From Burnout to Balance

This article is excerpted from CFP’s Changing Face of Pharmacy magazine, published in November 2023. Click here to get the complete article—with more tips—and magazine.

Manjit Hansra

Manjit Hansra had an enviable career as a pharmacist. Eighteen years after graduation he was a pharmacist-owner of a large Toronto pharmacy with a staff of 65 and sales of $20 million. But last year he quit that job. The pandemic pushed him over the edge and he craved more balance in his life. He wanted to spend more time with his two young children. “I wanted to live with no regrets,” he says.

Hansra is one of the thousands of Canadians who “pivoted” during the pandemic, who took stock of their lives and realized they needed to make a sanity-saving change.

In his case it was launching a consulting firm that offers “Rx for Renewal” wellness retreats to help healthcare professionals improve their resiliency and manage burnout. Once burnt out himself, he’s now teaching others the strategies he’s adopted to lead a healthier and happier life.

The decision to get off the treadmill changed his life, he says. “I’m more present with my kids, which has taught me a lot about myself. I’ve put a focus back on my mental and physical health and I am continuing to search for what I am passionate about and share my experiences in life to help others grow and develop into better versions of themselves.”

If you’ve found yourself wanting to quit your job like Hansra, you’re not alone. In fact, you are among the thousands of Canadians pharmacists, who, after close to three years on the frontline of the COVID-19 pandemic, are at their breaking point.

The picture is pretty grim. Eighty per cent of pharmacists are at risk of burnout. Only four in 10 are fulfilled by their work. One in three are considering leaving the profession and half say inadequate staffing is having a negative impact on their mental health and wellbeing. These facts are from a 2023 national survey of more than 1,000 pharmacists and almost 200 pharmacy technicians commissioned by the Canadian Pharmacists Association (CPhA).

We all know that the pandemic slammed stressed-out, sleep-deprived pharmacists who were under intense strain as they worked overtime on the frontlines, administering millions of COVID-19 tests and vaccines while still managing their regular responsibilities of filling prescriptions and counselling patients. Almost 40 per cent of pharmacy staff experienced abuse or harassment from patients at least on a weekly basis during the pandemic, according to the CPhA survey.

The workplace demands inevitably took their toll on home lives. Recreational activities, fitness routines, domestic chores and vacations took a backseat. Pharmacists’ roles as partners and parents became more challenging and stressful.

“Pharmacists are exhausted and overwhelmed and, in some cases, are facing more conflict because everyone is quicker to anger and more emotional and frustrated,” says health coach Cheryl Breukelman, President of Epiphany Coaches, a global leadership firm based in Hamilton, Ont. “They’ve been working on overtime for so long. They are resilient people, but they got punched in the face with COVID.”

While the worst of the pandemic is over, it can take months or even years to fully recover from burnout. The restoration of work-life balance is key.

Personal and organizational change

Pharmacists can take many steps on their own to recover balance in their lives (Breukelman’s top 10 tips can be found in CFP’s Fall 2023 Changing Face of Pharmacy magazine). Employers also have a huge role to play. But both parties need to recognize it takes time and commitment. There is no easy fix.

Karen Agro

“We can’t solve issues of burnout and overwork with aromatic massages, a bubble bath, a gift certificate or even a cheque for $5,000 as a bonus at the end of the year,” says Karen Agro, Director of Agro Health Consultants, based in Waterdown, Ont. A community pharmacist for more than 30 years, she is also a consultant to the pharmaceutical industry. Three years ago, she became a workshop facilitator and keynote speaker to help individuals and corporate teams avoid burnout and create thriving employees.

“There’s a tug of war in pharmacy,” she says. “Pharmacists and staff are at one end and the volume of work is at the other. We are in this game because we wanted an expanded scope—we have been asking for it for years. But work is pulling so hard that staff on the other side is going to tip over.”

Agro says if we continue to ignore the problem, the rate of attrition will only get worse. “We need to find ways to empower and strengthen our people. Otherwise, we are going to lose ourselves in that tug of war.” If you’re curious about your own level of workplace stress, Agro’s “Corporate Burnout Scorecard” will help determine where you land on the stress-versus-fulfillment scale.

A dedicated classical guitarist, Agro combines her training as a pharmacist and musician in her workshops and keynote addresses. “My goal is to help transform stressed-out workers into resilient ones and one of the ways to do that is teaching people how to improve their mood and productivity through music.”

Agro also extolls the restorative power of microbreaks—short pauses that last from a few seconds to a few minutes throughout the day, taken whenever needed. A microbreak can be a short walk outside for fresh air, a few minutes to stretch or just closing your eyes. Music, of course, can be brought into these breaks.

