Be the Positive Voice

I happen to work with a pharmacist who is just so good at bringing in the positive.  When the team is seeming to dip into complaints about a particularly challenging patient or situation, she always comes up with an empathy statement that helps us see the other side.  When we all of a sudden get a surge in patients, are run off our feet and stress is escalating, she often will make a statement that ‘busy is good’ as it means the business is growing due to our excellent patient care. These kind of situations where stress or negativity are escalating are often redirected by this type of engagement and it often infuses fresh energy into the team

We all have patients who challenge us.  They call multiple times a day, are extra particular about how something is dispensed, they blow-up- in anger over something that is not our fault.  Pharmacists face these challenging situations and many more in an already stress filled, fast paced work day, and it is easy to slip into negativity.  It is actually human nature to be negative or to complain during periods of high stress or difficulty.  Expressing negativity or complaining can foster a sense of validation of how we are feeling, and can bring a sense of connectedness between the individuals who agree with us and reinforce the negative with other’s own aligned thoughts.   Basically, venting with colleagues who agree with us just makes us feel better. 

The unintended consequence however is that negativity grows and can become a norm for the team dynamics.  When negativity becomes the norm it risks low morale, less team cohesion and higher staff turnover.  Working in this type of environment also can increase anxiety and contribute to people feeling unsupported.   

This is not to say that we should let ourselves be trampled on.  Burn out from being treated poorly is very real in health care.  To be clear, we need to protect each other as colleagues and team members.  We must acknowledge burnout and attend to ourselves and others when needed and ensure safety and well-being is a priority. 

One of the most powerful ways to buffer against burnout in a pharmacy team is to care for those you work with and to extend positive empathy.  This guards against sinking into pessimism and feeling unsupported in our teams.  This sounds easier that it actually is. 

It takes much less energy to complain than to come up with creative solutions, much easier to criticize than to see things from the perspective of the other.   And this is especially hard when we are tired, burned out or frustrated. 

It takes vulnerability and strength to be positive, but excellent patient care and healthy dispensary teams depend on strong leaders and a continued commitment to supporting each other and being that positive voice.  

Courage to Lead

Leading a team is tough.  It takes courage, strength and resilience. There are days where everyone is working together like a fine oiled machine, and there is positive energy, a lightness in engagement and great productivity.  Then there are days where every hour seems a struggle, relationships seem strained and the negativity that hangs in the air gets passed onto the patients we serve.  

With all the pressures on pharmacy managers, it can be extremely hard to focus on the health and functionality of our teams.  But without this focus, our teams are prey to negativity, competition, and complaining.  A team mired in negative behaviour is stifling to creativity, leads to poor performance and job dissatisfaction and ultimately less effective patient care..  

Leading a team is all about human relationships because teams are made up of humans.  Humans who all have their own stressors, insecurities, fears and anxieties as well as significant life events; all of which they bring to work with them.  So how do we, as leaders, foster a culture of cooperation, empathy towards co-workers and a sense of common purpose.   

I have said this many times, but it is worth repeating:  Our responsibility as leaders is not to drive results, but to create environments where our people can work at their natural best.  They will produce the results. 

Take a stance of empathy

See the person in front of you for who they are, not just their role.  We all have stresses, insecurities and fears.  As a manager It is easy to become frustrated with our people or to “label” a person as the problem rather than address a behaviour and work with the person to find the root cause .  Complaining to yourself or to others that “Dave just doesn’t know how to be on-time” is counter-productive, and if voiced to other team members, contributes to the negativity and break down of the team.  A strong leader would sit down with Dave, acknowledge the behaviour as an issue and ask Dave how he thinks it can be solved together and then create a plan you both agree with.  

In the same way, we need to take mistakes as learning opportunities, not as opportunity to blame and shame.  

I reinforce this with team members when one person comes to me with a complaint about another. I have zero tolerance for staff talking behind someone’s back, spreading negativity, or blaming. It requires strong emotional intelligence to not fall prey to these behaviours because we are human, and it makes us feel better to create “sides” and have people agree with us and be on our side.  Inter-personal issues always need to be addressed up front, and I always start with encouraging all parties to see the other person as human, to assume good intentions and to resist the tendency towards gossip and negativity. 

Check in 

We talk a lot about mental health, and as pharmacists we address mental health issues daily with our patients.  But how often do we make a point of assessing the mental health of the team members we lead?  I’ve talked about the importance of the ten-minute check in quite often, but it has been an eye opener for me to consciously focus  on mental health when I’m meeting one-on-one with a team member.  I assume everything is fine and when checking in I discover that I have a staff member who is really struggling.  Check ins have at times addressed such things as recommending counselling, suggesting simple self-care such as meditation or calming APPs, encouraging time off or a change of hours, and enlisting support of other health professionals.  It’s important to know what’s available for staff in your own organization (eg. coverage for services) and within your community.  When thinking about your team members, consider that if we aren’t checking in, maybe no one is.  




Model Healthy behaviours

Leaders need to be conscious of self-care.  Sometimes we are the worst models of healthy behaviour as we push ourselves to keep the engine running.  Be honest about what you do to stay balanced and the struggles you may have with implementing strategies to reduce stress.  If you follow Brene Brown’s work on leadership, you’ll hear that it’s not only okay to be vulnerable, it is necessary.  Team members will be more likely to adopt recommendations for self-care when they see and hear you talk about how you do this in your own life.  

Resources

https://hbr.org/2020/08/8-ways-managers-can-support-employees-mental-health

https://brenebrown.com/hubs/dare-to-lead/

Care of the Leader

Pharmacists are experiencing one of the most challenging times in their careers.

