Since the onset of the COVID-19 pandemic, the issue of healthcare worker burnout has taken center stage. Healthcare leaders have realized the toll the last nearly-two years have taken on their staff, and patients have every reason to be concerned about how providers’ feelings of exhaustion, uncertainty, and powerlessness might affect the delivery of timely care.
A phenomenon that was previously recognized as a critical impediment to sustainable careers has now become an existential threat as front-line workers are pushed to the brink amid a public health crisis that hasn’t yet seen its final days.
A 2021 survey by the Kaiser Family Foundation and the Washington Post found that 55% of front-line healthcare workers reported burnout, with 62% reporting a negative impact on their mental health. The culture among healthcare workers, particularly physicians, of putting themselves last when caring for patients eventually caught up with them. For many, the COVID-19 pandemic has evaporated our feelings of control, but perhaps for no group more acutely than the selfless professionals providing care to overflowing hospitals full of COVID-19 (and non-COVID) patients.
Healthcare workers’ frustration and exhaustion can no longer be ignored. In mid-October, nearly a third of all California hospitals reported critical staffing shortages to the federal government as a mix of respiratory therapists, nurses, midwives, physical therapists and other professionals pushed back against record patient volumes exacerbated by burnout, early retirements, and the stress of the pandemic.
Medical professionals are committed to putting others’ well-being first. But when they can no longer cope with the stresses of their job, they’re not just at risk of quitting – they also sometimes turn to alcohol and other drugs. So what can healthcare workers do to find peace in a world that feels increasingly out of control?
Take charge by identifying what feeds your habit loops
While trying to find a solution for my patients, I came across research that suggests anxiety can be perpetuated like any other habit, which consists of a self-reinforcing loop of triggers, behaviors, and results. Let’s look at how this can play out in a typical healthcare setting:
Trigger: Look at the ballooning caseload for my shift
Behavior: Think about how the system is broken and only getting worse
Result: Get more cynical and become burnt out
Indeed, research my team published last year in JMIR mHealth found a strong correlation between physician anxiety and burnout.
Once healthcare workers have identified the mechanism of their anxiety, it’s easier to unwind it methodically by applying awareness practices, like curiosity. If I can carefully examine what’s driving my feelings, it’s easier for me to isolate each step of the process as it happens and thus gradually remove myself from the cycle.
Check in with yourself
Taking the time to slow down enough to learn how to work with our minds can seem like an impossible task to an anxious healthcare worker. Fortunately, mindfulness can be practiced at any point, even in the middle of a shift. The team in my lab has found that short moments throughout the day can still measurably reduce stress and anxiety. You can think of these as “short mindful moments, many times.” One of my favorites grounding exercises is called five-finger breathing.
Start by placing the index finger of one hand on the outside of the pinky finger on your other hand. As you breathe in, trace up to the tip of your pinky, and as you breathe out, trace down the inside of your pinky. Then on the next inhale, trace up the outside of your ring finger, and on the exhale, trace down the inside of your ring finger. Inhale and trace up the outside of your middle finger. Exhale and trace down the inside of your middle finger. Continue until you’ve traced your entire hand, and then reverse the process as you trace from your thumb back to your pinky. What’s it like to trace even a few fingers? Most people find it can quickly crowd out stressful thoughts and, when you have time, pave the way for further reflection.
Staving off healthcare worker burnout shouldn’t be a solo activity
Curiosity, awareness, and kindness can be transformative when practiced at an individual level, but health systems should take shared responsibility for their employees’ well-being if they are serious about retaining them.
At SSM Health St. Anthony Hospital in Shawnee, Oklahoma, leadership is making great strides to combat healthcare worker burnout. A recently opened rejuvenation suite, made possible thanks to funding from Avedis Foundation, has become an instant hit as a refuge from the stresses of life on the floor. (Full disclosure: SSM Health St. Anthony Hospital – Shawnee has partnered with digital health company Sharecare, where I serve as executive medical director of behavioral health, on a population health initiative called Blue Zones Project by Sharecare.)
Like many health systems, St. Anthony Hospital – Shawnee’s intensive care unit is currently over capacity due to COVID-19 cases, and the larger community is suffering from sky-high stress levels: During 2021, Sharecare’s Community Well-Being Index found that 89% of Shawnee residents were experiencing moderate to high levels of stress risk. Offering staff short moments to decompress throughout the day, or before or after a shift, is a priority for leadership at a time when the daily demands of the job are greater than ever. As Angi Mohr, the hospital’s president, recently told me, the pandemic has focused leadership on “brain health” as a critical component of overall wellness. To that end, the rejuvenation suite includes a number of features used by employees to slow down the pace of the day, including a projection wall that recreates sounds and imagery from nature, a conversation zone, and a calming water feature. In the future, the hospital plans to use the space for guided meditation sessions.
In addition to designated spaces like the rejuvenation suite, digital therapeutics, like Unwinding by Sharecare can keep up with healthcare workers throughout the day, offering help to decrease stress and change habits no matter where they are.
Helping healthcare workers cope with the stress of responding to a once-in-a-century public health crisis should be an imperative – to retain them, yes, and to recognize the selfless service they have provided. Through some key perspective shifts and partnerships between health systems and healthcare workers, we can start to unwind the anxiety driving so many heroes to burnout.