Policy-25: Pharmacy Disaster Preparedness. These allow pharmacists to use their professional judgment and education to provide an emergency prescription refill to ensure continuity of patient care until the prescriber can be contacted for authorization.
“It’s a shame sending people to the emergency room when pharmacists can be part of the solution,” says Chris Cameron, Pharmacy Manager with Pratt’s Pharmacy in Kamloops.
“We already have a shortage of primary care physicians in Kamloops,” adds Ford, “We really wanted to avoid creating a burden on medical clinics in the area.”
From bad to worse
On July 15, winds picked up and Williams Lake was evacuated. Now 10,000 people were on the move and the volunteer pharmacists in Kamloops were getting very busy.
Ford notes that when Williams Lake was evacuated evacuees started coming through the night. The volunteers set up a table, put up a sign, and started helping patients.
The emergency services volunteers would check in the lines to see if evacuees needed help and then escort them to the makeshift pharmacy. Pharmacist volunteers helped patients with a variety of needs including diabetes, heart medication and methadone.
For patients who didn’t have the means to leave the evacuation centre, the pharmacy now had a fridge to store medications and some over-the-counter medications. Once the team identified a patient's needs, the patient was directed to a pharmacy that was most helpful or arranged to bring their medications back to the team evacuation centre.
Everyone in town stepped up to help. The pharmacy team organized an email distribution list to schedule volunteers for four- to eight-hour shifts. Back at their stores, colleagues changed shifts to make sure the evacuation centre had pharmacist coverage. Pharmacies donated supplies such as first aid materials, OTCs, EpiPens, glucometers, needle and sharps containers and wound dressings.
The volume and pace was intense. The volunteer pharmacists had never done this before. Of her time at the centre, Ford says, “I have never seen such a large group of people look so devastated and desperate. People were in shock. They didn’t know when they could return home, or what they would return to.”
Help from around the province
The closure of Highway 20 in the Chilcotin region, an important connector between remote communities and Williams Lake, meant many people were unable to get their prescriptions. Patrice Gordon, a nurse practitioner in the Chilcotin, needed help from pharmacists, and people from across the province stepped up.
With the roads cut off, Gordon connected with the new Shoppers Drug Mart at Tsawwassen Mills Outlet Mall and began working with Agnes Wu and Chris Ng who prepared medications for up to 40 patients at a time and got everything ready for shipment — with Wu hand-delivering the medications to Vancouver’s South Terminal airport at 6 a.m. to be picked up by Pacific Coastal for a flight to Anahim Lake.
“It was incredibly complex,” Gordon says. “It went beautifully with no screw-ups. Agnes and her team were phenomenal.”
“We hear so much about the wildfires and there isn’t a chance to help out. It was great to be able to do something to help make a difference,” Wu says.
Gordon and Dr. Robert Coetzee relied on other BC pharmacies to make sure their patients got the medication they needed. Gordon adds, “In addition to Tsawwassen, we got shipments from Bella Coola and Kamloops when the roads were open. Cathie Hamm, from Kornak & Hamm's Pharmacy, in Williams Lake, had permission to go in and get going 10 days before people were allowed back as part of essential services. She worked ridiculous long hours and was simply amazing.”
“I wanted to help in any way I could. The one way I could help them was to make sure they got their medications. It’s nice that we can help out this way, there is a need for us,” Decker says.
Pam Pasicnyk, a Sobeys regional manager who lives in the Lower Mainland, drove up on weekends to volunteer. “People were traumatized. They need us. Everybody needs to know there’s a place of comfort during an emergency,”
During the crisis, pharmacies and pharmacists in the area stepped up to see what they could offer. Patients benefited from the volunteered time and the donations of goods and medicines. Ford says, “The patients themselves were so appreciative and relieved. I’m so proud of the pharmacists.”
This won’t be the last time BC pharmacists will be asked to step up in an emergency situation. Julie Ford has some suggestions on what would make a difference to providing better patient care next time.
- Pharmacists weren’t considered an essential service. Emergency services needs to know it can reach out to pharmacists.
- Pharmacists should be able to prescribe for minor ailments and in this case, pharmacists could have relieved the strain on area hospitals and health clinics prescribing inhalers for the smoke.
- Pharmacists should have the ability to access PharmaNet remotely under emergency situations. Volunteer pharmacists spent a lot of time phoning other pharmacies and triaging patients. It would have been more efficient if pharmacists had immediate access to PharmaNet to determine which medications the patients needed.