Microbreaks can and should become an intentional workplace strategy to decrease fatigue and increase engagement. “Research on microbreaks has been based on the surgeon’s space—they can’t leave their sterile work area, but studies have found those who were allowed to step away for a few minutes without leaving their environment saw an increase in their mental focus and fatigue rates went down,” Agro explains. “Research proves this works. We are a science-based profession. Why aren’t we listening to the science and incorporating microbreaks into our days?”

The traditional pattern for work-time breaks started more than 100 years ago at the time of the industrial revolution, but in today’s knowledge economy the output of our work is from our brain, not our bodies, she adds.

“The problem in pharmacy is we are all working full tilt, and we rarely get the breaks we need. When someone steps away from the dispensary the team may think they aren’t working, but people need to rest their minds. If our knee is sore, we need to sit down. When our brain is full, we need to step away for a few minutes. People don’t always understand that.”

Hansra, who still works part-time in community pharmacy, echoes Agro’s advice about the importance of taking time-outs at work. “If you work 50 to 60 hours a week, you have to bring some self-care and mindfulness into your work.”

While pharmacists will go the extra mile to care for patients, it often comes at the expense of their own health and wellness, he continues. “I wanted to do something to help pharmacists put the focus back on themselves so they can be of even greater service in their communities.”

It all starts, he says, with how we breathe. “The average person takes 22,000 breaths a day, so much of it unconsciously. It needs to become conscious. We are taught how to do so many things in life, but we aren’t taught how to utilize the very thing that keeps us alive.”

A trained breathwork facilitator, Hansra says breathwork allows a person to move quickly from a dysregulated state to a regulated one. “It’s beneficial for pharmacists because they can do it anywhere, anytime. If you have a challenging situation with a patient or staff member, you can go back to your computer, stare at the power button and do five or six rounds of breathing. It only takes two minutes and it decreases your heart rate and allows you to get refocused.”

Hansra offers free monthly virtual breathwork sessions and also writes about this technique and other lifestyle hacks in his weekly Sunday newsletter.

Like microbreaks, pharmacy owners and managers can encourage—and bring in training for—work-life skill sets such as breathwork to help staff surmount both professional and personal challenges.

Last but not least, employers who encourage or even facilitate forms of exercise will benefit as much as their employees. “Integrating exercise can be challenging for those of us suffering from burnout,” says Hansra, “but I cannot stress enough how quickly you will notice an improvement in your physical state and mental clarity.”

He also recommends incorporating self-care as part of the regular morning and evening routine. This could be sitting quietly for two minutes, journaling or shutting down digital screens an hour before bedtime. Hansra’s own routine includes reading, answering three questions in his journal—“What did I learn today?” “How did I grow today?” and “What will I do differently moving forward?”— and a prayer of gratitude. He also does five to 15 minutes of stretching. “As pharmacists our backs and legs need the ability to reset,” he notes.

Cultivate happiness at work

It’s one thing to learn to calm yourself in a stressful work environment, but the workplace culture itself needs to be such that people feel valued and happy when at work.

“We need to learn from other sectors, like the tech sector,” says Agro. “Those employees love going to work because they are in a cool environment—lunch is provided, snacks are available, music is playing, it’s a fun place to be.”

More than that, happiness at work is about making connections. “When was the last time someone at work asked you how you are really doing and what’s happening in your world? When was the last time you felt celebrated for the work you do? A lot of pharmacies and management don’t see the value in that—and they are going to lose people because of it,” stresses Agro.

One of the ways pharmacists can support employees “is to help your team members embrace life outside of work,” she recommends, citing a cover story in the Harvard Business Review, “To Retain Employees, Support Their Passions Outside of Work” (March 2022). Successful strategies include flexible work hours, dedicated time off (such as for sabbaticals), financial stipends to support outside interests, and time for team members to share their passion pursuits (for example during lunch breaks and staff meetings).

“Employers need to support people in their passions outside of work because that might be what lights them up, what rejuvenates them. Their energy often comes from what they do outside of work and they bring that to work with them,” says Agro.

Another way employers can make people feel good about their workplace is to determine their core values, then openly communicate and actively practise those values. “If compassion and honesty are your core values, are you showing these on a daily basis?” asks Hansra. “If you are, you will have a more engaged relationship with your team members, which promotes productivity and helps with patient outcomes. Click here to read the rest of the article in CFP’s Fall 2023 Changing Face of Pharmacy magazine.