ASHP InterSections ASHP InterSections

April 22, 2019

Overcoming Burnout: Advice from Your Pharmacy Peers

MORE THAN 50 PERCENT OF PHARMACISTS WHO PRACTICE IN ACUTE AND AMBULATORY CARE SETTINGS EXPERIENCE BURNOUT, which is characterized by exhaustion, cynicism, and/or a low sense of personal accomplishment. While burnout is devastating on a personal level, the syndrome can also affect a pharmacist’s ability to fulfill their duties, which can negatively impact patient care.

 

Often when we have a problem, we turn to our peers for support and guidance. ASHP InterSections asked a student pharmacist, a new practitioner, and a pharmacy leader to share their thoughts on resilience and burnout. Here’s their advice.

 

ASHP InterSections: What have you found most challenging about thriving at work or school?

 

Sydney Stiener

Sydney Stiener

ASHP member since 2015

Student Pharmacist and Pharm.D. Candidate (May 2019)

University of Wisconsin-Madison School of Pharmacy

“The biggest challenge for me has been finding the right balance between meeting school-related priorities and dedicating myself to hobbies that help me recharge and be efficient and successful. As a pharmacy student pursuing a residency and facing a competitive job market, there is a constant expectation to do more. On top of rigorous course work and other demands of pharmacy school, students spend many hours a week involved in student organizations, taking on leadership positions, participating in research — and the list goes on and on. Beyond these extracurricular activities, it’s a challenge to find time to care for ourselves by doing things that make us happy outside of school. Without these things, it’s easy to lose perspective and forget the reasons you wanted to become a pharmacist in the first place.”

 

Shannon Kraus, Pharm.D., BCPS

Shannon Kraus, Pharm.D., BCPS

ASHP member since 2015

PGY1/PGY2 MS/Pharmacy Administration Resident

Riverside Methodist Hospital, Columbus, Ohio

“It’s been challenging to me as a new practitioner to balance providing quality care with the realities of needing to do so in a cost-effective way, both across the organization and within the pharmacy service line. For example, while I try to provide optimal patient care and work toward outcomes like decreased readmissions through pharmacist-led counseling at discharge, having limited resources has certainly tested my resilience.”

 

Paul Bush, Pharm.D., M.B.A., BCPS, FASHP

ASHP member since 1975

Chief Pharmacy Officer and HSPA/MS Residency Program Director

Duke University Hospital, Durham, N.C.

“I currently lead a large pharmacy program that includes 428 staff and complex pharmacy operations, so there are many moving parts that I need to be thinking about. It can be challenging to manage the many details and the demands of my job.”

 

ASHP InterSections: How do you ensure your well-being and resilience?

 

Stiener: “I can’t always control the challenges that can lead to symptoms of burnout but I can control my attitude toward those challenges. A philosophy that’s helped me bounce back from a bad exam grade, get through long hours of studying, learn from mistakes, and ultimately excel in my program is Hal Elrod’s 5-Minute Rule, which says it’s OK to be upset, angry, frustrated, or negative when something unfavorable happens to you, but you get only five minutes to feel that way. So, I allow myself five minutes to feel those emotions, but then I force myself to put it behind me, learn from it, and move on with my day with a positive attitude and a smile on my face.

 

“I also prioritize activities that make me happy and recharge my overall well-being, like running outside in the fresh air and spending time with friends and family.”

 

Dr. Kraus: “Every morning at 4 a.m., I fill up my resilience bucket by first reflecting on what I am grateful for from the previous day. After that, I go to my local fitness studio. Exercising strengthens me both physically and mentally.

 

“Throughout the day I try to spread my positive energy with my residency family. I’ve even developed Wellness Wednesday, where I send an email focused on physical, emotional, intellectual, spiritual, or financial health with the hope of providing others with an uplifting moment and helping them build resilience.”

 

Paul Bush, Pharm.D., M.B.A., BCPS, FASHP

Dr. Bush:I think the key to stepping up and leading in challenging situations is simply to stay focused. A book called The 7 Habits of Highly Effective People by Stephen Covey — and specifically the idea of putting first things first — has helped me get through the week and stay focused.

