| Pharmacist
attacks Society employee with metal bar at Statutory Committee hearing, ran a headline in The Pharmaceutical Journal for 28
October
(p503). Although there may be no connection in this particular case,
the report about a pharmacist who reacted thus, when told he would be
struck off for misconduct, prompted me to think about the issue of stress
in pharmacists, about its causes and about what can be and is being done
to address the problem.
As chairman of the Society’s Listening Friends scheme, I am certainly
well aware of the problem of stress. The scheme was set up nearly 11
years ago to help pharmacists who were affected by stress. The idea arose
because Sue Sharpe, who was then head of what is now known as the Society’s
Fitness-to-Practise and Legal Affairs Directorate, told me (I was then
a member of the Society’s Council and chairman of its Infringements
Committee) that inspectors were increasingly coming across pharmacists
who were failing to meet required professional standards through an inability
to cope with increasing workload and pressures of the job. She believed
that something needed to be done to help them, and that doing so would
also contribute to safeguarding the public.
Little researched in pharmacists
Stress in pharmacists is a little researched topic, certainly in the
UK. The only piece of specific research appears to be a study published
in 1996.1 This found that the level of
occupational stress was about the same as that of GPs and higher than
the norm for health workers
generally. The main concerns contributing to stress were lack of time
for professional development, inflexible working hours, low professional
status, constant interruptions, inability to make minor changes to
prescriptions, and being the first to be blamed if a prescription was
incorrect or incomplete.
A later survey of job satisfaction among health professionals in New
Zealand2 found that community pharmacists
had the lowest job satisfaction of all groups surveyed, although women
pharmacists were more satisfied
with their work than men. Pharmacists more frequently contemplated giving
up their jobs due to work stress than all other groups. They also felt
more overwhelmed by paperwork, reported more financial concerns and high
levels of frustration at bureaucratic interference. Pharmacists also
had the highest proportion of cases of psychological distress.
Recently, a qualitative interview study of 30 women community pharmacists
in England3 explored the effect on them
of increased workload with minimal increases in remuneration in recent
years. Factors that emerged that
led to increased stress and dissatisfaction with the job include increased
dispensing volumes coupled with falling staff levels, resulting in insufficient
time for patient contact and worries about compromising patient safety.
In the past 11 years stress factors in pharmacy have certainly increased.
From conversations I have had with pharmacists, and cases dealt with
by the scheme, it appears the new NHS community pharmacy contract is
proving to be a source of increased pressure, as profits on dispensing
have been reduced and funding has been redirected to clinical services
that many contractors are finding difficult to provide. The contract
has also introduced new clinical governance requirements, including monitoring
of premises and standards by primary care trusts additional to that already
carried out by Society inspectors. Additionally, the contract has increased
the amount of record keeping, form filling and dealing with bureaucracy,
leaving less time available for pharmacists to fulfil their professional
functions.
Employees of multiples complain of being pressured by their companies
to take on additional roles without an increase in either staff resources
or pay. In hospital and primary care pharmacy, recent NHS financial cutbacks
have increased workload, and the reorganisation of PCTs has left pharmacists
employed by them uncertain about their futures.
Another source of stress reported is the perceived more hostile attitude
in the past few years of the Society to its members in relation to disciplinary
and fitness-to-practise matters. Concerns have also been expressed about
the large increase in numbers of people studying pharmacy as a result
of the expansion of intakes of existing schools and the opening of new
ones, and the implications for future employment and pay prospects.
There seem to be no quick and easy solutions to these problems, although
it may be believed that the Society has a responsibility to address those
issues over which it has influence. While I was a member of the Council
it certainly did what it could, although its power in many areas was
less than members seemed to imagine. In the past few years, rightly or
wrongly, the perception has grown that the Society is taking less interest
in representing and looking after the interests of its members, in favour
of a greater interest in regulation. Nevertheless, the Society still
provides a range of welfare services through its Benevolent Fund, of
which the Listening Friends scheme is one.
Since its inception the scheme has helped around 3,000 pharmacists cope
with stress-related issues, although not all of these have been directly
related to work. One of the recognised ways of coping with stress is
to relieve the burden by talking it through with somebody else, and this
is the core principle of the scheme’s operation and the basis of
its success. Most of the caseload are single calls where the caller wants
to get a problem off his or her chest. They then usually feel better
able to deal with it themselves and do not feel the need to come back
for further support, although it is always available if wanted. Unique advantage
The unique advantage of Listening Friends is that all its volunteers
are pharmacists and therefore have an understanding of the problems
being expressed to them, and can genuinely empathise with callers.
In addition, they all have initial and ongoing training in listening
and counselling skills, and many have additional counselling or therapy
qualifications. Callers can feel secure when they contact the service
because they call in anonymously to an automated line, giving only
a first name (or a pseudonym if they prefer), a number and a suitable
time to call back on. If they have a preference, callers can request
to speak to either a male or female Listening Friend. Calls are picked
up daily by a co-ordinator (one of a team of four senior pharmacists
in the scheme), who then allocates them to LFs. LFs are trained to
listen, and to help callers, if they want, towards finding their own
solution to their problem. LFs also have a list of resources for further,
more specialist help in specific situations, if they think it would
be of use.
The Society may not have it within its power to resolve all the issues
that cause stress for its members, and some members may even feel that
it contributes to them, but it does provide effective help in coping
with stress and it is only a telephone call away — on 020 7572
2442.
References
1. Willett VJ, Cooper CL. Stress and job satisfaction in community
pharmacy: a pilot study. Pharmaceutical Journal 1996;256;94–8.
2. Dowell A, Westcott T, McLeod DK. A survey of job satisfaction, sources
of stress and psychological symptoms among New Zealand health professionals.
NZ Medical Journal 2001;114:540–3.
3. Gidman WK, Hassell K, Day J, Payne K. The impact of work intensification
and role expansion on female community pharmacists.International Journal
of Pharmacy Practice 2006;14(Suppl2):B21. |
The
Pharmaceutical Journal