Surviving Burnout in Health Care
Burnout remains a crucial priority for health systems as it continues to be a significant issue impacting employees and patients alike. Several environmental factors contribute to health care burnout such as long working hours, inadequate support, heavy workloads, administrative tasks, and a lack of social support.
Burnout is causing higher rates of absenteeism and turnover, which is bad news for an industry that’s already dealing with staffing shortages. In a recent survey, hospital executives identified “workforce challenges” as their top concern. The National Academy of Medicine found that burnout had reached crisis levels in the United States, with 35-54% of nurses and physicians reporting symptoms of burnout. For younger nurses, the situation is even more dire. A recent survey found that 69% of nurses under 25 have been suffering from burnout.
Recognizing the Symptoms of Burnout
Burnout is characterized by a reduction in energy that manifests in emotional exhaustion, lack of motivation, and feelings of frustration that may lead to reductions in work efficacy. The signs and symptoms of burnout include the following, and their presence among staff members should serve as a call for help:
- Feelings of energy depletion and exhaustion
- Dreading going to work
- Mental distance from one’s job, or feelings of negativism or cynicism
- Feeling apathetic about helping others
- Constant dread or panic about work
- Loss of appetite
- Increased anxiety and depression
The Consequences of Staff Burnout
The physical, emotional, and mental exhaustion caused by long-term involvement in emotionally demanding and stressful work negatively impacts the well-being and safety of medical personnel. Self-destructive behaviors including substance use and suicide are occurring at an alarming rate among our nation’s healers. Burnout is linked to mental health problems, including anxiety and depression, and leads to decreased job satisfaction, presenteeism (reduced or partial productivity), absenteeism, disability, and turnover.
Clinicians experiencing burnout are more at risk of making errors and practicing unsafely. Several studies have identified that both burnout and measures of well-being (such as depression, stress, and anxiety) are associated with poorer patient safety. Important professional consequences of burnout include lower patient satisfaction, impaired quality of care, breaches in infection control, and patient safety events that may result in malpractice suits with substantial costs for caregivers and hospitals.
Overcoming Barriers to Mental Health Care
Workplace culture in health care – the set of values, norms, and beliefs that make up the way employees interact with each other, their managers, and patients – must evolve. Health care workers devote their careers to saving the lives of others despite the danger, and get the job done no matter the obstacles. Silent suffering is a tradition. The stoic culture of self-sufficiency is driven by a fear of stigmatization, judgement from others, and the potential loss of their medical license when seeking mental health assistance. Health system leaders who want to address burnout must acknowledge the prevalence of mental health problems, drive awareness campaigns, provide education, offer resources, and protect individual privacy of those seeking help.
Clinicians and hospital employees are also having a hard time accessing care due to a shortage of mental health workers, long appointment wait times, inadequate insurance coverage, and inflexible schedules. Mental health-related stigma among health care providers is a major barrier to treatment, reducing help-seeking behavior and negatively mediating the work environment.
Initiatives to expand the mental health workforce are in order, though they are long-term fixes. A short-term solution uses virtual technology to deliver behavioral health programs and services.
Building Resilience and Well-being
Studies have shown that building resilience in nurses and other health care workers can serve as a protective factor against negative outcomes related to the job including burnout, anxiety, and depression, and can improve patient outcomes.
The American Psychological Association (APA) defines resilience as the process of adapting well in the face of adversity, trauma, tragedy, threats, and significant sources of stress. The APA further identifies factors that contribute to how well people adapt to adversities, predominant among them:
- The ways in which individuals view and engage with the world
- The availability and quality of social resources
- Specific coping strategies
Cognitive Behavioral Therapy: A Tool for Positive Change
Mental health support for health care workers is paramount in today’s high-pressure, high-stress environment. Health care workers are struggling with common mental health problems—21.7% are experiencing depression and 22.1% are dealing with anxiety. Healthcare organizations can alleviate burnout with evidence-based cognitive behavioral therapy (CBT), which is effective for a range of mental health problems. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.
CBT provides tools and resources to help health care workers become more resilient and experience less burnout.
Identifying and challenging negative thoughts
One key component of CBT is identifying and challenging unhelpful thought patterns. A health care worker who is experiencing burnout may feel cynical or overwhelmed. CBT helps a person recognize unhelpful thoughts and replace them with more useful and realistic ones.
Developing coping strategies
Another important component of CBT is learning new strategies to reduce stress including relaxation techniques like deep breathing and progressive muscle relaxation. CBT may also involve goal-setting and problem-solving strategies, which can help health care workers feel more in control of their work environment and better able to manage their workload.
Learning new skills and strategies for managing stress and improving communication
Gaining new communication skills are another key component of CBT. In an environment like health care where patients and their loved ones are distressed, health care providers may be able to use new communication strategies to manage stressful situations and support their own emotional well-being.
Learning new strategies to manage worry and depression
CBT helps individuals manage anxiety and stress by learning how to face fears through gradual exposure. Participants also discover how to manage worry by adopting mindfulness strategies where they allow their thoughts, emotions, and impulses to come, and then go, while focusing on the things they value and the goals they set.
CBT also teaches us to prevent low moods, in part by getting more activated – building a more rewarding lifestyle. Instead of skipping pleasurable activities and responsibilities when we are especially busy, one can learn to build more rewards into their routine.
Alleviate Burnout and Improve Well-being
Health care workers are under tremendous pressure managing heavy workloads and long hours. Those challenging work conditions have put over 20 million U.S. health workers at risk for mental health problems. Online access to clinically proven programs is an effective solution to overcome our nation’s mental health access issues and support busy health care providers.
Convenient, confidential, 24/7 availability removes traditional barriers to mental health care and reduces the impact of depression, anxiety, and burnout, and improves resilience and well-being. Download the fact sheet to see how your organization can move from burnout to resilience.