Studies are indicating that burnout has become a major problem for nurses and physicians (and their patients), especially since the added stress of dealing with the pandemic.
What is Burnout?
Burnout is described as a long-term stress reaction marked by emotional exhaustion, depersonalization, feelings of negativism or cynicism related to one's job, and reduced professional efficacy.
While burnout is not currently characterized as a mental disorder or medical condition in the DSM-5, it is included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon. (1)
What are the ramifications of burnout to healthcare workers?
Nurses and physicians came into their professions because of their passion and purpose in life to help others. Their jobs are not easy. There is tremendous pressure to operate at peak performance for long periods of time, not only executing complicated procedures, but keeping an overload of patients attended to.
The demands of physicians and nurses have always been extraordinary, yet during COVID, the pressure and working conditions became unendurable.
In a study published in June 2023, 62% of frontline healthcare workers during the Covid crisis reported symptoms of burnout and a poor state of general mental health. (2)
Beyond having compromised mental health, those healthcare providers experiencing burnout may also deal with what is called ‘moral injury’. This is when one feels they have violated their conscience when they take part in, witness or fail to prevent an act that contradicts their own moral values — and in the case of physicians and nurses, their Hippocratic oath. Unfortunately, moral injury is psychologically devastating and contributes to burnout and the drastic rise in number of physician suicides. Watch: Dr. Kip Wenger - Helping Those With Physician Burnout
According to Your Health Care May Kill You: Medical Errors (3), medical error has been considered the 3rd leading cause of death. Yet because only 10% of medical errors are reported, it logistically would make it the number 1 cause of death, over heart disease and cancer. We are all prone to making errors, however ongoing medical errors due to burnout, needs immediate and serious recognition.
What are the ramifications of burnout to patients?
In the case of healthcare workers, burnout can threaten patient safety and care quality when depersonalization leads to poor interactions with patients and when burned-out physicians suffer from impaired attention, memory, and executive function. (4)
I realize that this segment may trigger some readers, however, I have chosen not to ‘soften’ it because truth needs to be revealed; and softening it will lessen the dire need for a solution and a paradigm shift in our healthcare system.
As a Fitness for Duty officer in a large hospital, I quickly learned to recognize the signs of healthcare providers that were desperately trying to cope with burnout through substance usage and abuse. I was on call when a patient woke up before her surgery was over because the anesthesiologist had not administered all of the necessary anesthesia. In later meetings with the anesthesiologist, he revealed that he needed some of the substance for himself in order to cope with his ongoing symptoms of stress, anxiety, and burnout. In another incident, after witnessing patients screaming in pain as their attending nurse had kept a portion of their oxycontin medication for herself, she later revealed her incredible moral dilemma.
She knew she was in burnt out, however as a single parent, she needed the medication to keep functioning at her job in order to support her children. Other inhumane situations involve a patient’s wrong leg being amputated, or a cancer patient’s healthy breast being removed rather than the cancerous one. It’s interesting that as a culture we have become so lax in accepting these atrocities as part of life, without making a genuine effort to resolve the health care provider burnout epidemic. I believe it is our job as humanity to do all we can to help the healthcare providers do the jobs that they came here to do.
Unfortunately, I witnessed the devastating effects of burnout during my mother’s hospital stay, as well. It was clear to me that several of her caregivers were in a stage of cognitive impairment and late burnout demonstrated by glazed over eyes, blank stares, careless time lapses and aggressive patient interactions. I watched physicians and nurses make irrational decisions about my mother’s care. My mother was not only dehumanized during the last days of her life, their miscommunications and diagnostic errors led to her actual death.
I understand that the healthcare workers themselves are not ‘bad’ people, yet if they do not recognize (or do not act upon) the effects of their burnout, they are seriously harming their patients.
Is there a solution for the burnout epidemic?
One possible solution to this problem would be to assess for burnout early. Yet the challenge in that is because there is such a stigma associated with burnout, medical professionals don’t want to disclose their symptoms for fear of losing their job, their reputation – or in a case where a medical error has already occurred, they could lose their license and be faced with legal action.
Rather than wait until the burnout has reached critical level, an early diagnosis using a new AI brain scan would resolve the problem.
The qEEG scan, as discussed in our previous article Using AI Brain Scan for Early Detection and Diagnosis of 9 Common Mental Health Issues, takes 6 minutes to administer and 15 minutes to receive the results, and costs a fraction of the price of other types of brain scans. This innovative test can detect the slippery slope of burnout even before the health care provider experiences serious symptoms.
In addition, hospitals and health care providers can establish personal wellness strategies to help prevent burnout. Dr. Faysal Tabbara, an Emergency Medicine Specialist and Critical Care Fellow who has worked in hospitals in Lebanon and North America, provides his perspective on the magnitude of health care provider burnout, and offers strategies to maintain optimal levels of functioning while in this profession.
Conclusion
Even though we have recognized healthcare provider burnout for decades, the death toll continues to rise such that medical error is now considered the #1 cause of loss of life. It is time to take serious action to address this problem. Combining older and newer strategies/technologies to decrease the degree of suffering of both the healthcare providers and their patients seems to be a place to start.
RESOURCES:
(1) World Health Organization : Burn-out an "occupational phenomenon": International Classification of Diseases
(2) International Journal of Environmental Research and Public Health: Health Workers’ Burnout and COVID-19 Pandemic: 1-Year after—Results from a Repeated Cross-Sectional Survey
(3) Studies in Health Technology and Informatics : Your Health Care May Kill You: Medical Errors
(4) Agency for Healthcare Research and Quality: Physical Burnout
