The pharmacist's guide to saying 'no'

In our fast-paced, ever-demanding world, we often find ourselves stretched too thin, juggling multiple commitments and responsibilities. This is where the art of saying "NO" can be a powerful tool. This is particularly important for us pharmacists. As the most accessible healthcare professionals, we are approachable, available and convenient for patients to contact. While this has helped us become one of the most trusted professionals, it also creates expectations that we are always there to provide free and timely information. We need to reframe our thinking about saying 'No' and realize that doing so does not mean we compromise patient care, but rather, we enhance it. Imagine your life as a canvas, where each task is a brushstroke that shapes your creation. Saying ‘Yes’ without discretion, you'll soon find your canvas cluttered with random strokes, leaving no room for a coherent picture to emerge. Embracing the art of 'No' allows you to choose what strokes will appear on your canvas. It's your chance to create a picture that truly reflects you and what's important to you.Saying NO at workThe most limited and precious resource we have is time. This is true for everyone, and especially pharmacists. Unlike most other professionals, we have little control over the workload we encounter on any given day. We are literally at the mercy of the fax machine (yes, that thing that Xerox invented in 1964 that nobody else uses), incoming phone calls (when we get to them), and walk-in traffic. Time is one resource we can never replenish; once spent, it's gone forever. If we do not respect our time, then how can we expect our patients to respect it? By saying 'No' in certain situations, we can make better use of the time we have to direct our attention to the things that matter most both to ourselves and to the clients we serve. The ability to say 'No' is not about denying service or care; it's about setting boundaries and prioritizing tasks that align with our professional roles and responsibilities. As our role within the healthcare system continues to evolve, it’s prudent to embrace our expanding scope. This involves stepping away from the traditional association with dispensing drugs and moving towards a more service-based role. If you have a Registered Technician on staff are they being fully utilized in their scope so you can focus on providing professional services? Read: How to ditch, delegate and defer, strategicallyAn effective way to say 'No' is to relay the message without actually saying the word 'No.’ For instance, when a patient is asking for a service to be done immediately but you have two people waiting for a flu shot, someone on hold and a counsel to do, you can say ‘I understand you would like this done immediately. You are welcome to wait. I am willing to help you after I finish up with another client. I will call you when I am available.’ This comes from Greg Mckeown’s book, Essentialism, and follows the format ‘You are welcome to X. I am willing to Y.” Simple enough, right? How many times have you put more pressure on yourself and your team by saying YES too much? I have seen saying YES to everything erode relationships between pharmacists and technicians. I have seen saying YES drain colleagues to the point of burnout. Most of us became pharmacists with the admirable intention of helping serve patients. At times, this can lead to overpromising commitments. I recall the CSI metric for monitoring the timely nature of getting a prescription ready. The question for patients was not ‘Was your prescription ready in 10 minutes?’. The question was ‘Was your prescription ready when promised?’ Training staff to provide realistic expectations helps with workflow and teamwork.We can also leverage technology to help schedule clinics and provide professional services when we have adequate staffing. Although we cannot control the various systemic factors at play, we can control how much fuel we throw on the fire. Control what you can control.It is fair that patients expect us to be available. What we need to remember is that patients do not always expect us to provide them with a solution at the moment. There have been many times when I have explained to a patient that I can answer their question, but may need some time to research it and will get back to them by the end of the day. This does not work if a patient is in a hurry for a service or their issue is urgent, but you would be surprised by how many patients are okay with you giving yourself and your team some time. We often put unnecessary pressure on ourselves because of our expectations of how we should be helping. Embracing this expanded scope of practice requires a shift in mindset for many pharmacists. It involves recognizing that saying 'No' is not a negative action, but a strategic decision that allows us to better serve our patients.Saying NO in lifeSaying 'No' is not about being negative or dismissive; it's about setting boundaries and making conscious choices. It's about understanding that every time we say 'No' to something or someone, we are saying 'Yes' to something else—something that may be more aligned with our personal goals or values. This includes spending quality time with loved ones, investing in our personal growth, or simply taking a moment to breathe and relax.FOMO, or fear of missing out, plays a role in saying YES to things that do not serve us. This is where reframing can be a useful tool. When faced with a choice, Mckeown recommends replacing the question, “How will I feel if I miss out on this opportunity?” with “If I did not have this opportunity, how much would I sacrifice to obtain it?”. This is useful because it helps us put a value on our time.The art of saying 'No' is really about embracing the power of prioritization. Let's start setting boundaries and making conscious choices. This allows us to create a picture that truly reflects who we are and what matters most to us. It gives us the freedom to choose which strokes make it onto our canvas. Using this skill allows us to care for our patients, without compromising our wellbeing.Check out more articles on combating burnout by subscribing to my weekly newsletter.

The pharmacist's guide to saying 'no'

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Manjit Hansra

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