The secret equation for saying no gracefully in pharmacy

How do you answer the tough and inevitable questions well?

“Can I have a raise?”

“Can you prescribe puffers?”

“Do you do stitches for this?”

“Can I leave early?”

“Can you dispose of this?” (Hands over an unmarked plastic bag with needles poking through.)

In the daily duties of practising pharmacy, we need to say no. As much as we have a distaste for confrontation and want to help everyone in our sight, we are organically the gatekeeper for many requests that come through the pharmacy. 

With practice, pharmacists can become more comfortable denying requests with confidence, without feeling bad or hurting anyone. Luckily, there are three common models to help us say no: communicating in fantasy, saying what you can instead of what you cannot, and recognizing interpersonal variance.

To explore these deeper, imagine the case of a pharmacist asking us to cover the cost of a costly annual subscription to clinical reference.

Communicating in fantasy

First, we can communicate in fantasy, by applying humour to lightheartedly exaggerate the request. We might say, “I wish we could pay for that subscription, a conference or two and take the staff offsite for extra training, maybe somewhere hot.”

The goal is not to poke fun or belittle the request, but rather show them that you care about their vision by actually thinking bigger. For this, the fantasy has to be aligned with the request and take it one step further to show your imagination.

Do instead of do not

Second, we can focus on what we can do instead of what we cannot. How about: “We can take care of the annual licensing fees and some team building-type lunches but cannot fit in the subscription, unfortunately.”

By lumping in a few ways we have said yes in the past, we remind the requester that we have offerings to show that we care, so they leave the interaction understanding that we are sincere. 

Pointing to interpersonal variance

Third, we can point out interpersonal variance. Each person has their own preferences as to what is important to them and it would be impossible to accommodate all of them. Since it is reasonable and common for others to forget that others also want things, it is okay to remind them that we need to be fair to the entire team.

For example, “I appreciate the relevance and usefulness of the subscription but I have had to say no to a few others’ requests to similar things since we cannot cover them all for everyone, out of fairness.

Here we are showing that we put effort into everyone’s requests without revealing direct details that could derail the conversation.

Finally, when you are having trouble fitting the request into the three categories, apply this equation:

I have to say no—we–plan.

I have to say no (confirms you are in charge by clearly ending the dilemma and preventing them seeking the answer elsewhere), followed by we (infers you and the requester are on the same team) followed by a clear plan will not be able to do the subscription and will make sure to keep resources like these in mind(presents a plan so they do not leave knowing where to go next).

While saying no can be unpleasant, it is a necessary part of the job. Our job is to have a systematic way of managing requests consistently.

With time two things happen: first, we practise saying no and get better at executing it gracefully. Second, others learn what types of requests are likely to be granted and denied.

Either way, everyone is on the same page and respects each other. 

Now, what to do with this bag of needles….