July 2015
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Healthcare Worker Burnout

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  • #82215 Under Stress in EMS: How to Manage It
  • #35414 Work/Life Balance
  • #12215 Coping with Stress Management for the Physical Therapist
  • #13515 Breathing Easy: Stress Management for Respiratory Therapists
  • #16814 Stress Management for Radiologic Technology

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Did You Know?

Healthcare Worker Burnout

Did you know that the term “burnout” was first coined in the 1970’s by an American psychologist, Herbert Freudenberger, to describe the consequences of severe stress and high ideals experienced by people working in “helping” professions? Doctors and nurses, for example, who sacrifice themselves for others and end up being exhausted, and unable to cope – “burned out.” In a 2013 CareerBuilder survey, 60 percent of healthcare workers reported feeling burned out on their jobs.

Today, “burnout” is used freely by people in almost every industry to describe various states of workplace stress, but real burnout is “a serious, life-altering problem because it means you either can’t do your job effectively anymore or can’t find any enjoyment within it,” says Rob Dobrenski, PhD, a New York-based psychologist who specializes in mood and anxiety conditions.

Burnout has yet to be classified as a distinct conditions in the Diagnostic and Statistical Manual of Mental Disorders (DSM), but it is generally described as a state of emotional, mental, and physical exhaustion brought on by excessive and prolonged work-related stress. While stress first heightens emotions and creates a sense of urgency to get a situation under control, burnout creates a sense of emptiness, lack of motivation or caring, and helplessness. Initially, burnout can be distinguished from depression if mood and energy are elevated when outside the workplace while engaging in hobbies or leisure activities with friends and family. Prolonged burnout, however, may lead to chronic depression where a person is unable to find pleasure in those same activities.

Both stress and burnout are known to cause severe physical, psychological, social, and work-related symptoms. The most common are:

  • Sleep disorders (insomnia or hypersomnia)
  • Headache
  • Gastrointestinal issues
  • Irritability
  • Depression
  • Lack of emotional energy
  • Lack of communication with co-workers, friends, and family
  • Treating others with suspicion and criticism
  • Marital conflict and divorce
  • Neglecting family and social obligations
  • Frequent absenteeism
  • Poor work performance – higher rate of errors, poor attention to detail, work-arounds, poor decision-making, loss of empathy/indifference, low reaction time
  • Low customer/patient satisfaction

Although high levels of work stress among healthcare workers have been well-documented for many years, not all individuals experience burnout. Certain risk factors associated with the work environment, demographic characteristics, and personality are known to increase the likelihood of experiencing burnout.

Risk factors associated with the work environment include:

  • Work overload – low staffing levels, amount of overtime, job complexity, fear of not completing work, high emotional demand
  • Lack of control over work responsibilities – inability to perform job functions as believed are the “right” way
  • Low reward – lack of professional recognition and/or opportunity to advance, inadequate salary/benefits
  • Poor workplace support system – lack of close peer relationships, ineffective managers/leaders
  • Conflict of values – divergent job requirements and personal principles

Demographic risk factors include:

  • Younger age – thought to be related to job/career expectations versus reality (loss of work-life dream)
  • Early in career - statistics show burnout usually occurs in the first 1 to 5 years
  • Lack of life partner or children – emotional support provided by family is thought play a role in preventing burnout
  • Higher level of education – advanced education is associated with higher job/career expectations

Risk factors related to personality include:

  • Low self-esteem or confidence
  • High need for approval
  • Tendency to overachieve
  • Need for autonomy
  • Intolerance
  • Perfectionism
  • Self-giving
  • Type D personality – a tendency for negative emotions and social inhibition

There are many strategies known to help prevent workplace stress, fatigue, and burnout. Proactive self-care is essential for maintaining energy, physical and emotional stamina, and overall health. These qualities are especially important in healthcare occupations where individuals are exposed to high levels of emotional strain and often put the care of others ahead of themselves. The American Psychological Association suggests the following steps:

Track stressors – Keep a journal for a week or two to identify the situations that create the most stress and how you respond to them. Record thoughts, feelings, and information about the people and circumstances involved and how you reacted. Did you raise your voice? Get a snack? Vent to a co-worker? Taking notes can help identify patterns.

