ASHP InterSections ASHP InterSections

April 30, 2020

ASHP Continues to Support Members and the Healthcare Community Through the COVID-19 Pandemic

Dear Colleagues,

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

THE COVID-19 PANDEMIC is changing our country’s healthcare landscape every day. Critical health policy changes are occurring at an unprecedented rate. We continue to engage with state and federal policymakers to ensure that pharmacists’ expertise is fully utilized and that healthcare providers are equipped to safely and effectively respond to the pandemic.

Update on States’ Response Efforts

State governors are issuing executive orders that expand pharmacists’ ability to provide high-quality care to patients during this crisis. For example, Michigan now permits pharmacists within licensed health facilities to contribute to routine health maintenance and manage chronic disease states without physician supervision. This expansion alleviates burdens on primary care providers and expands access to care, especially in rural and underserved communities where pharmacists are the most accessible healthcare professionals.

We are also seeing a positive trend in pharmacists’ ability to manage therapeutic interchange. In Iowa and Kentucky, executive orders grant pharmacists the authority to substitute medications in response to drug shortages.

Point-of-care testing for COVID-19 is critical to the national pandemic response. Some states already permitted pharmacists, under their scope of practice or through collaborative practice agreements, to order and administer these tests. Pennsylvania, which previously allowed pharmacists to order and administer tests, has taken emergency measures to grant pharmacists explicit authority to order and administer COVID-19 tests. States like Florida, Illinois, Kentucky, and, most recently New York, issued executive orders that permit pharmacists to order and administer COVID-19 tests. State-level COVID-19 response is a rapidly changing situation as local healthcare providers respond to patient surges and the demand for testing. Please check with your state’s board of pharmacy for more information about the status of COVID-19 testing in your area. Helpful information on COVID-19 testing can also be found on the National Community Pharmacists Association’s website.

ASHP applauds state governors’ efforts to expand pharmacists’ scope of practice during this state of emergency. However, we are concerned that authorizing the expansion of pharmacists’ services without authorizing payment for those services will limit the delivery of care in some pharmacy practice settings. COVID-19 is already highlighting shortcomings in state Medicaid payment systems and commercial payer policies that prevent qualified pharmacists from fully serving patients. ASHP is working closely with our state affiliates and other organizations to request reimbursement for the new services they are providing under the state of emergency. This advocacy aligns with ASHP’s Pharmacy Readiness for Coronavirus Disease 2019 (COVID-19) Recommendations for State Policymakers. The recommendations address shortages of drugs and medical supplies and reimbursement of pharmacists for patient care services and also provide readiness and resilience resources for clinicians.

Pharmacists are Essential Healthcare Personnel

ASHP continues to voice our support for all pharmacists who are working tirelessly across the continuum of care in response to the COVID-19 pandemic. Yesterday, I sent a letter to the chief executive officer of Novo Nordisk responding to a full-page NovoCare ad that ran last weekend in the Wall Street Journal and other publications. Pharmacists were omitted from a list of individuals, including nurses, doctors, researchers, and other essential workers who were acknowledged for their caring efforts on the front lines of the COVID-19 response.

In the letter, I reinforced that pharmacists are highly skilled, licensed healthcare professionals who play a key role in selecting and optimizing medication therapy for patients. Pharmacists also oversee the entire medication-use process in hospitals and health systems, including the purchasing, distribution, preparation, and administration of pharmaceuticals. I further explained that, as members of interprofessional healthcare teams, pharmacists are providing a broad range of patient care services during the COVID-19 public health emergency, from directly caring for mechanically ventilated patients in critical care settings, to providing point-of-care testing and medication management to patients in community pharmacy settings and beyond.

It is my hope that Novo Nordisk will appropriately recognize pharmacists and the important role they play in future communications.

ASHP’s Response to Disruptions in Residency Training

In last week’s blog, I discussed the COVID-19 pandemic’s impact on residency training. As a result of disruptions in routine or elective procedures and reductions in inpatient hospital stays, some hospitals and health systems are facing the difficult situation of furloughing their PGY1 and PGY2 pharmacy residents. These actions can disrupt patient care and make residents ineligible for board certification and professional positions that require postgraduate pharmacy residency training. We believe that educating future generations of pharmacists is more critical than ever, and ASHP has issued a statement opposing the furlough of residents.

As always, ASHP is here to support residents and residency programs. If you need assistance with a furlough situation, please reach out to Janet Silvester, vice president of Accreditation Services, or Stephen Ford, director of Residency Accreditation Services.

