The ideal 24-hour schedule:

1. Sleep: 6 hours
2. Food consumption: 30 minutes (between casts or while plunking, if possible)
3. School: 0 hours!
4. Bath, stool, etc.: 15 minutes (unavoidable)
5. Housework and miscellaneous chores: 30 minutes (yards unnecessary; dust not unhealthy; utilitarian neatness easily accomplished)
6. Non-angling conversation: 0 hours
7. Transportation: 45 minutes (live on good fishing river)
8. Gear maintenance/fly tying/rod building/ log keeping, etc.: 1 hour 30 minutes
9. Fishing time: 14½ hours per day!

Ways to actualize the ideal schedule:

1. Finish school; no college!
2. Move alone to a year-round stream (preferably coastal).
3. Avoid friendships, anglers not excepted (wastes time with gabbing)
4. Experiment with caffeine and nicotine to eliminate excess sleep.
5. Do all driving, shopping, gear preparation, research, etc., after dark, saving daylight for fishing only.

Result allowing for unforeseeable interruptions: 4000 actual fishing hours per year!

The River Why

–David James Duncan

Experienced pharmacists describe hectic days sagely as “having to wear many hats.” Freshly graduated pharmacists call these days “a hot mess.” In reviewing the Society of Critical Care Medicine and ACCP position paper on critical care pharmacy services, the list is daunting, even to the most ambitious pharmacists.¹ More practical individuals simply question the feasibility of expectations for an average 40-hour workweek. Upon reading the position paper’s list of “fundamental,” “desirable,” and “optimal” activities, my mind went back to a dear book I had read a decade before, titled The Ideal 24-Hour Schedule. In The River Why, Gus Orviston’s calling is fishing, and in this field, he shows both passion and skill.² As pharmacists, we too have found our life’s work, and we feel its importance intrinsically. We strive to provide optimal patient care, sharpen our own skills, and mentor the next generation of pharmacists to similarly high expectations. Gus describes his application of the ideal schedule:

I hung the Ideal Schedule on the wall by my bed and began to live it: I proceeded to fish all day, every day, first light to last. All my life I’d longed for such a marathon – and I haven’t one happy memory of it … each night my log entries read like tax tables or grocery receipts, describing not a dream come true, but a drudgery of double shifts.

The question becomes, How do pharmacists achieve such standards without burnout? How is it that we as a group define and then foster success?

“After two weeks of ‘ideal’ six-hour nights and sixteen-hour days I got an incurable case of insomnia.” In the dead of night, alone, he writes in his journal and records a conversation with his brother:

12:30 am – another Id. Sched. Result: insomnia. Positive I don’t like this! And tonight Bill Bob asked “Are you happy, Gus?” And I didn’t know, didn’t think so, couldn’t say. Not sure of relationship between fishing and happiness; not sure of much of anything; must consider further.

In residency, my preceptors would tell us to name our non-negotiables as a way to prioritize. I always wanted to ask what is negotiable in the world of patient care and the surrounding activities that would make you a better practitioner? Although working weeks that pushed the duty-hour limits certainly resulted in an almost exponential learning curve and a highly productive 2 years, residency left me drained and wary of the years to come. Responsibilities would only be higher as a practitioner, and it seemed that I knew just as many “successful” pharmacists who were happy as those who were unhappy. This worried me.

Pharmacists seem to fall into three categories:

1. Pharmacists living Gus’s Ideal Schedule with similar results (many)
2. Pharmacists settling for the more “fundamental” activities out of all the potential pharmacy services in favor of a better work-life balance (fewer)
3.  Pharmacists who have found something for which the prior groups had sought and had not found: “optimal” activities without burnout. These individuals truly have the Ideal Schedule.

My fascination with the third group is profound. Here is the professional and person I am trying to be: a caring and passionate practitioner who is viewed as a competent and knowledgeable professional and can take on challenges and new learning experiences while living a full life beyond those sandstone hospital walls. I see the full life containing fulfilling friendships, engaging hobbies, and happy families. Pharmacists in this third category are self-confident and emotionally at peace while operating in the commotion of our common pursuit of excellence.

Here are my observations on pharmacists who truly have the ideal schedule:

1. They make mentorship a top priority. These individuals actively seek and maintain various mentoring relationships. They speak freely of mentors they have kept in contact with since pharmacy school or residency (a span of up to 25 years or more!) and seek to act as mentors for the next generation.
2. They hone their emotional intelligence continuously. Emotional intelligence consists of:
   1. Self-awareness (ability to articulate one’s emotions)
   2. Self-management (ability to manage emotions effectively)
   3. Social awareness (ability to name others’ emotions)
   4. Relationship management (taking the above three skills to build effective relationships)

These individuals make it an active practice to self-reflect, seek feedback, step back from a situation, and, ultimately, achieve success through others. These individuals also tend to have a wonderful sense of humor and an ability to laugh at themselves.

3. They believe that “done is better than perfect.” Sheryl Sandberg’s quote is really a variation on the theme “don’t sweat the small stuff.” We all know the allure of “the perfect medication administration regimen”; however, these individuals have found a way to set a high standard for excellence that also accommodates everyday realities.
4. They harbor a deep love of learning. Pharmacists with the ideal schedule continuously find joy in the learning process. They relish the moments of realizing they do not know something and then energetically dive in to find the answer. These pharmacists find small joys in a busy day.
5. They identify an achievable definition of success. These individuals have a keen awareness of both their achievements and their future goals and balance their sense of accomplishment with the desire for improvement. In the pursuit of excellence, perhaps we should remember Emerson’s definition of success: “to know even one life has breathed easier because you have lived.”

References:

1. Rudis MI, Brandl KM. Position paper on critical care pharmacy services. Society of Critical Care Medicine and American College of Clinical Pharmacy Task Force on Critical Care Pharmacy Services. Crit Care Med 2000;28:3746-50.

2. Duncan DJ. The River Why. New York: Back Bay Books, 1983.

About the author: Andrea Sikora Newsome, Pharm.D., BCPS, BCCCP, is a clinical assistant professor at the University of Georgia College of Pharmacy and a critical care pharmacist at Augusta University Medical Center. She graduated from the University of Georgia College of Pharmacy and completed PGY1 pharmacy and PGY2 critical care specialty pharmacy residencies at the University of North Carolina in Chapel Hill, North Carolina. She is currently a KL2 Scholar through Georgia’s Clinical and Translational Science Alliance.