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By Rachel Tirabassi
It’s about time the burnout syndrome is making headlines in healthcare. But what exactly is it? An article published by JAMA, defines burnout as “an individual losing enthusiasm for work (emotional exhaustion), treating people as if they were objects (depersonalization), and having a sense that their work is no longer meaningful (low personal accomplishment).” Worldwide studies from all medical and surgical studies indicate that approximately 1 in every 3 physicians are experiencing burnout at any given time. 1 Nurses also work busy, long hours and are suffering from burnout. 98 percent of hospital nurses reported that their work is physically and mentally demanding and 63 percent claim it’s caused burnout. 2 It’s the healthcare industry’s responsibility to address this epidemic, undergo major improvements and raise awareness to decrease these high numbers.
All healthcare professionals are at risk for burnout. Healthcare is one of the most stressful careers and people who work in the field tend to take their work home with them. Sandy Ewing, an expert in burnout believes, “it’s good to really care about your patients. But if you don’t know how to distance yourself at times, it will be a problem.”3 Fully recognizing and understanding the warning signs of burnout is the first step to creating a healthy career and personal life balance.
- Emotional ExhaustionEmotionally exhausted individuals are completely drained after a day of work and are unable to fully recover on their time off. As time goes on, their energy level begins on a downward spiral and affects all aspects of their life. 3
- DepersonalizationHealthcare professionals become cynical or sarcastic about patients. Their attitude takes a shift and turns negative or cold. They think their patients are annoying and complain more than ever. This aspect is also referred to as “compassion fatigue” and it is more difficult to notice in yourself than in others. 3
- Low Personal AchievementIndividuals begin to question if they are making a real difference. “What does it matter?” becomes a frequent thought. 3 One must try not to see these symptoms as personality flaws. There could be a deeper issue with a coworker or within one’s self. Healthcare professionals have an important job, but an important job should never comprise one’s own health and happiness.
How Does Burnout Effect All of Healthcare?
- Patient CareBurnout effects the well-being of healthcare professionals and puts patients’ safety at risk. In a cross-sectional study of over 71,000 surgeons, burnout was a predicting factor of reporting a medical error and being involved in a medical malpractice lawsuit. When medical errors were made by a healthcare professional, it worsened the existing state of burnout and depressive symptoms. Other studies even found a correlation between physicians and nurses working in intensive care units with higher mortality rates. 4 When employees are not doing well in their personal life, it shows in their work.
- High Turnover RatesReports show that when burnout is associated with job satisfaction the odds of leaving increase more than 200 percent. The National Academy of Medicine also reported that a 1-point increase in exhaustion and a 1-point decrease in job satisfaction between 2011 and 2013 was associated with a 28 percent and 67 percent greater likelihood of a reduction in effort over the following year. Reduction in effort results in a reduction of work hours and a loss of productivity at the national level estimated to equate eliminating the graduating classes of seven medical schools. Turnovers strain hospitals that are already struggling with finances and other needs. Nurse turnovers cost an estimated amount of 82,000-88,000 per RN in 2007. Some physician turnovers can cost up to hundreds of thousands to more than 1 million. Most healthcare systems cannot afford to lose their valuable staff members to burnout.4
Treatment for Burnout
- Documentation Improvement TechnologyHealthcare professionals, especially doctors, are spending too much time on administrative work. A recent report from the Annals of Family Medicine claims that 87 percent of physicians named the leading cause of work-related stress and burnout as paperwork and administrations. 5 On top of keeping patients healthy there is the additional stress of documentation. Doctors from the same study even claimed they spend a third of their day on administrative tasks alone. Technology, such as artificial intelligence, is improving the quality of care in more ways than one.Voice recognition also helps reduce the burden of necessary paperwork. Yale’s School of Medicine recently added speech recognition software to their EHR, which helped doctors input their notes more quickly at the point of care. One Yale doctor was even skeptical about speech recognition before turning into a fan of the software. “I type very fast and I thought, ‘I don’t need voice recognition,” Allen Hsiao, MD, the chief medical information officer at Yale, told AMA Wire. “I quickly found that I have better notes, higher quality, I put in things that I would have thought isn’t worth the time and effort to type, but I will now speak them. It is easier to speak them even for people who type well.” At Yale, voice recognition reduced physician time spent charting by 50 percent. 6
- Reduce Physical and Emotional FatigueGetting a full night’s rest and scheduling personal time away from work are essential for preventing fatigue. For those who cannot take off work, it is important to schedule time once a week for one’s self. Physical activities like running, walking, cycling and yoga will allow one to decompress and clear their mind. Nonphysical activities like meditation, going to the movies, reading a book for fun or going to a museum will also achieve the same results. It’s important to develop a hobby that one looks forward to every day. Adding a companion can even enhance the restful nature of these activities. 7 Scheduled vacation time and being mindful of your emotions goes a long way.
