ASHP InterSections ASHP InterSections

July 15, 2019

Mindfulness and Medication Safety: Pharmacist Brings Calm to Hospital Chaos

Lisa Hanlon Wilhelm, BS.Pharm., R.Ph., teaches a weekly meditation session to hospital staff to help build a resilient healthcare workforce.

IT’S WEDNESDAY AFTERNOON AT PENN STATE HEALTH HERSHEY MEDICAL CENTER, in Hershey, PA. The dimly lit hospital chapel has soft music playing, but the clatter from the cafeteria next door still seeps in. The only sources of light are the many windows around the room. An assembled group of pharmacists, nurses, and other hospital employees – looking for a few moments of inner peace – sit upright on benches, cushions, and stools.

The meditation group is led by Lisa Hanlon Wilhelm, BS.Pharm., R.Ph., the medical center’s Medication Safety and Compliance Specialist, who speaks soothingly to the participants. She helps them focus first on their posture, then their breathing and heartbeat, finally linking heart and breath. She encourages them to ignore the clanking of dishes from the cafeteria, the patter of feet in the hallway – to instead focus on concentrating on their breath and heart.

“When you first enter the room, all you hear is the noise coming from the cafeteria,” said Joanne Martin, LPN, an oncology nurse and participant in the class. “As we begin to meditate and focus on our breathing, the noise remains, but your awareness of it is no longer your focus. It always amazes me because no matter how unsettled I feel when I first arrive, I always walk out with a peacefulness.”

This practice, known as Heart Rhythm Meditation (HRM), is an ancient form of meditation, which begins with mindful breathing, and then focuses on your physical heart and spiritual center. “When you get your breathing in rhythm with your heartbeat it creates physiologic coherence,” says Wilhelm, who is certified in the HRM method. “Conscious breathing helps you feel more relaxed, reduces blood pressure, and slows the heart rate.”

Joanne Martin, LPN

Studies show that meditation can help with memory, creativity, and focus. And focus is essential when it comes to medication safety. “As pharmacists, we push ourselves beyond reasonable expectations at times. Our work is very exact; errors can be catastrophic,” said Ronald Lay, M.S., R.Ph., one of Wilheim’s first meditation students. “Our responsibilities are increasing to play a more prominent role in patient care. We push ourselves to do it all. It’s important to take time for ourselves, to step back and take a deep breath.”

Creating Mindfulness
Wilhelm, who completed an ASHP Executive Residency in 1995, has spent the bulk of her career at Hershey Medical Center in the Medication Safety Officer role. As part of her job, she teaches medical students, new nurses, and advanced practice clinicians about medication safety and regulatory compliance, and she reviews medication event reports.

The role is challenging, and she has seen first-hand how stress and burnout can lead to errors. She realized that while system changes could fix many medication safety problems, there are other issues at play as well.

“Sometimes I think [healthcare providers] need to stop and look at a medication label, or stop and read a patient’s chart or medical note, or stop and pay attention to a patient, a colleague, or a situation. Basically, just stop for a moment,” she said. “Taking that moment to pause and focus can avoid accidental errors made in haste.”

Wilhelm was always interested in meditation, but it was after she had completed a 2-year training program in HRM that she decided to try leading a weekly drop-in meditation class at the hospital. With the support of the Director of Pastoral Services, Wilhelm started her Wednesday program in October of 2017.

Meditation Improves Care
Ronald Lay, who was then working as the Director of Inpatient Pharmacy at the medical center, was one of the early participants in Wilhelm’s meditation class. Lay, a member of ASHP for 41 years, has since semi-retired and works part-time as a staff pharmacist. 

Over casual conversation, he heard about her meditation class and decided to try it. “I’ve been a pharmacist for 41 years, 37 of those in management positions,” explained Lay. He found himself dealing with issues that all pharmacy managers experience: personnel issues, increased regulation, budget cuts, and the expectation to do more with less.

Ronald Lay, M.S., R.Ph.

“I was becoming more tired and irritable and experienced classic symptoms of burnout. I ate lunch at my desk every day and took work home regularly,” he said. “I was having trouble sleeping. I realized I needed to slow down and take better care of myself.”

Lay tried the class, hoping it might help his sleep problems and stress level without medication or therapy. “The result? I find it does!” he said, “The biggest surprise was the level of physical and emotional relaxation. I felt like a whole different person after the meditation – like a weight was lifted off my shoulders. I walked out so much more slowly – no longer in a rush.”

The sessions also helped him work in a more focused way. “Now that I am working as a staff pharmacist, I still experience stress from the demands of patient care. It is easy for emotions like frustration or anxiety to take over, and to rush through the work. Meditation allows for a more calm and logical approach, which should reduce the opportunity for errors,” he said.

