BURNOUT IS BECOMING INCREASINGLY COMMON among early career pharmacists. A study published in AJHP found that pharmacy residents working more than 60 hours per week reported high levels of stress, depression, and hostility. ASHP InterSections caught up with four former ASHP externs, who were student pharmacists during their rotation experience at ASHP HQ, to learn how they integrate well-being into their busy schedules and inspire resilience among their co-residents and colleagues.
Embrace Team Power
In the middle of a relentless month of 4:30 a.m. wake-ups, long clinic hours, and late nights reading for the next day’s topic discussions during a pediatric hematology/oncology rotation in her second year of residency training, Emily Belarski, Pharm.D., felt she had to change her approach.
“The biggest thing that led to burnout during that period was having a huge knowledge gap and finding it really, really overwhelming to fill it,” recalled Dr. Belarski, who is now a General Pediatrics Clinical Pharmacist Specialist at University of Chicago Medicine’s Comer Children’s Hospital.
She was reluctant to bring it up to her preceptor, but it turned out that her preceptor was very receptive. Dr. Belarski shared her struggle, and together, they devised a plan to strengthen her clinical skills while decreasing stress. “By choosing one topic to learn about daily, rather than floundering with a long list of topics for the topic discussions, I could build my learning skills and not become overwhelmed by my knowledge gaps,” she said.
This strategy led to an a-ha moment for Dr. Belarski. “I was there to build the skills to find the answers, not just to learn the answers. That changed my outlook on residency and made me a lot less stressed,” she said.
Learners may be intimidated to ask for help in a situation like this, but reaching out to her preceptor was something Dr. Belarski wishes she had done sooner. “Talking with my preceptor at the time left me feeling that it was okay not to know everything,” she said.
Adding her preceptor to her support network also enlarged a circle that already included family, friends and, importantly, co-residents, Dr. Belarski noted.
Promote a Culture of Listening
Meredith Oliver, Pharm.D., a PGY2 infectious diseases pharmacy resident at the University of Utah Health, considers herself an advocate for resilience and well-being among the hospital’s residents.
“As healthcare professionals in training, we have a lot of responsibilities that pull us in many directions every day,” said Dr. Oliver. “But slowing down and listening to both our colleagues and our patients is crucial to our work and the success of patient outcomes.”
Dr. Oliver said she struggled to maintain her resiliency while working with “very sick patients” and managing complex treatment regimens during a recent hematology-oncology ICU rotation. “I was having many difficult conversations about the goals of care with patients, and these were often challenging to process,” she said. “However, working alongside amazing healthcare professionals meant that I did not feel alone in fighting for my patients.”
Dr. Oliver said the experience left her wanting to help others cope with their instances of burnout, so she trained to be a peer support volunteer through the University of Utah’s Health’s Resiliency Center. The Center helps healthcare professionals, including the pharmacy program’s 25 residents, manage clinical burnout and teaches them strategies to create wellness and resilience.
One of those strategies is to grant colleagues “the space to feel heard,” said Dr. Oliver. “I’m very grateful that I can share my successes and struggles with my co-residents.”
Although personal strategies can help ensure resilience and well-being, “it needs to be paired with an organizational culture and structure to combat clinician burnout, so that we can give ourselves fully to our patients. They are what matter the most,” said Dr. Oliver.
Student Wellness Curriculum
Imagine this: as a student pharmacist, you saunter into a classroom and casually chat with your peers about a new restaurant you want to try, or a hike you’d like to take. Then you sit down for a 10-minute guided meditation.
If this sounds like a guilty pleasure in a busy student’s life, Autumn Pinard believes you should think again. “We need to make sure we take care of ourselves so that we can take care of our patients,” said Pinard, who is entering her P2 year at the University of New Mexico College of Pharmacy.
Pinard enrolled in the new elective wellness course described above to avoid burnout. “In the past, I gave too much of myself, and I wasn’t paying attention to my well-being,” she said.
In addition to helping her improve resilience, the course inspired Pinard to help other students. She is looking into being a teaching assistant (TA) for a new iteration of the course slated for the 2020 spring semester. “I want to promote resilience and well-being in school early on, before people experience burnout,” Pinard said.
She is currently waiting for confirmation of the course and the TA position. Her vision for the new curriculum is “to dedicate lots of time to exploring meditation, learning more about ourselves and our strengths, and developing emotional intelligence.”
Access to Free Counseling
When Lubna Mazin, Pharm.D., started pharmacy school at the University of Texas at Austin College of Pharmacy, access to mental healthcare required going through a vetting process, being placed on a list, and then paying for the services.
“There were a lot of barriers that prevented students from getting counseling,” said Dr. Mazin, who is currently completing a health-system pharmacy administration residency at Nationwide Children’s Hospital, Columbus, Ohio.
In her P3 year, after coming out of her own period of burnout and finding ways to reduce the risk of a repeat episode – primarily by maintaining a daily exercise regimen – Dr. Mazin joined the university’s Mental Health and Wellness Committee. She advocated for easier access to mental health services. The committee’s efforts paid off, and the university’s president signed off on a new policy that provided free counseling services to students.
“The free services were especially important after several tragedies took place at the school,” recalled Dr. Mazin. Students were reluctant to discuss the difficult topics that arose during those crises, Dr. Mazin noted. The counselors turned to a tried-and-true method of bringing students together—free pizza. “That got students sitting around in one place and gave counselors an opportunity to ask them how they were feeling,” she said.
Moving forward, Dr. Mazin would like to see wait times for university mental health services, particularly for those in crises, reduced. “Getting funding for that type of mental health service, even if it’s talking to someone for 15 minutes, is the next step,” she said.
By David Wild
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