 

“I go full speed for five days a week, 10 hours a day, so recharging over the weekend with family is very important to maintaining well-being. During the week, I get on the treadmill for 20-30 minutes a day, which is both physically helpful and a good diversion. I also eat a healthy diet and try to sleep for seven hours a night. And I watch my favorite TV series and sports.”

 

ASHP InterSections: What advice would you give others in your position to help them thrive and rebound from burnout?

 

Stiener: “Surround yourself with positive and supportive friends, classmates, mentors, family members, and others who can see you through stressful times and help you maintain perspective. Also, make time for your own hobbies outside of school. It’s amazing how much easier it is to focus and stay engaged when you invest a little time in yourself.”

 

Dr. Kraus: “The triggers of burnout are often our own self-limiting beliefs. However, we can also choose to cultivate joy in our everyday life and remember that, as E.E. Cummings said, ‘The most wasted of all days is one without laughter.’”

 

Dr. Bush: “Give yourself time to recover from stressful events and reduce your workload when these things happen. Maintain a sense of hope, optimism, and self-efficacy and focus on feeling joy at work. Joyful activities such as ensuring patients have positive experiences and improving patient outcomes are healing, create connections, and add meaning and purpose. Make sure you have strategies for self-care and draw on your social safety nets and support from your organization and your peers.”

 

By David Wild

 

 

 

 

 

 

 

April 9, 2018

ASHP Leading the Way on Well-Being & Resilience

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

THE FOCUS ON CLINICIAN BURNOUT as a growing public health problem is gaining significant momentum. ASHP is an original sponsor of the National Academy of Medicine (NAM) Action Collaborative on Clinician Well-Being and Resilience and is honored to lead the pharmacy profession on this issue. We recognize that a healthy and thriving clinician workforce is essential to ensuring optimal patient health outcomes and safety. Therefore, ASHP is committed to fostering and sustaining the well-being, resilience, and professional engagement of pharmacists, pharmacy residents, student pharmacists, and pharmacy technicians. In his inaugural address, ASHP President Paul Bush called for a three-pronged approach to supporting the pharmacy workforce: building staff resilience, providing technician training and support, and encouraging clinicians to be leaders. ASHP’s commitment to improving pharmacy workforce well-being and resilience can be read here and is embedded within our recently revised Strategic Plan (Goal 4, Our Patients and Their Care).

Burnout is associated with a loss of productivity in the healthcare workforce. If you extrapolate this loss to a national level, it is equivalent to the elimination of seven graduating classes of medical schools. And healthcare worker burnout is not the only concern; a bidirectional relationship exists between burnout and medical error. For example, one study found that nursing burnout resulted in increased healthcare-associated infections. At the individual clinician level, burnout presents as emotional exhaustion (i.e., compassion fatigue), depersonalization and cynicism, and a low sense of accomplishment. At the healthcare-system or institution level, it is associated with medical errors, loss of productivity, added malpractice claims, and increased risk of patient harm. Currently, we don’t have a deep research portfolio specific to the pharmacy workforce, but we hear from you that it is an issue that needs to be addressed, and ASHP stands ready to help.

The Action Collaborative formally kicked off in January 2017 and has three goals related to increasing understanding of and identifying evidence-based solutions for clinician well-being and resilience. ASHP is actively contributing to discussions on individual and external factors that impact well-being and resilience as part of the conceptual model working group. Since the risk of clinician burnout spans all ages, stages, and career paths, this working group is tasked with identifying a model that captures the complexity of clinician well-being and resilience without oversimplifying the contributing factors. A new conceptual model was recently created to illustrate the interrelated and interlocking factors affecting clinician well-being and burnout while simultaneously conveying a vision and solutions. ASHP is a contributing author to the discussion paper that details the journey in constructing this new model.

