Shane Desselle, RPh, PhD, FAPhA

The modern pharmacy, regardless of practice setting, can be rife with frustrations. Managers and peers have likely experienced, drug shortages, certain staff not appearing to pull their own weight, role conflict expectations from various stakeholders, problems with third-party payers, and many other issues. Between work and even family/social issues, it is little wonder that the average person vents several times per day.

Venting is defined as the discharge of negative feelings by expressing or discussing it with others.

 A commonly held belief is that venting is healthy in nature because it allows the venter to get negative emotions off their chest rather than bottling it inside.

However, extensive literature in psychology demonstrates considerable nuance into the ramifications of venting. Venting has been found to shift one’s mental capacity toward a focus on negative emotions rather than problem-solving.

Furthermore, venting does NOT actually help the venter feel better; rather, it just evokes a re-run of the same negative emotions over and again.

It is important for managers to realize that the events that trigger venting are typically routine in nature. Examples of triggers may include perceived unequal work distribution, challenging patients, inventory shortages, malfunctioning equipment, and/or troubles outside the work environment.

The second thing to realize is that venters either consciously or subconsciously choose their listeners. According to Behfar et al, venters are looking for cognitive and emotional support.

 They want to feel safe. It is important for managers to foster a safe work environment in which comments borne from frustration are not silenced or ridiculed.

Behfar et al also found that a listener who was able to provide new insight for the venter was the most helpful in regard to problem-solving. Cognitive or emotional affirmation of a venter was not helpful since it did not provide any new information. In fact, it was found to perpetuate negative emotions.

Thus, managers must not only possess high levels of emotional intelligence, but should also be a role model and encourage development among staff that facilitates more effective and creative outlets for frustration and help instill better coping strategies than venting. They might even go so far as to codify, in writing, expectations for staff comportment as it relates to potentially frustrating situations so that employees do not engage in the type of venting or other activities that can disturb or even upset their colleagues.

Managers should attempt to reorient venters to new insights that may help them think or feel differently about their situation rather than offer a placating response or return their venting with anger of their own. Providing new perspectives allows for increased problem-solving behavior that can lead to better work and better patient care outcomes.

Pharmacy Management: Essentials for All Practice Settings, 5e

Alicke M, Braun J, Glor J, Klotz M, Magee J, et al.Complaining behavior in social interaction. 

Personality and Social Psychology Bulletin

Folkman, Susan, and Richard S. Lazarus. Coping as a mediator of emotion.

Brown SP, Westbrook RA, Challagalla G. Good cope, bad cope: Adaptive and maladaptive coping strategies following a critical negative work event. 

Bushman BJ. Does venting anger feed or extinguish the flame? Catharsis, rumination, distraction, anger, and aggressive responding. 

Kowalski RM. Complaints and complaining: Functions, antecedents, and consequences. Psychol Bulletin. 1996;119(2):179-193.

Nolen-Hoeksema S, Morrow J. A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta Earthquake. 

Thomsen DK, Mehlsen MY, Christensen S, Zachariae. Rumination—relationship with negative mood and sleep quality. 

Behfar KJ, Cronin MA, McCarthy K. Realizing the upside of venting: The role of the challenger-listener. 

. Touro University California College of Pharmacy

. Professor of Social and Behavioral Pharmacy, Touro University California College of Pharmacy

Articles

Pharmacy managers must not only possess high levels of emotional intelligence, but should also encourage development among staff that facilitates more effective and creative outlets for frustration.

Tip of the Week: How to Handle Venting at Work?

Resilience is a lifelong skill that can improve adaptability to many situations, especially in the workplace. According to Merriam-Webster, resilience is “the ability to recover from or adjust easily to misfortune or change.”

The pharmacy environment, constantly evolving with new treatment regimens, updated laws, and more patient-centric practice recommendations, is a place where improved resiliency can come in handy. Especially when faced with uncertain times during a pandemic, resilience helps pharmacy personnel cope with mounting pressures and demands that come from stressed patients, tense supervisors, nervous patients, and precarious supply chain balances.

