Health care workers have one of the most demanding jobs in the world, especially now. With the existence of a global pandemic and growing health concerns, those in the healthcare industry are called on more than ever, and yet, it is not anything new to them. However, neither is the burnout associated with their stressful profession.
Burnout is common, especially in health care workers. In fact, studies have shown that around 50% of American doctors show signs of burnout, a number that has risen sharply in recent years and drastically with the appearance of COVID-19.
Burnout is a condition that affects health care workers and, in turn, their patients, negatively impacting the lives and quality of care for everyone involved. In this article, we will explore burnout, why it is so common among health care workers, and what that means for them and those around them.
Health care workers have a demanding job. Whether it is doctors, nurses, or the many other people in the healthcare industry, they work long hours at jobs that regularly push them to their limits. In turn, they suffer stress, not simply due to the difficulty of their job but because of how emotionally taxing it can be.
It is known that when someone is exposed to stress over long periods, it can have major consequences. For some, the consequences come in the form of burnout, which occurs when emotionally demanding and stressful work results in physical, emotional, and mental exhaustion in an individual.
Burnout is a syndrome that affects people in all walks of life and often presents with exhaustion, disillusionment, and a slew of other symptoms, but it can be seen in the healthcare industry more than anywhere else. The question is, why? To answer that, we are going to look at the various aspects of how burnout affects health care workers.
Burnout is a problem everywhere and in every field. However, of the many professions out there, those related to the healthcare industry suffer from particularly high percentages of burnout. In fact, while different studies have varied results, they all agree that those in the medical field suffer a significant increase compared to the average.
To understand just how common it is, it is important to understand how burnout rates differ, even amongst those within the field. We will be looking at various aspects of burnout related to health care workers, including:
- Health Care Workers Versus the Average
- Prevalence by Specialty
- Gender, Generation, and Organization
- The Overall Trend
It will become obvious as we go just how common it is and how it affects the different people within the healthcare industry. Not only that, but we will examine how it affects the industry as a whole and how it has been growing over time, especially with the rise of COVID-19.
In 2018, a Gallup survey of 7,500 full-time employees was conducted, and out of those people, around 23% said that they felt burned out often or always, with over 40% admitting to occasional feelings of burnout. However, while those numbers might seem staggering, the truth is that physicians in the US show numbers over double that.
In 2017, a report put out by Medscape found that out of around 20,000 physicians, 51% reported burnout, a rate more than double that of the average workforce. However, physicians are not the only health care workers with an increased burnout rate. In act, nearly every single health care worker suffers from particularly high burnout rates.
- Nurses share similarly high statistics, ranging anywhere from around 30% to almost 40% depending on the workplace, with the higher percentage being those working in long-term care facilities.
- While not as extensively researched, some preliminary testing suggests that the numbers for physician’s assistants and other similar positions are equally high.
The specialty and job scope of health care workers, such as doctors and nurses, also matters. For nurses, the difference can be massive, the difference between 30% and 40% mentioned previously depending in large part on whether they work in a hospital or a long-term care facility such as a nursing home.
However, for doctors, the gap is even wider, with burnout rates ranging anywhere from 29% to 54%, depending on specialty. Some of the specialties that consistently rank within the top percentages of burnout rates are:
- Urology at 54%
- Neurology at 50%
- Family medicine at 46%
- Critical care at 44%
Those with lower burnout rates are specialties such as ophthalmology and public health and preventive medicine, both having percentages around 30%. However, they are in the minority of lower-percentage specialties.
Specialty is not the only factor that affects burnout rates, though, with a variety of factors seeming to carry some significance when it comes to health care worker burnout rates.
While the reasons behind these statistics need further exploration, it has been shown that gender, generation, and organization can greatly affect burnout rates in physicians. For instance, women report feeling burned out more than men, with almost 50% of women reporting burnout compared to less than 40% of men.
Additionally, generation seems to affect how common burnout is as well:
- Baby boomers, those born from 1946 to 1964, have burnout rates of around 39%
- Generation X, those born from 1965 to 1980, have burnout rates of around 48%
- Millennials, those born from 1981 to 1996, have burnout rates of around 38%
Even where a physician works affects how common it is for them to be burned out. For those operating a solo practice or single-specialty group practice, the burnout rates hover in the mid-30s to about 40%, while those working at an outpatient clinic or for a healthcare organization show far higher numbers from around 45% to almost 50%.
The trend seems to be clear, with all burnout rates being well above average for those in the healthcare industry. In fact, not only are the numbers shockingly high, but they have been on the rise over recent years. So, not only is burnout common in health care workers, but it is becoming all the more prevalent.
This trend can be seen throughout the medical field, and it is not exclusive to doctors, nurses, and medical assistants. Administrators, orderlies, and even psychologists suffer from elevated rates of burnout. In particular, those on the frontlines and those who deal with emergency medical situations, such as EMTs, suffer the most.
What is alarming is that the statistics are still on the rise, especially in 2020 with the COVID-19 pandemic. However, while it is clear that burnout is a common problem amongst health care workers, why is that the case? What makes health care workers so prone to burnout syndrome?