Strong leadership is even more crucial at this time. Emotional intelligence, being the calm in the storm, providing clarity and direction, and holding the team together is essential. Leaders need to be the backbone of their team. Flexible yet strong.

But who looks after you? How do leaders not only survive but thrive during this time? Who is your support? Leaders must have their own support and connection in order to keep their teams healthy. Here are my top three tips for leaders of pharmacy teams.

1-Seek out other leaders who manage similar teams. Engage them in sharing of frustrations and best practices. When I do this I always learn something. A new system, tips for efficiency or stress reduction. At the very least you get to express your frustrations with someone who just “gets it”.

2- Take time to recharge. I know this is a struggle There are many times when I’m trying to take a half day or a full day off and then there’s an emergency, a fire to put out, something that needs immediate attention. This can be difficult when you’re trying to have time away from it all. The clearing of the mind of work related thoughts for a period of time is so important. Find it.

3- Feed the team. I mean this quite literally and figuratively. When the team is positive it is so much easier to manage the small and big fires. It allows them to figure things out for themselves, remain calm and attend to patients with kindness in the midst of chaos. What does this look like? Use humour to diffuse tension. Share information freely so they know where things are at currently and how they may be evolving. Be honest when you just don’t know. Ask them for their advice and input. And yes, food. Never underestimate the importance of bringing in lunch or a celebratory cake or any other food for your team! My favourite from this year is the cake on which I wrote “Covid sucks”. It boosts moral, adds to positive team culture and is just plain fun.

It’s up to us

Practice change. Expanded scope. Clinical services. It seems that as pharmacists across the country gain additional authority, many still struggle with progressing their practice. Getting the prescription out the door is still the primary priority, engaging patients in optimizing drug therapy, chronic disease management and preventative care come second, and often not at all.

Pharmacists are perhaps the only health care professional that upon completion of their training are prepared to practice a profession and end up using only a fraction of their education to do their job.

I’ve heard pharmacy leaders express that our amazing pharmacy students will save the profession. They are primed for “expanded scope” and will ensure pharmacists do not become an irrelevant profession as more and more patients move to having Alexa order their drugs for delivery and get their “patient counselling” from google.

Is that a realistic expectation for the profession? Pharmacy students are struggling. If a new grad is lucky enough to get a job in the depressed market that exists in many parts of the country, what they face is joining a less than desirable practice or one where they hope they can effect some change, but within a very short time slide into apathy.

Inevitably when I present at a conference, I have many students come up afterwards and ask me how they can avoid the peril of apathy after getting into practice. They’ve seen many pharmacy students before them go through the seemingly inevitable slide and they are afraid of what their own future holds.

The problem however is really with us. It is with veteran pharmacists and pharmacy teams who are comfortable doing things “the way they have always been done.” It is almost impossible for a new grad joining a dispensary to change this.

Every dispensary has a “culture”. The culture is the way we interact with each other, the way we talk to patients, our work flow, what we accept and don’t accept, what we complain about, what we value, how we treat each other and what is generally acceptable and for sure what is NOT acceptable in that dispensary. When a new member enters a dispensary, it is an unexpressed expectation that they will fit in and “conform” to the current culture, regardless of what that culture is. A new grad may be asked to “add” some clinical stuff in, as almost a separate entity to the regular work flow, but the essential nature of the culture is not to change.

If the prevailing culture in dispensaries is not a proactive engagement of patients, utilizing the full scope of pharmacists expertise in improving patients quality of life, but instead in utilizing pharmacists as a “checking machine”, new grads will slowly be assimilated into the same role.

If real change is to happen, it will have to come from us. We cannot afford to remain dispensers of drug products and information. Drugs and information are to be had much more conveniently and cheaper than in our pharmacies. Third party payers, government and patients themselves are figuring this out. But our expertise in determining, with the patient, the “best drug therapy” for them ie: solving drug related problems, is a skill no other profession has.  We need to embrace it, or risk losing it altogether. 

Worthy Praise

CCflickr shared by Avard Woolaver

Some of us are better at recognizing our own gifts and talents more than others.  Most people, if pressed, could list two or three of their own talents.  Usually they are obvious ones; personal skills or expertise that has contributed to our career, or positive personality traits we have developed.

What might not be obvious are the gifts you have that impact other’s lives.  Just like those around us may not be aware of the gifts we feel they have.  Humans can be slow to praise and general in our thanks.

The people we work alongside, those we run into day-to-day, probably have no idea that we appreciate them or recognize their contribution and hard work.  I was involved in a virtual chat with health leaders/practitioners across the globe (although mostly North American) and we were tossing around what the essential qualities were for showing appreciation and thankfulness.  Some of the prevailing thoughts were that praise should be:

  • Genuine:  Praise that is not genuine feels contrived.  If you don’t actually recognize the value of and appreciate the person, don’t say it.  This involves some reflection on our part, as everyone has value and talents.
  • Specific:  One of the most meaningful compliments I ever received was being told that I put people at ease, help them feel  comfortable.  That’s specific, and something I didn’t know. Referencing a specific incident or particular skill is valuable when offering praise.  It shows you recognize specific qualities and often encourages personal growth for the person being praised.
  • Generous Praise to colleagues, staff and friends should come with no strings attached, no “to-do” list at the end.  It should just be what it is, an acknowledgment of hard work, contribution, or talent.
  • Personal  What came up over and again is that praise which is personal means more.  Praising colleagues or staff publicly in newsletters, staff meetings, in posts online, all are important.  But so is the handwritten note, or the phone call or the one-on-one thanks.

We all need to feel acknowledged and appreciated.  Remembering to show gratitude or praising our colleagues and staff is an important part of team and community building.