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Special report on burnout: How it starts and what to do about it

The results are in from NEJM Catalyst’s Insight Council survey about burnout in the healthcare industry. They tell a sobering story.

The respondents were healthcare staff, in various roles, from organizations across the country. Collectively, their responses reflect a deeply pessimistic outlook on the burnout problem.

According to the survey, 90% of physicians and 89% of nurses believe that burnout is a serious issue among their ranks. That’s not good news. Among the respondents, 70% expect that the burnout problem will get worse over the next two years. That’s up 10% from a similar survey in 2017.

While such stark figures might alarm organizational leaders, it unfortunately may not surprise them. Leaders are well aware of the urgency of the burnout problem. They also know that many organizations have struggled to find an effective response to it.

That should not suggest, however, that leaders are helpless to change things for the better. A comprehensive approach to employee well-being can curb burnout’s worst effects.

The best solutions, as ever, are rooted in coming to a true understanding of the people who make up the healthcare workforce. This article will serve as a primer on what that understanding my look like—and how best to achieve it.

Burnout’s insidiousness

A major implication of the NEJM survey comes through remarks collected from individual staff-members. They tell just how devastating burnout can be, and how difficult it can be to detect.

Like many mental health issues, burnout can strike anywhere, and it’s not always obvious who’s suffering. In the NEJM survey, most of the burnt-out staff members reported “anxiety and sadness,” “isolation,” and “sleep loss” as their most prominent symptoms.

These symptoms are subtle, but they can noticeably degrade the care experience. In the NEJM survey, a full third of staff members mentioned “a decline in work quality” as one of the foremost markers of burnout. They say they’re “more likely to snap at coworkers” and feel a marked “loss of compassion” for patients.

These are outcomes no healthcare leader can countenance. But they are increasingly becoming a reality of working in the industry.

Not just a COVID problem

Given the seriousness of the problem, it’s important to examine the root causes of burnout in organizations. Perhaps the most important finding from the 2020 NEJM survey is this: the uptick in burnout rates is not exclusively due to COVID-19.

The coronavirus crisis has absolutely provoked an unprecedented level of distress among healthcare teams. At the same time, however, clinicians have proven remarkably resilient to the pandemic’s stressors. According to NRC Health’s Workforce Engagement data, some measures of workplace satisfaction have even risen during the pandemic.

Instead, the culprits behind the spike in burnout rates are much the same as they’ve always been. Respondents from the NEJM survey cite “administrative burden” (60%) and “infrastructure” (31%), which includes electronic medical records, as the top drivers of burnout—even during the pandemic.

What to do about burnout

Burnout is a complex issue, and no one solution will curb it at every organization. For possible tactics to explore, though, the NEJM survey is not short on suggestions.

The survey asked healthcare staff members directly about what leaders can do to make burnout better. Their answers fall into three broad categories.

  1. Recognize burnout as a systemic, structural problem

Before anything else, leaders must understand and accept that burnout is not a problem with individuals.

The factors that contribute to burnout are, for the most part, not within an individual provider’s control. A clinician cannot change the volume of documentation they must deal with; they’re largely unable to influence their caseloads; they can’t, on their own, change the culture of their workplaces.

A common recurring theme in the NEJM clinician survey responses is despair over “a lack of autonomy in our lives.”

This should suggest to leaders that resolving burnout is by and large an organizational responsibility.

  1. Empower clinical leaders

For clinicians, combating burnout may also be seen as a fight to reclaim work-life balance.

According to the survey, many clinicians say that flexibility in scheduling (40%) and more lenient PTO policies (33%) are the best ways to help them recover from the stresses of their jobs.

All too often, however, nurse and physician managers are unable to make the accommodations that these clinicians are looking for.

Leaders should strive to change that. New approaches to coverage, a deeper roster of clinicians, and more leeway for frontline managers can help create a staffing schedule that works for everybody.

  1. Empathize with clinical staff

The final recommendation for leaders is also perhaps the most important: listen.

49% of clinician respondents said that “consistent engagement with frontline workers” is the single most important thing that leaders can do. Taking the time to talk to clinicians, hear their concerns, and move them toward a meaningful resolution will go a long way toward easing workplace distress.

Make empathy a practice

The final section of the NEJM survey report is dedicated to firsthand comments from healthcare staff. One organization leader made a particularly revelatory remark about how to address the burnout crisis. He said, “You have to remember that your employees are your customers, too.”

That simple message captures a crucial lesson for leadership. Much as with caring for patients, making staff members feel heard is the first step toward healing. Human understanding is just as important for the workforce as it is for the community.

And while there’s no substitute for walking the floor, NRC Health’s Workforce Engagement solution can help you bring that kind of understanding that much closer. The solution gives leaders instantaneous insight into how employees are feeling, what they need from their workplace, and how to rally staff to create a culture of compassion.

It’s an indispensable tool in the fight against burnout. If you’re looking to protect your employees, have a look at Workforce Engagement today.