Burnout Among Pharmacists by Monina R. Lahoz, PhD, and Holly L. Mason, PhD Summary A nationwide mail survey of a random sample of the American Pharmaceutical Association membership was conducted to study the degree of burrwut among pharmacists and to identify individual and job charocteristics that make a pharmacist susceptible to burrwut. Analysis of 1,261 returned questionnaires (57.1% .response rate) revealed moderate levels of burnout among pharmacists. The study found that the typical pharmacist who reported the highest level ofburrwut was a woman less than 40 years old, who works in a chain community pharmacy setting, and who has been in proctice and in the same job fOr less than 10 years. Further work is needed to identify other personal and proctice conditions that make pharmacists susceptible to burrwut. In the meantime, employees are encouroged to establish interpersonal communications designed to identify and deal with signs ofburrwut. Monina R. Lahoz, PhD, is assistant professor of pharmacy administration, College of Pharmacy, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425-2302. Holly L. Mason, PhD, is associate professor of pharmacy administration, School of Pharmacy and Pharmacal Sciences, Purdue University, West Lafayette, IN 47907. Submitted January 1990; revised March 1990; accepted March 1990.
28
Introduction ·
I
n May 1982, the cover of American Pharmacy showed a light bulb with
the word ''burnout" underneath it Seven pages of that issue dealt with the well-being of pharmacists and included a pilot study of the state of well-being and burnout of North Carolina pharmacists. 1 •2 Problems addressed in that issue were dissatisfaction, job turnover, stress, and burnout among phannacists. A need still exists to know more about these problems and the problem of professional impairment - how severely these problems affect practitioners and what can be done to prevent or reduce their detrimental effects. 1b begin addressing these issues, a nationwide swvey was conducted to investigate stress among pharmacists. 3 Its purpose was to learn more about what makes phannacy practice stressful, where stress comes from, and how stress affects phannacists. This article deals with the section of the study that looked specifically at burnout of phannacists.
Burnout is defined as a "syndrome of emotional exhaustio~ and cynicism that occurs frequently among individuals who do 'people-work' of some kind."4 Burnout is most often seen in occupations that require extensive and intensive involvement with people needing help. It stems from persistently being under stress. The study's objectives were to determine the extent of burnout among phannacists and to identify the fuctors that contribute to this problem. Specifically, two general questions were being researched: • What is the degree of burnout experienced among practicing pharmacists in the United States? • What individual and job characteristics are potentially useful in characterizing individual differences in burnout levels?
Methods
Q
uestionnaires were mailed to 2, 780 pharmacists, randomly selected from the membership list of the American Pharmaceutical
American Pharmacy, Vol. NS30, No. 8 August 1990/460
Association (APhA). The number of potential respondents was reduced to 2,210 because some surveys were nondeliverable or unusable. A total of 1,261 scoreable responses were used for data analyses. This represented a net response rate of 57.1% (1,261/2,210). The Maslach Burnout Inventory (MBI) was used to measure the degree of burnout that pharmacists perceived they were experiencing. (Normative data and the construct validity and reliability of the MBI when used with pharmacists have been reported in the literature. 5 ) The MBI consists of 22 items that measure burnout in terms of three constnicts or subscales: emotional exhaustion (nine items), depersonalization (five items), and devalued personal accomplishment (eight items). Emotional exhaustion is brought about by excessive interaction and involvement with patients and their problems. Depersonalization is the development of negative and dehumanizing attitudes and feelings toward clients receiving one's service. The burned-out pharmacist sees customers as less human and more object-like and views relationships with them in analytic terms. Devalued personal accomplishment is the development of feelings of inefficacy resulting from repeated failures to produce positive results or changes in one's work. A burned-out pharmacist does not feel competent and successful in his or her work. The MBI asked each pharmacist to rate how often he/she experienced the described feeling. Each item was scored from 0 (never) to 6 (evecy day). Data were analyzed using the Statistical Package for the Social Sciences (SPSS). 6 A significance level of 0.05 was used in all statistical tests. Response frequencies were calculated for individual and job-related characteristics. For each MBI item and subscale, means and standard deviations were calculated to determine the degree of burnout experienced among pharmacists. Analysis of variance (ANOVA) was used to investigate which of several individual and job characteristics might be useful in describing differences in degree of burnout among groups ofpharmacists. Where a significant ANOVA F-value was obtained, the Sche:ffe test was
executed to pinpoint which mean scores were different from each other.
