Burnout in Healthcare Workers. What is it? Signs, Prevention and Resources.

A Larger Wave of Burnout

Are you or someone you know suffering from burnout in practice due to job stress? Burnout isn’t new- it’s been around and studied for years. Before the pandemic in 2019, the National Academies of Medicine (NAM) ¹ declared that burnout had “reached crisis levels”. Increased demand on healthcare workers due to the COVID-19 pandemic has thrust an even larger wave of burnout onto the healthcare community including the occupational and physical therapy professions. It is important for both employees and employers to recognize the signs of burnout to help prevent unnecessary strain on employees and prevent workforce losses. 

Stress and Burnout? What’s the Difference? 

Sometimes when under increasing amounts of stress, it may be difficult for an individual to identify burnout. Stress involves the feeling of too much pressure/demand where burnout is the feeling of being ‘empty’ and mentally exhausted ⁶. 

The Impact of Burnout on Healthcare

A recent surgeon general advisory projected a future loss of 140,000 physicians by 2033. ¹ 

Signs of Burnout in Healthcare Workers 

A 5-stage model, referenced in this  2020 article ⁵, is typically used to represent the stages of burnout. Early-stage warning signs for burnout include anxiety, inability to focus and irritability. Later-stage symptoms include pessimism and behavior changes. 

Prominent models for the cause and development of burnout include the Job Demand-Control Model, the Effort-Reward Imbalance Model, and the Organizational Injustice Model. ⁵ 

Job Demand-Control Model

Looks at the balance between demand (job strain) and control (control over daily tasks and activities). ⁵ 

Effort-Reward Imbalance Model

Founded in 1996, this model identifies an employment-threatening combination of high workload and low control over reward. This model focuses on maintaining the balance between effort and reward. ⁵ 

Organization Injustice Model

Focuses on how employees view the behavior of their employers. ⁵ 

Ways to Prevent Burnout ^{6 7}

1. Get support

Find support from friends, family, and coworkers. If your company offers an employee assistance program these can often provide support.  

2. Try mindfulness

Mindulness meditation can be practiced during breaks. You can find mindfulness resources for healthcare providers on Mindful.org.

3. Try relaxation techniques

Progressive muscle relaxation, meditation, yoga, deep breathing techniques and more! 

4. Take breaks

Take regular breaks at work.

5. Evaluate options at work

Be vocal at work and look at solutions with a supervisor. 

6. Reduce exposure to stress and negative people

Negative people may make your mood worse. Read more about prevention here.

7. Socialize

Get together with friends and family for support.

8. Get some sleep

Make sure to get a good night’s sleep.

**For a list of meditation apps and relaxation techniques for OT practice, check out Relaxation and Mindfulness Techniques in OT Practice.**

Personalities and Populations at Risk

Certain professions, such as the helping professions, are at higher risk for burnout. Also, people with personality traits ⁶ such as perfectionism and having ‘type A’ personalites may be at a higher risk for burnout.  

If you are experiencing symptoms of burnout or recognize it in a friend or coworker, it is important to address it right away.

Potential Causes of Burnout

What factors contribute to burnout? The graphic below outlines common situations that may play a role.

Burnout in Occupational Therapy

One in two ¹⁷ occupational therapists experiences burnout. 

The meta-analysis of burnout in OT referenced in the image below is limited to a selection of organizational and psychological factors (You can read the full review here). ¹⁸ Some factors seem obvious, but others you may find surprising; such as part-time work’s association with burnout. This could be due to organizational or other factors.  

Insight From the Meta-Analysis 

The Meta-analysis above provides insight into some areas that healthcare organizations may need to examine more closely within their organizations to better support their employees. 

Interestingly enough, personal factors such as age and marital status (unmarried) positively correlate with burnout in the analysis; but age and education had a negative correlation ¹⁸. 

This idicates that younger, less experienced therapists are experiencing more burnout, which is detrimental to the growth of the profession. Perhaps managers aren’t providing these new therapists with the support and professional mentoring that they need to succeed in the field. 

Resources For Healthcare Professionals 

Plenty of online resources are available for healthcare professionals experiencing burnout. Here’s a list of resources divided by profession.  

Occupational Therapists  

AOTA has come out with a great resource for coping with stress. AOTA’s ⁸ resource page includes links to meditation and mindfulness techniques, along with advice for preventing burnout.  

Physicians and Nurses 

The AMA website provides useful resources for physicians, including mental health resources. It also provides educational modules and information on practice transformation that health system leaders can reference to help prevent burnout in their organizations. The AMA Steps Forward® ⁹ program consists of modules designed for health systems leadership and includes a module on burnout and well-being. 

• The end of this article ¹⁰ from the AMA in 2016 lists resources for physicians.  
• This article from NurseJournal, ¹¹ written by RNs, provides some good burnout prevention tips for nurses.  
• The American Association of Critical Care Nurses ¹² has free resources for mental health and a Well-Being Initiative ¹³

Physical Therapists

If you have an APTA membership the association has published several articles since the beginning of the COVID-19 crisis, including this open-source article on resilience ¹⁴ in 2021. 