Austin and Gregory examined the resilience of pharmacists during the COVID-19 pandemic.

 They found that pharmacists demonstrated practice resilience during the pandemic if several factors were in play, such as comfort with technology use, early adoption of corporate/professional guidance, and a workplace that focuses on effectiveness of singular tasks rather than on multitasking.

The study demonstrated that companies that had previously invested in technology to help with prescription filling or with communication were better able to manage the influx in prescription volume at the beginning of the pandemic. Pharmacists who were comfortable with the technology reported feeling as if they had a better grasp of the workflow and were better able to triage patients based on priority and need. Having a system already in place to handle potential increases in workload proved helpful in adapting to new situations.

Additionally, having clear corporate/professional guidance was key to pharmacy personnel navigating new situations. The beginning of the pandemic brought a deluge of information that may not have been practical for implementation in real time. Having clear guidance from a central source helped pharmacists understand how to approach workplace situations and how to inform and communicate with patients.

Workplaces that focus on work quality also helped pharmacists feel more in control over their work and in navigating increased workloads. Scheduled breaks create a supportive cultural environment that helps workers take time to decompress from pandemic-related stressors. Moreover, supplying pharmacists with personal protective equipment and other pandemic-related supplies allowed workers to perform their jobs more effectively.

Overall, the study demonstrated that pharmacy managers and organizations can help pharmacy personnel in their resilience. Pharmacy managers can help support their pharmacists become more responsive at any time, especially during unprecedented and precarious moments.

Creating a supportive environment in which pharmacists are more in control of their work environment with the tools they need is paramount to ensuring that the team can maintain their resilience and continue to provide great patient care. Resilience, like so many other skills, is not merely something we are born with. Rather, it is something learned and also that which we can all help one another in reinforcing.

, PharmD Candidate, Touro University California College of Pharmacy.

, Professor of Social and Behavioral Pharmacy, Touro University California College of Pharmacy.

1. Resilience. (n.d.). Retrieved February 21, 2021, from https://www.merriam-webster.com/dictionary/resilience

2. Austin Z, Gregory P. Resilience in the time of pandemic: The experience of community pharmacists during Covid-19. 

Resilience helps pharmacy personnel cope with mounting pressures and demands that come from stressed patients, tense supervisors, nervous patients, and precarious supply chain balances. 

Tip of the Week: Resilience During the Pandemic and Beyond  

The effectiveness of patient-centered health care depends greatly on how well interdisciplinary health care professionals work together. While being under one “roof” and system facilitate communication and collaboration for those in hospital and clinic settings, the challenges of working under various systems in disparate locations can present challenges for family practitioners and community pharmacists.

Infrequent communication between physicians and pharmacists in ambulatory care can erect a lack of trust barrier, thus mitigating the potential effectiveness of interdisciplinary health care. Mercer et al examined the communication between primary care physicians and community pharmacists.

They revealed through interviews with physicians and pharmacists that physicians communicated differently with pharmacists with whom they knew or worked previously when compared to pharmacists with whom they were not as familiar.

The authors discussed how physicians expressed trust and confidence in pharmacists who were nearby or in the same clinic. In contrast, physicians were less likely to establish a working relationship with pharmacists who were not in the same area.

From the pharmacists’ aspect, it was revealed that communication with physicians was difficult due to gatekeepers, such as reception staff and/or nurses. Trust between a physician and pharmacist is essential to the overall quality of patient-centered care.

However, trust cannot be acquired unless effective communication is made feasible and routine. Another problem with lack of communication is that physicians may not be able to gauge the knowledge of pharmacists, which exacerbates lack of empathy for, and understanding of, potential roles in treating patients.

As such, pharmacy managers should engage in communication with their patients’ physician to build trust. Pharmacy managers are ideally situated for this role, since they are the ones most likely to have been with the same pharmacy for longer periods of time and can hopefully leverage their networking skills to forge new opportunities.