Results and Discussion
0
f the sample of pharmacists who responded to the study, 892 (70.8%) were men, the mean age was 41.3 years, the mean years of experience in pharmacy were 16.3, the mean years in current job were 9.1, and the mean weekly work hours were 42.6 (Table 1).
American Pharmacy, Vol. NS30, No. 8 August 1990/461
Degree of Burnout The degree of burnout experienced is described in terms of the three MBI subscales. (The use of a total score on the 22 items to determine level of burnout is not recommended by the developers of MBI because of psychometric insufficient data on the instrument.) For each subscale, a mean score is computed and then categorized as low, moderate, or high. An individual is said to be experienc-
29
pharmacies. Although notable differences existed among the burnout scores of pharmacists in various practice settings, significant differences between group means were detected only in the EE and DP subscales using the Scheffe test. Independent community phannacists reported significant!~ lower levels ?f emotional exhaustion than their counterparts in large chain and hospital pharmacies. Independent community and hospital phannacists also had significantly lower scores in the DP subscale than practitioners in large chain pharmacies. The mean scores were within the moderate range except for the PA mean score of hospital pharmacists, which was in the high degree of burnout range. Practitioners in large chain phannacies seemed to be experiencing higher levels of burnout than any of their counterparts.
ing high levels of burnout if he/she has high scores on either the em~ tional exhaustion (EE) or depersonalization (DP) subscale, or a low score on the personal accomplishment (PA) subscale. In all subscales, more than 50% of the pharmacists experienced moderate to high levels ofburnout (see Table 2). At least one out of four pharmacists reported high levels of burnout - 25.8% in the EE subscale, 39.9% in DP, and 43.1% in PA. In the analyses of data, phannacists were grouped according to several individual and job characteristics. ANOVA results are reported in Table3. Sex: Women pharmacists reported higher levels of burnout than men pharmacists. Compared to ~he mean scores of men phannacists (n=892), the mean scores of women phannacists (n = 366) were significantly higher in the EE subscale and significantly lower in the PA subscale (Table 3). The mean scores were within the moderate range except for the PA mean score of women, which was in the high degree of burnout range. Age: More than half (55.7%) of the pharmacists in the study were 40 years of age or younger. Degree of burnout varied according to age; in general, the younger the pharmacist, .the higher the degree of burnout. A slight deviation from this trend can be seen in the PA subscale scores where the highest mean score was reported by the 41-50 age group. The mean scores were within the moderate range except for the EE mean score of the over-60 group which was in the low degree of burnout range.
Cmrent Job Position: Job position seemed to be a differentiating factor
30
in determining burnout levels. Staff or employee pharmacists reported being the most burned out of all the groups, especially when compared to pharmacy owners or partners. They consistently reported higher mean scores in all the MBI subscales than pharmacy owners or partners. The mean scores were within the moderate range except for the PA mean score of staff or employee phannacists, which was in the high degree of burnout range. Staff/employee pharma~ists were experiencing diminished feelmgs of accomplishment in their jobs. This may be because staff or employ~e pharmacists did not feel that therr responsibilities and daily tasks were significant or of much value.
Years Active in Practice: Considering the mean age of pharmacists in the study, it was not surprising to ~d that 43.5% of them have been In practice for 10 years or less. Significant differences in the mean scores were found in the EE and DP subscales but not in the PA subscale. In general, the longer the phannacist had been in practice, the lower the degree of burnout experienced. This may reflect gaining experience, knowing more about being a pharmacist, and having adjusted personal expectations of the practice of pharmacy through the years. The mean scores were within the moderate range except for the EE mean score of the group with more than 40 years in practice, which was in the low degree of burnout range.
Current Practice Setting: Nearly half (44.5%) of the phannacists were working in independent community
Years in Current Job: Closely related to years active in practice is
American Pharmacy, Vol. NS30, No. 8 August 1990/462
years in current job. The same mean
score patterns emerged; that is, significant differences were found only in the EE and DP subscales but not in the PA subscale. Interestingly, pharmacists who have ~een in the
same job for 30 to 39 years reported the lowest mean scores. They have significantly lower mean scores than those who have been in the same job for less than 10 years. The mean scores were within the moderate range
except for the DP mean score of the 30--39 group, which was in the high degree of burnout range.
