Resilience Critical for Army Pharmacists

The U.S. Army encourages its clinicians, including pharmacists, to take advantage of resources that enhance well-being and promote resilience, says Col. Hope Williamson-Younce, Director of the Army System for Health Directorate.

“The strength of our Army is inextricably linked to our soldiers’ health and wellness,” Williamson-Younce said. “The Army’s ready and resilient resources, the strategies and policies — they’re applicable across all Army disciplines, whether you’re a nurse, a pharmacist, or a warfighter.”

The System for Health Directorate is an initiative of the Army Public Health Center in the Office of the Army Surgeon General and the U.S. Army Medical Command. In collaboration with Army Public Health Center, the directorate integrates policies, programs, and partnerships that support the Army's Performance Triad — sleep, physical activity, and nutrition — as the basis for the personal strength, endurance, and mental agility required of service members.

Williamson-Younce, a nurse practitioner in emergency medicine and trauma, said pharmacists need that mental agility because they serve as the clinical team’s “gatekeepers” to ensure the safe and optimal use of medications.

“The commitment to well-being and readiness and resilience of pharmacists and pharmacy personnel continues to be a top priority,” she said.

She said that in the civilian world, long work hours and high-stress situations place pharmacists at risk for burnout. And military pharmacists have the additional stress of always being subject to deployment for training exercises and to combat zones.

“Pharmacy officers, in particular, they can deploy with field hospitals during times of conflict ... for extended periods of time,” she said. “The threat of bodily harm in combat environments is also stressful. So not only are they taking care of their patients, but they have to exercise their survivability skills.”

Williamson-Younce said education about healthy lifestyle, healthy behavior, and work-life balance starts as soon as a service member joins the Army and continues throughout the person’s time in service.

Army public health activities that support resilience include mental skills training, community health initiatives, and substance abuse treatment and prevention. Leaders are also trained and encouraged to embrace personal resilience as an example for those under their command.

“The challenges inherent to taking care of others and accomplishing the mission in complex, fast-paced, multidisciplinary environments can make it hard for clinicians and other leaders to acknowledge and manage stress in their lives,” Williamson-Younce said.

Col. Jeffrey Neigh, Deputy Director of the Army Pharmacy Service Line in Falls Church, Virginia, praised the Army Public Health Center’s resilience initiatives.

“They’ve done a really good job of advertising that these resources exist, that burnout is real, and that it’s OK to ask for help,” Neigh said.

He said the military’s ongoing consolidation of Army, Air Force, and Navy medicine under the Defense Health Agency umbrella creates uncertainty for pharmacists and other clinicians.

“There’s a lot of unknowns,” he said. “I think we’re definitely moving forward in a positive direction. I think at the end of the day everything is going to work out.”

Meanwhile, he said, evolving definitions about roles and responsibilities contribute to stress and highlight the need for staff to seek out and use resilience tools.

A recent activity of the Expanding Clinical Pharmacy Outcomes (ECHO) program indicates that military pharmacists are actively engaged in learning about resilience. Neigh said ECHO started in 2015 as a monthly educational program for Army clinical pharmacists but now includes pharmacists from the Air Force, Navy, and Defense Health Agency.

“Every month we cover a different clinical topic with a morning and afternoon webinar,” he said. “We typically have anywhere from 100 to 150 pharmacists dial in for this each month.”

February’s ECHO topic was burnout and resilience, and the webinar was presented by ASHP’s Anna Legreid Dopp, Director of Clinical Guidelines and Quality Improvement, and Christina Martin, Director of Membership Forums.

The webinar covered a variety of topics, including what burnout is, how it affects pharmacists and their patients, and how to reduce burnout and improve resilience.

Neigh said the ECHO group requested the webinar after reviewing ASHP’s resource center on workforce well-being and resilience. He said information in the webinar about how clinicians can assess their state of mind and determine when to seek help were especially useful.

He said ECHO hasn’t planned additional resilience sessions but may do so in the future.

[This news story appears in the August 15, 2019, issue of AJHP.]