Healthcare in the 21st century is facing a pandemic other than COVID-19: the burnout of health care workers. Burnout affects almost half of American physicians and nurses. This increasing problem is detrimental to both healthcare workers and their patients and is contributing to an overall shortage of healthcare professionals.
Symptoms of burnout include three major categories: exhaustion, cynicism, and reduced capability. The prevalence of burnout in the health care field especially comes from a multitude of causes such as, long hours, less control increased clerical work, rapid technological growth, less time with patients, emotional demands, and financial stress.
Burnout is not a problem that can be ignored, and the first step to fixing anything is learning to see the problem. With this guide, you can learn to do just that. Keep reading to learn how to spot both already existing and impending health care worker burnouts.
If you want to be able to recognise when a worker is suffering from burnout, it helps to know precisely what burnout is. Burnout implies far more than simply being stressed and tired because of your job. It is a term used to describe a discouraged and exhausted mental state that is both long term and job-related.
Burnout does involve chronic fatigue and exhaustion. However, burnout goes beyond that to also produce extreme negativity towards a job and one’s personal contribution to that job. Someone suffering from burnout will often begin to perform poorly at their job as well.
Burnout is not just stress. Stress is temporary and often heavily circumstantial. Burnout, however, is a chronic condition that is related to stress buildup but which does not depart as easily. Stress often disappears when the stressful situation is resolved, but burnout implies a larger and more embedded source of anxious and depressed feelings.
It is unclear at this point if burnout is a separate issue or should be classified as a result of other depressive and anxiety disorders. Its use is specifically tied to job-related stress, and thus it has become useful as a distinguishing term. It is a problem in the healthcare field that needs to be addressed regardless of its specific classification.
In the high-stress medical field, burnout has long been a noticeable phenomenon. So much so that its signs and symptoms are now widely recognized.
Burnout is characterized by fatigue, negativity, and inefficacy. A worker becomes disgusted, discouraged, and/or apathetic towards their job. They will begin to be less effective in their tasks and lose motivation.
Burnout can be identified through common symptoms that result from these feelings. Every health care worker experiencing burnout will not react the same way, but these symptoms are a good indicator that they may be dealing with more than temporary stress.
There are three general signs of burnout: fatigue, a pessimistic view of work, and reduced efficacy. These three signs can be broken down further into the following notable symptoms.
Let us begin with an obvious symptom: fatigue or exhaustion. Fatigue refers in this sense not only to a need or lack of sleep but to overall decreased energy, which cannot be shaken. One good night of sleep is not enough to cure the exhaustion that burnout brings.
A healthcare worker with burnout has exhaustion that is severe enough to cause a host of other problems. They will be less efficient, less motivated, and apathetic. This is not someone tired after a long shift, but rather someone who shows up to work already exhausted and performs all their tasks with little energy.
A symptom that goes with chronic fatigue is the persistence of ailments. This refers to those colds that never seem to go away, perpetual headaches, and other minor but long-lasting illnesses.
The presence of these small but seemingly incurable issues suggests that the person’s body is not receiving enough rest to heal itself. If they are not getting enough rest to physically heal, then they are not getting enough rest for mental recovery either.
As many people become more tired, they also become increasingly sensitive. One way to spot extreme fatigue in a worker is a sudden lack of control over emotions. A worker suffering from burnout is often irritable and prone to bursts of emotion. They may cry unexpectedly or even shout at coworkers or patients.
Determining if sensitivity is a sign of burnout is a matter of relativity. If a worker is acting more sensitive than their personality and previous behaviour suggests is normal, then it may be that the prolonged stress and exhaustion of burnout is the cause.
Besides exhaustion, burnout will also display itself in a negative attitude towards work. One way this negativity may appear is through a decreased sense of self-worth.
Workers with burnout often feel underappreciated. They do not see the value in their contribution or efforts in the workplace. For someone suffering from burnout, work has become a dreaded place. The positives of their job, such as their achievements, begin to fade from their view.
Another sign of the negative attitude that comes with burnout is cynicism. As a person becomes more exasperated with their work, they resort to a pessimistic approach to their job.
Health care workers especially can develop this trait because of the emotional involvement and high stakes nature of their job. The disappointments and stress of the job can cause a health care worker to turn to cynicism as a defense.
Instead of growing cynical, some health care workers suffering from burnout become detached instead. They stop investing themselves in their job. They display less interest in patients and their coworkers.
Another emotion that can become heightened during burnout is suspicion. The prolonged period of stress and fatigue results in overall tension that can be shown through increasing paranoia.
Paranoia does not mean that health care workers think they are being followed or someone is trying to kill them. Rather it usually displays itself as a tendency to think every mischance or accident is out to get them and to expect the worst in every situation. This is closely related to cynicism.
Besides exhaustion and a negative view of work, the final sign of burnout is simply poor performance in the workplace. Between being extremely tired and dreading work, workers with burnout are bound to prove less effective at their jobs.
Workers with burnout will start making mistakes. They will take longer to do tasks and even fail to get some things done. In health care workers this reduced capability can have disastrous consequences.
