Dr Catriona Bradley explores moving beyond endurance in pharmacy practice
I was delighted to find myself back in the South-East recently, speaking at the Pharmacy Education and Networking Event in the South Eastern Technical University. It felt less like a professional engagement and more like coming home. I was born locally, grew up here, and the region has shaped both the person and the pharmacist I became. At 17, I left for Dublin to study pharmacy because that was the only option available at the time. The idea that students can now study pharmacy in the South East is genuinely exciting — not just for the region, but for the profession nationally.
I was asked to speak about wellbeing, self-care and resilience. Three deceptively simple words that conceal enormous complexity. Entire modules, perhaps entire careers, could be devoted to any one of them. I had 15 minutes. That constraint forced me to focus my thinking. I reflected on all I have learnt over the course of my career, and life, to date, and forced myself to identify insights that I felt were most likely to be of use to pharmacists.
What follows are three insights. They are neither new nor dramatic. They are, however, grounded in experience, research, and many conversations with pharmacists who are trying to do good work in increasingly complex systems. They are concepts that I use in my own life to navigate challenges and to achieve wellbeing and I offer them in the spirit of support and friendship.
The context
Before we talk about resilience, it is important to acknowledge the environment in which pharmacists are expected to be resilient.
Workload pressures, staffing challenges, administrative burden, regulatory complexity, and constant change are not imagined. Nor are they uniquely Irish. International research has been describing similar stressors for over a decade. A nationwide French study published in 2017 (Balayssac et al) identified work overload, interruptions, insufficient breaks, and lack of recognition as key contributors to stress among community pharmacists. Reading it now, one is struck less by its novelty than by its familiarity.
What has also remained remarkably consistent is how pharmacists are positioned within healthcare systems. Too often, we are discussed in terms of products, supply, and cost containment, rather than in terms of professional judgement, risk management, medicines optimisation, or patient safety. Surgeons are not defined by their instruments. Doctors are not conflated with their prescription pads. Pharmacists, however, are regularly framed in relation to the ‘tool’ rather than the skill.
That framing matters. It shapes how others perceive us and, over time, how we perceive ourselves.
What pharmacists say they need
Ahead of the SETU event, I asked what attendees wanted me to focus on.
The most common response was not wellbeing. It was leadership.
On the surface, this is unsurprising. Pharmacists lead every day: Teams, services, clinical decisions, and increasingly, system change. But the absence of explicit requests for wellbeing is revealing. Once again, pharmacists prioritised stepping up, supporting others, and taking responsibility, often without naming the cost to themselves.
This pattern is deeply embedded in the profession. Pharmacists are people- centered, conscientious, and problem- oriented. We see a gap and we fill it. We see a need and we respond. Through the COVID response and through the delivery of vaccination programmes and expanded services, the profession has demonstrated extraordinary adaptability and commitment.
But stepping up repeatedly, without stepping back to reflect, eventually takes its toll. Which brings me to my first insight.
Insight 1: Self-awareness is not self-indulgence
Resilience is often misunderstood as endurance; the ability to keep going despite difficult situations. Resilience is not about pushing harder; it is about understanding yourself well enough to respond earlier and more intelligently to pressure.
Self-awareness involves understanding your own values, triggers, physical stress responses, personality and neuro- distinctiveness. It involves knowing what makes you tick, what brings you joy, what inspires and motivates you. Many pharmacists share characteristics that serve patients well: High responsibility, attention to detail, and a strong internalised sense of duty. These same characteristics can, if left unexamined, drive over-extension and burnout.
Pharmacists are remarkably good at tolerating pressure. We stretch ourselves, adapt, and carry on, but resilience is not infinite. Understanding your own early warning signs, physical cues, emotional shifts and behavioural changes allows you to act before stress becomes distress.
It isn’t always easy to know what your values are. Sometimes, we only recognise
them when they are threatened or damaged. The value of Fairness is a good example of this, with people often failing to realise how closely they hold this value until they encounter a situation that leaves them feeling they have been treated unfairly. Awareness of our values, and how we react when they are threatened, can change how we interpret stress and how we make decisions. It also makes it easier to understand why certain environments or interactions are energising while others were depleting.
