There has been much discussion about burnout among physicians and nurses, but a new survey reveals high rates of work fatigue in nearly all healthcare-related occupations.
Physicians, nurses, clinical staff, and non-clinical support workers in healthcare are all experiencing high levels of burnout, according to a recent Journal of General Internal Medicine report. For instance, the percentage of nurses (56%), clinical staff (54%), doctors (47%) and non-clinical staff (46%) who reported burnout was very similar.
As per UPI, the lead researcher, Dr. Lisa Rotenstein, an assistant professor of medicine at Harvard Medical School, stated, “Every member of the healthcare team is crucial for patient outcomes and patient experiences of care.” It is vital that we keep this in mind as we strive to optimize both patient outcomes and the experiences of our workforce.
Rotenstein and her colleagues surveyed employees at 206 large healthcare organizations between April and December 2020, during the height of the pandemic, for this study. There were more than 15,000 physicians and 11,000 nurses among the participants.
Researchers also polled more than 11,000 non-clinical staff, including housekeeping, administrators, lab technicians, and food service workers. The clinical staff surveyed included pharmacists, nurse assistants, therapists, and social workers.
In addition to high levels of burnout, the researchers discovered that many workers intended to leave their jobs within two years, including 41 percent of nurses, 32 percent of clinical and non-clinical staff, and 24 percent of physicians.
47% of nurses and clinical staff, 44% of non-clinical staff, and 37% of physicians also reported work overload. Even though the survey was conducted during the height of the pandemic, Rotenstein suspects that conditions for healthcare workers have not improved in the years since.
“As we have moved into a new phase of the pandemic, certain stresses have persisted,” Rotenstein said. “There are personnel gaps. Patients who delayed care as a result of the COVID pandemic have resulted in an increase in demand for healthcare. Frequently, healthcare professionals are asked to do more with less.”
Dr. Joe Betancourt, president of The Commonwealth Fund and a primary care physician, notes that one should not overlook the fact that the pandemic lasted well beyond 2020.
“After that, we faced the difficult labor of the subsequent surges,” Betancourt said. “As I reflect on that time period, I realize that we were exhausted and overworked at the time; we thought we had gotten through it, but then the next surge occurred, followed by another. Over time, this exacerbated the burnout significantly.”
A recent HealthDay/Harris Poll revealed that burnout remains a factor in the healthcare industry. In February, the survey revealed that two-thirds of physicians and nurses are experiencing moderate to severe job burnout.
According to Dr. Atul Grover, executive director of the Research and Action Institute of the Association of American Medical Colleges, cost-cutting in the healthcare industry has resulted in a tremendous amount of stress among workers at all levels.
“Healthcare is extremely labor-intensive. Over fifty percent of health system expenses are attributable to labor “Grover said. “If you want us to eliminate costs from the healthcare system, you’re essentially asking us to find a way to pay people less or eliminate them. I believe that is essentially impossible at this time.” Grover added that patients today are typically sicker and require more treatment, attention, and paperwork.
“We have done a very good job from a biomedical standpoint of improving the care of chronically ill patients, whether they have renal disease, diabetes, pulmonary disease, or cancer,” said Grover. “However, this implies that patients have multiple medical conditions. They appear significantly sicker in every setting.”
Administrative personnel must coordinate coverage for complex care with insurance companies. More information must be entered into electronic health records by nurses and doctors. To meet the basic needs of more ill patients, support personnel must exert more effort.
Rotenstein stated that requiring all of these workers to do more with less cannot help but impact patient care. “We know from existing studies that burnout is associated with both a decline in the quality of care and medical errors,” Rotenstein explained.
Every member of the healthcare team affects a patient’s journey, from the person at the front desk checking in the patient or determining when the next available appointment is, to the social worker who is working with the patient and the home health aides who interact with patients on a daily basis, said Rotenstein.
“All of these roles are essential for the provision of high-quality healthcare,” she continued. “Therefore, we anticipate that these types of workplace experiences and stress will ultimately have an effect on care delivery and, more importantly, the availability of care,” Grover stated that burnout can also have a negative impact on one of the most essential emotional aspects of healthcare — workers’ compassion for the sick.
“If the clinicians, counselors, and even food service workers in their health system are extremely stressed and unhappy, it becomes exponentially more difficult to be empathetic,” said Grover. Betancourt stated that health systems have attempted to combat burnout through a “cottage industry” of wellness offerings, such as gift certificates, yoga classes, and meditation groups.
“Many of my peers tell me that it’s not about needing those perks,” Betancourt stated. Even if I wanted to, I lack the time and energy to complete those tasks. Instead of reducing the workforce, Betancourt suggests focusing on developing and expanding it, as well as streamlining the paperwork and approvals required to provide care.
Through artificial intelligence and voice-to-speech recognition, for instance, electronic health record companies could be required to modify their systems to make data entry easier, according to Grover. “What can we expect from these companies that receive billions of dollars annually from the U.S. healthcare system? What can they do to implement programmatic changes and use AI to improve and alleviate clinicians’ workload?” Grover said.
Rotenstein stated that healthcare systems could do a better job of tracking work overload and burnout among all employees. “We have a tool to measure work overload, and it may be advantageous for organizations to begin measuring that actually upstream of burnout and intent to leave,” said Rotenstein. “Once you reach the point of burnout or intent to leave, it’s in some ways too late,” he added.
She added, “There is an opportunity to measure work overload and then adjust the workload of employees in all role types.” “In a time of healthcare staffing shortages, when certain individuals may be performing the duties of others, this is of utmost importance. I would say that this is a significant and tangible opportunity.”