Seeking Connection: Short term or long term?

The day to day responsibilities of any clinical pharmacist can make it hard to know what day it is. What I mean is that the day-to-day activities of direct clinical activities can become repetitive. Over the course of early-career where every patient case is totally exciting, this shifts to patterns of recognition and a feeling of “hey, I’ve seen this before.” As the experience continues to grow and responsibilities expand, one can start to wonder, where is all this effort going? What’s really changing? It’s my belief that this is where burnout begins to set in. 

While in the past, this point in many pharmacists’ careers was a roadblock. You either had the natural ability to overcome it, or you simply lacked that trait. The secret code to break these feelings was simply unknown and inaccessible to those who even dared to look. But with social media and the innumerable experiences shared in podcasts and other media, those skills are no longer inborn. What I’ve observed is that these skills are learnable. From this recognition, burnout transforms from some sort of flaw in your character to a natural emotion that we all must encounter.

What I’ve come to observe in researching into burnout among our profession is that most who experience it are between 25-35 years of age. In that group, the vast majority are within 5 years of completing residency. While there are an incredible amount of confounders that play into each individual’s experience and emotion, are we observing a symptom of short term planning taking precedence over long term planning? 

These young professionals have learned to break their lives into 1-2 year increments: P4, PGY1, PGY2, first job. These first three elements have discrete endpoints, where the fourth doesn’t. Likewise, continuing with the same perception of one-year incremental projects and objectives can evolve into a perception of repetitiveness and the Groundhog Day effect. Since it begins to feel as though you’re not making progress, you keep fighting the same battles, and doing the same projects… yea it makes sense you feel burned out.

But why do we see burnout numbers drop as professionals continue to age? I do not believe its because individuals simply give up. Sure, some do, but there is a more hopeful answer. It’s that we evolve our frame of reference from thinking in the day-to-day and year-to-year projects and growth. We, in fact, stop thinking in these terms altogether. Instead, at least for me, the outcomes and purpose of work change all-together.

I feel happy / I’m doing great because _____ [accomplishment] → I feel content or I feel connectedness. (From Tim Ferriss #410)

We feel less satisfied by piling up accomplishments. We shift to caring less about the things that feel important into perspective. Do you remember that awesome intervention you made three weeks ago? Or do you remember helping a student understand something better? Did that protocol you made last year bring you satisfaction? Or did listening to a colleague explain what’s been hard for them now that they’re a single mother?

But the key is that in order to be able to reach this point of connectedness and realize “don’t sweat the small stuff” you must first experience a visceral feeling that changes your emotional and mental state. That state just happens to be brought upon by what we call burnout.

Turns out this is not new thinking and it’s not even atypical. It’s in Maslow’s hierarchy of needs. It’s the top of the pyramid where you reach “self-actualization.” It goes to show how difficult these concepts can be to comprehend without first truly experiencing the emotions. It also speaks to the difficulty in trying to teach these concepts to college students. For me personally, of course, I understood the concepts of empathy and could correctly describe Maslow on an exam, but applying it to myself wasn’t even a thought. 

It is and reminds me of a quote from the Dali Lama himself: (I’m paraphrasing) Walking down a street and encountering a homeless individual can elicit empathy and cause you to help you acknowledge this person’s suffering and feel it as well. But compassion for this person compels you to actually do something to help relieve the suffering.

Considering this small, but important difference can help inform methods to change and begin to remove these feelings of burnout. That person on the street isn’t a stranger. It’s you. 

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