Hours Worked Per Week: Significant differences in mean scores were
Table 3. Results of Analysis of Variance of Mean Burnout Scores of Pharmacists by Group Characteristic
American Pharmacy, Vol. NS30, No. 8 August 1990/463
31
obtained in the DP and PA subscales but not in the EE subscale. In the PA subscale, pharmacists who worked from 35 to 40 hours per week had much lower scores than those who worked more than 45 hours per week. This indicated that pharmacists who worked longer hours were not necessarily experiencing higher levels of burnout. The mean scores were within the moderate range except for the PA mean score of pharmacists who worked 19 or fewer hours or 35 to 40 hours per week, which was in the higher degree of burnout range.
Conclusions s a group, pharmacists were experiencing moderate levels of emotional exhaustion, depersonalization, and lowered feelings of personal accomplishment, or an overall moderate level ofburnout. Several individual and job characteristics were shown to be potentially useful in differentiating pharmacists' burnout levels. If one were to characterize the pharmacist most susceptible to burnout, that pharmacist would be a woman, less than 40 years old, and/or a staff or employee pharmacist in a large chain community pharmacy setting, who has been in practice and in the same job for about 10 years -regardless of how many hours he/she worked per week. However, one needs to look more closely to determine whether being a woman really makes a pharmacist more susceptible to burnout. Current demographic data show that women pharmacists make up the younger work force, have been in practice for a shorter period of time, and hold staff or employee positions. These characteristics have previously been shown to make a pharmacist susceptible to burnout, regardless of sex. Further studies need to be conducted to examine whether these characteristics that make a pharmacist more susceptible to burnout are consistent over time. One disturbing trend observed in this study was that pharmacists reported low levels of feelings of personal accomplishment. Furthermore, unlike emotional exhaustion or depersonalization - which seemed to decrease over time - low feelings of personal accomplishment did not
A
32
seem to be related to any time dimension. These observations need to be further addressed. Why do pharmacists have low levels of feelings of personal accomplishment? How and on what basis do pharmacists evaluate personal accomplishment? What makes a pharmacist experience personal accomplishments from being a pharmacist? Why is it not related to time.? Caution must be used in generalizing these findings to all pharmacists. There are inherent limitations to the use of a mail survey as a data collection method. One cannot confirm the reliability of the answers provided by the respondents. A more serious concern is the possibility that nonrespondents are different from those who completed and returned the survey. One cannot be sure if the pharmacists who responded were more or less burned out than those who did not participate in the study. Was the burned-out pharmacist, by the vecy nature of his or her condition, more likely to have discarded the survey and not responded, or would he/she have taken advantage of the opportunity to let others become aware of the problems of stress and burnout in pharmacy practice? This study was not designed to explain fully why pharmacists experience burnout. Rather, it was an attempt to provide some preliminacy characterization of the pharmacist at high risk of burnout. FUrther work should be done to identify other personal and practice conditions that make a pharmacist highly susceptible to burnout, and also gain a better understanding of the extent to which burnout has been detrimental to pharmacy and pharmacists. In doing so, we can then proceed to formulate solutions to the problem. In the meantime, steps can be taken by both employee pharmacists and employers to minimize or avoid burnout in the profession. One step is to focus on who is likely to burn out and why. \\e found in this survey that those most prone to burnout are women pharmacists under 40 years old, who have practiced for less than 10 years. We suggest several factors that may be causing larger numbers of young women pharmacists to burn out. They may be experiencing the emotional strain and stress of trying to maintain
a balance between private and professional life. There might be conflicting or competing demands for time and energy between launching a pharmacy career and building a personal or family relationship. Also, in the workplace, the woman pharmacist may perceive that she needs to work harder to prove her competence. If this personal conflict remains unresolved for some length of time, sooner or later, it will take its toll. Therefore, from the woman pharmacist's perspective, she may need to reevaluate her priorities and the available resources around her that will enable her to juggle her responsibilities more effectively. From the employer's perspective, some consideration may be given to the fact that more female pharmacists are entering the work force. Then one may ask: Does the value or benefit derived by women pharmacists from their job and career differ from that of their male counterparts? Do they require a different style of management? Regardless of the employee's sex, the employer must establish open and honest communication with the employee. Engaging in effective interpersonal communications often has been written and talked about as a valuable management activity. The employer, however, must take the time to support and encourage employees, to listen to their suggestions and ask for their input when appropriate, to find out what's bothering them and what their aspirations are.®
References 1. Pfifferling J, Eckel FM. Promoting pharmacist well-being. Am Pharm. 1982;NS22:240. 2. Ciaccio EA, Jang R, Caiola SM, et al. Well-being: a North Carolina study. Am Pharm. 1982;NS22:244. 3. Lahoz, MR. Burnout among pharmacists: the influence of individual and job characteristics. PhD Dissertation, Purdue University, 1987. 4. Maslach C, Jackson SE. The measurement of experienced burnout. J Occup Behav. 1981;2:99. 5. Lahoz MR, Mason HL. Maslach Burnout Inventory: the influence of individual and job characteristics. Psycholog Rep. 1989;64:1059. 6. SPssx User's Guide, 2nd ed. Chicago, ll.: McGraw-Hill Book Company, 1986.
