Anaheim, CA—According to the results of a recent survey of hematopoietic stem-cell transplantation (HSCT) professionals, burnout is prevalent across all HSCT disciplines, with pharmacists showing the highest rates of burnout and moral distress.
“It’s been well published that burnout can lead to medical errors, loss of professionalism, and turnover. We know that moral distress can also decrease our moral sensitivity to patients and lead to withdrawal from ethically challenging situations, and many people decide to leave the profession because of these distresses,” said Joyce Neumann, PhD, APRN, AOCN, BMTCN, Program Director, SCT/Advanced Practice Nurse, and Adjuvant Ethicist, The University of Texas M.D. Anderson Cancer Center, Houston.
“Those of us taking care of patients in hematology/oncology need to take better care of ourselves,” stated Dr Neumann at the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference.
Although compassion fatigue and moral distress have been studied in the nursing profession, there is an absence of literature concerning burnout among pharmacists, said Dr Neumann. To assess the prevalence of work-related distress among HSCT professionals, Dr Neumann and colleagues administered a 90-item, web-based survey in early 2015. Practicing physicians, nurses, pharmacists, advanced practice providers, and social workers who had provided direct patient care to hospital-based programs or clinics were included in the survey.
To examine burnout, investigators used the Maslach Burnout Inventory with 3 subscales—emotional exhaustion, depersonalization, and personal accomplishment. A revised version of the Moral Distress Scale was also employed. In addition, the survey asked questions about work–life balance and career satisfaction.
A total of 1541 healthcare professionals responded to the survey, including 95 pharmacists. Most respondents worked with adult populations and in inpatient and outpatient settings.
As Dr Neumann reported, burnout was prevalent across all disciplines, but pharmacists had the highest level in the study, with 53% self-identifying as having had burnouts. Moreover, when subscales of the Maslach Burnout Inventory were examined, emotional exhaustion appeared to be the primary cause.
Levels of moral distress were also highest among pharmacists when compared with other disciplines, said Dr Neumann, who noted that moral distress was a predictor of burnout in all disciplines. The majority of respondents reported low levels of depersonalization and high personal accomplishment.
Finally, burnout and work–life balance were significantly associated with career satisfaction—81% of respondents who were dissatisfied with their careers in HSCT self-identified as having burnouts.
Nevertheless, despite moderate-to-high levels of emotional exhaustion, most pharmacists recommended a career in HSCT.
“This was perhaps due to the gratification of caring for patients, high personal accomplishment, and commitment to the specialty, demonstrated by membership in professional associations and societies,” Dr Neumann observed.
To prevent future burnout, she recommended strategies such as mindfulness training and resiliency training.
“Professional organizations like HOPA need to look at ways to mitigate some of the distresses experienced by pharmacists so that we can stay engaged and involved, and interventions like Schwartz rounds and multidisciplinary rounds could help, too,” said Dr Neumann.
“In addition, there’s a need for personal time and relief from emotional exhaustion. Pharmacists need to make sure that they have a voice and feel like they’re being listened to if they speak up about a case or situation,” she added.
Finally, more interventional studies are needed, because what may work for nurses may not necessarily work for pharmacists and physicians, Dr Neumann concluded.