We have seen burnout. We have studied burnout. We have attended burnout webinars and listened to burnout podcasts. We have heard about burnout’s causes, symptoms, and the looming catastrophic consequences it will cause.
We have become skilled at talking about burnout. We have been less successful, though, at solving it. This is not surprising though. To solve burnout, we will have to seriously consider the merits of every possible remedy. We will have to have uncomfortable conversations about the mistakes we’ve made in the past that we can ill afford to repeat. But these are the things we should talk about. Everything else is just noise.
Is the solution simple?
Burnout is complex problem, with a simple root cause. It comes down to a single word: Understaffing
Historically, U.S. hospitals have been deeply understaffed. In fact, legislative pushes to mandate minimum staffing levels at healthcare facilities had been a target for state and federal regulators for decades. It is not hard to see why. This study by Aiken et al. found that with every additional patient your nurse has to care for, you are 7% more likely to die. The same study found that lower staffing levels, unsurprisingly, were also linked to higher rates of burnout. This case study by Bagnall et al. discusses two Australian hospitals that successfully implemented programs to reduce burnout. The crux of their approach was monitoring workloads and increasing staffing levels.
The key question then is not: How do we solve burnout?
It is: Why haven’t we already?
The answer to that question is also fairly simple. The pandemic turned an artificial staffing shortage into a real one. Covid-19 induced burnout led to thousands of qualified, experienced healthcare workers leaving the profession for good. This real staffing shortage is also, undoubtedly, part of the reason why 90% of nurses said they would consider leaving the field within the next year. A decade ago or even in 2019, the healthcare burnout crisis had a simple solution: Hire More Staff. But now we face a more complicated reality. While looking back won’t save us, maybe there are some viable solutions that will.
Band-Aids and Bandages
Burnout solutions come in two main varieties: band-aids and bandages.
Some solutions are band-aids, smaller near-term relief for burnout. Examples of band-aids include providing more uninterrupted breaks for healthcare workers, mindfulness training, employee support programs, and workforce management technology. Other solutions are bandages, structural long-term remedies that will ultimately reduce or eliminate burnout. Examples of bandages include raising staffing levels, investing in and improving educational programs for healthcare workers, reforming scope-of-practice laws and further combatting abuse and harassment in healthcare workplaces. To truly solve burnout, we will need both band-aids to stop the bleeding now and bandages to heal the wound for good. Band-aids that are supported by the current data include: outdoor breaks and mindfulness training. These individual-focused interventions are designed to help our healthcare workers deal with the stresses of their job as it exists today. Give our healthcare professionals uninterrupted breaks. Give them training and support. Treat them like they treat their patients and make sure they are always taken care of. In short: take the easy wins, where you can get them. Bandages are more obvious, costly, and will take longer to yield benefits. The include: increasing staffing levels, more affordable education, and changing scope of practice laws to free up existing healthcare professionals to serve patients. Just because these bandages may cost more money, and take longer to implement and deliver results, doesn’t mean they are not urgent priorities. In the long-term, making sure that our healthcare professionals are properly supported and never worked to brink of exhaustion, that their education is optimized and affordable, and that they are capable of practicing to the very top of their experience and certifications. These investments will reduce costs and safe lives. If we focus to heavily on band-aids, if we just treat the symptoms, then burnout will continue to increase and damage our healthcare system long-term. Bandages, on the other hand, will offer little near-term relief to the thousands of healthcare professionals preparing to start their shifts right now. To hold together this system and truly address healthcare burnout, we will need both types of solutions.
Some solutions are band-aids, smaller near-term relief for burnout.
Examples of band-aids include providing more uninterrupted breaks for healthcare workers, mindfulness training, employee support programs, and workforce management technology. Other solutions are bandages, structural long-term remedies that will ultimately reduce or eliminate burnout. Examples of bandages include raising staffing levels, investing in and improving educational programs for healthcare workers, reforming scope-of-practice laws and further combatting abuse and harassment in healthcare workplaces. To truly solve burnout, we will need both band-aids to stop the bleeding now and bandages to heal the wound for good. Band-aids that are supported by the current data include: outdoor breaks and mindfulness training. These individual-focused interventions are designed to help our healthcare workers deal with the stresses of their job as it exists today.
Give our healthcare professionals uninterrupted breaks. Give them training and support. Treat them like they treat their patients and make sure they are always taken care of. In short: take the easy wins, where you can get them. Bandages are more obvious, costly, and will take longer to yield benefits. The include: increasing staffing levels, more affordable education, and changing scope of practice laws to free up existing healthcare professionals to serve patients. Just because these bandages may cost more money, and take longer to implement and deliver results, doesn’t mean they are not urgent priorities.
In the long-term, making sure that our healthcare professionals are properly supported and never worked to brink of exhaustion, that their education is optimized and affordable, and that they are capable of practicing to the very top of their experience and certifications. These investments will reduce costs and safe lives.
If we focus to heavily on band-aids, if we just treat the symptoms, then burnout will continue to increase and damage our healthcare system long-term. Bandages, on the other hand, will offer little near-term relief to the thousands of healthcare professionals preparing to start their shifts right now.
To hold together this system and truly address healthcare burnout, we will need both types of solutions.
Where do we go from here?
This next step is the important one. It will involve hard conversations and collaboration. It will involve sacrifice, reform and patience from healthcare industry leaders, regulators, and any stakeholders who share concern for how our healthcare system functions.
It will be this step that determines whether we are serious about healing the damage done by burnout, both today and in the long term.
