ASHP InterSections ASHP InterSections

October 22, 2019

Surviving Stress: Tips for Staying Sane through Pharmacy School and Beyond

Brooke and Ashley Barlow

STRESS CAN START EARLY in your pharmacy career. Pharmacy school and residency are particularly challenging, which is why focusing on well-being and self-care at the beginning of your career can build healthy habits that can last for a lifetime. PGY-1 residents Ashley and Brooke Barlow know exactly what that feels like.

Well-being and Sisterhood
The sisters, while identical, are not twins, but rather two-thirds of a set of triplets! Their sister is not identical, and not a pharmacist. They hail from a family where healthcare was always important – both parents are nurses. Brooke is currently a PGY1 Pharmacy Resident at the University of Kentucky Healthcare. Ashley is a PGY1 Pharmacy Resident at the University of Maryland Medical Center. They went into pharmacy after spending time with a pharmacist who cared for their grandfather during his terminal illness.

“Our first year at Jefferson College of Pharmacy was hard,” said Brooke. “We realized that we could be happier and healthier.” Both are former athletes – Ashley is a swimmer and Brooke competed in track and field hockey. The duo decided to combine the concepts they learned as athletes with their long-standing interest in well-being to develop ways to combat burnout and stress. This resulted in practical techniques they could use to promote resilience during pharmacy school and their residencies.

The following are Ashley and Brooke’s tips for staying resilient through pharmacy school and beyond:

  • Make time for self-care. It’s easy to put yourself and your needs on the back burner when you are loaded with work. However, neglecting to put aside time to care for yourself can have long-term consequences. “Create a list of self-care activities that you enjoy,” Ashley advised. “Set a 5-minute alarm on your phone each day and take time to do something unrelated to pharmacy. For me, I might call my mom or dad, or go outside and take a walk. You can always spare 5 minutes to take care of yourself.” A 5-minute break is also a great way to rest your eyes, clear your head, and refocus.
  • Integrate physical activity into your day. “It’s important to advocate for your health,” said Brooke. “You may not have time to go to the gym anymore, but that doesn’t mean you can’t be active.” The sisters noted that there are easy ways to add activity into your day – take the stairs instead of the elevator or park farther away from your destination. Particularly during residency, it’s vital to squeeze in some time for physical activity. When organized sports were no longer an option for Ashley and Brooke, the sisters took up weightlifting to stay physically fit.
  • Tackle your demons first. Organization reduces stress. “Prioritize your time and get started,” said Brooke. While the natural tendency is to do the easiest task first, the sisters recommend the opposite. “Tackle your demons first,” Brooke added. She recommends developing a task timeline with deadlines. “This can eliminate a lot of stress if you start early and are structured,” she said.
  • Stop and smell the roses. Don’t overlook celebrating your successes. “Part of burnout comes from a lack of self-fulfillment,” said Ashley. “It’s important that instead of just moving on, you stop, pause, and allow yourself to enjoy what you accomplished.” Recognizing and celebrating your successes, even small ones, can help you feel more fulfilled.
  • Find a creative outlet. Face it, school (and sometimes work) can be monotonous. Monotony can lead to burnout, noted Ashley. Doing a fun activity in your downtime can help you feel more creative and motivated the rest of the time. Ashely has taken up photography as a creative outlet, and both sisters are enthusiastic cooks. They have combined both interests into a cooking blog that serves as their creative outlet.
  •  What’s your why? “One piece of advice we would give to all residents and students to mitigate burnout is to find the answer to the question ‘What’s your why?’” said Ashley. “Everyone has a different fuel for their fire. If you have identified your ‘why’ in life, it will make what you do much more fulfilling and bring you closer to your meaning of well-being!”

 The Bottom Line
Although stress and burnout can occur during school, residency, or in the workplace, there are ways to reduce the pressure and help you feel better. Exercise, creative hobbies, and taking time for yourself are things you can do today to improve your resilience and well-being. Ashley and Brooke’s final bit of advice stems from Drayton Hammond, Pharm.D., M.B.A., M.Sc., Assistant Professor and Clinical Pharmacy Specialist at Rush Medical Center. “Don’t ever let the fear of failure hold you back from great opportunities,” he said.

 

By Ann Latner

 

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September 17, 2019

Young Pharmacists Show that Helping Others is a Prescription for Well-Being

Emily Belarski, Pharm.D., goes hiking to decompress after a stressful day.

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.

Meredith Oliver, Pharm.D., spends time in Utah’s Wasatch National Forest after a long day in the hospital.

“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.

Autumn Pinard improves her resilience by spending time outdoors.

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.

Lubna Mazin, Pharm.D., climbs mountains to ward off burnout and stress.

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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