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Precious cargo

by Katie Bausler, Community Relations Director

Low horizon sunlight illuminated the tarmac at the Juneau Airport as a cluster of reporters and a handful of hospital staff stood along a protective chain-link fence, cameras and microphones at the ready. They were waiting for the next jet to arrive with extremely precious cargo: the first box of vials of the first-approved COVID-19 vaccine. In the on-pins-and-needles group was Bartlett Director of Pharmacy Ursula Iha.

"I was so excited to be there to receive the first shipment of the new vaccine," Ursula recalls.

After weeks of anticipation and planning for how best to store, prepare and administer the vaccine, the moment had arrived. The plane pulled up to the Alaska Air Cargo hangar for retrieval of a cardboard cube with enough vaccine for more than 1,000 doses on dry ice. The small group gathered round as a UPS driver gingerly loaded the box onto his truck, then they quickly dispersed to their individual vehicles for an impromptu caravan with the UPS truck to the front door of Bartlett Regional Hospital. The truck was met by an applauding group of staff, including pharmacy technician Krischelle Batac, who whisked the cube away on a wheeled cart to an ultralow freezer, housing doses for not only the hospital but the rest of Juneau.

Krischelle then donned full personal protective equipment and joined a small group of colleagues in a clean room, where she mixed and drew up the capital city's very first dose of the Pfizer vaccine. Within two hours, that vaccine was injected into the arm of Infection Preventionist Charlee Gribbon, who headed up a massive staff volunteer effort to inoculate nearly 500 coworkers over the course of five days.

"We had doses in arms within two hours of when it landed in Juneau," Ursula told a national pharmacy trade magazine.

Behind the scenes

Well into the worldwide vaccination push to herd immunity from a deadly virus, pharmacists are getting their overdue five minutes of fame. But much of the pharmacists' work—mixing, counting, measuring and more—takes place behind the scenes in cramped quarters on the hospital's third floor.

Likewise, community vaccine recipients at the first mass vaccination events at Centennial Hall saw volunteers at check-in, check-out and when they got their shot. What they didn't see was pharmacist Khalid Srour, hidden in a tent and hunched over a tiny vial of vaccine. Khalid removed the vial from a specially designed cooler, let it sit for 30 minutes, diluted the vaccine with sodium chloride, and held the vial between his thumb and forefinger as he gently inverted it 10 times. He then placed the vial back in the cooler for retrieval by a runner to be drawn up by the nurse administering the vaccine.

Pharmacists and other Bartlett staff trained for this—at health fairs and the first-ever drive-up flu vaccine clinic, which took place in October 2020.

Keeping staff up to speed

Pharmacists also provide prescription information to patients and, in the case of the COVID-19 vaccine, safety information.

Pharmacist Chris Sperry took on the job of informing some of his initially skeptical colleagues about the safety of receiving the first COVID-19 vaccines.

Chris recalls the challenge of putting together the small snippets of information trickling in. "Once we got the whole picture, it was published in The New England Journal of Medicine," says Chris. Then there was U.S. Food and Drug Administration approval. "We had good science saying yes, these vaccines are safe and highly effective."

His supervisor had high praise for his informational presentation to Bartlett staff. "This is brand-new science, and he really dug deep," says Ursula.

COVID-19 impact

Ursula oversees a tight-knit staff of 10 pharmacists and 11 pharmacy technicians, dispensing an average of 17,000 in-house prescription doses per month.

COVID-19 changed pharmacy staff operations. Employees were divided into team bubbles, working seven days on, then seven days off.

"If one team got sick, then we could still provide service," says Ursula.

Other than that, it is business as usual for the pharmacy. "As far as the clinical services we're providing, nothing's changed. We still provide a very high level of care," says Chris. "I think you could apply that to the whole hospital. It's just one more thing—the level of care hasn't changed at all."

Like a short-order cook

Chris likens the job of in-house pharmacist to that of a short-order cook.

"Things are getting thrown at you so fast, but you have to make sure everything else is cooking properly at the same time. At any given time, you have six doctors in the hospital and dozens of nurses. Their patient is their No. 1 priority," says Chris.

Pharmacists work closely with health care providers on the best drug treatment plan for the patient. "And we're seeing better outcomes when you have a collaborative effort with the nurses, the doctors, the pharmacist, the respiratory therapists, physical therapists, all working together. It increases the level of safety," he adds.

Time-sensitive orders rise to the top as prescription orders flow in and out of the pharmacy "kitchen."

"We're still filling orders for every single patient in the hospital. I mean every surgery, every colonoscopy," Chris says. "I may be verifying prescriptions for colonoscopies while I'm managing medications for a patient with invasive streptococcal disease."

A prescription's final destination, of course, is home with the patients. While patients may be anxious to get on with their lives, the pharmacist is responsible for counseling to ensure that they'll be taking the right medications in the correct amounts after they are discharged from the hospital.

And the new job duties that arrived a year ago along with COVID-19?

"I feel blessed to have this opportunity—to educate our providers and patients, to distribute the vaccine, to be part of this, to be part of protecting our community," Chris says. "I feel truly blessed and feel lucky to be in this position."

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