Letting Go: Burn Out and Claiming Your Well-Being
I’ve been researching the subject of burnout lately for an article and the more I read and talk to people, the more I recognize the symptoms in myself at certain times in my career.
Characterized by emotional exhaustion, cynicism, lack of enthusiasm for work, and a reduced sense of personal accomplishment, burnout is becoming all too prevalent among professional students and healthcare workers. Emotional exhaustion, you bet (thank you pharmacy school)! Cynicism, absolutely. Reduced sense of personal accomplishment, that feeling was what catapulted one of my biggest career moves!
Stress and burnout have become common topics for the welfare of healthcare professionals recently. Health systems are starting to put initiatives in place to encourage employee wellness. This is why it is (or would be) so important to have a few built in breaks in community pharmacy! Burnout is associated with more medical errors, poorer patient safety outcomes, and poorer patient satisfaction. Just a few moments of downtime each day would significantly help (again, community pharmacy owners, are you listening?!).
The Agency for Healthcare Research and Quality estimates that 10-70% of nurses experience burnout, as well as 30-50% of physicians, nurse practitioners, and physician assistants. The job satisfaction of pharmacists’ differs depending on the setting and surveys show that over 60% reported increased job stress over the previous year. And a recent article in AJHP noted that pharmacists are particularly vulnerable to burnout because we work in a tightly regulated profession with excessive documentation, depersonalization in work, and “incongruities between skills and actual day-to-day tasks” – so we often feel like we aren’t doing what we were trained to do or what we entered the profession to do!
Burnout is typically a result of too much time with unresolved stress and not enough time of rest. Most of us have gone through this at one point or another. In the past, it was usually just accepted, but the climate is changing now and we are starting to develop awareness and understand the outcomes too much unresolved stress. I’ve experienced this several times in my life and career. One big quality of burnout is that it seems unrelenting without any sign of reprise or relief. Maybe it’s an unpleasant work situation, an enormous job load, or just the world of flu shots, insurance claims, key performance indicators and unhappy patients! It’s almost like having those labor contractions over and over again without any rest and without any reward at the end!
So, we are stressed, possibly experiencing burnout and our jobs keep getting busier and more demanding – we don’t need a trial to tell us that. But, what do we do?!
I find that pharmacists expect a lot from themselves - excellence in every area of their lives. And sometimes, something has to give. That thought alone is enough to stress out many type A’s. We need to be able to let go of that perfect picture in our heads that everything will just run smoothly all the time and that we are less of a person if it doesn’t. It won’t. Give yourself permission to react and be stressed out. That is a normal reaction to everything you are doing. And when that stress doesn’t let up, well, then it’s time for a break or change. As the bar of expectations continues to rise, it is just not even a matter of if, but when.
So, can you do something or is all lost, and our profession is spiraling into a well of overworked, stressed out workers run by metrics driven corporations?
Why did you go into this profession?
Connect your purpose to what you are doing. Did you enter into pharmacy for the good hours (hopefully not J!) so that you could have more family time? Did you do it for the rewarding patient interactions? Did you do it to be involved in healthcare and change? Connecting to your purpose during times of stress is important to seeing the big picture and finding satisfaction.
Students, why are you going to school? It’s hard to see the light at the end of the tunnel especially if graduation is 3 years away. Know that you are working hard for a purpose and it will be easier to move forward.
Awareness of the overload
Just acknowledging that you are doing a lot and that our profession requires a lot is a big step. We often feel isolated in our challenges and gaining a sense of “you are not alone” can give us the perspective we need. The stigma of burnout is also going away. National initiatives are underway and research is starting to be done on the effects of stress and productivity. Change may be on the horizon.
Don’t be afraid to take a break
Someday, we will be able to take breaks in all practice settings. Some states are starting to mandate breaks while others lag behind. Don’t be afraid to take a mental health day. But who will cover for me, you may ask. They can figure it out. Sometimes just a few extra hours or a day here and there will do wonders for how you feel about work. And it will give you the energy to work on yourself which can also aid in resilience.
Can you step back? If it is really too much to handle, can you reduce hours or look at another avenue in pharmacy? I know you think the job market is touch or that it is impossible to break into hospital or another form of pharmacy, give yourself more credit than that! You’ve learned a lot so far, put yourself out there, learn some new skills, hire a coach, and see where it takes you.
Strengthen your resilience
Speaking of resilience, wouldn’t it be nice if there was an easy toolkit for developing this innate quality that will apparently buffer us from feelings of hurt, rejection and demise? There may not be a perfect formula, but there are a few things that you can do to build this quality of knowing that we can handle challenges, difficulties, and hardships in our lives.
Are you good with change? Accept that change is an inevitable part of healthcare (and life!). All of the change we experience is very stressful to some people – but with drug shortages, new technology, changing regulations, we are always going to be going through some state of change. Getting enough sleep and exercising can also do wonders for your mental state. Having solid goals and feeling like you are making progress on those goals adds to your resilience as well as learning from your failures and setbacks.
Join or participate in your community
Along the lines of awareness is community. I am a member of a pharmacist online group and it is amazing at the camaraderie in there. People will post a question unique to their billing software or dispensing system and they have resources; and it’s not just for technical issues – questions come up covering all aspects of pharmacy. Knowing that you are not alone is such a big factor with burnout, stress, and depression. Yes, healthcare professionals keep doing what they have to do and it’s hard when we look around and compare because it appears that everyone else is handling things well.
Let it go
I say this all the time, it’s not personal. Work is work and some lucky people are working their passion (more on this later and how to get there!). Go home, take off your shoes, and stop replaying those stressful moments in your head.
There are many resources out there for you! The Fit Pharmacist has written a book on this subject. If you need more specifics, please send me a note.
As always, I am hear for questions, thoughts, or just for sharing your story!