For healthcare workers across the country, the past year and a half has felt like an angry ocean of challenges.
They’ve done their part battling wave one, then two, then three... and now four, but the feeling of drowning has not stopped, and the emotion that’s been bubbling underneath the surface has fully come to light.
“It’s a space filled with grief, loss, and an ever-increasing sense of hopelessness,” says Jacinta Harman, Regional Clinical Lead at Marvin. “The feelings of burnout and lack of autonomy are at an all-time high.”
Something must be done to reverse this despair, restoring and replenishing the personal achievement of our front-line workers.
Burnout within the healthcare industry is nothing new. In 2015, the Medscape Physician Lifestyle Survey reported a burnout rate of 46 percent of physicians, up from 39 percent in the 2013 survey. However, the pandemic has driven this trend to new heights. Moored by a lack of personal protective equipment, changes in staffing, and a never-ending stream of incoming patients, healthcare workers are exhausted. But perhaps even more troubling, there is significant loss of joy in the profession and the sense of achievement that had always kept them afloat.
A lacking sense of personal achievement can be devastating. It strikes to the core of what many healthcare professionals see as their identity. To work in this field, you are a healer, serving others in one of the most respected careers. It’s why physicians go to medical school, and why emergency nurses endure disrupted circadian rhythms, sleeping at odd hours of the day. You are a lifesaver, and a true servant of the general good. When the healthcare heroes are no longer considered ‘heroes’, it becomes even harder to push on and to find even the littlest bit of adrenaline to serve others.
A lack of personal achievement also strikes to the very definition of burnout itself. The foremost definition was developed by Christina Maslach, who structured it as a psychological syndrome of “emotional exhaustion, depersonalization, and reduced personal accomplishment that develops in those who have an expert relationship with others”. In her model, feelings of personal achievement are a protective factor that can act as a shield, promoting health and well-being. These feelings help you to persevere towards your goals in the face of adversity, and while they certainly do not impact the external scenarios around you, they can help to navigate them and maintain resilience despite the issues at hand.
Why has a lack of personal achievement become such a challenge during the past year? More clerical work and intense hours certainly contribute, but the celebrations of banging pots and pans in the support of healthcare workers have also stopped. The news stories have only become more negative, and the sense that healthcare workers will be able to support us to the end of the pandemic have also diminished. Closely related, the lack of confidence in vaccines, the FDA, and the general administration of our health system erodes the healthcare provider’s sense of self-worth. Americans previously clapped for healthcare heroes - now, many of the sickest patients are distrusting of the care system itself.
The path to move forward is by no means simple. Structural challenges in the healthcare system, along with a lack of equipment, a backlog of patients, and increasingly short-staffed provider teams, have built a trench of challenges that are going to take years to overcome. No matter the sense of personal achievement, we will need to address these issues systematically. However, an increased sense of personal achievement can add wind to the sails of healthcare teams, helping to provide the strength to move forward and build out of the deep challenges that we face.
For health systems, this starts with the following:
- Publicly and privately recognizing the great work that our healthcare heroes have done. The celebration of a successful diagnosis or surgery can go a long way in a field where mistakes are frequently the major points of discussion among colleagues. As healthcare systems managers, employees, and colleagues, we can work together to build a culture that highlights and appreciates the great work of our providers.
- Creating a system with increased autonomy and ownership overwork, letting healthcare professionals focus on their true passion - their patients. By minimizing unnecessary friction around the electronic medical record and other systems, and bringing on additional clerical staff, we can build a model that allows for more flexibility over individual hours and shifts and allows workers to focus on their families when needed.
- Implementing support systems to help process the trauma of the past year. Burnout and depression are at all-time highs, and it’s easy to stay focused on the worst of what has occurred. Cognitive-behavioral therapy and other therapy techniques can help, restoring a sense of self-worth and shifting focus to the rewarding parts of the work.
These challenges are by no means easy. But if we don’t push for structural change that develops a greater sense of achievement than we have today, we may find that we no longer have providers to care for us during the next wave of the pandemic.
John Bracaglia is the CEO of Marvin.