So, not only is burnout common with health care workers, but it appears far more among people in the healthcare industry than it does in most other occupations. To start answering the question of why, it is important to know what causes burnout to begin with, for all people, not just health care workers.
As mentioned earlier, burnout is a physical, mental, and emotional exhaustion brought about by stress. In particular, burnout is a syndrome associated with work stress and emotionally demanding jobs, with common stressors including work-life imbalance and extremes of activity, otherwise known as chaos.
While those are just two examples of the many common stressors, they already fit well with the known difficulties faced by many health care workers.
Additionally, working in the healthcare industry is emotionally demanding, especially for those working in emergency medicine and with the elderly. Think back to the difference between nurses working in a hospital compared to those working in a nursing home, and you will see how impactful a certain workplace or set of responsibilities can be.
In general, health care workers are known for their long hours and difficult work, especially if they work in or around the frontline specialties. While it is more than just long hours, the work hours are certainly one of the leading causes. A few of the other factors that contribute the most to burnout in doctors and other health care workers are:
- Having too many bureaucratic tasks
- Insufficient compensation and reimbursement
- Lack of control or autonomy
- Feeling a lack of respect from administrators, colleagues, staff, and patients
While most of the causes of burnout are shared by every profession, health care workers seem to have jobs that breed stress and lead to burnout. They work hours that most people would not want to in a job that can be difficult, chaotic, and even thankless. On top of that, most struggle with debt, particularly in the early part of their careers.
Furthermore, think about the previous statistics, which showed that those working in healthcare organisations and outpatient clinics suffer a higher percentage of burnout. In those types of practices, the physician is often overworked, underfunded, or not in control of their own practice, which are prime causes of stress and potential burnout.
Another reason burnout is so prevalent in health care workers is due to the way they choose to cope with it. In a survey conducted by Medscape, it was shown that out of the physicians coping with burnout, around 45% chose to isolate themselves from others in response. That alone makes it difficult to move past even the most basic cases.
Of course, isolation does not mean ignoring it. Many physicians reported using various methods for burnout relief, such as exercising and talking with their friends and family about their jobs and what they were experiencing. However, it is not always easy for health care workers. For instance, consider these common coping mechanisms:
- Setting boundaries
- Taking a break from technology
- Taking time off
While doing such things can be difficult in any job, for a health care worker, they may be even less of a possibility. After all, health care workers not only work long hours naturally but work in a field that is known for being understaffed. Additionally, technology is becoming more present than ever in healthcare, making it difficult to separate from.
Of the various workplaces, those such as larger organizations, hospitals, and other high-pressure, low-autonomy options have the highest percentages of burnout. While this is due to a variety of reasons, many of them stem from a lack of support and understanding of burnout in the workplace and those in charge, such as:
- Unmanageable Workload: This covers anything from the work hours expected to the number of patients seen. With many organizations pushing health care workers to see more patients in less time, it causes stress both due to overwork and the feeling of failing to provide as good of care as they want to.
- Decreased Job Autonomy: While workplaces may encourage their health care workers to take the time to overcome burnout, it is hard for them to do that with such limited control over their professional lives. Furthermore, self-care does not always eliminate burnout, even if health care workers find the time.
- Lacking Social Support: It is difficult for a social system to be strong and healthy when everyone involved is overworked, driven by unrealistic expectations and workloads, and rarely given the time to take care of themselves. This leads to many not having the skills to cope, especially new doctors and residents.
Burnout is not as simple as a feeling of exhaustion. It is a condition that leads one to feeling overwhelmed and physically, mentally, and emotionally drained. It also saps motivation, erodes away at confidence and interest, and can even cause one to start feeling as if every day is a bad day, severely impacting their mood.
When someone is suffering from burnout, it becomes far more difficult for them to do something as simple as care about their work or home life, and they often feel like even if they work hard, it will not matter. Such feelings can have a hefty impact on the quality of their work and their life at home, affecting both loved ones and patients alike.
To understand why burnout is so devastating to health care workers, it is important to take a closer look at the signs and symptoms associated with the syndrome.
The signs and symptoms of burnout can be put into three categories, which are physical, emotional, and behavioural. However, keep in mind that burnout is more associated with the emotional and behavioural symptoms, while stress accounts for much of the physical side of things.
- Physical: Feeling tired and drained is a big issue since it has some of the greatest impact on a health care worker’s ability to provide proper care and deal with the demands of their job. However, a loss of appetite, weakened immunity system, and headaches or muscle pain are all commonly seen with burnout.
- Emotional: A loss of motivation is common, and a sense of failure or self-doubt is equally prevalent. More than that, health care workers suffering from burnout often grow more cynical, feel helpless and defeated, and struggle with a sense of detachment. There is even a lowered sense of accomplishment and satisfaction.
- Behavioral: Due to the emotional impact and negative feelings, health care workers suffering from burnout often withdraw from their responsibilities, isolate themselves, and procrastinate. There are even instances of alcohol use and missing or skipping work, two very serious things for those in the industry.
