Editor’s note: This story originally appeared in The Tablet magazine, a publication of the B.C. Pharmacy Association.
Special to the Morning
When Vernon’s Sam Nolan graduated from the University of British Columbia’s Faculty of Pharmaceutical Sciences in May of this year, he had some pretty big shoes to fill.
Not only was he joining the ranks of his father, Tom, and grandfather, Don, who had become community pharmacists before him, but he was set to work at family-run Nolan’s Pharmasave, established in 1927 by his great-grandfather, Hazel, and his brother, Chester.
“We have a lot of seniors in our community who seemed to recognize me right away, before actually knowing my name,” said Sam. “They always say I must be a Nolan; I have my grandfather’s look.”
While his kindergarten journals reveal that, at age five, he already wanted to be a pharmacist, at times, Sam went back and forth with the decision. In 2004, he began working as a staff member on the front tills, and progressed his way from stocking shelves into the dispensary as an assistant.
“It’s always given me a sense of home and made me feel connected to my grandparents,” he said.
After completing two years of medical biochemistry at UBC Okanagan in Kelowna, Sam knew his passion for pharmacy wasn’t going away, and made the trek to Vancouver to complete the four-year UBC program.
“A Nolan had graduated from UBC exactly every 30 years since 1927,” said Tom. “In 1927, 1957, 1987 and now 2014. Sam kind of upset the rhythm by graduating early.”
As pharmacy manager at Nolan’s, Tom said he too knew from an early age that he would follow in the family business.
“I grew up in the pharmacy and was exposed to it my whole life. Part of it is I was well aware of the lifestyle the profession provided. As a pharmacist, you have to be a people-person, and as pharmacy manager or owner, you have to be someone who loves the retail world to stick with it this long, because it certainly does have its challenges.”
The recent shift towards a more clinical approach for pharmacists has been the biggest change on a professional level, said Tom. On a business level, his concerns lie with the challenges and time-consuming process of dealing with PharmaCare and third-party payers.
Yet Nolan’s Pharmasave continues to strive to expand its clinical services. A compounding pharmacy, the location does a lot of hormone replacement therapy and veterinary prescriptions, and includes a clean room for injectables and ophthalmics. It services the local hospice house and has a palliative care specialist pharmacist available 24 hours a day.
With a population of approximately 40,000, Vernon is far from rural, yet it still has the benefits of a close-knit community of health providers.
“We’re certainly familiar with all of the local physicians’ signatures, names and voices, which makes authenticating prescriptions a lot easier,” said Tom, noting the industry has grown drastically in recent years, with 18 community pharmacies now located in the small city.
To adapt to the situation, Nolan’s recently expanded beyond its full-service pharmacy footprint to open two smaller clinical locations: one inside a medical office, and a second within Vernon Jubilee Hospital.
Also under the Pharmasave banner, the hospital location is a full-fledged community pharmacy, serving not only emergency room and discharged patients, but also providing a convenient location for hospital staff and nearby residents.
“It’s been quite an interesting experience as various hospital departments begin trusting us and relying on pharmacists for more services,” said Tom.
Traditionally, when patients are discharged with deep vein thrombosis or coagulation issues, they go through a teaching program provided by the hospital, followed by seven days of injectable therapy with daily INR monitoring before bridging over to oral warfarin or other medications. Since the new pharmacy has opened, Vernon Jubilee Hospital has rolled that process over to Nolan’s community pharmacists.
“Patients are still required to do five to seven days of daily lab visits, but now our pharmacists monitor patients’ daily lab values and adjust their warfarin dosage, instead of having the strain put on the emergency department,” said Tom.
Like many community pharmacies, they also run diabetes programs that focus on meter training, insulin training and devices. It’s a process that continues to evolve and look for ways to enable pharmacists to perform some of the more clinical parts, while the in-hospital diabetes educators continue to focus on a dietary and nutritional approach.
“Most importantly, the pharmacy can capture patients before or immediately after they’re discharged,” Tom said. “It’s a very good step for most diabetics, and it’s been great seeing our staff become increasingly comfortable with counselling procedures.”
Sam is also looking forward to implementing some of the transitional outpatient care programs now that the hospital location is in full-swing.
“In the future I see pharmacists playing a much bigger role, including daily follow-up and contact in outpatient care immediately following discharge from hospital,” he said, “Especially for new diagnoses such as heart attack or stroke, or chronic disease in more severe stages such as heart failure or COPD.”
Sam feels it’s an area where there is a disconnect in B.C.’s health care system, resulting in re-admissions and wasted health care money.
Nolan’s Pharmasave puts a new spin on continuity of care as it nears its ninth decade in business.
“After being here for 87 years, there’s a significant loyalty factor to our customer base,” said Tom. “We often see multi-generational customers – grandchildren of the original customers – and they share stories about things that they find in their attics relating to old memorabilia.”
He pointed to a particularly poignant example – old prescription labels and advertising with the pharmacy’s original phone number.
“Back when you only needed two digits to call somebody – you just dialed 2-9 to reach the pharmacy.”
Nolan’s Pharmasave remains in the original heritage building from the early 1900s.
“It’s a turn-of-the-century building and we love to embrace the history,” said Tom.
But with pharmacy continuing to move forward, there are some aspects of history both Tom and Sam are happy to leave behind.
“A customer came in recently, an older gentleman who had been coming to the pharmacy since the 1940s, and he recalled seeing my grandfather and his brother smoking cigars in the dispensary,” said Tom, laughing. “He thought my grandfather was quite a character, but I have to say, I certainly couldn’t imagine that happening now.”