Pandemic Shapes Community Pharmacy Residency Learning Environment

The COVID-19 pandemic brought about an unusual learning experience for Lauren T. Le, outgoing chief resident at the H-E-B Pharmacy—University of Texas at Austin community pharmacy residency program.

“It’s been difficult but ... rewarding,” Le said of the past year. “I’m very, very happy with my decision to do the residency.”

The pandemic was in full swing when Le started her residency last summer, and she expected COVID-19 to shape the year’s activities. But she and her colleagues were surprised at the pace of vaccine development and the resultant need to quickly roll out a robust vaccination campaign.

“We immunized upwards of 1,000 people per day,” Le recalled. “They even had us travel to surrounding areas like Waco and San Antonio to help with vaccination efforts.”

Le said the biggest problem for her home-store pharmacy team was establishing a workflow for COVID-19 vaccination while managing normal pharmacy operations.

The staff had to take into account prescription volume, the number of pharmacists onsite, and the availability of vaccination-capable pharmacy technicians. Space wasn’t an issue at Le’s home store, which already had a private, dedicated vaccination room.

She said some community members, when they became eligible for vaccination, had “very negative preconceptions” about the vaccines and feared that they had been authorized without solid safety evidence. But conversations with patients often revealed that they simply wanted to do what was best to keep their families safe.

“Everyone was just trying to protect the people that they loved,” Le said. By starting from that perspective, she was able to allay some peoples’ concerns and make them comfortable enough to get vaccinated on the spot.

She said a major benefit of the COVID-19 vaccination campaign is that community members who viewed H-E-B as primarily a grocery store chain began to engage with the pharmacy staff.

“We had patients that had never visited our pharmacy come and get their vaccines with us,” Le said. “So it was our opportunity to demonstrate our value and knowledge as healthcare professionals.”

Some of these patients, she said, have since transferred prescriptions to H-E-B.

“We saw a great increase in our call volume as well, just questions about how do I get scheduled or people sharing their concerns with us,” she said.

Le said she chose community pharmacy as a career because, for her, it’s the ideal way to serve her community. Encouraging vaccination is part of that service.

One of Le’s most memorable patient interactions occurred when COVID-19 vaccines first became available to healthcare providers, and a nurse came in for her appointment.

“She sat down in the chair, I gave her the immunization, and she just started crying. And she was like, ‘I can’t believe this day is finally here,’” Le said. The nurse related that she worked in a hospital and had seen too many patients suffer and die from the virus.

Le said she was grateful for the opportunity to speak with the nurse, “healthcare professional to healthcare professional,” and share their hopes that the pandemic was at a turning point.

Another memorable experience occurred in mid-February, when Texas suffered a deep freeze and widespread power and water outages. At the time, Le had just started taking shifts at H-E-B locations other than her home store.

“That was something that I was very excited about, just getting to see the way that different things were done at certain stores. And because of the weather, a lot of pharmacists were not able to go to work,” Le recalled.

So she offered her services to a H-E-B store near her home, where the pharmacy team was coping with an onslaught of prescription transfers and emergency refills. Le also took shifts at busy stores in Austin, where patients were in urgent need of medications.

“We were just trying to churn them out as fast as we could to make sure that patients on important maintenance medications weren’t going without,” Le said. She said H-E-B’s nonpharmacy staff also came to work despite difficult personal circumstances to help take care of their local communities.

Le said the residency program director and H-E-B corporate pharmacy group supported the residents as they completed their required projects and made sure residents didn’t focus exclusively on COVID-19.

“We were still able to complete our business plans, we still did our research projects,” Le said. “COVID was really just another learning experience.”

Le said that because H-E-B’s corporate offices were closed during the pandemic and staff were working from home, some of the planned rotations didn’t take place as envisioned. As chief resident, Le worked to boost her coresidents’ morale throughout the year.

“Making sure that all of my coresidents still felt connected and supported throughout this year has also been a challenge,” she said.

“I really just tried to make sure everybody understood that this was a once-in-a-lifetime opportunity to learn and serve our community.”

Le said the weekly virtual meetings replaced the face-to-face meetings that would normally have taken place at H-E-B’s Austin corporate offices. The group had its first in-person social event in the latter half of the residency year.

“It was great, once everybody was vaccinated ... to get together and celebrate,” she said.

Despite all the challenges, Le had such a positive experience that she accepted a permanent postresidency position with H-E-B as a floater pharmacist.

She said she’d like the incoming residents to know that their work is valued, and the residency is a great learning experience even if it doesn’t unfold exactly as expected.

“Be flexible,” she advised. “Try to make the best out of every situation and try to learn as much as you can, because residency is so short. And ... accept as many possibilities and opportunities as you can, and keep an open mind.”

ASHP's Section of Community Pharmacy Practitioners supports the unique needs of members who specialize in community-based practice. Visit our member sections page to register for the section.

For more information and free tools regarding the pandemic, including the Assessment of Evidence for COVID-19-Related Treatments and patient-level COVID-19 vaccine monographs in English and Spanish, visit ASHP’s COVID-19 Resource Center and the COVID-19 Community at ASHP Connect.