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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May 14, 2019

Mindfulness and Improv Help Pharmacy Students Cope with Burnout

Anne Graff LaDisa, Pharm.D., BCPS, uses improv to teach student pharmacists about effective communication skills.

IN A QUIET LOW-LIT CLASSROOM, students sit comfortably with their eyes closed and their spines straight. They bring attention to their breathing and imagine that they have a balloon in their stomachs. Every time they breathe in, the balloon inflates. Every time they breathe out, the balloon deflates. With every exhale, the students imagine their daily stresses and frustrations floating away. This isn’t a mindfulness retreat at some hideaway resort or the calming conclusion of a power yoga class. It’s a pharmacy course at the Concordia University-Wisconsin School of Pharmacy, where two professors are teaching students to use mindfulness to cope with burnout both during school and throughout their future careers.

According to Christina Martin, Pharm.D., M.S., Director of Membership Forums for ASHP, pharmacist burnout is a serious concern. A 2018 study published in AJHP reported that more than half of health-system pharmacists surveyed felt a high degree of burnout. In addition, a recent salary survey found that two-thirds of pharmacists experienced increased job stress over the previous year, and that 72 percent said workloads increased from the year before.

“When healthcare providers feel stressed, it can also have an impact on their patients,” said Dr. Martin. Burnout is associated with more medical errors and poorer patient safety outcomes, according to the Agency for Healthcare Research and Quality. “We really have to care for the caregiver and ensure that we’re providing resources and support to those who are caring for patients in very chaotic healthcare times,” she added.

Mindfulness in the Classroom

Elizabeth Buckley, Pharm.D., CDE

Elizabeth Buckley, Pharm.D., CDE, Associate Professor of Pharmacy at Concordia University-Wisconsin School of Pharmacy, often includes the balloon-in-the-stomach exercise in her classes. She first introduced it while teaching a diabetes elective for third-year pharmacy students in the spring of 2017 — and she saw immediate changes. It made a huge difference “on attitude, on calmness, on collegiality,” she said.

It worked so well that in the fall of 2018, she added it to her weekly lectures in the Applied Patient Care I course, which is for first-year pharmacy students. “The tone of the class changed in a significant way. Everyone settled down and the discussion was more robust,” she said. “The mindfulness exercise centered me, and it centered the class.”

Dr. Buckley hopes that teaching pharmacy students mindfulness now will help them avoid burnout in the future. “If you’re going to be in a career where you care for other people, you have to figure out self-care in order to be good at being a clinician,” she said.

Improv Shakes Things Up

Anne Graff LaDisa, Pharm.D., BCPS, Associate Professor of Pharmacy at Concordia University-Wisconsin School of Pharmacy, began teaching an improvisational class to first-year students to help bolster communication and teamwork skills. Improv is a theatrical technique where the characters and dialog in scene or story are made up on the spot. Communication skills learned through improv can help a student become a good pharmacist, she noted. Although she didn’t introduce improv classes for pharmacy students with combating burnout in mind, she explained that improv exercises allow students to be creative and break up a school routine.

Anne Graff LaDisa, Pharm.D., BCPS

Dr. LaDisa began taking improv classes herself in 2003. When she discovered that medical schools were using improv to teach and improve medical students’ communications skills, she became intrigued — even more so when she learned that the University of Arizona has been using improv in its pharmacy school since 2004.

She introduced improv to an existing course in 2015, then taught her first stand-alone elective course for first-, second-, and third-year students in 2017. At the beginning of every class, she reviews the rules of improv, which include always saying “yes, and …” to what your partner is trying to communicate, emphasizing the here and now, being specific, and focusing on characters and relationships.

In Dr. LaDisa’s class, a two-person scene requires the students to follow the rules of improv and may involve a scenario unrelated to healthcare. After the students complete the improv exercise, she asks them questions about how they felt about the activity – what things they found challenging and what skills they felt they had to use to be successful. Finally, the students talk about how to apply those skills to clinical pharmacy practice.

Role-playing in a healthcare or social setting can help pharmacy students improve collaboration and teamwork skills. “Improv training gives students an advantage when it comes to communication, which is a critical skill for all pharmacists,” she said.

By Jen A. Miller


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