If a normally adept physician or nurse makes increasing errors and displays at least one of the other signs a burnout may be responsible. If the burnout is not addressed, these errors will only mount in number and severity.
Symptoms are the first thing to look for when identifying burnout. Symptoms indicate a change in behavior, which suggests that the worker’s mental state has also changed. However, to correctly recognize burnout, these symptoms should be connected to a cause.
Symptoms are the effects of a problem. To be sure the problem is there, a cause should also be present. There are reasons besides burnout that a health care worker could display the above symptoms. However, if these symptoms are connected with one of the below common causes, it is much more likely that burnout is the culprit of the behavioral changes.
Know that we are not suggesting that if a worker is not experiencing any of the below issues, they are not suffering from burnout. Burnout is caused by a multitude of issues, and a person’s private life can also have a great impact on it.
These causes are issues known to plague health care workers and which have often been linked to burnout. This list is not exhaustive, but it does provide some possible stress factors that can help you recognize burnout. If you can see both symptoms and a cause, burnout is probably present.
Health care workers are known for working long hours, but just because they are well-known does not make those long hours any less wearing and exhausting for the workers.
Long hours mean less sleep, and no one can function properly without adequate sleep. Sleep deprivation over a long period of time will cause issues. Consistently getting less than seven hours of sleep will hurt a person’s physical and mental health.
Despite the obvious detrimental effect of long hours and lack of sleep, health care workers are encouraged to work grueling hours with pay incentives. Unfortunately, that may ultimately hurt rather than help a worker by piling on stress with less sleep.
If a physician or nurse is constantly working and begins to show signs of burnout, you probably do not have to look far to find the cause.
Doctors in 21st-century medicine have far less control over their patients than they once did. Insurance companies and administrative personnel now often dictate what treatment a patient can receive.
This lack of control over decisions involving their patients not only causes stress but can also produce disillusionment and cynicism towards their jobs, which is already linked with burnout. When doctors are unable to do what they believe best for their patients, it is not hard to see why they are becoming increasingly cynical and fatigued.
Most health care workers join the medical field because they want to work with people, yet many of them find themselves spending more time at their desk than with their patients.
Most people can expect their jobs to have some part they do not like. Paperwork has been dreaded by many workers for a long time. However, physicians are now facing a situation in which half of their working day is being taken up by clerical and administrative duties.
Electronic health records (EHR) were supposed to help streamline the amount of clerical work physicians were facing, but they have actually increased it. Many physicians now have to work extra hours at home to catch up on their EHR tasks.
Finding yourself not able to perform your job because you are bogged down with clerical duties is tiring, frustrating, and discouraging. It is no wonder that this is a leading factor of burnout.
EHR isn’t the only technology causing problems for health care workers. We live in an age of rapid technological development, and why that can be great, it also takes a toll.
As new medical equipment and technology are introduced, health care workers have to work to stay up to date. This means more training and time spent learning new skills. Learning takes time, and with technology changing so fast, it can become an overwhelming task.
This new technology is often meant to help health care workers, but the fact of the matter is that it is often implemented too quickly and before all the kinks have been worked out, which only creates more stress.
In the long run, new technology could help the physician burnout problem, but assuming that using the newest technological tools always makes things easier on health care workers is a drastic mistake. If it doesn’t work well, then technology only adds to the likelihood of burnout.
Medical school is expensive and paying off that enormous debt often becomes a large motivating factor in doctors working long hours and pushing themselves to the breaking point.
Student loans will push doctors to establish an unhealthy working lifestyle, which, while it may earn them more money for a while, will eventually cause them to break down physically and mentally, leading to burnout.
A lot of these causes add up to one thing: less time with patients. Time learning about new technology and dealing with paperwork or EHR takes away from the reason doctors do their job, the patients.
This problem has only been exacerbated by the health care worker shortage. As the number of health care workers in America has gone down, the number of patients per doctor has gone up. Now doctors are forced to juggle more patients along with their other responsibilities leading to less and less time with each individual patient.
Health care is a human career. Health care workers want to help people. Being able to spend less and less time with the people they are trying to help proves incredibly discouraging and makes it harder for physicians to do their jobs well.
This is often more of an issue for nurses, but in general, working in the health care field brings quite a lot of emotional stress. Being around human pain and suffering all day will wear on anyone, but health care workers are additionally expected to give emotional support to patients and their families.
Essentially many health care workers see enough pain on a daily basis to need counseling themselves, yet they often find themselves being the counselor for grieving families and upset patients.
The high levels of empathy that doctors and nurses use so much can backfire. If this emotional burden becomes too large, the workers can react by becoming callous and cynical.
There is a reason so many parents want their kids to be doctors. Doctors tend to be well-respected. People assume that they are both smart and rich (though student loans say otherwise). Putting people on a pedestal though takes a toll.
Doctors are held to extremely high standards, and while some of this is justified, perfection is just not something that can be achieved. It certainly does not help that many doctors tend to be high achieving and meticulous individuals anyway. The result is a deadly combination of high personal and social standards that wear away at a physician’s self-esteem.