How Can Administrators Assist in Reducing Burnout? 

Systemic, management and organizational practices can contribute to healthcare practitioner burnout. It’s not an issue that just occurs at the individual level. Here are some ways that administrators can help fight burnout:¹⁵ 

• Create more effective leadership through continued support and training 
• Use metrics to track your organization’s progress 
• Implement specific solutions based on that data 
• Improve your organization’s sense of community 
• Support work-life balance by providing more flexibility to employees.  

In the annual Physician Lifestyle Report by Medscape, the company asks physicians to rank various job factors by significance. Between 2013-2018 these factors were rated in the top four ¹⁶ for causes of burnout: 

• Too many bureaucratic tasks 
• Too much time at work 
• Increasing computerization of practice 

While this report was physician-specific and there is much more data collected about physician and nurse burnout than occupational and physical therapist burnout, it can provide insights into issues that may also be experienced by other healthcare providers such as OTs, PTs or SLPs. Some settings for these professions may have higher instances of burnout and the factors contributing to it.

Mental Health Programs for Employees 

Integrating a mindfulness program into the workplace has been shown to reduce stress and anxiety ¹⁹ amongst healthcare workers, according to a 2021 study. Referenced below is a mindfulness app and two sample programs for healthcare employees.  

• Johns Hopkins offers Mindfulness-Based Stress Reduction (MBSR) classes to staff in its school of medicine ²⁰.  
• Ohio State’s Mindfulness-In-Motion (MIM) 8-week program has shown promising results in reducing burnout in healthcare workers in a study ²¹ at Wexner Medical center. 
• Headspace for workers is an online and app-based mindfulness program for organizations.

Strategies to support depleted Healthcare Workers 

If staff is feeling emotionally depleted or drained, there are several strategies you can use to reduce clinician burden. The approaches below come from a Harvard Business Review article.²² 

• Extended team approach – Helps to reduce clinician time spent on administrative tasks. Tasks to delegate across teams might include filling out forms, scheduling, or triaging communications to reduce the burden on the physician and other team members. Hawaii Pacific Health created a unique program where employees can nominate redundant or difficult-to-use EMR tasks for removal from their EMR system.  
• Employee supportive policies – Such as no lay-off policies during the COVID-19 pandemic. 
• Foster a kind environment 
• Allow time for cultivating patient relationships, and avoid rushed encounters. One example is the Peter MacCallum Radiation Center in Australia, which requires its clinical staff to invite patients to express concerns and questions. 

Reducing Strain Has Never Been More Important.  

The prevalence of burnout among healthcare professionals continues to increase, but there are strategies you can use to combat these trends. By educating staff about symptoms of burnout, prevention, and strategies to address it, administrators may be able to combat this threat to the future of our professions. Burnout is a two-way street between the individual and the employer. It’s time to be proactive and work together to end this crisis.  

BIONIK is Dedicated to Reducing Strain on the Therapist 

Reducing physical strain is just as important as reducing mental strain. At BIONIK our goal is to reduce as much physical strain on the therapist as possible. We do this by aiding physical and occupational therapists to achieve over 7.5X the amount of upper extremity movement repetitions that patients would normally get during a traditional therapy session with less strain on the therapist. Just because neuroplasticity demands higher-intensity treatment doesn’t mean it needs to affect team safety, reduce productivity, and increase stress for the therapist.  

If you are experiencing mental health symptoms from burnout a qualified psychologist or mental health counselor may be able to help. If you or someone you know is experiencing a crisis call 988 for the Suicide and Crisis Lifeline.

Seek medical attention in an emergency. 

