Overcoming Burnout among Healthcare Providers

Shari Fisher Hinds, RN, MSN, FNP

The recent COVID-19 crisis has increased stress in all aspects of life, but especially so in the healthcare field. Burnout rates are high and medical providers are seeking ways to manage this stress. In the IARS symposium, “Wellness and Resilience,” presenters discussed the overwhelming demand COVID-19 has placed on healthcare professionals and ways individuals can cope, as well as how institutions can help.

Keith Baker, MD, PhD, Vice Chair for Education in the Department of Anesthesia, Critical Care and Pain Medical at the Massachusetts General Hospital, moderated the session.

Afton Hassett, PsyD, Associate Professor, Anesthesiology, Clinical Psychologist, Anesthesiology, and Director, Clinical Pain Research at the University of Michigan Medical Center, began her presentation by discussing how extreme persistent adversity takes a toll on the body. This can lead to burnout, which results in increased somatic symptoms, increased psychological problems, and risk for suicide and substance abuse among healthcare providers.

COVID-19 has led to increased rates of burnout due to many factors, including uncertain patient prognosis and lack of resources to treat them. Another factor has been the lack of adequate PPE for providers. Additionally, frequent policy changes within institutions, misinformation (both internally and publicly), and fear of transmitting the infection to family and friends creates additional stress. This stress creates psychological and biological forces that tax the body system and causes increased susceptibility to illness by stimulating the hypothalamic-pituitary-adrenal axis, Dr. Hassett explained.

The key to overcoming this is to become resilient to adversity, which is achievable by focusing on the basics: eating, sleeping and exercise. Dr. Hassett recommended the use of mindfulness, laughter and the power of optimism. A helpful evidence-based activity is the use of gratitude journaling. She recommended writing down 3 different things every day for which you are grateful. She also recommended scheduling pleasant activities 3 to 5 times a week. Savoring can also help engage the senses to prolong an enjoyable activity. Texting with friends or loved ones can help bring a sense of emotional connection. Resources shared during the presentation included Headspace, a meditation app free to healthcare providers, Insight Timer, a free guided-imagery app, Good News Network, and the Substance Abuse and Mental Health Services Administration.

Next to present was Scott Markowitz, MD, an Associate Professor of Anesthesiology at the University of Colorado School of Medicine. He shared how the effects of stress on healthcare providers are pushing them to change careers to find happiness. Having these highly trained individuals leave the specialty is a major loss to the field of medicine. He believes that burnout happens on an individual level, but is the responsibility of the institution, and that by providing professional coaching we can improve the resilience of healthcare providers. Leaders within these institutions that are more learning-focused and more willing to make institutional changes tend to have fewer problems caused by burnout within the organization.

The use of coaching can provide a listening, nonjudgmental and reflective ear to an individual seeking achievement. It is relatively quick to train peer coaches and an inexpensive method of supporting staff. Coaching differs from mentoring and advising, roles that oftentimes provide advice and guidance. Peer coaching has been shown to be effective among physicians who participated in MD to MD coaching, increasing Press Ganey percentile ranking for physician to patient experience scores from the 25^th to 81st percentile. Peer coaching is also critical to the development of leaders, who then go on to affect positive change within an organization. This leads to better outcomes and less burnout.

Healthcare providers have been through a tough year, which has allowed insight into the areas of weakness within the healthcare system. As more data is collected and analyzed regarding the effects of stress in the workplace, there will be a better understanding of individual intervention so that these practices can be more broadly used. Leaders need to continue developing creative solutions to protect the wellness of their staff, or suffer the loss of more health professionals due to burnout.