After four gruelling years in the pharmacy school, many of us would joyfully admit ourselves into the profession hoping to make an impact. However, instead of devoting our time and effort to undertakings with profound positive influence, most pharmacists fall victim to the demanding job. Most aspiring young professionals eventually succumb to the cruel transition to a mere existence in the grand machinery we called healthcare.

Making sense of the magnitude of the problem

Burnout among pharmacists is not something new. Albeit the problem among pharmacists may receive less publicity than that of doctors’ – it is still a problem which deserves every bit of attention, nonetheless. In fact, a report on suicide deaths by different occupational groups published by CNN observed pharmacists ranked as one of the most likely to take their own lives.

Over in Japan, a separate study conducted among hospital pharmacists in the country discovered a large proportion of the individuals suffered from psychological stress and compassion fatigue, in addition to burnout. Intriguingly, the study revealed that work-related stress may become ‘more manageable’ with years of experience. However, similar conclusion could not be made between the likelihood of experiencing burnout and working experience.

Such discussion of burnout and work-related psychological stress necessitate an overview of the multidimensional syndrome of burnout, and how it differs from stress.

Understanding the psychology behind burnout

Dr Guido Zanni, a psychologist and health system specialist, attributes three core characteristics to burnout:

• Cynicism — negative job and workplace attitude, often directed at staff and clients, which leads to depersonalisation (considered by many as burnout's distinguishing characteristic)
• Emotional exhaustion — feeling physically and emotionally depleted, apathetic, and indifferent
• Ineffectiveness — with time, a sense of inadequacy, which leads to devaluing one's own work and causes anxiety and trepidation from a belief that new work tasks are meaningless.

The last domain has the potential to undermine a pharmacist's value perception of his or her work, which subsequently leads to the belief that new tasks are meaningless.

There are fundamental differences between burnout and stress, although the two are intimately linked. Job stress may trigger anxiety, irritability and emotional exhaustion. But, cynicism and the feeling of inadequacy are pervasive in burnout.

Professor Christina Maslach, a prominent researcher in job burnout and health psychology, once wrote that “What started out as important, meaningful and challenging work becomes unpleasant, unfulfilling and meaningless. Energy turns into exhaustion, involvement turns into cynicism, and efficacy turns into ineffectiveness.”

The impact of burnout on pharmacist

There is an abundance of contributing factors in the pharmacy profession that trigger the syndrome. In addition to psychosomatic illnesses such as depression and anxiety, empirical evidence also indicated increased odds to abuse alcohol or to commit suicide.

The widespread problem of burnout among healthcare professionals is a stark contrast to the nature of work for these people: to prevent and relieve the suffering of others. However, the threat of burnout among a sizeable portion of our healthcare workers looms larger.

The quality and safety of the services provided are among the most obvious casualties of burnout among healthcare professionals. Studies conducted on physicians and surgeons suggested that burnout was an independent predictor of medical error and malpractice. Such observation was also consistent among nurses, where healthcare-associated infection, such as urinary tract infection and surgical site infection, were linked to the rate of burnout. Additionally, emotional exhaustion in the critical care team was shown to have a direct impact on the quality of interpersonal teamwork and patient mortality ratio.

It is unsurprising that similar conclusion may be drawn for pharmacists. Scientific literature that links burnout among pharmacists and other healthcare professionals with patient safety is emerging, which strengthens the need for policymakers to delegate the issue as a high priority for action.

Ultimately, pharmacists, as part of the larger healthcare community should take the initiative to manage our workload and take charge of our mental health. Staying mentally fit for work is, after all, part of our professionalism, too. MIMS

Read more:
The burnt-out pharmacist
5 warning signs physician could be heading towards burnout
From the public to the healthcare community: Addressing the shortage of psychiatrists in Malaysia