- Seek HelpOver the past few decades, healthcare professionals have experienced busier schedules, higher expectations and more time documenting. This means physicians and other professionals are spending less with their peers. As a result, physicians keep their mental struggle within, so they do not seem weak or subpar to other doctors. Dr. Shanafelt told AMA Wire that “interacting with other physicians has always been part of the fabric of the profession, an essential part of what binds doctors together and makes the profession great.” Physicians need to remember that they are not alone. Other doctors understand their struggles and might need someone to talk to too.8
Physicians need to be encouraged to seek professional help, especially if they are suffering from suicidal ideation and depression. Some physicians avoid seeking help because they are worried about running into former patients or acquaintances. Vania Manipod, a physician who has overcome burnout, drove an hour away to see a therapist outside of her medical organization. She’s publicized her treatment to inspire other doctors who need to seek help. She says, “There are things we can do instead of waiting for larger bureaucratic changes, and I’m an example of that.” 8
- Shanafelt, T. D., MD. (2009, September). A Prescription for Preventing Physician Burnout and Promoting Patient-Centered Care. JAMA. Retrieved from https://jamanetwork.com/journals/jama/article-abstract/184612
- Larson, Jennifer. (n.d.). New Survey Finds High Rate of Nurse Fatigue. Retrieved from https://www.americanmobile.com/nursezone/nursing-news/new-survey-finds-high-rate-of-nurse-fatigue/
- Drummond, D., MD. (n.d.). Physician Burnout – 3 Signs and 3 Simple Prevention Steps. Retrieved from https://www.thehappymd.com/blog/bid/290398/Physician-Burnout-3-Signs-and-3-Simple-Prevention-Steps
- Dyrbye, L. N., Shanafelt, T. D., Sinsky, C. A., Cipriano, P. F., Bhatt, J., Ommaya, A., . . . Meyer, D. (2017, July 05). Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care. Retrieved from https://nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care/
- Byrne, R. (2017, April 18). The Physician Factor: Beating Burnout with Technology. Retrieved from https://medium.com/aspire-ventures/the-physician-factor-beating-burnout-with-technology-c92e0e0b1997
- Butler, Mary. (2018, July 18). Artificial Intelligence and Machine Learning Help Treat EHR ‘Click Fatigue’. Retrieved from http://journal.ahima.org/2018/07/18/artificial-intelligence-and-machine-learning-help-treat-ehr-click-fatigue/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+$%7bJournalOfAhima%7d+($%7bJournal%7d)
- Samano, Kate. (2017, June 7). Advice for physicians struggling with burnout or mental illness. Retrieved from https://thedo.osteopathic.org/2017/06/advice-for-physicians-struggling-with-burnout-or-mental-illness/
- Berg, Sara. (2018, July 30). 5 reasons physicians are less likely to seek support. Retrieved from https://wire.ama-assn.org/life-career/5-reasons-physicians-are-less-likely-seek-support