When thinking about all that the industry is facing since the rise of the COVID-19 pandemic, it is unsurprising that burnout in healthcare workers has become increasingly difficult to avoid, and that rates of burnout are rising dramatically across this sector of the workforce.
Burnout is a psychological syndrome resulting from chronic job stress and presents through a diminished sense of:
- Personal accomplishment – The belief that one is no longer effective at their job
- Depersonalization – Cynical and detached responses to what is going on at work
- Emotional exhaustion — Work-related fatigue and psychological depletion
Increased irritability, anxiety, procrastination, challenges with sleep (fatigue or insomnia), apathy, isolation, obsession with mistakes, and somatic symptoms including headaches and gastrointestinal issues, are amongst the common symptoms. Less commonly discussed are increases in errors, self-deprecation, cynicism, and incivility (rudeness, callousness, or blaming others for mistakes) at work.
Beyond work, family and friends might notice their burned-out loved one becoming overwhelmed by the burden of seemingly small tasks, more withdrawn and sullen, beginning to lash out in an uncharacteristic manner and finding less joy in hobbies and social interaction.
Because burnout develops over time, recognizing early symptoms in oneself or others can promote intervention to prevent further decline and worsening symptoms.
The Job Demands-Resources Model of Burnout
The Job Demands-Resources (JD-R) model of burnout is particularly informative because it describes not only the factors that lead to burnout but also suggests how to manage burnout through changes that can inhibit or reverse it. This widely accepted model of burnout suggests that the syndrome develops over time when job demands (time pressure, role overload, shiftwork, emotional labor, etc.) exceed the resources (autonomy, decision-making, justice, control over scheduling, social and emotional support, etc.) individuals require to be at peak form while at work.
The JD-R model also helps to explain the increase in burnout in healthcare workers during the COVID-19 pandemic. When COVID-19 struck, job demands increased and resources depleted rapidly and dramatically – both at work and outside of work – and individuals were unable to adequately recover from the daily stressors, so this stress turned to strain.
However, as more and more individuals burned out, this left fewer and fewer individuals to carry the workload, which left workforces short-staffed, and imposed even more demands on remaining employees, creating a feedback loop. More demands, fewer resources, more burnout, fewer employees, more demands – and the cycle begins anew. To break this cycle and prevent further healthcare worker burnout, it is imperative that organizations make adjustments to either reduce job demands or to increase the resources made available to employees for coping with these demands and to manage burnout.
What Organizations Can Do to Help Manage Burnout in Healthcare Workers and Facilitate Prevention
Examining burnout in healthcare workers through a JD-R lens demonstrates that though employees are the ones who experience the symptoms, this is not an individual-level problem – it is an issue that is inherent to the work environment. Therefore, the onus should be on the workplace to reorganize work to maximize resources and minimize demands to the greatest extent possible.
Each workplace will, of course, be unique and so not all solutions will fit. The key takeaway from all recommendations is to reduce obstacles and make the job as easy and rewarding as possible for employees.
In clinical settings, this might mean:
- Reducing the need to search for the materials necessary to do one’s job, such as making personal protective equipment readily available near patient rooms or ensuring that all gauges of needles and sizes of gloves are well stocked.
- Reducing patient load and clustering similar cases might also help, as this will reduce the amount of cognitive load (and therefore cognitive energy) that is spent in any given workday.
- Allowing employees greater control over what shifts they take might be triply effective, as it increases autonomy and maximizes their ability to recover and to take care of life outside of work. If not already undertaken, perhaps consider instituting a consultation with the team to figure out if an alternative shift rotation schedule (for instance, working six-hour shifts rather than twelve), might be helpful for promoting recovery time away from work. Again, this solution serves the dual purpose of benefitting both autonomy and recovery. Reducing overtime and constant switching between day and night rotations is likely to help with recovery in off-work hours, as well.
- Providing, if at all possible, resources to help individuals in their home lives (such as facilitating transportation, housekeeping, or meal delivery), so they can devote more attention to recovery when away from work, and less to domestic labor.
- Last but certainly not least, it is crucial to provide a range of ways that employees can speak up about the challenges they are facing, and to act on these to the greatest extent possible – make it easy for employees to signal their distress and be open to recommendations for how to improve their work environment for them. Leading with compassion and empathy, and working collaboratively towards solutions, will promote self-efficacy, trust, and the feeling that one matters, which is desperately needed in an exhausted and dejected workforce.
There is a reason why burnout was first studied among healthcare professionals: the physical, cognitive, and emotional psychological demands of their work made burnout prevalent among them.
This remains as true today as it did during the 1970s, but the pandemic has exacerbated these trends. Those who work in healthcare chose their profession out of a desire to help others. Perhaps the most devastating consequence of burnout is that it can extinguish that passion.
Being aware of the signs and symptoms to watch out for in colleagues, friends, or family is an important first step, but major overhauls to the organization of healthcare to help prevent and manage burnout are likely to be needed to avoid a shadow pandemic of psychological harm among workers on the front line.
By Chelsie Smith
BSc, MA, PhD Candidate, Sprott School of Business, Carleton University
Originally published January 10, 2022
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