Expert Discusses Burnout and Mental Health for Pharmacy Technicians

Sara Wettergreen, assistant professor in the department of Clinical Pharmacy, and Department of Family Medicine, at Skaggs School of Pharmacy and Pharmaceutical Sciences, on burnout and mental health concerns among pharmacy technicians

Ashley Gallagher: Hi, I'm Ashley Gallagher from Pharmacy Times ®, and today I'm speaking with Sara Wettergreen, assistant professor in the Department of Clinical Pharmacy and Department of Family Medicine at Skaggs School of Pharmacy and Pharmaceutical Sciences, on burnout and mental health concerns among pharmacy technicians. To start off, it's no secret that health care workers face burnout, especially during the COVID-19 pandemic. But there is little focus on pharmacy technicians. What are some signs and symptoms of burnout that pharmacy technicians could be facing?

Sara Wettergreen: Ashley, you're absolutely right. Burnout is certainly prolific across the spectrum of health care, and I feel like we especially saw that during the pandemic. I think even outside of our own health care team, we're seeing this in the communities that we care for. So anyone who is working directly in the community, like many of our pharmacy technicians are, are really experiencing that firsthand and seeing not only how it affects themselves, but others as well.

The first thing to think about, when looking at signs and symptoms of burnout, are first looking at the difference between signs of stress and signs of burnout. When we think about signs of stress, we're really thinking about that sense of overactivity, so feeling extra engaged in your work, maybe you're working longer hours, you might feel more reactive in the work that you're doing or having that sense of urgency. I think many of our pharmacy technicians will be able to relate to that feeling of stress day to day.

The challenge that really comes from burnout is different than stress, and that burnout is from prolonged times of stress. So I especially worry about burnout in our pharmacy communities, now thinking about how the pandemic has gone on for many years now, we've been in this state of higher stress for a prolonged amount of time.

I'm potentially concerned about this risk of burnout. Looking at the symptoms of burnout, they are a little bit different and stress. We're really thinking of somebody who is checked out, someone who's burned out might be more disengaged, they might have decreased emotional responses, feel hopeless, or even depressed. I like to think of those signs of stress, or even some of those signs as burnout, as early indicators to let you know when it's time to make some changes.

Ashley Gallagher: Oftentimes, pharmacy technicians and pharmacy professionals, in a more general sense, do not really prioritize their own mental health because they're taking care of others. So why should they start?

Sara Wettergreen: I often hear that expression that first you have to take care of yourself in order to best take care of others. That's certainly true, and that might resonate for some people, but I think it's actually okay to take care of yourself, just for the point of taking care of yourself as well.

I think taking care of your mental health is such an important aspect to living a fulfilling life, and you deserve that, everyone does. When I think of an individual who's mentally well, they might be more present with their friends or family, they might have more energy, interest in the hobbies they enjoy, and they might even find more joy in their work, day to day.

I think one of the biggest challenges comes in when you're already feeling burnt out and you don't know where to start. Once you've become burnt out, the things you've previously enjoyed might not bring you as much fulfillment as they used to. For my own experience, I know how hard it can be to be in that dark hole and trying to dig yourself out.

For my perspective, I really think it's important to watch for signs of stress before you get to that sense of feeling burned out and making changes early on to keep you from getting into that hole.

That's where assessment tools like the Pharmacy Professional Well-Being Index can come into play, as this can be a way to track for those red flag indicators of stress early on and to start to make changes.

Ashley Gallagher: So you mentioned the Pharmacy Professional Well-Being Index. What is this and how can it help pharmacy technicians to assess their own burnout?

Sara Wettergreen: The Pharmacy Professional Well-Being Index is a helpful tool that can be used by individuals to assess their own well-being. This was created and validated by the Mayo Clinic, and the American Pharmacists Association partnered with the Mayo Clinic to make this tool available to pharmacy professionals for free.

It's easily accessed by either downloading the My Well-Being Index app, or you can navigate to a website that will be in the show notes. It will also be available at app.mywellbeingindex.org/signup.

Once you get to the Well-Being Index then you can use the invitation code “APHA” to get started. A little bit more about the tool itself, so once you have access to the tool, it is a 9-question assessment, and it really only takes a couple minutes to complete. It measures many different dimensions of distress and well-being such as burnout, fatigue, risk of medical errors, quality of life, and your overall well-being.

Once you complete the tool, you receive your results in a dashboard type format, kind of like you might expect with the dashboard of a car, and you can see how your overall score is in your readings and each of these dimensions you assessed compared to others within the pharmacy profession.

When I recently completed my own Well-Being Index, I found that I rate similarly to other pharmacy professionals in finding meaning from my work, but I'm at a slightly lower risk of burnout. It's important to note that the results for comparison are only available in aggregate, so your data that you complete and this assessment, are completely confidential. No one can tie them to us specifically. They're just an aggregate for comparison purposes.