ASHP is Here for You and the Entire Healthcare Community

Over the past several weeks, I have been sharing information about new and timely resources that ASHP has developed and made available to optimize medication use and patient outcomes during this public health emergency. The response to these offerings, which is captured in a new ASHP infographic, has been tremendous. We are immensely proud of our staff and volunteers who have been working tirelessly to deliver highly relevant information across multiple channels. Our COVID-19 Resource Center is updated regularly with new content and I hope you continue to find the tools and information produced by ASHP valuable as needs related to the pandemic response evolve.

Thank you for being a member of ASHP and for everything that you do for your patients and our profession.

Sincerely,

Paul

 

April 9, 2020

Important Wins on the Advocacy Front in the Fight Against COVID-19

Dear Colleagues,

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

AS THE IMPACT OF THE COVID-19 PANDEMIC CONTINUES TO ESCALATE ACROSS THE COUNTRY, there is increased urgency to ensure that frontline pharmacists, pharmacy technicians, and our healthcare partners have the medications and equipment they need to successfully treat their patients. ASHP continues to spearhead multiple advocacy efforts that support your ability to provide the best care possible for those in need.

Mitigating shortages of critical medications like propofol, fentanyl, midazolam, paralytics, and others remains a high priority. We continue to engage with relevant federal agencies to improve access to medications. I am pleased to report that the Drug Enforcement Administration (DEA) and the Food and Drug Administration (FDA) have taken critical actions in direct response to ASHP’s advocacy efforts.

ASHP, in coordination with the American Medical Association, the American Hospital Association, the Association for Clinical Oncology, and the American Society of Anesthesiologists, sent a letter last week to the DEA requesting an immediate increase in the annual production quota allocations for Schedule II controlled substances. This would enable manufacturers and 503B outsourcing facilities to increase the supply of opioids critical to the care of COVID-19 patients on ventilators. As a direct result of this collaborative advocacy effort, the DEA announced yesterday that it is taking immediate actions to address this critical issue. These actions include increasing the annual production quota for controlled substances, including fentanyl, morphine, and hydromorphone, that are used for the treatment of mechanically ventilated COVID-19 patients, and increasing the amount of ketamine, diazepam, and other controlled substances that can be imported into the United States.

We also sent a letter to the FDA advocating for regulatory flexibility in compounding drugs in shortage and compounding in hospitals. ASHP’s advocacy efforts, including significant staff engagement on the issue, directly triggered the FDA to clarify existing compounding guidance, including the removal of the one-mile radius requirement for hospitals compounding medications. FDA’s quick action to reduce regulatory hurdles for health systems is an important step to help clarify compounding guidance during this crisis.

ASHP will continue to advocate for additional compounding flexibility, including the expansion of FDA’s drug shortage list to include products ASHP has identified as in shortage. We will also continue to seek 503B outsourcing facility flexibility, particularly for hospital-owned or affiliated 503B operations, to help ensure they can meet hospitals’ medication needs.

Yesterday, we were pleased to see that the Department of Health and Human Services (HHS) authorized pharmacists to order and administer COVID-19 tests pursuant to the Public Readiness and Emergency Preparedness (PREP) Act. The authorization is responsive to the joint COVID-19 recommendations we created with other national organizations. While this authorization does not address pharmacist reimbursement, we are encouraged to see HHS providing pharmacists with a greater role in supporting the COVID-19 response, and we continue to work on that issue.

We also continue to actively advocate for Congress to recognize pharmacists as providers in the Medicare program to further support the COVID-19 response and beyond. Yesterday, ASHP and 11 other national organizations sent a letter requesting that Congress immediately support legislation that would establish pharmacists as providers in Medicare Part B on an emergency basis to provide COVID-19 and flu testing. This authority is an important step in being able to rapidly expand access to testing across our country to support the national response to this crisis. We also see this as a step toward expanded recognition of pharmacists by payers, including Medicare.

Finally, ASHP is also working with our members and other stakeholders to gain access to medications from the Strategic National Stockpile (SNS). Most recently, we joined with several organizations to request that FEMA immediately release all available quantities of a number of critical drugs from the SNS to the New York and New Jersey Departments of Health to address urgent patient care needs. We are also working to support other state affiliates and members across the country with these important requests.

ASHP and its government relations team will continue to work tirelessly with our collaborating partners to ensure that U.S. regulatory authorities are responding to the current needs of pharmacists and healthcare providers.

