Dealing with Burnout in Healthcare
Burnout in healthcare is no big deal, right? I mean, of course, we all get tired of our jobs and need to change scenery occasionally, but that’s healthy, isn’t it? Maybe, and maybe not. If there is one lesson from being given a front row seat to a healthcare crisis during a pandemic is that the effect on the human psyche of the blend of being overworked, understaffed, under-resourced, and with no clear expiration date of the crisis is profound.
It is my recommendation you identify your anchors and your indicators to make it safely through this season. I’ll get to what anchors and indicators are in our next post. In this post, I’d like to start this multi-week blog post discussing the three important realizations I feel you should be aware of if you plan to last in healthcare because burnout is coming for you whether you like it or not.
We are all in a Perpetual Stage of Burnout
Think of burnout like a tank of gas. You are only ever full for the moment after you fill up the tank, but when you drive away you are already depleting your emotional, spiritual, and mental resources. We as healthcare providers show up on shift to see our coworkers in various stages of emptiness. There’s that one nurse who is always happy and talking about her new workout routine. That one patient care tech who is on her third husband and complaining about her bills. The nurse practitioner who wants to be your friend because they are new to town and don’t know anyone yet. Someone is likely already on social media, and the manager is probably tasked with putting out a few fires already though it’s only 5 minutes into shift. The patient in room 375A just coded and their family is arriving and distraught.
Your full load of patients is already weighing heavy on you and call lights are already on while you’re trying to give report. You already were told to page someone who you know isn’t on yet and will likely be a phone call you cringe to pick up, but you do it anyway because that’s the job, right? And in the end, you say to yourself “well at least I chose this”. Feeling triggered yet?
Here’s the thing. When you walk into a known dumpster fire, you have to plan for it or you will get burned. The average length of an ICU nurse tenure before burnout before the pandemic was 7 years. That’s it. And in the world of COVID, ICU nurses are dropping like flies, leaving holes that the remaining staff are left to fill, thereby only exacerbating the stress. To start out, identify where you are at on the gas gauge before you expect to make any significant road trips or you WILL run out.
Loyalty is a Lagging Indicator
Lagging indicators are evaluation points that occur with dependence on a process and tend to be reasons we seek a root cause analysis for quality improvement when they are not looking so hot. On the other end of the spectrum, leading indicators are used to evaluate prospective change and processes with more active engagement to steer towards a win. Hiring and pay rates may be a leading indicator while you expand services for that new COVID floor, but retention numbers tend to be a lagging indicator that reflects a lost opportunity for the organization to have intervened in time for those separated employees.
As previously mentioned, retention numbers are abysmal right now. With sensational offers like $10,000 or more per week to be a travel nurse working in COVID hotspots, why would anybody hang around and stick with the grind at your regular pay when you could be paying off your student loans or gassing up the yacht?
The reality is that for many nurses, security is a big motivator, and it’s a good thing because that motivation may be the strongest asset any healthcare organization can exploit to retain high quality employees. As it turns out, money cannot buy happiness and even short-term financial gains do not a happy nurse make. Simple laws of microeconomics dictate that we spend what we make and it takes a change in spending habits to actually improve one’s financial health. A short-term travel assignment may grab some cash, but in exchange, most of it will be spent on normal goods and de-stressing from the added stress of yet one more new variable of a new environment and a lack of security since your travel gig is only a few more weeks.
Loyalty is no longer valued as it is not expected, and it is not expected because it is not valued. Survival in this environment means first identifying what your unique motivation is to be in healthcare in the first place and make sure your tank is being filled with the right fuel. Otherwise, all the financial incentive in the world does nothing when your motivation is a better schedule, flexibility for advancing your education, that right blend of weekends with your significant other and family, or opportunity for advancement.
Just ask your Kids or Family
What is my opinion on anything? Just ask my wife and kids. I’m fairly confident my verbal processing (which comes off as rambling at times) could pen novels. And when it’s all said and done, we all come home to our “people” whether a significant other, spouse, child, friend, and totally dump all the weights of the day on their heads. We tactfully call it decompressing. And it’s extremely important because being pent up and emotionally unavailable is unhealthy and only breeds resentment which spills over into those around us. I liken this to exhaust for our fuel/car metaphor. The engine only works if it can properly exhaust.
If you asked me what was on my mind, my top three things would probably revolve around simple things, but if you REALLY prodded, you might actually get me to start talking about the things I stay up awake at night over or what I dream about. I’m confident we all guard our emotions and minds more than we should because actually discussing it is far too uncomfortable and honestly, after a long day of work with awful things going on around us, why would we want to ruin the precious time we have at home discussing work?
Here’s the thing though. You are not free of your day just because you left the hospital. You are only free of your day when you decompress it and fuel up for the next day. PTSD, moral distress, moral fatigue, anxiety, and depression are real monsters, and as someone who has struggled with what is most likely PTSD after a few pretty awful experiences in healthcare, I personally believe this is fundamental to avoiding burnout.
If you don’t have a person, find a person who you can talk to. It’s easier than you think. Your coworkers are in a unique position to actually understand you in ways even family cannot, so don’t overlook the obvious opportunity to decompress with a coworker you can trust and you just might find you’re far from alone.
I hope this helps put in to brief perspective some of what is on my mind and likely yours as well if you are in healthcare at this time. Next time, I will discuss what I call Anchors and Indicators and will provide clearly actionable steps to identify and reverse the course of burnout before it’s too late and you give up on what was once your dream job.