Specifically, for pharmacy technicians, you can use the Pharmacy Professional Well-Being Index to compare results to others in the profession and also track your own results over time. It's helpful that this assessment can be taken as often as monthly. Because, by reassessing, I often find that I'm able to start seeing when things are changing early on. I've noticed the habit of wanting to only assess this in times of struggle, and I think it's actually more helpful, potentially, to also assess in times when things are going well, so that I can see what did I do in the last month that made things a little bit better? And how can I reinforce continuing that habit?

Ashley Gallagher: What is the WBI’s distress percent, and how can this be beneficial to pharmacy technicians and how can they compare their results to others?

Sara Wettergreen: Each month, state associations received a district report showing results from the Pharmacy Professional Well-Being Index, and that aggregate data is presented as a distress percent. So you're right, it's important that you first understand what that information means, so you're interpreting that correctly.

The aggregate results presented as a distressed percent represents the percent of individuals who completed a Well-Being Index and had a score greater than or equal to 5, as that represents a risk of high distress.

For example, national data representing all previous assessments of the Pharmacy Professional Well-Being Index, through May 2022, reported the overall distress percent of about 32%. When reviewing the data, that distress percent is understood as the percentage of those who completed the tool within a certain time period who are at risk of high distress. That means that right now 32% of individuals who completed the Well-Being Index are in the pharmacy profession, and did this up until April 2022, were at risk of high distress.

For all our pharmacy technicians listening it may not be too surprising, but when this data was broken down into student pharmacists, pharmacists, and pharmacy technicians, the data showed the highest distress percent for pharmacy technicians. With this data about 45% of pharmacy technicians were at risk for high distress.

The importance of understanding and seeing this data for being at risk of high distress is related to the implications from that. The distress percent represents these overall risks, and those at high distress are an 8-fold higher risk of burning out and a 2-fold higher risk for medication error. Looking at and reviewing this data from the Well-Being Index in aggregate can give you a sense of where the profession of pharmacy is at overall in terms of well-being, and those associated risks with distress.

Ashley Gallagher: Now that we know how to identify burnout and signs of being stressed and being at risk of burnout, how can pharmacy technicians begin to combat burnout?

Sara Wettergreen: It's definitely important to not only know how to assess your burnout but to do something about it. Once you take the well-being index, you'll gain access to a library of resources with different recommendations based specifically on your survey results.

For example, when I most recently took the Well-Being Index, I was given resources for stress management and resiliency. I dug a little deeper into this section, and there are different webinars, resources for yoga and mindfulness, Continuing Education programs focused on combating burnout and more. While this is a great way to assess your burnout, and see if you're at risk, there's also a great hub here to give you some information in getting started and trying to combat these challenges.

When thinking about these different options, I think it's really helpful that there is a library of resources because the strategy that might work well for me, or that I find helpful, may not be a preference for somebody else. I personally enjoy yoga, and that was something that was recommended for me. So this year, I challenged myself to do 22 minutes of yoga every day.

Well, I don't do it every day, but having that challenge there certainly helps keep me more accountable to that goal, and I always feel better after yoga and feel even better if I'm helping to accomplish my goal.

As I mentioned earlier, I do you think it is harder to combat burnout once you're already feeling that burnout. So if this is your situation, I would definitely encourage you to speak to your primary care provider to learn about different mental health resources available to you. I personally attend therapy, and this has helped me to overcome some challenges of my own that are contributing to me feeling burnt out. I recommend for others to seek out mental health support as well where you can.

Ashley Gallagher: And lastly, how can a pharmacy technicians stop working on autopilot at their job and how can this actually help their burnout?

Sara Wettergreen: Yes, this is definitely a challenge. I think working in autopilot becomes so common, that at times, you don't even realize it's happening. Sometimes you might notice you're feeling like you're going into autopilot while driving, and while that's certainly concerning to go into autopilot while driving, it can be even more concerning to get into that autopilot sensation when doing things like filling prescriptions or actively working in a pharmacy because there's that risk of medication errors.

Mindfulness is the opposite of autopilot. Mindfulness really focuses on bringing you into the present moment, whereas autopilot, you're just sort of functioning day to day based on your habits. By practicing mindfulness, the brain can become more trained to be present in the moment, helping to keep you from going into that autopilot sensation in your life and at work.

Mindfulness has also shown benefits and improving empathy, burnout, and fatigue. There are many different ways that someone can start practicing mindfulness, and it doesn't necessarily need to take a lot of time. I think when I first thought about starting mindfulness practices, I imagined someone needing to go to a yoga retreat or a meditation studio and having hours upon hours to practice this and needing to be the expert. That is not true at all.

You can start by even spending a few minutes per day doing breathing exercises, a body scan, where you kind of feel how you're feeling throughout your head to toe, and even just some simple meditation exercises to bring this mindfulness into your daily life.

One free resource I like to use is called Insight Timer. Within this app, there are a lot of different mindfulness resources and different things that you can look into of all different types of formats and length that can really help you to find something that will work for you.

Personally, I like to use a 5-minute quick break in the app as there are different pauses that you can take to recenter during your day on breaks, and sometimes I'll also use a guided meditation to help me fall asleep at night.