Self-awareness is not about introspection for its own sake. It is a professional skill that supports better decision-making, healthier boundaries, and more sustainable practice.
Insight 2: Psychological safety matters more than personal toughness
The second insight is this: Even highly resilient individuals struggle in unsupportive environments, while less- naturally resilient people can thrive in psychologically safe ones.
Psychological safety refers to an environment in which people feel able to ask questions, admit mistakes, challenge decisions, and say ‘I don’t know’ without fear of embarrassment or reprisal. It is not about comfort or consensus. It is about trust.
In my research, psychological safety emerged as an important predictor of pharmacist wellbeing. This finding was consistent across roles and settings — from early-career pharmacists, to managers and business owners.
Pharmacists face particular challenges in this regard. In community pharmacy, retail-clinical tensions can undermine professional autonomy. In hospital settings, pharmacists may struggle for inclusion unless they are persistently proactive. In large corporations, company cultures impact hugely on psychological safety.
Psychological safety is shaped by everyday behaviours: How questions are received, how errors are discussed, how disagreement is handled, and how power is exercised. While leadership plays a critical role, psychological safety is co-created by everyone in a system.
Whether you are an employee, a manager, or a superintendent, you both contribute to, and are affected by, the level of psychological safety around you.
Insight 3: Acceptance is not resignation
The final insight relates to acceptance and focus.
There are many aspects of our professional environment that are difficult to change quickly: Legislation, regulatory frameworks, reimbursement models, and broader health system constraints. Fighting these realities daily is exhausting and, often, unproductive.
Acceptance does not mean approval.
It means clarity. It involves distinguishing between what you can control, what you can influence, and what sits outside both. Energy spent railing against immovable structures is energy not available for patient care, leadership, or self-preservation.
Acceptance paired with strategic action is powerful. It allows you to direct effort where it can have impact, rather than remaining locked in chronic frustration. It also helps dismantle the quiet narrative many pharmacists carry; that if they were just more efficient, more organised, or more capable, the pressure would ease.
Some pressures are personal. Many are systemic. It is important to change, control and influence what you can to reduce stress and pressure for you, your relationships and your environments. When issues are beyond your control or influence, accepting the reality of the situation is a powerful way of conserving energy and sanity. For some, tolerating discomfort is difficult, particularly when values are challenged. However, there is great wisdom in the ‘Serenity Prayer’: ‘Grant me the serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference.’
Drawing the threads together
These three insights are interconnected. Pharmacists are sometimes thriving, sometimes surviving, but few of us exist at either extreme for long. More often, we move back and forth along that spectrum, shaped not only by our own resilience, but by the environments we work in, the expectations placed upon us, and the degree to which our values align with our practice.
Moving beyond endurance requires a shift in how we think about professional wellbeing. It asks us to move away from the idea that coping quietly is a marker of professionalism, and towards a more honest recognition of what is needed for sustainable practice. Self-awareness allows us to notice when we are
merely surviving. Psychological safety determines whether we feel able to say so. Acceptance helps us direct our energy towards what can be influenced, rather than what simply drains us.
Pharmacists are essential to communities and healthcare systems, and that importance has never been more visible. Thriving cannot be built on goodwill alone, nor can survival be the default expectation. We all have a responsibility to ensure that we are not just enduring our working lives but are able to practice
in ways that are professionally satisfying, psychologically safe, and sustainable over time. I have offered three insights that I hope are useful. As always, I’m interested to hear readers’ perspectives.
Reference
Balayssac D, Pereira B, Virot J, Lambert C, Collin A, Alapini D, Gagnaire JM, Authier N, Cuny D, Ven- nat B. Work-related stress, associated comorbidi- ties and stress causes in French community phar- macies: a nationwide cross-sectional study. PeerJ. 2017 Oct 26;5:e3973. doi: 10.7717/peerj.3973. PMID: 29085764; PMCID: PMC5660873.
Dr Catriona Bradley is a pharmacist and psychologist and former Executive Director of the Irish Institute of Pharmacy. She’s particularly interested in exploring psychology in pharmacy and always welcomes pharmacists’ views & comments in this area at catriona1.bradley@gmail.com.
