Resilience vs. Burnout: Tips for Staying Sane During Residency…and Beyond

By Laura Nice, PharmD, Alonna Greene, PharmD, Sarah Raake, PharmD, BCACP, LDE, & Kimberly Elder, PharmD, BCPS

During one’s pharmacy residency, many moving parts do not always seamlessly coexist. It is up to residents to manage daily patient care activities, staffing requirements, preceptor duties, and more. Residents like us want to prove we are capable and gain the respect of our peers and superiors. However, new and unfamiliar responsibilities can be overwhelming. All of this can also be accompanied by that feeling of inadequacy and being ousted as a fraud, also known as the imposter syndrome. We start to question, “What have we gotten ourselves into? Are we setting ourselves up for burnout, that three-dimensional syndrome consisting of emotional exhaustion, depersonalization, and reduced personal accomplishment?”1; With a direct link shown between workload and burnout in pharmacists, it makes sense that a crucial component of residency is learning how to manage it all.2 Fortunately, we’ve had mentors share tips and best practices for managing these responsibilities. These can be summarized into the themes below in order to maintain well-being and resilience.

Manage your time
Three best tips that we have found most helpful to improve time management:

  • Write It Down – We have found one of the most important things to do is write it down (whatever task it is) to help remember the details of tasks not initiated in that moment.
  • Keep a Prioritized To-Do List – Find an approach to write a to-do list, which can really be a lifesaver if you use it to prioritize your necessary tasks.
  • Use a Calendar to Organize Everything – It is extremely helpful to use a calendar to organize EVERYTHING, even if it’s blocking time for to-do list items.

Overall, we’ve learned effectively managing time and tasks doesn’t lessen the workload, but it can avoid unnecessary stress in the long run.

Quit constant communicationn
It’s both a blessing and a curse to live in a time with constant communication. It helps us feel connected and avoid feeling lonely; however, this expectation to always be available can lead to burnout. Even though being always “plugged in” is something we’ve heard many pharmacists admit they struggle with, it is important to set boundaries for work and life activities. Most people face constant emails during the work day, but remembering that email etiquette suggests responding within 48 hours has been extremely beneficial. One piece of advice that has helped is, “Someone else’s urgency is not always your emergency.” We have to remind ourselves that emails are not emergencies. We have found some peace in turning off email alerts on our phones to avoid constant notifications. This is not to say email is unimportant, but rather dedicating time to address emails has decreased this feeling of a need to be in “constant communication”.

Combat imposter syndrome
Residents work hard throughout school to prepare for pharmacy practice, yet some of us experience imposter syndrome. These self-doubt feelings lead to beliefs such as “I am not smart enough to be here” or “Everyone else knows more than me, so why even try?” These negative thoughts can impact our job performance and interprofessional relationships. Imposter syndrome and burnout among medical students has been described in the literature with indicators such as psychological distress, cynicism, and emotional exhaustion.3

When we start doubting abilities, we stop and think about where we are on our journey as pharmacists. We were fortunate to have mentors instill the idea that pharmacists are always learners. It has been extremely helpful to witness pharmacists’ vulnerability and recognize they do not know everything while maintaining confidence. We have also found it helpful to have “safe spaces” with mentors to talk about feelings and differentiate between real concerns of knowledge gaps versus imposter syndrome and burnout.

Use your resources
Through all the tips recommended, the common theme is our mentors. We recommend using your mentors as the valuable resources they are for instilling well-being and resilience. In addition, there are many national organizations that have developed resources for clinicians. You can be further proactive in preventing burnout by reviewing these websites:

The finish line
While there are many factors that lead towards burnout, appropriate time management, positive influences from mentors and counterparts, and proactively using resources can assist residents in maintaining well-being and resilience. Faculty, preceptors, and administrators play an important role in the development of pharmacists, and part of this role should be to instill resilience. Residency training may still seem overwhelming, things will not always go as planned, but how we cope with these or even deal with failure will impact our resilience.

How are you avoiding burnout and promoting resilience amongst your students, residents, and coworkers?

References

  1. Bianchi R, et al. Burnout–depression overlap: A review. Clin Psychol Rev. 2015;36:28-41.
  2. Jones G, et al. Factors Associated With Burnout Among US Hospital Clinical Pharmacy Practitioners: Results of a Nationwide Pilot Survey. Hosp Pharm. 2017;52(11):742–751.
  3. Villwock J, et al. Imposter syndrome and burnout among American medical students: a pilot study. Int J Med Educ. 2016;7:364-369.

Laura Nice is a PGY1 Pharmacy Resident at University of Louisville Hospital in Louisville, KY. She will be completing a PGY2 in oncology and aspires to be practice-based faculty. Her current academia interests include precepting and developing case-based assessments. In her free time, Laura enjoys swimming, traveling, and exploring Louisville’s restaurants.

Alonna Greene is a PGY1 resident at the Sullivan University College of Pharmacy and practices at Frankfort Regional Medical Center. Educational scholarship interests include preceptorship and technology. In her free time, Alonna enjoys reading and visiting family and friends.

Sarah Raake is an Assistant Professor at Sullivan University College of Pharmacy in Louisville, Kentucky. Educational scholarship interests include authentic assessments and instructional design and technology. In her free time, Sarah enjoys traveling, scuba-diving, and farming.

Kimberly Elder is an Associate Professor in the Department of Clinical and Administrative Sciences at the Sullivan University College of Pharmacy. She is the co-advisor of the Rho Chi Society Delta Kappa Chapter, Teaching Certificate Program Coordinator, coordinates several Patient Care Lab courses, and has a practice site in Internal Medicine at the Robley Rex VA medical center. She loves spending time with family and friends, traveling, and reading.


Pulses is a scholarly blog supported by Currents in Pharmacy Teaching and Learning

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