Anyone who has visited a chain retail pharmacy knows that we are understaffed. It becomes obvious as patients stand in a long line, watching one of the few technicians waiting for the pharmacist to finish verifying an order before they can help the next customer. That pharmacist has a phone to one ear and is helping another technician with an antibiotic to be mixed for a sick child at the drive-thru window. Another patient stands at the counter waiting for a consultation on a potential drug interaction as the phone rings, unanswered, with a doctor on the other end. The waiting room fills up as immunization appointments begin to run behind.
These working conditions have become so normal that all pharmacists like me can think is “it could be worse.” For us it has become just another Tuesday.
What many don’t see is the fear many of us feel. It’s the knowledge that the impossible workload we’re given could one day lead to a mistake that could have been prevented.
I have worked at a retail pharmacy for more than 15 years, and it has never been more challenging to do my job safely. Across the country, pharmacists and technicians are expected to process hundreds of prescriptions a day with staffing levels that sometimes leave a single pharmacist essentially running an entire clinical operation. (While pharmacists are held professionally liable for all care delivered at the pharmacy, technicians are the backbone of daily activities despite being paid significantly less than pharmacists.) The workload hasn’t decreased; it has intensified at a rate that outpaces any tool or technology that is intended to help.
The pandemic added an influx of immunization responsibilities to our daily duties, and now vaccines — including Covid-19 boosters, RSV shots, flu shots, and travel immunizations — are treated as priorities. At times, it is common to immunize continuously throughout the day while also verifying prescriptions, counseling patients, answering phones, conducting medication reviews, performing prescriber outreach, and resolving insurance claims.
Each distraction is a potential error.
Pharmacists increasingly have less time to thoroughly examine patient profiles, catch potential drug interactions, think critically about dosing, or notice subtle discrepancies in a prescription. In many settings, there is often less than a minute to review an order before falling behind. When you are verifying hundreds of prescriptions, each one representing a person who trusts you, that pressure is crushing.
The public assumes pharmacy errors are rare, and thankfully, many are caught before they reach a patient. But they are caught because pharmacy staff are highly trained, deeply committed, and meticulous. What happens as you remove the time and clarity necessary for that vigilance? What happens when pharmacists are expected to perform at the same level while workplace conditions deteriorate?
In 2023, the situation reached such a crisis point that thousands of pharmacy professionals across multiple employers walked out in what became known as “Pharmageddon” — an organic, national uprising sparked by unsafe staffing. These were not political actions. They were a warning sign of a broken system.
Turnover has become its own crisis within the crisis. In many stores, technicians — the backbone of the pharmacy — leave as fast as they can be hired, driven out by the stress, the intense workload, and the low pay. Every time a tech leaves, the pressure on the remaining staff intensifies. And every time a pharmacist is left without support, patient care suffers.
This cycle is not sustainable. Pharmacy professionals certainly did not enter this field to rush or cut corners for the sake of “efficiency” or “optimization.” We entered it to help people.
But we cannot help people if we are stretched thin to the point of breaking. How can one perform safety-critical work when you are surrounded by constant interruptions and metrics that increasingly have less to do with individual clinical judgment?
We are at a breaking point.
In response, pharmacy professionals across the country began building power. At my store in Wakefield, R.I., we organized with the Pharmacy Guild and won our union election, becoming one of the first CVS retail pharmacies in the country to unionize in the company’s home state. Three more Rhode Island stores won their union elections shortly after.
We unionized because we know that the current system of corporate profit-driven health care can erode clinical autonomy. This is not going to change unless we professionals force it to. We have a clear message for corporate executives: it’s time to put patients before profits.
For too long, frontline pharmacy professionals have been systematically shut out of decisions that shape our practice. We are given our prescription and staffing budgets. We are given immunization targets. We are expected to multitask beyond reason.
Now, we are using our collective voice to raise our concerns about safety, staff turnover, and burnout because we no longer want to feel dismissed.
Unionizing has given us a voice. It gives us a seat at the table where decisions are made. It allows us to negotiate staffing levels that ensure safe practice. It gives back clinical autonomy. It gives us a way to hold corporate leadership accountable to professional standards.
And most importantly, it gives us the power to protect our patients.
Retail pharmacies in America are at a crossroads. One path continues down the road we are on now: burnout, chronic understaffing, and the quiet erosion of one of the most trusted health care professions. The other road leads to a system where pharmacists and technicians have a say in providing resources, time, and staffing to provide the care our patients deserve.
The Pharmacy Guild/IAM exists because pharmacy professionals across the country decided to fight for that better path. We are doing what our employers have failed to do: protect the integrity of our profession and the safety of our patients.
We hope more pharmacy workers will join us. Our patients are counting on it.
Chris Eggeman is a member of the Pharmacy Guild and a pharmacist at CVS in Wakefield, R.I.