Burnout might seem personal, like an issue that only impacts the individual suffering from it, but that is not true, especially for health care workers. After all, most health care workers directly deal with other people all day long, so even if they manage to do their job well, they may not avoid saying or acting in a negative manner.
It may sound strange, but positivity is important in the medical world, not only to push someone to try their best but for patient recovery. Mental health plays a major role in recovery, with those experiencing anxiety or stress suffering from more complications and a slower recovery. So, a pessimistic doctor or nurse can have a great impact.
Moreover, burnout has been linked to worsened memory, a reduced ability to focus and concentrate, and a decreased attention to detail. Imagine how devastating that can be to the quality of care and safety of a patient. A single slipup could cost someone their life, and even if it does not, health care workers may struggle to perform up to standard.
There is even a tendency for health care workers to become desensitized, seeing their patients as numbers or units instead of individuals. This feeling is not only due to the lacking emotional fulfillment but from the expectations of productivity from employers. All in all, it leads to a severe reduction in their desire and ability to care for their patients.
The effect of burnout in a health care worker’s personal life is equally severe, both at home and in the workplace. In the workplace, it has already been mentioned that there is lacking social support, with health care workers finding it difficult meet expectations and properly balance their lives, but there are other impacts in the workplace as well:
- Negativity and pessimism hurt relationships and affect the morale of colleagues
- Being late or absent, even quitting, are all common, which impacts colleagues
- Those suffering from burnout isolate themselves, putting up walls
The problems with isolation and negativity are not limited to the workplace, either, often spilling over into their personal lives. Even before these symptoms of burnout appear, health care workers already often find it difficult to balance their demanding and draining work with demands and responsibilities at home.
In addition, the causes of burnout correlate with increased depression and suicide rates, making it and its causes very harmful for every aspect of a health care worker’s life.
COVID-19 has changed the medical world, influencing every aspect of life for health care workers. Part of this simply comes from the increased amount of cases and the added stress of a potentially dangerous contagion being around every day. After all, health care workers, no matter how careful, are far more likely to be exposed.
Furthermore, the sudden eruption of COVID-19 revealed a certain truth, which is that the healthcare industry was ill-prepared for something as major and serious as a global pandemic. Not only did this strain the already existent workforce shortages, but it forced many to take on roles they normally would not.
Even the previous stressors, such as lacking resources and high work hours, are worse than ever, making stress and burnout far more likely to occur. It is also more than that, though, because it has added new factors to consider, ones that push health care workers even further than before, increasing their strain and exhaustion to the limit.
Simply put, COVID-19 caused a massive surge in the number of people experiencing burnout, with the overall statistic shooting up to over 50%. What that means is that more than half of people working during the pandemic are suffering from exhaustion brought on by stress, and most of it is emotional.
For health care workers, the numbers are even more severe, and it is not just burnout. In a survey given to health care workers, it was revealed that:
- 93% of them were experiencing stress
- 86% of them were feeling anxious
- 77% of them reported frustration
Burnout is brought on by long-term stress, and feelings of anxiousness and frustration merely exacerbate the problem. What these feelings have led to is a whopping 76% of health care workers reporting exhaustion and burnout. That is a massive increase, and it is simply an average, not taking into consideration the various specialties.
The same startling results are seen in the symptoms of burnout, with over 80% reporting emotional exhaustion, 70% having difficulty sleeping, and almost 70% mentioning physical exhaustion and work-related dread. Among these, nurses revealed even higher statistics concerning exhaustion, linked in part to their higher exposure.
With burnout so much more prevalent than before, what are the causes? The most obvious is exposure. Facing a new threat, one without a sure-fire prevention method, forces all those in the healthcare industry to face becoming exposed and infected. In turn, this leads them to worry about their loved ones constantly.
In fact, due to the risk of exposure and incubation period, they often have to choose between spending time with those they love and keeping them safe, leading to isolation and a lack of available support, especially emotionally.
Additionally, workloads have increased for doctors across the board. Not only are the number of patients staggering due to the large number of COVID-19 cases, but the number of doctors and other health care workers has only decreased, with many getting sick and being unable to work in the process of pushing themselves to take on more.
It is a vicious cycle, one that leaves health care workers struggling to keep up with unmanageable workloads, faltering support at home and in the workplace, and crippling uncertainty about the future. If that is not enough, in many cases, they take on all the extra risk for the same compensation, even when their responsibilities have grown.
Along with the changing landscape of the healthcare industry, the responsibilities of health care workers have changed. This includes having to do more to ensure every patient is treated, not only requiring more work but also pushing many health care workers onto the frontlines. For instance:
- Due to quarantines, health care workers may have to stand in for family members during a patient’s last moments. With burnout being linked to emotionally demanding work, this is certainly a difficult thing to face.
- Hospitals are so strained that many states have altered licensing rules, allowing retired professionals to step in and help. The same desperation has also led to health care workers being pulled into areas outside their specialty, putting them on the frontline, a major factor for burnout.
Burnout is at an all-time high all around the world, but it is particularly present in the healthcare industry. In fact, health care workers are around twice as likely to encounter burnout in some form or another. With the negative impact, burnout has on both the health care workers and those they take care of, it is an issue worthy of attention.
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