Pharmacies are boring. Pharmacies are supposed to be boring. But lately, they might be getting too interesting for comfort.

The normally staid business has been shaken awake by a series of nonunion “wildcat strikes” over the last few weeks. In incidents scattered around the country, pharmacists have refused to go to work or walked off the job.

There are signs that a larger strike is brewing, with more walkouts targeting large chains like Walgreens, CVS and Rite Aid in late October and early November. The pharmacists don’t have a union, so there is no way to tell how many people might participate or how many locations could be affected.

The strikes are unusual in that the strikers aren’t asking their employers for better pay. They’re asking them to hire more staff so their workloads are less overwhelming. They are also seeking better working conditions in many cases.

“It’s really about having support to do the job safely,” Bled Tanoe, a pharmacist in Oklahoma City. She currently works for a hospital pharmacy and formerly worked for Walgreens. Tanoe isn’t going on strike herself, but she has been a spokesperson for frustrated pharmacists.

She created the hashtag PizzaIsNotWorking in 2021 to criticize the pharmacy chains’ response to complaints from staff. More recently she’s been calling the potential Oct. 30 to Nov. 1 walkout “Pharmageddon.”

Mounting frustrations

There are signs a lot of pharmacists are unhappy with the state of the business. In a nonrandomized survey in 2021, the American Pharmacists Association and National Alliance of State Pharmacy Associations reported that 74% of 4,482 pharmacy workers said they did not have enough time to safely perform nonclinical work, and 75% said there were not enough other staff, like techs and nurses, to safely perform clinical work.

The issue made headlines in late September, when numerous CVS pharmacies in the Kansas City area were shut down. The company soon met with the strikers and said it would address some of their concerns.

The pharmacists who organize, strike or speak out are taking some notable risks. Employees in a union usually have a legally protected right to strike, but the pharmacists’ employers can fire them for striking or organizing a walkout.

A number of factors have combined to ratchet up the tension behind the counter. Pharmacies are offering more services to patients, especially immunizations, which means they are busier. That makes for more frustrated customers.

“This is a nationwide problem that pharmacists have been internally yelling about for years,” said Amanda Applegate, a licensed pharmacist and director of practice development with the Kansas Pharmacists Association. Her group spoke with some of the people who went on strike in Kansas City.

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Pharmacist Jennifer Morrow says she worked for CVS from 2013 to 2021. She told NBC News she saw staffing problems from the very beginning, and wasn’t able to spend enough time with patients as a result.

Over time, Morrow said there was a “gradual decline” in which management would repeatedly cut back on the hours for pharmacy technicians, which made it harder to train new hires. That created more work for experienced technicians, who would get burned out and quit.

“What we end up doing is cutting care to our patients. At some point it has to stop,” she said.

Morrow says that when she warned managers that the company was at risk of violating New York state pharmacy staffing regulations, she was demoted. She later quit, and now works at a nonfranchised pharmacy.

The potential strike is targeting big chains for a reason. According to Applegate, many pharmacists are also frustrated that those companies have been buying up the small stores where they used to work, or else using their superior size and their insurance and pharmacy benefits management units to put them out of business. She said pharmacists at those stores often feel that their working conditions are deteriorating and their jobs are getting busier.

“There’s nothing special about what happened in Kansas City. You just had a group of individuals that reached the end of their rope because they’ve been asking for these changes from management for years, even pre-Covid,” she said.

And over the last two years, the three biggest drugstore chains have all started closing stores. CVS is in the middle of shuttering 900 locations in three years, while Walgreens said in June that it would close 150 U.S. locations. Rite Aid is closing at least 154 stores, and probably more, as it goes through Chapter 11 bankruptcy reorganization. That means there are fewer locations serving customers, which makes the remaining stores busier.

“When you’re moving that quickly you miss a lot of things, and we are the last line of defense until the patient gets the med,” Morrow said.

After leaving CVS, she said she now works at a community pharmacy.

“The difference is beyond night and day,” Morrow said. “It took about four months for me to be able to calm down enough to go to the bathroom once a day.”