While our collective attention is on the needs of frontline practitioners, I wanted to take an opportunity to highlight some positive news about the newest members of our profession. ASHP’s 2020 Residency Match concluded this week, and I want to congratulate the 5,269 future pharmacists who matched with 2,551 PGY1 and PGY2 pharmacy residency programs across the country. This number represents a 46% increase in the number of available positions over the past five years – a remarkable rate of growth. I am pleased that our accredited residency programs have demonstrated an outstanding commitment to training during the pandemic. While managing multiple critical priorities, these programs continued to interview applicants virtually. This undoubtedly will be a unique time during which to begin a residency program regardless of its focus. ASHP is committed to ensuring that these young practitioners and their programs have the needed resources to successfully conduct critically important resident training this year and beyond.

In the same vein, please know that ASHP stands ready to offer you and your healthcare colleagues that same level of steadfast support. In addition to advocating to give you access to critical medications, ASHP continues to update and create new resources and tools that can be found on our COVID-19 Resource Center. We have also opened access to many evidence-based online resources and tools on ashp.org, making them widely available to all pharmacists and the broader healthcare community.

Over the last few weeks, I have heard countless stories from members and others about the challenges they are facing, but I’ve also heard many stories of hope and heroism. I, and David Chen, ASHP assistant vice president for Pharmacy Leadership and Planning, have listened in on calls from pharmacy leaders at major health systems in New York City, the pandemic’s current epicenter. We are incredibly impressed by how these leaders have shared their information and experiences and how they support each other and their frontline staff. This is a tremendous example of how peer-to-peer connection and communication can aid in the pandemic response. Their experiences and willingness to share their stories will undoubtedly help others in responding to COVID-19 in facilities across the country. We applaud them for these efforts.

Please also know that ASHP is here to support your well-being, which should remain a priority for all healthcare personnel during this challenging time. Please make sure that you are taking care of yourself and your family.

“ASHP has our backs.” These are the words of a member who recently reached out to us. This really resonated with me, and I can assure you that we will continue to work across all fronts, leveraging our talented staff, our valued partners, and our amazing members to provide you with the information, connections, and resources you need today and in the future.

Thank you for everything you do for your patients and the profession.

Sincerely,

Paul

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

 

# # #

May 20, 2019

ASHP is Committed to Ensuring that all Medications are Accessible, Safe, and Effective

Dear Colleagues,

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

Many of you may have seen recent stories in the media questioning the accessibility and safety of generic drugs, including those manufactured overseas. These stories, and others like them, could lead to fear and confusion among patients, potentially leading to adherence issues and poor health outcomes. As the medication safety experts on the front lines with patients, it is critical that our members know that ASHP is committed to working with you, our partners in government, and other key stakeholders to help ensure that medications are accessible, safe, and effective, regardless of origin.

We have been in recent contact with FDA leaders to ensure that they fully appreciate the concerns that ASHP and our 50,000 members have regarding the absolute need for quality generic medications, and the need for the entire pharmaceutical industry to adhere to standards of quality. ASHP will continue to meet with FDA, Congress, industry leaders, and other stakeholders to help assure the public that the medications they take are safe and effective, and will strongly advocate for any changes that may need to be made to law or regulation to support that goal.

On Friday, the FDA’s Office of Regulatory Affairs issued a statement that reaffirms their commitment to safety and quality and outlines their risk-based approach to global inspections.

The safety and efficacy of medications is central to ASHP’s patient care and public health mission and we have championed these issues in our ongoing work in a number of areas, including sterile compounding and drug shortages. We enjoy a close partnership with officials at the Food and Drug Administration (FDA) and, as a longtime leader and Board member in the Alliance for a Stronger FDA, have been a vocal advocate for sufficient federal appropriations to the agency so that it has the resources necessary to ensure the safety and effectiveness of medical and other FDA-regulated products.

We will continue to be in close contact with the FDA and will keep you informed on steps they are taking to ensure the quality and safety of generic medications in light of recent stories in the media.

ASHP has also long been at the forefront of efforts to address escalating drug prices, including generic medications, and their impact on pharmacy practice and patient outcomes.

ASHP is a lead member of the Steering Committee for the Campaign for Sustainable Drug Pricing (CSRxP) and is actively involved in other collaborative efforts to identify bipartisan solutions to address skyrocketing drug prices and provide more affordable choices for patients. ASHP strongly supports the need for reforms to address the underlying causes of high drug prices, including increased transparency, competition, and value.

In addition to our work with CSRxP, ASHP is actively engaging Congress on critical issues related to access and affordability of medications. ASHP has submitted 11 statements related to drug pricing to congressional Committees over the past year, and in just this month alone, ASHP representatives have met with two dozen congressional offices, representing the voices of our members on the tremendous impact of escalating drug prices.