Once an initial working relationship has been formed, other pharmacy team members can be better integrated into the care team. Relationships shape collaborations and interactions.

Team building, networking, gratitude, emotional intelligence, transparency, contact initiation, engagement, and kindness are important in the development of relationships, which in turn help build trust and actuate effective teams even in the presence of spatial and geographic boundaries. Pharmacy managers can deploy these skills and include their staff in effective teams with area prescribers.

can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.

Mercer K, Neiterman E, Guirguis L, Burns C, Grindrod K. "My pharmacist": Creating and maintaining relationship between physicians and pharmacists in primary care settings. Res Social Adm Pharm. 2020;16(1):102-107. doi:10.1016/j.sapharm.2019.03.144

Xeng Xiong, PharmD Candidate, Touro University California College of Pharmacy.

Shane Desselle, RPh, PhD, FAPhA, Professor of Social and Behavioral Pharmacy, Touro University California College of Pharmacy.

Trust between a physician and pharmacist is essential to the overall quality of patient-centered care.  

Tip of the Week: Create Interdisciplinary Care Teams Through Effective Relationship-Building

The economic impact of the coronavirus disease 2019 (COVID-19) has left many people in the United States in a precarious living situation. Prior to the pandemic, homelessness was a pervasive occurrence throughout the country, and as the virus continues to rampage through our communities, the likelihood is that homelessness will only become further exacerbated in the interim and aftermath of the pandemic. Homelessness, as a social determinant of health, is a problem faced by hundreds of thousands to potentially millions of people across the country.

Individuals who are homeless are more likely to suffer from poor health and have been found to have increased usage of the emergency department, creating an economic burden on health systems across the nation.

Addressing the health concerns of homelessness involves the creativity of all health care professionals in their respective roles. It is in the interest of the pharmacy manager to deliver to the needs of our communities by creating value-added services that relieve pressure off our local health systems.

One of the recent innovative strategies was performed by a pharmacy resident who, under a collaborative practice agreement, performed cardiovascular risk reduction disease state management once a week at a clinic that serves homeless people.

 In the encounters, the pharmacist was able to perform services such as tobacco cessation, patient education, comprehensive medication reviews, and medication regimen optimization.

 During each interaction, the clinical pharmacist was able to perform an average of 4 interventions.

This study demonstrates the value that a clinical pharmacist can bring to a health care team. By being able to perform independent disease state management, a pharmacist gave members of a vulnerable population the opportunity to receive time and attention from a knowledgeable health care professional, showing the value that pharmacists bring to issues of public health.

The provision of value-added services not only allows pharmacists to practice at the top of their license and help patients in need, but it also enhances the image of pharmacists in the public eye. The encouraging results of this study demonstrate the extent to which pharmacists can be integrated into various health care teams to provide value for the public.

Pharmacy managers can facilitate the awareness of their staff of vulnerable populations and determine efficient and effective methods to leverage available resources in delivering care to these patients, even seeking them out so as to make for a healthier population.

 is a PharmD candidate at Touro University California College of Pharmacy. 

  is a professor of social and behavioral pharmacy at Touro University California College of Pharmacy.

Jackson MP, McSwane DZ. Homelessness as a Determinant of Health. Public Health Nursing 1992; doi: 10.1111/j.1525-1446.1992.tb00098.x

Stafford A, Wood L. Tackling Health Disparities for People Who are Homeless? Start with Social Determinants. 

Kushel MB, Perry S, Bangsberg D, Clark R, Moss AR. Emergency department use among the homeless and marginally housed: results from a community-based study. 

Albertson S, Murray T, Triboletti J, Pence L et al. Implementation of primary care clinical pharmacy services for adults experiencing homelessness. 

. 2020; doi: https://doi.org/10.1016/j.japh.2020.10.012

Addressing the health concerns of homelessness involves the creativity of all health care professionals in their respective roles.