The need to distinguish between acceptable stress levels and burnout contributes to the increasing number of burnouts and people leaving the health care field. Trying to draw an objective line between what is acceptable stress and what is burnout will only alienate workers who need support.
Recognizing burnout is about noticing symptoms and a health care worker’s need for rest and support. It is not about judging whether or not a health care worker’s burnout is acceptable. An acceptable amount of stress is whatever an individual can handle.
Be kind to yourself and others. You can recognize that you or someone else is having burnout and take steps to help without the need to justify that burnout.
Realising that you or someone else is having burnout is great, but what happens next? Unfortunately, burnout is a stage of stress. As we mentioned earlier, burnout is a state that has become chronic. If it gets too far, a worker can become completely dissatisfied with their job.
Thus, the key to dealing with burnout is prevention. As soon as you recognize signs of burnout, steps need to be taken to prevent it from developing further. Here are some things health care workers can do to prevent burnout.
Work will be a whole lot less stressful if you have friends with you on the job. Health care workers can become so focused on their job that they forget to talk to colleagues, even during 12-hour shifts.
Health care workers do not have to be best friends with their colleagues, but maintaining friendly relations can go a long way in making the entire work environment feel more comfortable. It can also make it easier for a struggling worker to ask for help.
Improving this aspect of health care work lies largely on individuals and their decision to reach out to colleagues. However, the larger organization can encourage this through small things such as coffee gatherings. It may seem like a waste of time, but happier, less stressed, workers will perform better.
Health care workers push themselves to the limit, and while that is wonderful and admirable, it is also unhealthy. Health care workers need to be allowed to set boundaries about how much work they can reasonably do.
Largely this means encouraging health care workers to take their time off. Double shifts and constant calls are necessary at times in the health profession, but if health care workers cannot say “no” ever then they will burnout.
Taking the time they need to rest can make physicians and nurses feel guilty. However, these workers need to rest in order to do their jobs. Most patients do not want someone who is so tired they can barely stand seeing to their medical needs. Setting boundaries with their time is beneficial to both the workers and patients.
In a similar vein to setting boundaries, getting enough sleep may be the number one way to prevent burnout. Lack of sleep slowly chips away at your ability to function physically, emotionally, and mentally. Even if your job is stressful, facing it with enough sleep will make it way easier to handle that stress.
As we mentioned, health care workers often end up becoming de facto therapists for struggling patients and families. That is a huge emotional responsibility, and seeking outside support to deal with that responsibility can be a powerful tool in preventing burnout.
Health care workers deal with a lot of grave and upsetting situations. Finding a way to release the pressure that causes is vital for maintaining your sanity. Therapy is one way to do that.
Although some of us do not like to admit it, exercise makes you happier and healthier. Failing to take care of your physical body will only increase mental pressure and stress.
When you feel good physically, you have more energy and stamina. Because health care workers face such long shifts and grueling work demands, the energy they get from staying in shape can be the difference between managing everything and burnout.
It is easy to imagine that health care workers never do anything but work because this is the reality for many of them. However, keeping up with friends, family, and other non-work-related things is an excellent way to avoid burnout.
If work becomes everything, then when work is stressful, your entire life is stressful with no relief. Having a life outside of work provides health care workers with needed relaxation. Friends and family also give emotional support, which can help you through the stressful times instead of letting them buildup to the point of burnout.
Burnout is a personal thing, and a lot of preventing and reversing it comes down to adequate self-care. However, there is no denying that having unrealistic and unhealthy standards for health care workers makes it much harder for them to perform this necessary self-care.
Health care worker burnout has become an increasing problem in our modern age, which means that our modern health care system likely has something to do with it. Our health care workers are important. Recognizing that the system hurts these workers at times and finding ways to improve it is vital.
Technology has the potential to decrease the workload and stress of health care workers by a lot, but it has so far done the opposite because of clunky implementation.
Advancements in technology are exciting, but it is important to make sure that this technology is usable and user-friendly before making it widespread.
EHR is a great example of technology that has potential but desperately needs to be improved. Evaluating our current technology and figuring out what can be done better could greatly help ease the burden on our health care workers.
Since burnout is known to be a widespread issue in the health field, providing support through therapy services and other wellness programs could combat the issue. Besides giving resources to struggling health care workers, such programs would help to open the conversation about burnout and encourage more workers to seek help before they reach burnout.
One reason many health care workers work long hours and take double shifts is money. Payment incentives push people to work themselves to the absolute breaking point. While there should be rewards for excellent performance and extra time, bribing workers to work till they are unhealthy and burnt out does not help anyone.
If we are honest about the prevalence of burnout amongst our health care workers, it would be beneficial, to be honest about it from the beginning. Most burnout cases can be prevented by self-care. Teaching people who wish to enter the health care field about the importance of self-care may be the largest preventative step we can take against burnout in the medical field.
Health care is always going to be a stressful career field simply due to the nature of the job. The men and women who work in this field face enormous pressure and stressful circumstances daily. Learning to recognise when a health care worker is facing burnout is vital for giving this group the support they need.
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