Abstract
Purpose: To explore the interplay among burnout, moral distress, and moral injury; examine current trends and realities in pharmacy; and call for potential beneficial actions by individuals, the pharmacy profession, and healthcare systems.
Methods: A narrative review of recent events and research into challenges and problems in the pharmacy workplace indicative of burnout, moral distress, and moral injury among pharmacists, pharmacy technicians, and other pharmacy staff.
Results: Burnout in the workplace is caused by chronic stress and results in emotional exhaustion, feelings of cynicism/ detachment from the job, and lack of accomplishment or a sense of ineffectiveness. A growing body of evidence indicates that what is termed burnout may in fact be moral distress, and this can lead to moral injury if not recognized and corrected. Indicators of moral distress are psychological distress, situational impact constraining an ability to act, and the effect of inaction upon doing what is deemed right. Over the long term, moral distress leads to moral injury, which is characterized by pain (psychological, existential, and/or spiritual) and resulting from dissonance from doing and/or seeing actions that violate deeply held moral beliefs and expectations. The intersectionality of burnout, moral distress, and moral injury can produce serious sequelae, including suicidality and death by suicide. In addition to burnout, stressful pharmacy job demands have been linked to patient safety concerns, especially medication errors that are worrisome for pharmacists and other pharmacy personnel, cause injuries to patients, and result in negative media attention focused on the individual and the profession.
Conclusion: Burnout has been well-characterized for healthcare professionals, and continued attention to this matter for pharmacists and pharmacy personnel is warranted. What is critical to deal with now is further consideration of moral distress and moral injury and their impact on the pharmacy profession, as burnout does not adequately characterize all of what pharmacists and pharmacy personnel are experiencing.
