Tip of the Week: Fatigue Must Be Addressed in the Pharmacy Workforce

Most people suffer from physical and mental fatigue at various points in their lives and it may negatively impact our ability to respond to situations requiring high levels of focus and concentration. Pharmacists may also be faced with occupational fatigue, which is multifactorial in nature and includes physical, mental, and emotional aspects, sometimes resulting from excessive workload in combination with the sharp mental acuity they must maintain throughout their careers. Recognizing that pharmacists may be confronted with occupational fatigue is important to acknowledge and address, since operating in a diminished capacity can lead to increased medication errors and compromises in patient safety.

A recent study conducted to categorize pharmacists’ fatigue found that both physical and mental fatigue were identified as key domains.1 The study, conducted by Watterson et al, explored occupational fatigue in pharmacists to determine whether the same dimensional structures found in other health professions were applicable to them. Survey respondents represented a broad array of practice settings and cumulatively worked an average of 9.5 hours per day.¹

The results showed that both physical and mental characteristics contributed to occupational fatigue. Of the possible survey responses related to the physical domain of fatigue, the most frequently selected responses included feeling that energy decreased over the course of the day, feeling more tired later in the day versus the beginning, and feeling generally fatigued, in a broader sense.¹

The most common reasons selected for mental fatigue included difficulty thinking clearly, forgetting whether or not tasks had been completed, spending longer completing a task later in the day, and feeling like they were not performing at their best. Elements that were found to be germane among other professionals but were not reported among pharmacists included feelings of pain and taking shortcuts when providing patient care to ameliorate mental fatigue. Although pharmacists may stand for very long periods, they did not report feeling pain or discomfort. Pharmacists did not acknowledge that mental fatigue contributed to taking shortcuts in patient care, which may be attributed to liability concerns and to being especially dutiful.¹

Watterson et al. constructed a conceptual model of occupational fatigue in pharmacists, which shows that excessive demands of the work system lead to occupational fatigue and may result in burnout, decreased job satisfaction, compromised patient safety, and a reduction in information retention.¹ Pharmacies are unique health care settings where pharmacists may not have access to the same level of information that other health care providers do, such as a patients’ medical records, but are expected to provide timely advice and recommendations regarding the patient’s health and wellbeing. One of the most distinctive aspects of pharmacy that sets it apart from other health care settings is that the business is often for-profit, which adds another dimension of demand.

The quadruple aim framework emphasizes that there are 4 interrelated tenets to improve health care: better outcomes, lower costs, improved patient experiences, and the wellbeing of the health care provider. Given that pharmacists have to juggle so many tasks that require a high level of cognitive function, a more concerted effort to conceptualize solutions to prevent occupational fatigue should be addressed.

Organizations and supervisors must ensure that employees do not feel overextended so that they can perform their required tasks with the appropriate mental acuity and necessary precision. When employees hint or openly share that they are feeling overextended, managers should acknowledge their concerns and work toward creative solutions. Potential solutions may be providing training for better time management, delegating tasks, and developing more efficient workplace processes to help reduce stressors.

Examining job descriptions, workflow, redundancies, unnecessary tasks, availability of adequate resources, appropriate staffing levels at the right times of the day, information technology functioning, and other operational processes can potentially shed light on a combination of approaches to optimize labor capital and mitigate fatigue. It is essential to create open communication between managers and staff to ensure timely feedback and avoid creating a culture where employees feel penalized for identifying areas of concern. Focusing on the mental and physical well-being of employees may lead to better performance and patient outcomes.

More information about Managing People and Managing Operations can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.

ABOUT THE AUTHORS

Valerie Wasem is a PharmD candidate at Touro University California.

Shane P. Desselle, PhD, RPh, FAPhA, is a professor of social and behavioral pharmacy at Touro University California.

REFERENCES

1. Watterson TL, Look KA, Steege L, Chui MA. Operationalizing occupational fatigue in pharmacists: An exploratory factor analysis. Res Soc Admin Pharm. 2021;17(7):1282-1287.