Martin agrees that meditation can be beneficial. As an oncology nurse, her job involves working with the outpatient cancer institute triaging phone calls from patients regarding symptom management, chemotherapy side effects, and other issues. “Meditation has helped me be more present for my patients, use more therapeutic communication, and overall just be more empathetic,” she said.

Mindful Moments
In addition to her weekly meditation sessions, Wilhelm has led a continuing education program for pharmacy staff at the hospital on meditation for stress reduction. For ASHP, she conducted a webinar and a meditation for pharmacy students at the 2018 ASHP Midyear Clinical Meeting. Wilhelm incorporates simple mindfulness techniques in her medication safety lectures and plans to expand more moving forward. She and a colleague recently led a meditation class for graduating medical students at Penn State College of Medicine held immediately after their lecture on loan repayment.

For healthcare providers interested in learning to incorporate these practices in their work, Wilhelm noted that mindful moments could be tucked in throughout your day. “Walking through the threshold of a patient’s room, or washing your hands, or getting ready to program an IV pump, or verifying a prescription … these can all be mindful moments if you stop for a moment to breathe and get centered,” she said. “Taking that pause to stop, think, assess, and review can lead to better communication, clearer focus, and ultimately, improved patient care.”

 

By Ann Latner

 

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July 11, 2019

ASHP, Well-Being, and You

Dear colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

There is a great deal of national attention on the issue of healthcare provider burnout, which is affecting our pharmacists, pharmacy residents, student pharmacists, and pharmacy technicians at unprecedented rates.

As many of you know, burnout is a syndrome characterized by emotional exhaustion, depersonalization, and low personal accomplishment. Moreover, there is a significant correlation between poor well-being of healthcare professionals and worsening patient safety. In May 2019, the World Health Organization clarified that burnout is an occupational phenomenon caused by chronic workplace stress that needs to be monitored and better understood. It’s also an expensive problem. Research conducted at the Mayo Clinic estimates that burnout costs the U.S. healthcare system $4.6 billion every year.

A healthy and thriving clinician workforce is essential to ensure optimal patient health outcomes and safety. That’s why ASHP has been a leader in well-being and resilience (WBR) for nearly 40 years. We first addressed this as a critical practice issue in a 1982 AJHP article that explores recognizing, reversing, and preventing hospital pharmacist burnout.

In 2017, ASHP became the pharmacy sponsoring organization of the National Academy of Medicine (NAM) Action Collaborative on Clinician Well-Being and Resilience. This four-year initiative is raising the visibility of clinician burnout, improving baseline understanding of challenges to clinician well-being, and advancing evidence-based solutions to improve patient care by caring for the caregiver. ASHP is a member of the NAM Action Collaborative Conceptual Model Working Group which is charged with identifying factors that affect clinician well-being and resilience. The goal is to create urgency and understanding of the issue while being careful not to oversimplify the complexity of it. In addition, we recently participated in a NAM meeting in Chicago, focused on redesigning the clinical learning environment to enhance well-being. ASHP member Kofi Andoh, a rising third-year student at Notre Dame of Maryland University School of Pharmacy in Baltimore, was one of five participants selected to share his perspective on the stressful demands placed on students.

To further assess the issue of workplace burnout, ASHP recently conducted a national survey of nearly 2,000 people with help from The Harris Poll. The results show that almost three-quarters (74%) of respondents are concerned about burnout among healthcare professionals. Furthermore, one in four Americans surveyed believes hospital pharmacists (26%) and retail pharmacists (25%) are experiencing burnout. These data show that pharmacy workforce stress is visible to our patients, which is why ASHP has made addressing pharmacy workforce well-being a top priority.

In June 2018, the ASHP House of Delegates approved a new professional policy on clinician well-being and resilience. At our Summer Meetings last month, the House of Delegates reinforced our commitment to WBR by approving a new policy on suicide awareness and prevention, the most tragic and extreme consequence of burnout. The policy recognizes the vital role of the pharmacy workforce in suicide prevention, and the importance of maintaining the health and well-being of both our patients and our colleagues.

June was National Employee Well-Being Month, and in honor of Global Wellness Day on June 8, we launched an online portal – Wellbeing & You – as a resource for pharmacists, pharmacy residents, student pharmacists, and pharmacy technicians. This website is also a place for colleagues to share their experiences with burnout and to pledge their commitment to strengthening personal and workplace resilience. I encourage you to visit the site to learn about burnout, view ASHP’s webinars on WBR, check out the ASHP State Affiliate Toolkit, and contribute to the ASHP Connect Community on Clinician Well-Being and Resilience.

Join ASHP’s movement to combat burnout by sharing your stories and taking the pledge. Keep your eye out for #WellbeingWednesday on social media, where we’ll offer even more WBR tips, member stories, and resources.

Please know that ASHP is here to support you in your career in every way we can and that we will continue to provide you with valuable WBR resources. Thank you for being a member of ASHP, and for everything you do for your patients.

Sincerely,
Paul

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