In addition to our collaboration with NAM and contributions through the working group, ASHP is engaging our members on pharmacy well-being and resilience by:

If your organization has been working on resilience efforts to support wellness of its employees, we would love to hear from you. We encourage you to share your stories through our community on ASHP Connect. Or, maybe you know of an individual or an organization that is demonstrating positive progress to start the conversation on resilience and supporting a healthy and engaged workforce. If so, we encourage you to send us these ideas, and we can take these concepts back to the national conversation on this topic.

Thanks so much for being an ASHP member and for everything you do for your patients and pharmacy teams.

Sincerely,

Paul

December 18, 2009

MUSC Residency Program Celebrates 50th Anniversary

 

Margaret Blair Bobo

MARGARET BLAIR BOBO was literally in a class by herself when she enrolled in the inaugural pharmacy residency program at the Medical University of South Carolina (MUSC) Medical Center in Charleston in 1958.Fresh out of the MUSC pharmacy school, where she was the only female in her graduating class, Bobo found being the program’s solo resident an exhilarating learning experience.

“My year there probably was the most monumental in my life,” Bobo said. “I had no pharmacy work experience, so I learned everything. I was a sponge.”

Bobo, who went on to join the MUSC staff as a pharmacist and assistant professor, is joining other alumni this year to celebrate the 50th anniversary of one of the country’s oldest residency programs. More than 450 pharmacists, have completed the ASHP-accredited program, a collaboration between the Medical Center and the South Carolina College of Pharmacy at the MUSC campus.

Over the years, the MUSC residency program has evolved into a multi-faceted program that is nationally known for the advanced practice experiences it offers. More than 40 clinical preceptors oversee the work of an average of 20 post-graduate year 1 (PGY1) and PGY2 pharmacy residents. About 200 pharmacy students apply for the available slots, of which only 60 are chosen for interviews.

 

MUSC's residency program is one of the most well-known in the country.

MUSC’s residency program is one of the most well-known in the country.

Changing with the Times

William H. Golod, M.S., Ph.D., the program’s pharmacy and residency program director from 1959 to 1965, is credited by many with helping to triple the number of MUSC residents by the 1980s.

That growth in residents has translated into more pharmacy care for more patients and improved patient outcomes, said Wayne Weart, Pharm.D., FASHP, professor of clinical pharmacy and outcome sciences at the South Carolina College of Pharmacy and professor of family medicine at MUSC College of Medicine. He completed a residency at MUSC in 1972.

The growth means that MUSC is “training more residents who go out and apply the high level of care they learn in our program,” said Weart. “We have over 400 alumni who are doing great things all over the country.”

“When I was there, I’m not sure I appreciated how far we had come” from the program’s initial founding in 1958, he noted.

By the time Ray became director, the program had already developed a “strong clinical flavor,” he said. At that time, residents joined daily hospital rounds with medical teams.

Today, the MUSC program boasts an array of disciplines, from psychiatric pharmacy to ambulatory care to adult internal medicine. That variety helps residents find their niches and sharpen the skills that today’s pharmacists need to work on healthcare teams, said Paul W. Bush, Pharm.D., M.B.A., FASHP, director of pharmacy and graduate pharmacy education at MUSC.

“With 23 residency positions, I think our program contributes in a large way to the enhanced role pharmacists enjoy in healthcare today,” Bush said. Today’s residents mentor pharmacy students, educate fellow clinicians and patients about medication therapy, and participate in drug-use review and drug policy development and management.

“It’s important to note that MUSC’s residency program has been ASHP-accredited since 1963. The fact that it has met such rigorous standards for so long speaks to the quality of the programs required of the residents,” said Janet Teeters, M.S., director of ASHP’s accreditation services division.

ASHP has been accrediting pharmacy residency programs to ensure consistent training and improve the level of practice since 1963. The Society will reach its own milestone—1,000 accredited programs—this year.

Current MUSC resident Michael DeCoske, Pharm.D., is thankful he has been able to experience so many facets of pharmacy before choosing his career path.

“It’s a great environment to start off a career in pharmacy,” he said. “You receive a lot of great career guidance. If I had never come here, I might have been off doing a specialty that wasn’t the best fit for me.”

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