Are pharmacists burning out?


Early career pharmacists are among the most stressed members of a high-stress profession, a new Australian survey has found

Half of Australia’s pharmacists are dissatisfied with their work-life balance, the National Stress and Wellbeing Survey of Pharmacists, Intern Pharmacists and Pharmacy Students has discovered.

And half have been worried by seeing other pharmacists depart from accepted professional standards.

The research, carried out by Monash University’s Emeritus Professor Colin Chapman, together with Master Research Australasia and the Pharmacists’ Support Service, found that pharmacists in general were more stressed than the Australian population.

Those aged under 30, and/or with less than 10 years of experience in the profession, reported the highest levels of stress.

“Compared to the Australian population, pharmacists, intern pharmacists and pharmacy students are more stressed,” the survey found.

“Compared to other health professionals, the pharmacy workforce appears to experience about the same levels of stress.”

John Jackson, President PSV; Gillian Swinnerton, Vice President PSS; Shane Jackson, President PSA; Kristen Michaels, CEO SHPA; George Tambassis, President PGA; John Coppock, President PSS; Kay Dunkley, Executive Officer PSS; Emeritus Professor Colin Chapman, Monash University; Jacki Baulch, Senior Industrial Officer Professional Pharmacists Australia; Dr Sally Wilson, Master Research Australasia; Dr David Wilson, Master Research Australasia; also attending the forum by webinar (not pictured) were Dean Schulze, Chair PDL and Sandra Minas, President NAPSA.

The new data supports previous findings in Australia and internationally which show that for pharmacists, stress is a significant problem: a 2012 online survey of Australian pharmacists, for example, showed that a high percentage of pharmacists were at risk of psychological morbidity.

A 2007 study showed that about one in 20 Australian hospital pharmacists were showing a high level of “burnout”. Young hospital pharmacists were the most vulnerable.

And work-life balance is a significant issue for the profession, the Stress and Wellbeing survey found.

The new report cited an Australian Psychological Society survey which showed that workplace issues made up 32% of stressors amongst the general population, but for pharmacists, this percentage skyrocketed to 60%.

“This means that the pharmacy workforce, generally, is experiencing workplace stress at almost twice that reported for the Australian population as a whole.”

Around 10% of pharmacists said in the new survey that in the last month they either “never” or “almost never” felt confident about their ability to handle their personal problems.

Comparing non-work stress to work-related stress is directly related to the concept of work-life balance, the report said, and to date there has been little data on the subject regarding pharmacists, though some UK data shows pharmacists have heavy workloads and this could impact their job satisfaction and wellbeing levels. This data noted a recent change which required pharmacists to be present during all times a pharmacy is open and which brought this legal requirement in line with Australia.

Those 26-29 years old and 30-39 years old reported a higher level of dissatisfaction with their work-life balance than did other groups.

A challenging workplace

The survey found that 45% of pharmacists were satisfied with their professional role as a pharmacist; 42% were satisfied with their workplace environment, and only 30% were satisfied with their workload.

Fifty per cent of respondents had observed behaviours in other pharmacists that depart from accepted professional standards, and 26% reported that they are expected to practice as a pharmacist in a manner which is a departure from accepted professional standards and this causes them to feel stressed.

Barriers to seeking help included fears of reprisal, of experiencing stigma, and of feeling intimidated or embarrassed. Job security issues were also a significant barrier to help seeking help.

Others expressed that it was not in their nature or culture to complain or seek help and for others a perceived lack of time was a barrier.

PSA president Dr Shane Jackson told the AJP that the survey was a “timely reminder that health professionals work in a stressful environment, and pharmacists’ environment is no different to doctors or nurses – no worse, but no better”.

He said that for many pharmacists, stress comes from several angles and can be cumulative.

“I think that often these things add up,” he said. “If you’re not feeling rewarded because your pay level might not be at the level you believe it should be, you have a high workload and you don’t have support structures in the workplace to allow you to discuss issues with other people, this can build up.

“It might create a significant response for some individuals and be difficult to deal with – and that’s not because people are unable to deal with it, it’s because they shouldn’t have to deal with those kind of things.

“If they’re seeing someone deviating from acceptable professional practice, which puts people at harm, those things shouldn’t be occurring… it’s not that they’re unable to deal with pressure.

“Obviously for a significant number of people they feel those structures aren’t in place.”

Pharmacists’ Support Service’s Kay Dunkley told the AJP that when young pharmacists in particular see behaviour that worries them, they may remain silent out of fear for their job.

“Pharmacists are obviously stressed, particularly young pharmacists, by seeing the realities of how some pharmacies practice,” Ms Dunkley said.

“This can happen when people enter the workforce and see things that aren’t in accordance with their university training and how they’ve been led to believe things should be done.

“One of the issues is that young pharmacists don’t feel empowered in their own workplaces to address this, because they’re very dependent on remaining employed and therefore feel that if they start to raise issues around practice, they might not have a job.

“And the job market is very competitive, particularly in the metropolitan areas, and so a lot of graduates and young pharmacists feel that they’re expendable. So they feel quite compromised.

“Workload is also a considerable issue, and from the point of view of PSS, we get a lot of calls around workload: people feel their ability to actually perform their job properly is compromised and that concerns them, because apart from the fact that they don’t want to harm the public, they’re the ones that will bear the responsibility if they miss something or a dispensing error occurs.

“It’s their registration at risk.”

Most pharmacists, interns and pharmacy students have not been provided with any training to prepare them for workplace-related stressful situations, the report observed.

However, support was provided the respondents rated the following as very effective: having an individual mentor; having a support group; participating in personal development courses; education about maintaining wellbeing; assertiveness skills, dealing with difficult customers, and communication skills.

The report suggested several strategies to manage pharmacy stress, including giving pharmacists better preparation for the workplace, including stress management in new and existing training programs and focusing on barriers to seeking help.

It also suggests that in the longer term, the profession consider one or more longitudinal studies to understand the influence of learning style and personality on the perception and effects of stress, and track long-term trends in stress and burnout in pharmacy; and repeating the stress and wellbeing survey regularly.

“It’s really interesting information, because we haven’t really had this sort of comprehensive survey about stress and wellbeing in pharmacy – without this kind of information, things are only hearsay, and this gives really good clarity to what the stressors are in pharmacy,” Dr Jackson said.

“Because we have that information, it means we can potentially do something about it.

“One of the things that needs to come out of the work of PSS is a profession-wide approach to trying to reduce stress and improve wellbeing in pharmacy… that’s the only way to do it.”

An outline of the report was presented recently to the presidents and/or CEOs from the National Australian Pharmacy Students Association (NAPSA), Pharmaceutical Defence Ltd (PDL), Pharmacy Guild of Australia (PGA), Professional Pharmacists Australia (PPA), Pharmaceutical Society of Australia (PSA), and the Society of Hospital Pharmacists of Australia (SHPA).

The project was funded by Pharmacy Board of Australia (the Board) under contract with the Australian Health Practitioner Regulation Agency (AHPRA) and carried out by Emeritus Prof Colin Chapman together with Master Research Australasia and the Pharmacists’ Support Service (PSS).

AJP will be reporting on stress affecting the pharmacy profession over the next couple of weeks. Readers are invited to tell their stories, either by leaving comments below or getting in touch with the AJP team.

Readers who are distressed can contact the Pharmacists’ Support Service on 1300 244 910.

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