Burnout may be a buzzword in healthcare right now, but has the term just earned a bad rep?
This question inspired Erika del Pozo, MOT, OTR/L, and formerly burned-out healthcare professional, to found Joy Energy Time, which provides wellness resources for fellow HCPs.
“Burnout has been misused to imply that the person experiencing it is at fault for having experienced it,” del Pozo tells Florence Health.
Although personal factors do play a role in the development of burnout, del Pozo continues, one can usually trace the roots of the problem back to the work environment, such as in-team and organizational factors. (Should we say it louder for the people in the back? Burnout is not your fault.)
To solve the issue of burnout, del Pozo advocates for peering through a holistic lens.
“Instead of facing burnout with this sense of shame, we need to start looking under the hood at these larger problems that result in burnout experienced by individuals,” she says.
And after taking this first step, according to del Pozo, you’ll likely notice these six core workplace factors that contribute to burnout, as published in World Psychiatry back in 2016. Here, del Pozo breaks down why these are so damaging.
An Unmanageable Workload
Healthcare workers in the U.S. face ongoing and increasing pressures to do more with less, says del Pozo, and the emphasis on productivity over patient care can be a major factor in burnout.
“Time is a resource, and healthcare workers are seeing more and more patients within the same timeframe, which leaves less time for documentation, researching case studies, or even being able to take a proper break,” she explains. “I’ve heard of some facilities that require 90-plus percent productivity, which essentially means you have no time to do other important tasks, like speak with the patient’s family members, complete documentation, review charts, confer the patient’s case with other healthcare professionals, or hardly even use the bathroom.”
That unsustainable pace and the message it communicates — that a health professional’s skills come down to “production” — is a recipe to crash and burn.
Decreased Job Autonomy
Many workplaces encourage employees to “fight” or “beat” burnout with self-care strategies, but this just isn’t possible when employees lack control over their professional lives.
“Self-care or personal well-being strategies are vital to the maintenance of your health,” del Pozo points out. “But you can’t ignore the things going on at work and expect self-care to make things all better if you are being treated unfairly.”
No Social Support from the Work Community
Nurses and advanced practice providers have a particularly high risk of burnout early in their careers. (We all remember the abrupt crash from the idealistic vision presented at school to the real world of patients, bureaucracy, and workplace stressors…)
“New grads are prepared with clinical skills, but they’re not taught how to navigate their career,” del Pozo says. “They significantly lack preparation in developing nonclinical skills like communication, leadership, and negotiating, as well as learning how to deal with the most common job challenges in healthcare, like burnout.”
And because new grads may be lacking these skills to begin with, a lack of support from coworkers in the work community will exacerbate the situation, or make an at-risk grad feel like they are solely to blame for their feelings.
“We enter healthcare because we are so compassionate and love helping others,” del Pozo says. “We give, give, give of ourselves for the sake of being a ‘team-player’ and think we are doing the right thing by putting everyone else first and our needs last.”
But in giving of themselves until there is nothing left, health professionals end up completely depleted. And if the actual rewards of the work they’re doing don’t match the amount they’ve given — financially, emotionally or even on a status level — that disconnect will start a slow descent into burnout.
“I like to think of it as going into the ocean,” del Pozo explains. “If you’ve been in the ocean talking with your friends for an hour, you may not notice that you are slowly drifting. After an hour has passed and you look to the shore, you now notice that you’ve drifted so far that you can barely see your stuff. It’s the same with burnout. You may not notice that you’re slowly drifting into the abyss.”
What’s more, “you may develop resentment towards your organization because in one way or another, your needs are not being met,” del Pozo adds.
Injustice and Lack of Respect
Burnout can happen to the brightest people, notes del Pozo — even those actively involved and initially happy at their jobs. Contrary to what many of us picture when we think of burnout, she says that an employee can actually get burned out even when they’re engaged at work.
“Engagement and burnout are not two opposite ends of a continuum, but can coexist,” she asserts. “Someone who loves their work and is over-engaged can become burned out with the introduction of other factors, like work conflicts, changes in workload and bullying.”
Value Conflicts Between Employee and Employer
You can “have a high, person-to-job fit and align with the values of the organization even if some things get unbalanced,” del Pozo says, but eventually the connection will erode.
For example, if your employer praises employees who never set boundaries for picking up extra shifts, or disciplines employees for calling in sick, you may struggle because your workplace’s established culture conflicts with your values.
“We become accustomed to having no boundaries because it’s the norm,” del Pozo continues. “It’s what we see more experienced workers do, so we feel like that’s just how it’s supposed to be.”
She explains that when employees overextend themselves to please the people they work with, they usually do so out of guilt or fear of not being liked, not being seen as a team player, or even to avoid losing a job. But working out of fear eventually catches up to you.
Employers understanding the six core factors that contribute to burnout — and introducing practical solutions to resolve them — will initiate change in the future of healthcare, del Pozo hopes. But in the meantime, individuals should work with their organizations to reduce burnout for everyone.
“It’s not a ‘us or them’ approach,” del Pozo says. “But rather a ‘both-and’ approach, meaning both the organization and the employee have a responsibility to reduce the root causes of burnout.”