Late last week the House of Representatives passed legislation to reduce the cost of generic drugs, by prohibiting brand manufacturers from taking steps to keep generic products from the marketplace, including barring pay for delay tactics, allowing generic manufacturers access to samples of branded products, and removing regulatory barriers to the launch of multiple versions of a generic product.

ASHP is supportive of the drug pricing provisions included in H.R. 987 as they represent important steps to promote competition and ensure that generic drugs reach patients sooner. In the weeks and months ahead, we will take this message to the U.S. Senate and advocate for drug pricing legislation.

We will continue to advocate for policies and regulatory solutions that support safe, effective, and accessible medications for our patients, and will provide updates on new activities, initiatives, and outcomes from our efforts as available. If you have any questions, please feel free to contact ASHP’s Government Relations team. Further, we will plan to keep you updated on this issue and others as new developments arise.  Thank you for being a member of ASHP, and for everything you do for your patients.

Sincerely,

Paul

 

April 30, 2019

ASHP Joins the National Academy of Medicine Action Collaborative on Countering the U.S. Opioid Epidemic as a Sponsoring Member

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

I AM PLEASED TO SHARE WITH YOU THAT ASHP has become a sponsoring member of the National Academy of Medicine Action Collaborative on Countering the U.S. Opioid Epidemic. The other Collaborative Sponsors are:

  • Accreditation Council for Graduate Medical Education
  • Aetna
  • American Hospital Association
  • American Medical Association
  • Arnold Ventures
  • Association of American Medical Colleges
  • Centers for Disease Control and Prevention
  • CDC Foundation
  • Centers for Medicare and Medicaid Services
  • Council of Medical Specialty Societies
  • Federation of State Medical Boards
  • HCA Healthcare
  • National Institute on Drug Abuse
  • Robert Wood Johnson Foundation
  • Substance Abuse and Mental Health Services Administration

The mission of the Action Collaborative is to “convene and catalyze public, private, and non-profit stakeholders to develop, curate, and disseminate multi-sector solutions designed to reduce opioid misuse and improve outcomes for individuals, families, and communities affected by the opioid crisis.”

ASHP and our 50,000 members who serve as direct patient care providers in hospitals, health systems, rehabilitation centers and ambulatory clinics will bring a great deal of expertise to the Collaborative and play a major role to mitigate and end the opioid epidemic on behalf of our patients and communities, while ensuring that our patients receive appropriate pain management.

ASHP will serve on the Action Collaborative’s Opioid Prescribing Guidelines and Evidence Standards Working Group, and will also be providing insights and expertise to the Collaborative’s Health Professional Education and Training Working Group; Prevention, Treatment, and Recovery Services Working Group; and Research, Data, and Metrics Needs Working Group.  As part of our initial work with the Collaborative, we have made several commitments that include but are not limited to:

  • Creation and dissemination of patient and prescriber education on pain management and opioid abuse mitigation best practices.
  • Enhanced patient access to evidence-based treatment for opioid use disorder through increased utilization of pharmacists on the healthcare team.
  • Standardization of a framework for pain stewardship to coordinate pain management, opioid prescribing, and use of non-opioid therapies.
  • Coordination of care among patients, caregivers, and healthcare professionals through the use of standardized patient-specific pain management and substance use disorder treatment plans.
  • Improvement of interoperability, artificial intelligence, and clinical decision support in healthcare information systems.
  • Identification of performance and quality metrics to assess impact.
  • Stimulating research on pain and opioid use disorders and their respective pharmacologic and non-pharmacologic treatments.
  • Advancing efforts to prepare the pharmacy workforce through pharmacy education and professional development programs.

ASHP has also been actively involved in numerous public and private sector efforts to address the opioid crisis through the leadership of pharmacists and has worked diligently across a number of fronts to identify enduring solutions, including advocating for better access to medication-assisted treatment. We had the pleasure of working with the White House Office of National Drug Control Policy and attending the ceremony to commemorate the signing of H.R. 6, the “SUPPORT for Patients and Communities Act,” bipartisan legislation to combat the opioid crisis in October. ASHP will also continue to pursue policies that further support the vital roles pharmacists play as patient care providers in the treatment of acute and chronic conditions, including opioid and substance-use disorders.

You can find additional ASHP resources on our website, including:

We look forward to sharing more about our work with the National Academy of Medicine Action Collaborative on Countering the U.S. Opioid Epidemic and on ASHP’s ongoing efforts surrounding the opioid crisis, including creating various tools, education, and resources to support you in your practice.

Thank you for being a member of ASHP, and for everything that you do for your patients.

Sincerely,

Paul

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

 

 

 

 

 

 

 

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