Develop healthy responses – Instead of turning to fast food or alcohol, try to make healthy choices when you feel tension rise. Exercise is a great stress-buster. Make time for hobbies and favorite activities. Set aside time to read a novel, go to a concert, play games with your family, or whatever you enjoy most. Get plenty of quality sleep Limit caffeine intake late in the day, as well as stimulating activities like computer and television.

Establish boundaries – Establish work-life balances, such as not checking e-mail from home, not answering the phone during dinner, and limit the number of hours you agree to work overtime.

Recharge – This requires disconnecting from work by having extended periods of time when you are neither working, nor thinking about work. It’s critical to “switch off” in a way that fits your preferences. Take time off to relax and unwind, so you can come back to work feeling re-energized and ready to perform at your best. Practice focusing your attention on non-work activities when not at work.

Relax – Techniques such as meditation, deep breathing exercises, and mindfulness (a state in which you actively observe present experiences and thoughts without judging them) can help melt away stress. Take a few minutes each day to focus on a simple activity like breathing, walking or enjoying a meal.

Talk to your supervisor – Healthy employees are more productive, so your boss should have an incentive to create a work environment that promotes employee well-being. Have an open conversation with your manager or supervisor to come up with an effective plan for managing the stressors you’ve identified. The plan may include ways to improve your skills in areas like time management, identifying employer-sponsored wellness resources, clarifying expectations, getting support from colleagues, enriching your job to include more challenging or meaningful tasks, or making changes to your job responsibilities to reduce stress.

Find support – Talk to trusted friends or family members to help improve your ability to manage stress. Utilize available employee assistance programs, look for online information, or seek counseling from mental health professionals.

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Learn how the Swank HealthCare Advantage has helped one hospital save over $16,000!

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The following are questions to help assess if you may be suffering from burnout. Rather than answering yes or no, consider the degree to which you answer each question and how often the experiences occur.

  1. Do you continue to find new, interesting, and exciting aspects of your job?
  2. EDo every-day challenges at work heighten your emotions, energy, and urgency to conquer them, or do they erode motivation and energy?
  3. After an extended break (48 hours or more) do you feel fatigued by the thought of another day on the job?
  4. Do you have the physical and emotional energy to carry out your daily work responsibilities the way you feel is the “right” way?
  5. Do you worry about how you treat people (co-workers, managers, patients/family members) at work?
  6. Do you struggle to think clearly or process complex things at work?
  7. Do you lack energy or interest in building relationships with people at work?
  8. Do you talk about your work in a negative way?
  9. Do you feel your job increases your irritability outside work?
  10. Do you find pleasure in hobbies or leisure activities with family and friends?

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See how well you score on these questions about burnout in healthcare.

In a 2008 survey, nurses (in the U.S.) who left their jobs reported the following as the most common reasons. Place them in order from most common to least.

A. Inadequate staffing
B. Low salary
C. Too many hours
D. Lack of collaboration/communication
E. Lack of advancement opportunities
F. Lack of good management/leadership

According to a 2013 CareerBuilder survey, healthcare workers who planned to stay in their jobs listed the following factors as the most compelling for NOT wanting to leave their organizations. Place them in order from most common response to least.

A. Flexible work schedule
B. I find my work satisfying and rewarding
C. Location is ideal
D. I enjoy my colleagues
E. Compensation, benefits, and perks

In the CareerBuilder survey, healthcare employers listed the following as the most challenging staffing issues. Place them in order from most common response to least.

A. Offering competitive compensation
B. Finding skilled workers
C. Retaining top talent
D. Lifting employee morale

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C. 27%
B. 22%
A. 21%
, F. 13%
D. 10%
E. 8%