Introduction

Community pharmacy counter assistants communicate frequently with the public with or without the involvement of a pharmacist.¹ The RPSGB Code of Ethics² states that one personal responsibility of a pharmacist is to ensure that 'if any tasks are to be delegated they are delegated to persons competent to perform them'.² This can have direct consequences to talk and the structuring of the interaction between the pharmacist, counter staff and clients. The present study employed Discourse Analysis (DA) to examine these. DA is the study of language in context from a functional point of view, focusing on the social and interactive aspects of talk. More specifically, talk is seen as social action. Furthermore, language is seen as constructing reality and DA looks at naturally occurring discourse to see how cognitive issues such as knowledge and belief or fact and error are conceived and expressed.³ Although conversation analysis (CA) has been used to study pharmacists in the specialised hospital paediatric oncology clinic setting,⁴ the order and structure of community pharmacy assistants' talk has yet to be reported, particularly from a DA perspective. The aims of the present preliminary study are to identify (i) the feasibility and benefits of a DA study of counter assistants and (ii) describe features of their interactions within the community pharmacy.

Method

Following ethics committee approval, conversations involving counter assistants working in three community pharmacies were audio-recorded and transcribedad verbatimusing a standard notation.⁵ Consent from clients, pharmacists and counter assistants was obtained.

Results

The data consist of 29 interactions with clients involving counter assistants. A number of themes have emerged from this initial study including the referral of clients within the pharmacy, for example:

1) from assistant to pharmacist when the assistant asks the pharmacist for advice

CAss (to PH):right ok [Mary] the lady wants something for her grandson who's four years old he's got diarrhoea (.)

I've looked at Imodium thing it's not suitable (R014, lines 34-35)

2) client is transferred from the pharmacist to the counter assistant

Client: hiya um my husband he's got (.) trapped wind what's the (.) what's the best thing for getting rid of it?

PH (to CAss):to find out erm [Pat]? (CA: yes?) (( )) no no no no find out what the symptoms are

CAss (to Client):right erm what are the symptoms of this? (B010, lines 1-4 )

Key: PH � pharmacist, CAss � counter assistant, (( )) � inaudible dialogue, (.) � pause, [ ] � names have been changed

Discussion

This preliminary study has identified a number of ways in which the action of referral between counter assistant and pharmacist in community pharmacy is achieved through talk as social action. With the pharmacy profession considering increased delegation of certain functions to appropriately trained staff, further DA studies are required to help understand the role of counter assistants when dealing with clients presenting with symptoms and also to identify potential training issues.

References

1. Bissell P, Ward P, Noyce PR. (1997). Variation within community pharmacy. 2 Responding to the presentation of symptoms. Journal of Social and Administrative Pharmacy .14(2), 105-115.
2. Royal Pharmaceutical Society of GB. Medicines, Ethics & Practice: A Guide for Pharmacists, July 2001. London: RPSGB, 84.
3. Edwards D, Potter, J. (1992) Discursive Psychology . London: Sage.
4. Pilnick A. (1998). 'Why didn't you say just that?' Dealing with issues of symmetry, knowledge and competence in the pharmacist/client encounter. Sociology of Health & Illness 20(1):29-51.
5. Maxwell Atkinson J, Heritage J. (1984/1999) Jefferson's transcript notation. In: A Jaworski and N Coupland (eds.) The Discourse Reader . London: Routledge, 158-166.