Time to pull the safety lever: Burnout in pharmacy is not a self-care issue but a workplace problem

The results from the newly released Canadian Pharmacy Mental Health and Workforce Wellness Survey present a picture of a profession in distress: more than 90% of pharmacists at risk of burnout, over 70% considering a major work change and close to 50% experiencing abuse or harassment on the job at least weekly. It’s an ominous cloud in the bright sky of a profession that has seen significant advances over the last two years, from more opportunities to work to the full scope of their practice to just more love from Canadians who now see the critical importance of their community pharmacist. “This is a wake-up call for everyone to stop and think about what needs to happen to create a sustainable delivery model for pharmacy so we can continue to be there for our communities,” Danielle Paes, chief pharmacist officer for the Canadian Pharmacists Association–which commissioned the survey–told Pharmacy Practice + Business. “Pharmacy teams have skillfully navigated so much change over the last few years but we’re still in a crisis mode and really we need to move into evaluating how we can make pharmacy sustainable.” Read: CPhA national survey finds 72% of pharmacy professionals considering leaving their job or the profession entirely To see what can happen when pharmacists are pushed over the edge, one need look no farther than the United States, where many pharmacies–already operating for years with reduced staff–were crippled by walkouts or “sickouts” by protesting pharmacy staff. These protests led to a number of stores–including national giant CVS–adjusting their hours so their pharmacists could take a scheduled 30-minute lunch break. It’s time to “pull the safety lever” to force meaningful changes in pharmacy, said Kelly Grindrod, a professor at the University of Waterloo School of Pharmacy. “The lens we need to look at this through is the safety lens,” she said. “Noone is going to change anything for the pharmacy workforce because people are tired or annoyed or feeling less valued in their job–that’s not how the system works. But safety is the lever you can pull because safety for patients is a concern.” The wide prevalence of burnout among Canadian pharmacists points to an urgent safety issue in pharmacy, said Grindrod. Overworked pharmacists are more likely to make mistakes. These errors are often small acts of omission–like putting the wrong label on a blister pack–that can have big consequences. “We’re not even talking about careless mistakes–these are easy mistakes to make when you’re having to do five things at once,” said Grindrod. “When you look at it that way, it’s almost expected you’re going to make mistakes because we’ve created workplaces for pharmacists where mistakes can easily happen.” Read: Meet Kelly Grindrod: Pharmacy educator, advocate, disruptor and founder of Pharmacy5in5 The industry may not want to shine a spotlight on this problem–perhaps out of concern it could make the profession look bad–but it’s what regulators and governments need to hear, said Grindrod. “This needs to be a regulatory issue,” she said. “Regulators need to set rules and standards on what’s a minimal competency workspace, how many pharmacists need to be there based on your prescription volumes, how many breaks pharmacists should have.” A common response–in pharmacy and in other industries–is to encourage those suffering from burnout to seek mental health support and find ways to cope. While these interventions can be helpful, they don’t address the root of the problem, said Grindrod. “Burnout in pharmacy is a workplace problem, not a self-care problem,” she said. “Self-care is an important part of recovery for burnout, but you can’t self-care enough to compensate for a workplace that burns you out.” Read: The pharmacists' dilemma So what needs to change in pharmacy workplaces? As a start, work breaks for pharmacists should be mandated, said Grindrod. This will ensure that pharmacy owners and managers schedule appropriate breaks for their pharmacy team members. It will also–hopefully–change the mindset among many pharmacists that sacrificing their wellbeing is just an expected part of the profession’s work ethos. “Pharmacists work hard and a lot of them won’t willingly take breaks,” said Grindrod. “That’s why you have to mandate it.” The industry also needs to make better use of pharmacy technicians. Jurisdictions where technicians have more narrow scopes of practice should allow them to do more. There should also be a concerted effort to build a more robust technician workforce, said Grindrod. Read: CVS Health to give pharmacists dedicated lunch break “In many places you can’t find technicians or you just can’t get them–often the hospitals really want them so community pharmacists are competing with hospitals,” she said. “We need to get more people interested in a career as a pharmacy technician. We can get them in the workplace fairly quickly because it’s a shorter college program and the entry requirements are lower (than for pharmacists).” There’s a lot of work ahead, said Paes at the CPhA. The problem of burnout in pharmacy–and the potential for a mass exodus from the profession–is a systemic issue that calls for coordinated efforts by pharmacists, industry advocates, regulators and governments. As part of its efforts to find solutions, the CPhA recently formed a multi-stakeholder steering committee with representatives from across the community, said Paes. This committee will serve as an advisory body to the association. Read: Meet Danielle Paes: Canada’s inaugural chief pharmacist officer at the CPhA A task force focused on mental health support and resources is also in the works, said Paes. “The challenge is the pharmacy landscape is so varied–what works in one province won’t necessarily be suitable for pharmacists in another part of the country,” she said. “There isn’t a one-size-fits-all solution.” While burnout has led to apathy and cynicism among some pharmacists, there’s also a lot of hope for a better way forward, said Paes. Many in the industry have put up their hand to help find solutions. “It’s been a really tough time,” said Paes. “But there’s an element of hopefulness among pharmacists, an excitement about how the profession is evolving. We won’t find the answers today but we are working towards solutions and we’re going to get there.” Read: At a breaking point: What governments and regulators need to do to help pharmacists survive COVID

Time to pull the safety lever: Burnout in pharmacy is not a self-care issue but a workplace problem

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