American Pharmacy, Vol. NS30, No. 8 August 1990/464
28
Introduction ·
I
n May 1982, the cover of American Pharmacy showed a light bulb with
the word ''burnout" underneath it Seven pages of that issue dealt with the well-being of pharmacists and included a pilot study of the state of well-being and burnout of North Carolina pharmacists. 1 •2 Problems addressed in that issue were dissatisfaction, job turnover, stress, and burnout among phannacists. A need still exists to know more about these problems and the problem of professional impairment - how severely these problems affect practitioners and what can be done to prevent or reduce their detrimental effects. 1b begin addressing these issues, a nationwide swvey was conducted to investigate stress among pharmacists. 3 Its purpose was to learn more about what makes phannacy practice stressful, where stress comes from, and how stress affects phannacists. This article deals with the section of the study that looked specifically at burnout of phannacists.
Burnout is defined as a "syndrome of emotional exhaustio~ and cynicism that occurs frequently among individuals who do 'people-work' of some kind."4 Burnout is most often seen in occupations that require extensive and intensive involvement with people needing help. It stems from persistently being under stress. The study's objectives were to determine the extent of burnout among phannacists and to identify the fuctors that contribute to this problem. Specifically, two general questions were being researched: • What is the degree of burnout experienced among practicing pharmacists in the United States? • What individual and job characteristics are potentially useful in characterizing individual differences in burnout levels?
Methods
Q
uestionnaires were mailed to 2, 780 pharmacists, randomly selected from the membership list of the American Pharmaceutical
American Pharmacy, Vol. NS30, No. 8 August 1990/460
Association (APhA). The number of potential respondents was reduced to 2,210 because some surveys were nondeliverable or unusable. A total of 1,261 scoreable responses were used for data analyses. This represented a net response rate of 57.1% (1,261/2,210). The Maslach Burnout Inventory (MBI) was used to measure the degree of burnout that pharmacists perceived they were experiencing. (Normative data and the construct validity and reliability of the MBI when used with pharmacists have been reported in the literature. 5 ) The MBI consists of 22 items that measure burnout in terms of three constnicts or subscales: emotional exhaustion (nine items), depersonalization (five items), and devalued personal accomplishment (eight items). Emotional exhaustion is brought about by excessive interaction and involvement with patients and their problems. Depersonalization is the development of negative and dehumanizing attitudes and feelings toward clients receiving one's service. The burned-out pharmacist sees customers as less human and more object-like and views relationships with them in analytic terms. Devalued personal accomplishment is the development of feelings of inefficacy resulting from repeated failures to produce positive results or changes in one's work. A burned-out pharmacist does not feel competent and successful in his or her work. The MBI asked each pharmacist to rate how often he/she experienced the described feeling. Each item was scored from 0 (never) to 6 (evecy day). Data were analyzed using the Statistical Package for the Social Sciences (SPSS). 6 A significance level of 0.05 was used in all statistical tests. Response frequencies were calculated for individual and job-related characteristics. For each MBI item and subscale, means and standard deviations were calculated to determine the degree of burnout experienced among pharmacists. Analysis of variance (ANOVA) was used to investigate which of several individual and job characteristics might be useful in describing differences in degree of burnout among groups ofpharmacists. Where a significant ANOVA F-value was obtained, the Sche:ffe test was
executed to pinpoint which mean scores were different from each other.
Results and Discussion
0
f the sample of pharmacists who responded to the study, 892 (70.8%) were men, the mean age was 41.3 years, the mean years of experience in pharmacy were 16.3, the mean years in current job were 9.1, and the mean weekly work hours were 42.6 (Table 1).
