A Canberra area pharmacist and PhD candidate is examining burnout in pharmacists in the context of COVID-19
Karlee Johnston is looking for pharmacists in all Australian settings to take part in the research, and hopes to help remove some of the stigma around burnout among members of the profession as they grapple with the novel coronavirus pandemic.
“The main thing that really ignited it is that I myself have experienced burnout – which at the time I didn’t realised, but noticed retrospectively,” she told the AJP.
Ms Johnson, an associate lecturer in pharmacology and PhD candidate at the Australian National University, worked in Intensive Care for years, eventually writing an article for the Journal of Pharmacy Practice and Research “on my own personal experience working in ICU, and being around a lot of deaths, dying and trauma”.
“Once I wrote it, I got so much feedback from the profession – people were emailing me saying, ‘Oh my goodness, I’ve gone through that and didn’t know what to do’. It wasn’t a ‘woe is me’ article, it was simply that this is how it is for us. We’re not trained, as pharmacists, to deal with a lot of this.
“I realised that there was probably a fair few people who had experienced it – I’d thought it was unique to critical care, but realised, when talking to pharmacists from all walks of life, that it’s pretty much everywhere.”
Ms Johnston took a step away from ICU pharmacy to have a break from practising, and decided it was a good time to do the PhD she had wanted to do for some time.
“I realised that if I wanted a long and successful career in pharmacy, I needed to understand what was stopping me at that time – burnout,” she said.
She said that while everybody’s story is different, the signs of burnout are very similar, across the profession and more widely – and that many of the pharmacists she has spoken to find comfort in speaking about their experience.
“Talking about it takes a lot of the stigma away from it,” she said. “But it’s so common. And I was very fortunate that I was senior and had been working in ICU for 10 years, so I could walk away – a lot of juniors, when talking to me, have felt that they couldn’t, that their career would really suffer, and I probably would have felt the same if it had happened five years earlier.”
Burnout could feel like emotional exhaustion, she said: either empathasing extremely strongly with patients and becoming more and more unable to put the challenges of the workday behind one after the end of the day, or finding oneself unable to care, particularly when a pharmacist is normally very caring.
“Then there’s things like being physically exhausted, working long hours, not feeling healthy and feeling that if you leave now, something terrible’s going to happen… that takes away from family life, then you feel guilty about not being a good mum, a good pharmacist, a good wife.
“There can be a constant feeling of inadequacy and guilt over what you’re not doing, so there’s zero time for yourself.
“At the time, it felt like a labour of love: ‘I’ve got to do it, this is the way I give back to my community’. But if you’re not doing it well and doing your best because of burnout, you’re doing people a disservice.
“Sometimes we think we are being selfless by giving our all, but in the end it ends up not looking like that.”
Ms Johnston started researching burnout in pharmacists, but found that while evidence exists, particularly studies on hospital pharmacy, the literature is “very mixed”.
“There’s all sorts of tools used to measure different cohorts, and the ways they use the tools are really different, so even in a literature review you can’t just pull it out,” she said.
“That was very frustrating, because as a pharmacist I wanted it to be just so!
“It needs to be done. And lots of people talk about burnout and trauma in pharmacy in Australia, but we haven’t measured it consistently in our population.”
Early in the process of planning her PhD with her supervisors at ANU, the COVID-19 pandemic struck, and Ms Johnston saw that there would be a significant effect on pharmacists, which proved to be the case when she spoke with friends and colleagues on social media.
“The hospital pharmacists were preparing for something to come but not feeling it; the community pharmacists were feeling it, but there was no time for preparation, and they were being asked all these different questions, dealing with people who were stressed… everyone was very uneasy and stressed just as humans, but certainly as frontline pharmacists,” she said.
“And there’s very little data on pharmacy in pandemics or any kind of emergency situation, so we decided to do that.”
The national research project is now investigating the psychological impact of COVID-19 on Australian pharmacists, and looking for input from as many as possible.
“I am concerned with the wellbeing of pharmacists who have a difficult and unique role to play at this time, and believe that understanding and sharing their experiences will be of benefit, not only to our profession, but also more broadly,” said Ms Johnston.
“I’m looking at how COVID has affected pharmacists as people, and their wellbeing, in the context of their work.
“The impression I have is that people are being affected personally, more so than their usual work would affect them – and it’s important that we’re recognised in that way, that we’re humans being affected by it.”
Ms Johnston is asking pharmacists to complete a survey every two months, if they can, with no expectation that the surveys will be ongoing for any individual. She told the AJP that the data is not individualised, but aims to get a wider picture of how the profession is coping with the COVID-19 challenge.
In the meantime, she urged pharmacists to access support networks such as the Pharmacists’ Support Service, be kind to themselves and help protect their own physical and mental health – as well as those of colleagues.
The survey can be accessed here.
Any readers who are distressed can call 1300 244 910 for anonymous and confidential support from a pharmacist colleague over the phone through the Pharmacists’ Support Service (PSS), available 8am to 11pm EST 365 days of the year.
For urgent assistance when PSS is not available, call Lifeline on 13 11 14.
For 24/7 confidential incident support for employee and owner pharmacists, members can call PDL on 1300 854 838 Australia wide.