Preventing burnout in healthcare
Recently a HR professional asked me if I had any suggestions on how we can reduce rates of chronic stress and burnout, my answer was embarrassingly basic and I left the conversation feeling like I hadn’t added any value or knowledge.
Because when you look at the list of ‘Top 10 questions wellbeing consultants hate being asked’ (that’s not a real list by the way… yet) then this would come in at number 1.
Simply because the healthcare sector has such a unique structure, way of working, set of pressures and tends to attach the type of selfless, caring, compassionate and self-sacrificing person that ends up being a prime candidate for burnout out because they give so much of themselves.
For example, one suggestion I have for your average corporate is to pair high performers together on projects. Can you imagine that in a hospital? “Hey this person is flat-lining but I need to wait for Tina because me and her work great together!”. Or another one is to give people a short break (such as a simple task) after completing something intensive, in a healthcare context you get “Well I’ve just on-boarded 2 new care residents and given Mr Robinson a bed bath so I can’t do your medication plan because I need a simple task!”
Doesn’t quite work, does it?
So, I set about finding actually helpful suggestions, the result is this blog post.
Now before we get down to the nitty-gritty I want to raise a really important (and maybe slightly controversial) point.
I don’t work in healthcare, never have, really wouldn’t be for me. What I’ve written below are suggestions and ideas. They might work for you, they might not but if not then don’t just dismiss it, have a think about whether there’s some variation or inspiration you can take. And if something can’t be done, then what would?
Something I hear – thankfully not too often – is ‘but that’s how we’ve always done it’. Yup, and that’s why you have such a high rate of absence and turnover. If anything is going to change, we need to create the change, bit by bit.
On that note, let’s crack on.
So first off we need to understand what’s causing our healthcare workers burnout, A study by the US library of medicine suggested the following external factors:
- High demands at work
- Poor leadership & red tape
- Lack of resources
- Poor teamwork
- Contradictory instructions
- Time pressure
- Increased responsibility
- Pressure from higher up to perform (especially government targets)
There are also internal factors like:
- Idealistic expectation of self
- Being a people pleaser
- Suppressing own needs
- Feeling irreplaceable
- Work becomes the sole focus of life
Add into the mix compassion fatigue – a psychological phenomenon common with caregivers where the stress, pressure and fatigue associated with carers result in a lack of empathy, energy and emotional numbness. It’s easy to see where the problem lies.
So what can be done?
Well from the organisation perspective
Take an active role
Encourage people to raise concerns and if they do, address them! Provide a forum for feedback and a method of communicating what is being done. We all know that the second bit might feel challenging but responding with ‘our hands are tied’ just isn’t very helpful. Even a conversation or a small change can make a big difference to how someone is feeling
Care about your people
Now I’d like to think this is obvious but apparently, it’s not to every organisation. Staff thrive when they’re happy, healthy and feel valued and this will show in the care the service users receive – the net result is likely more lives saved and more money available. Leaders and colleagues should be getting to know people on a personal level in order to create that culture of openness where people feel able to speak up about concerns
Encourage team debriefs
This is something I’ve seen various clients do in every industry but it’s especially important in healthcare. At the end of a shift just spend 5 minutes debriefing, defuse and destressing. Give people a chance to talk about what’s happened in their shift and if it works you, people, encourage deep breathing exercises to ‘come down’ from the high of the shift.
Promote your EAP
As a healthcare provider, you should have an employee assistance programme, if not then why not? However not nearly enough people use these. Particularly in healthcare, these should be used frequently but people often feel suspicious of them or don’t know what they’re for. Any EAP even offering basic quality will be 100% confidential (including from HR and management), completely free and offer counselling services. But does everyone know this, and do they know how to access it?
OK, if there’s one thing on this post that, as I’m writing it, I can feel the eyes rolling or the little scoffs it’s this.
Sweeping statement alert – health care is terrible for employee breaks and time off. I’ve seen care home workers go for `3 hours without a break, social carers go for months without a day off and don’t even get me started on hospital staff…
Now of course we get those people who don’t take the time off despite it being available, and to those people TAKE YOUR DAMN BREAKS! YOU ARE NOT A MACHINE (said with love).
But way too often I’ve seen health care organisations that say ‘We haven’t got the time/staff for breaks’
Either that’s bullshit or someone is poorly managing your organisation (looking in your direction UK government)
Sorry I know it’s harsh, but it’s true.
I’ve seen soldiers under attack stop to make a brew.
No organisation needs reminding of this but it’s a legal obligation for people to take daily breaks and to have time off from work, so if this isn’t being provided (and I mean actually provided, not just on paper) then you’re breaking the law.
The time saved of people not taking breaks will be lost 10 fold when they end up leaving or going on long term sick.
OK moving on now to what individuals can do:
Build a supportive network in and out of work
It’s genuinely great to have people at work you can chat/vent off to. Share the laughs, tears, frustration and horror stories with. Definitely do that. And if you notice someone who hasn’t then be an awesome human being and ask them if they want a chat.
But also you need to be able to close the hangar doors after work has finished. It’s difficult to do that when speaking to someone at work. So have people around you in your personal life with who you can do the same.
Top tip: Each day, set a 5/10/15 minute timer in which you can blow off steam, rant, swear, scream etc to someone and then the lid goes back on and you focus on life, not work.
Get enough sleep
Again, you may scoff at this, especially If you have little ones (My son is 5 months old at the time of writing this so yeah…. I feel your pain). But sleep is crucial to your physical and mental wellbeing.
Avoid blue light (your phone or tablet) after 7 pm, have a cold bedroom, invest in comfy bedding, charge your phone in a different room and avoid caffeine after lunch (sorry!). These are all really simple (in theory) tips that will improve your sleep.
By the way, I’m not going to say ‘Get 8 hours of sleep’ because it varies from person to person. Top tip, on a day off, make a note of when you go to bed and try waking up naturally without an alarm, that’s a basic clue to your normal rest time.
Be a little selfish
We seem to have vilified the concept of being selfish and it needs to change. I don’t mean be an arsehole, I mean make yourself a priority. Just for 15-30 minutes a day do something you enjoy, that relaxes you, that’s fun. Put that in your diary and tell those around that’s what you’re doing.
Put together a care plan
This is something that work can implement as well in the form of a wellbeing action plan but you can also do a simple care plan yourself.
Create 3 columns, In the first write things you enjoy but you can do on your own. In the second identify people in your life who help you. In the third write professional elements (like GP, EAP, therapy, Samaritans etc) that can help.
If you notice your mood dipping then start with column 1 and do as many of the things you can realistically do, if you notice no improvement then start on column 2 and speak to your support network (you can pre-empt these people that they’re on this list). If there’s no improvement, then bring in the pro’s and don’t allow yourself to talk yourself out of it. You can still use columns 1 and 2 if you’re in column 3.
Trust me, as someone who suffers from PTSD I can’t tell you how valuable this is! Do it!
To conclude, we’re never going to prevent all burnout, that’s not possible. But we can definitely reduce the rates and have a happier, healthier and safer workforce by taking small steps, supporting each other and putting things in place to support ourselves.
Because at the end of the day there’s only one of us, we only get one shot at this life and no job on the planet is more important than your health and wellbeing.