American Pharmacy, Vol. NS30, No. 8 August 1990/461
Degree of Burnout The degree of burnout experienced is described in terms of the three MBI subscales. (The use of a total score on the 22 items to determine level of burnout is not recommended by the developers of MBI because of psychometric insufficient data on the instrument.) For each subscale, a mean score is computed and then categorized as low, moderate, or high. An individual is said to be experienc-
29
pharmacies. Although notable differences existed among the burnout scores of pharmacists in various practice settings, significant differences between group means were detected only in the EE and DP subscales using the Scheffe test. Independent community phannacists reported significant!~ lower levels ?f emotional exhaustion than their counterparts in large chain and hospital pharmacies. Independent community and hospital phannacists also had significantly lower scores in the DP subscale than practitioners in large chain pharmacies. The mean scores were within the moderate range except for the PA mean score of hospital pharmacists, which was in the high degree of burnout range. Practitioners in large chain phannacies seemed to be experiencing higher levels of burnout than any of their counterparts.
ing high levels of burnout if he/she has high scores on either the em~ tional exhaustion (EE) or depersonalization (DP) subscale, or a low score on the personal accomplishment (PA) subscale. In all subscales, more than 50% of the pharmacists experienced moderate to high levels ofburnout (see Table 2). At least one out of four pharmacists reported high levels of burnout - 25.8% in the EE subscale, 39.9% in DP, and 43.1% in PA. In the analyses of data, phannacists were grouped according to several individual and job characteristics. ANOVA results are reported in Table3. Sex: Women pharmacists reported higher levels of burnout than men pharmacists. Compared to ~he mean scores of men phannacists (n=892), the mean scores of women phannacists (n = 366) were significantly higher in the EE subscale and significantly lower in the PA subscale (Table 3). The mean scores were within the moderate range except for the PA mean score of women, which was in the high degree of burnout range. Age: More than half (55.7%) of the pharmacists in the study were 40 years of age or younger. Degree of burnout varied according to age; in general, the younger the pharmacist, .the higher the degree of burnout. A slight deviation from this trend can be seen in the PA subscale scores where the highest mean score was reported by the 41-50 age group. The mean scores were within the moderate range except for the EE mean score of the over-60 group which was in the low degree of burnout range.
Cmrent Job Position: Job position seemed to be a differentiating factor
30
in determining burnout levels. Staff or employee pharmacists reported being the most burned out of all the groups, especially when compared to pharmacy owners or partners. They consistently reported higher mean scores in all the MBI subscales than pharmacy owners or partners. The mean scores were within the moderate range except for the PA mean score of staff or employee phannacists, which was in the high degree of burnout range. Staff/employee pharma~ists were experiencing diminished feelmgs of accomplishment in their jobs. This may be because staff or employ~e pharmacists did not feel that therr responsibilities and daily tasks were significant or of much value.
Years Active in Practice: Considering the mean age of pharmacists in the study, it was not surprising to ~d that 43.5% of them have been In practice for 10 years or less. Significant differences in the mean scores were found in the EE and DP subscales but not in the PA subscale. In general, the longer the phannacist had been in practice, the lower the degree of burnout experienced. This may reflect gaining experience, knowing more about being a pharmacist, and having adjusted personal expectations of the practice of pharmacy through the years. The mean scores were within the moderate range except for the EE mean score of the group with more than 40 years in practice, which was in the low degree of burnout range.
Current Practice Setting: Nearly half (44.5%) of the phannacists were working in independent community
Years in Current Job: Closely related to years active in practice is
American Pharmacy, Vol. NS30, No. 8 August 1990/462
years in current job. The same mean
score patterns emerged; that is, significant differences were found only in the EE and DP subscales but not in the PA subscale. Interestingly, pharmacists who have ~een in the
same job for 30 to 39 years reported the lowest mean scores. They have significantly lower mean scores than those who have been in the same job for less than 10 years. The mean scores were within the moderate range
except for the DP mean score of the 30--39 group, which was in the high degree of burnout range.
Hours Worked Per Week: Significant differences in mean scores were
Table 3. Results of Analysis of Variance of Mean Burnout Scores of Pharmacists by Group Characteristic
American Pharmacy, Vol. NS30, No. 8 August 1990/463
31
obtained in the DP and PA subscales but not in the EE subscale. In the PA subscale, pharmacists who worked from 35 to 40 hours per week had much lower scores than those who worked more than 45 hours per week. This indicated that pharmacists who worked longer hours were not necessarily experiencing higher levels of burnout. The mean scores were within the moderate range except for the PA mean score of pharmacists who worked 19 or fewer hours or 35 to 40 hours per week, which was in the higher degree of burnout range.
