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Shelby E. Lang, PharmD, BCPP
Center for Behavioral Medicine
Kansas City, MO

As burnout continues to tear through the medical community, it is clear that pharmacy is not immune. Therefore, strategies to manage and prevent burnout should be a crucial part of training new health care professionals and maintaining experienced ones. Considering the Oath of a Pharmacist specifically states “I will consider the welfare of humanity and relief of suffering my primary concern,” we have an ethical obligation to care for the wellbeing of the professionals providing care to our patients. We know, however, that intention and effective implementation are very different.

Contributing to a Healthy Pharmacist

In an effort to meet the requirements of The American Society of Health System Pharmacists (ASHP) and aid trainees in developing the necessary skills for long and healthy career as a pharmacist, the Center for Behavioral Medicine (CBM) PGY2 Psychiatric Pharmacy Residency Program (formerly Western Missouri Mental Health) developed and implemented one such program following ASHP guidance through input from current and past preceptors, residents, and students. The goal of the program is to create a culture of wellbeing and resilience for students and residents to prevent burnout during their APPE rotations and residency and to provide learners with skills to be used to prevent burnout in their future careers.

Program Components

The program is essentially divided into two parts. First, the learner is asked to reflect on their current state of wellness and to complete a burnout rating scale on a survey. Students and preceptors may also utilize a rating scale to highlight distinct areas of concern. Results are analyzed and discussed between residents and the Residency Program Director at least quarterly from the start of the residency year. The discussion aims to identify likely factors contributing to the learner’s burnout and guide necessary actions. Adjustments to the learner’s rotation schedule, deadlines, and opportunities for additional projects may all be considered as modifiable factors to reduce burnout. The mutual goal for the resident and the residency program is to ensure a healthy state of wellbeing for the resident as they achieve the minimum required objectives for completion of the residency program based on ASHP standards. All of this can also be modified and incorporated into an APPE rotation to help prevent burnout in our students.

The second portion of the wellness program is to encourage the resident to utilize the residency year to practice the application of various techniques and skills to prevent burnout and promote wellness throughout the course of their career. Residents are encouraged to pick at least one “House Rule” and one “Self-Care Skill” to implement on each rotation. The “House Rules” include strategies incorporated into your professional life that promote overall wellness. Examples include:

  1. Map It Out Mondays - Dedicated time every Monday morning to meet with your preceptor and physically review the resident’s calendar and strategize how and when each necessary task is going to fit and to reevaluate the resident’s progress towards short- and long-term goals.
  2. Finish Up Fridays - No meetings are scheduled for the last few hours of every Friday so the resident may wrap up their work week and utilize the weekend in a restorative way.
  3. Schedule a Break -  Residents schedule a dedicated lunch break or non-work related activity during the day, such as taking a short walk outside. The Self-Care Skills focus on allowing the resident to reflect on what brings meaning and value to their life, such as reading books for pleasure, dinner with friends or family to feel connectedness, being physically active, or getting enough quality restorative sleep.

The preceptor will then help the resident set specific goals in those areas and have check-ins to help the resident ensure that time and energy is dedicated to these tasks so that self-care becomes habitually prioritized.

Although the wellness program at CBM was initially created with PGY2 residents in mind, the core components can easily be incorporated into pharmacy student rotations. Preceptors can use any of the steps above to guide and support students through self-reflection and the implementation of targeted interventions to reduce burnout and improve wellbeing. At the end of the rotation, or anytime the need arises, preceptors can assist with evaluating progress and offer addition resources as appropriate.

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