 References

1. General, O. of the S. (2022, May 23). New Surgeon General Advisory Sounds Alarm on Health Worker Burnout and resignation. HHS.gov. Retrieved July 5, 2022, from https://www.hhs.gov/about/news/2022/05/23/new-surgeon-general-advisory-sounds-alarm-on-health-worker-burnout-and-resignation.html 
2. Medscape. (2022, January 21). Medscape Physician Burnout & Depression Report 2022 shows pandemic’s continued impact. Medscape Physician Burnout & Depression Report 2022 Shows Pandemic’s Continued Impact. Retrieved July 5, 2022, from https://www.prnewswire.com/news-releases/medscape-physician-burnout–depression-report-2022-shows-pandemics-continued-impact-301465333.html 
3. Kelly, J. (2022, April 14). Indeed study shows that worker burnout is at frighteningly high levels: Here is what you need to do now. Forbes. Retrieved July 5, 2022, from https://www.forbes.com/sites/jackkelly/2021/04/05/indeed-study-shows-that-worker-burnout-is-at-frighteningly-high-levels-here-is-what-you-need-to-do-now/?sh=7bb343c923bb 
4. Kaushik, D. (2021, June 4). Medical burnout: Breaking bad. AAMC. Retrieved July 5, 2022, from https://www.aamc.org/news-insights/medical-burnout-breaking-bad#:~:text=An%20overwhelming%2055%25%20of%20front,those%20ages%2018%20to%2029. 
5. De Hert, S. (2020, October 28). Burnout in healthcare workers: Prevalence, impact and preventative strategies. Local and regional anesthesia. Retrieved July 5, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604257/ 
6. Melinda. (2022, June 1). Burnout Prevention and Treatment. HelpGuide.org. Retrieved July 5, 2022, from https://www.helpguide.org/articles/stress/burnout-prevention-and-recovery.htm 
7. Mayo Foundation for Medical Education and Research. (2021, June 5). Know the signs of Job Burnout. Mayo Clinic. Retrieved July 5, 2022, from https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642 
8. Manage stress, avoid burnout, and stay inspired. Aota.org. (n.d.). Retrieved July 5, 2022, from https://www.aota.org/career/career-center/wellness-for-life-and-career/manage-stress-avoid-burnout-and-stay-inspired 
9. Ama Steps Forward: Transform Your Practice. AMA Steps Forward: Transform your Practice | AMA STEPS Forward | AMA Ed Hub. (n.d.). Retrieved July 5, 2022, from https://edhub.ama-assn.org/steps-forward 
10. Lyndra Vassar News Writer. (2016, January 27). How physician burnout compares to general working population. American Medical Association. Retrieved July 5, 2022, from https://www.ama-assn.org/practice-management/physician-health/how-physician-burnout-compares-general-working-population 
11. Top tips from nurses on dealing with burnout. NurseJournal. (2022, March 3). Retrieved July 5, 2022, from https://nursejournal.org/resources/tips-for-avoiding-nurse-burnout/ 
12. Aacn.org. (n.d.). Retrieved July 6, 2022, from https://www.aacn.org/clinical-resources/well-being 
13. Aacn.org. (n.d.). Retrieved July 6, 2022, from https://www.aacn.org/nursing-excellence/well-being-initiative 
14. Ivy building resilience to professional burnout LD – apta. (n.d.). Retrieved July 6, 2022, from https://www.apta.org/contentassets/b1a37e93f1f34b8cb9861ae2f8cf5810/ivybuilding-resilience-professional-burnout.pdf 
    
15. Rajeev Kurapati, M. D. (n.d.). How hospital administrators can combat provider burnout and improve the organizational bottom line. American Association for Physician Leadership. Retrieved July 6, 2022, from https://www.physicianleaders.org/news/how-hospital-administrators-can-combat-provider-burnout-and-improve-the-organizational-bottom-line#:~:text=Provide%20flexibility%20and%20work%E2%80%93life,of%20repercussions%20from%20administrative%20leaders. 
16. Reith, T. P. (2018). Burnout in United States Healthcare Professionals: A narrative review. Cureus. https://doi.org/10.7759/cureus.3681 
17. Katsiana, A., Galanakis, M., Saprikis, V., Tsiamitros, D., & Stalikas, A. (2021). Psychological resilience and burnout levels in occupational therapists in Greece. an epidemiological nationwide research. Psychology, 12(01), 86–106. https://doi.org/10.4236/psych.2021.121006 
18. Park, E.-Y. (2021). Meta-analysis of factors associated with Occupational therapist Burnout. Occupational Therapy International, 2021, 1–10. https://doi.org/10.1155/2021/1226841 
19. U.S. Department of Health and Human Services. (2021, January 12). Brief mindfulness program reduces Healthcare Workers’ stress. National Institutes of Health. Retrieved July 6, 2022, from https://irp.nih.gov/blog/post/2021/01/brief-mindfulness-program-reduces-healthcare-workers-stress 
20. Mennitto, D. (2019, January 17). Mindfulness program at The Johns Hopkins Behavioral Medicine Program. Program at the Johns Hopkins Behavioral Medicine Program. Retrieved July 6, 2022, from https://www.hopkinsmedicine.org/psychiatry/specialty_areas/mindfulness/ 
21. Mindfulness program reduces stress, builds resilience in health care workers: Ohio State Medical Center. Mindfulness Program Reduces Stress, Builds Resilience In Health Care Workers | Ohio State Medical Center. (n.d.). Retrieved July 6, 2022, from https://wexnermedical.osu.edu/mediaroom/pressreleaselisting/mindfulness-program-reduces-stress-builds-resilience-in-health-care-workers 
    
22. 5 ways to restore depleted health care workers. Harvard Business Review. (2022, March 11). Retrieved July 6, 2022, from https://hbr.org/2022/02/5-ways-to-restore-depleted-health-care-workers 
23. Kim J. J., Roh J. H., Won J. U., Lee S. Y., Chang S. J. The relationship between occupational stress and burnout among occupational therapists. Korean Journal of Occupational and Environmental Medicine. . 2010;22(3):173–182. doi: 10.35371/kjoem.2010.22.3.173. [CrossRef] [Google Scholar] [Ref list] 

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