Conclusions s a group, pharmacists were experiencing moderate levels of emotional exhaustion, depersonalization, and lowered feelings of personal accomplishment, or an overall moderate level ofburnout. Several individual and job characteristics were shown to be potentially useful in differentiating pharmacists' burnout levels. If one were to characterize the pharmacist most susceptible to burnout, that pharmacist would be a woman, less than 40 years old, and/or a staff or employee pharmacist in a large chain community pharmacy setting, who has been in practice and in the same job for about 10 years -regardless of how many hours he/she worked per week. However, one needs to look more closely to determine whether being a woman really makes a pharmacist more susceptible to burnout. Current demographic data show that women pharmacists make up the younger work force, have been in practice for a shorter period of time, and hold staff or employee positions. These characteristics have previously been shown to make a pharmacist susceptible to burnout, regardless of sex. Further studies need to be conducted to examine whether these characteristics that make a pharmacist more susceptible to burnout are consistent over time. One disturbing trend observed in this study was that pharmacists reported low levels of feelings of personal accomplishment. Furthermore, unlike emotional exhaustion or depersonalization - which seemed to decrease over time - low feelings of personal accomplishment did not
A
32
seem to be related to any time dimension. These observations need to be further addressed. Why do pharmacists have low levels of feelings of personal accomplishment? How and on what basis do pharmacists evaluate personal accomplishment? What makes a pharmacist experience personal accomplishments from being a pharmacist? Why is it not related to time.? Caution must be used in generalizing these findings to all pharmacists. There are inherent limitations to the use of a mail survey as a data collection method. One cannot confirm the reliability of the answers provided by the respondents. A more serious concern is the possibility that nonrespondents are different from those who completed and returned the survey. One cannot be sure if the pharmacists who responded were more or less burned out than those who did not participate in the study. Was the burned-out pharmacist, by the vecy nature of his or her condition, more likely to have discarded the survey and not responded, or would he/she have taken advantage of the opportunity to let others become aware of the problems of stress and burnout in pharmacy practice? This study was not designed to explain fully why pharmacists experience burnout. Rather, it was an attempt to provide some preliminacy characterization of the pharmacist at high risk of burnout. FUrther work should be done to identify other personal and practice conditions that make a pharmacist highly susceptible to burnout, and also gain a better understanding of the extent to which burnout has been detrimental to pharmacy and pharmacists. In doing so, we can then proceed to formulate solutions to the problem. In the meantime, steps can be taken by both employee pharmacists and employers to minimize or avoid burnout in the profession. One step is to focus on who is likely to burn out and why. \\e found in this survey that those most prone to burnout are women pharmacists under 40 years old, who have practiced for less than 10 years. We suggest several factors that may be causing larger numbers of young women pharmacists to burn out. They may be experiencing the emotional strain and stress of trying to maintain
a balance between private and professional life. There might be conflicting or competing demands for time and energy between launching a pharmacy career and building a personal or family relationship. Also, in the workplace, the woman pharmacist may perceive that she needs to work harder to prove her competence. If this personal conflict remains unresolved for some length of time, sooner or later, it will take its toll. Therefore, from the woman pharmacist's perspective, she may need to reevaluate her priorities and the available resources around her that will enable her to juggle her responsibilities more effectively. From the employer's perspective, some consideration may be given to the fact that more female pharmacists are entering the work force. Then one may ask: Does the value or benefit derived by women pharmacists from their job and career differ from that of their male counterparts? Do they require a different style of management? Regardless of the employee's sex, the employer must establish open and honest communication with the employee. Engaging in effective interpersonal communications often has been written and talked about as a valuable management activity. The employer, however, must take the time to support and encourage employees, to listen to their suggestions and ask for their input when appropriate, to find out what's bothering them and what their aspirations are.®
References 1. Pfifferling J, Eckel FM. Promoting pharmacist well-being. Am Pharm. 1982;NS22:240. 2. Ciaccio EA, Jang R, Caiola SM, et al. Well-being: a North Carolina study. Am Pharm. 1982;NS22:244. 3. Lahoz, MR. Burnout among pharmacists: the influence of individual and job characteristics. PhD Dissertation, Purdue University, 1987. 4. Maslach C, Jackson SE. The measurement of experienced burnout. J Occup Behav. 1981;2:99. 5. Lahoz MR, Mason HL. Maslach Burnout Inventory: the influence of individual and job characteristics. Psycholog Rep. 1989;64:1059. 6. SPssx User's Guide, 2nd ed. Chicago, ll.: McGraw-Hill Book Company, 1986.
American Pharmacy, Vol. NS30, No. 8 August 1990/464
