Dr. Zanni is a psychologist and healthsystems specialist based in Alexandria, Virginia.
What comes to mind when one thinks of occupational hazards? Most think of jobs involving heavy physical demands or exposure to potentially life-threatening situations. Pharmacists, however, are at high risk for a more subtle, insidious occupational hazard: burnout. It is psychologically and physically debilitating—even career-ending—and its warning signs should be red flags for all pharmacists.
Burnout, a multidimensional syndrome, is generally recognized only after symptoms wreak havoc. Acute burnout does not exist; slowly developing symptoms worsen progressively. Burnout's 3 core domains to recognize are as follows:
Burnout and stress differ. Stress may cause emotional exhaustion, but burnout always generates cynicism and a sense of inadequacy (characteristics that are absent from normal job-related stress). Job stress, however, generally includes somatic symptoms (eg, anxiety) that are not necessarily present with burnout. One also is usually aware of stress reactions but does not always notice burnout (symptoms can take months to surface).
When workplace expectations and realities are disparate, burnout is a given. The following 6 areas are often troublesome for pharmacies:
Pharmacy is fertile ground for burnout due to chronic staffing shortages, the heavily regulated environment, excessive documentation, the inability to control requests, a focus on negative outcomes (eg, prescription errors), incongruence between expertise and job components (eg, certified in disease management but performing peel-and-stick bench work), lack of positive feedback (eg, drug-use reviews rarely commented on), and few rewards for improved patient care or preventing contraindications. Inadequate pharmacy resources seem to reach epidemic proportions. In a recent pharmacy poll, 61.5% of respondents indicated their employer has unrealistic expectations regarding work that can be accomplished in an 8-hour day.3
Although >30 signs of burnout exist, the box highlights 10 classic signs that relate to pharmacists. Not all will experience each symptom; most experience at least 1 in each of burnout's 3 domains. Identifying with ≥1 of the signs listed in the box occasionally or regarding specific incidents is normal. When it becomes constant, action is needed, or burnout will consume and debilitate.
Pharmacists with burnout must self-assess, looking for workplace conditions that fuel burnout. The following are some effective strategies for each workplace antecedent:
Workplace Overload. Avoid focusing on quantity or working harder; instead, examine the process used to complete tasks with an eye to change. Explore job sharing or trading assignments with colleagues. Overhaul daily routine and reshuffle tasks.
Lack of Control. Define and separate work and home life. Avoid working while eating. Take breaks but avoid discussing and reading work-related material. Learn to say "no" when asked to voluntarily take on more assignments.
Insufficient Rewards. Seek positive feedback. Inform supervisors that both positive and negative feedback are important to you.
Lack of Community. Seek others suffering from burnout and form a peer support group. Initiate actions that foster interpersonal relationships; talk to a career-seasoned mentor.
Unfairness. Work with supervisors to improve the workplace. Document personal accomplishments to help ensure fairness.
Value Conflict. Seek out value-compatible assignments. Focus on the intrinsic value of your work, not on organizational constraints. Explore potential transfers. If the value conflict is irreconcilable, seek counseling or make a career change.1
Studies demonstrate that burnout affects younger professionals disproportionately, especially in the first 5 years of their career. Young or struggling pharmacists may hesitate to discuss concerns with supervisors, confusing feeling overwhelmed with personal inadequacy.1,2 Because most managers rarely discuss burnout, the staff struggles. Some find successful interventions or a mentor to help; others quit the job or the profession. Adopting prevention strategies to ward off or minimize burnout is a key component of ensuring job satisfaction.
Adapted from references 1, 2, and 4.