A Clinical Pandemic: Burnout Syndrome

The ongoing events of the COVID-19 pandemic have certainly contributed to the rate of burnout experienced by health care workers.  The volume of patients has risen exponentially and placed tremendous strain on the health care system. 

Prior to the pandemic, burnout has been a common problem that plagues most health care professionals. Burnout syndrome entails an emotional exhaustion, depersonalization and reduced personal accomplishment.^1,2 Physical therapists among other practicing health care professionals are constantly burdened with an increased case load, no documentation time, stress, student debt, low compensation, and work-life balance.  This can lead to clinicians experiencing exhaustion at work, developing feels of hostility towards others, and demoralization of personal accomplishment.^2,3  Prolonged exposure to such circumstances can create anxiety and stress, particularly if the parameters remain constant.³  Interpersonal relationships may also deteriorate among staff as well as between family members.^4-6 The topic of burnout has been recognized, however, there has not been much action to solve this problem in healthcare.  The prolonged state of burnout can lead to job dissatisfaction, decreased commitment, absenteeism, and turnover of staff .⁷

It is essential that we reduce the burnout rates of providers so that we can deliver the highest quality of care without constraints of anguish and defeat.      

Burnout Syndrome Factors

Healthcare professionals can be at a high risk for developing burnout syndrome. A study found that over 45% of physical therapists had a high risk for developing the syndrome while 16% experienced burnout.³ Another study found that almost half of healthcare workers were experiencing job.⁸ Perhaps there is a lack of recognition and monitoring our staff that would even indicate if individuals were facing any difficulties with their daily activities.  There may be some contributing factors that would play a role in developing burnout syndrome.

Increased Caseload Volume

Studies have demonstrated that individuals who experience burnout are those who work in larger hospital systems, in which organization factors that can play a role in increasing stress levels.^{9, 10} Healthcare professionals have progressively been overloaded with patient volume, feeling overwhelmed with work, and increased stress levels.⁷ Those factors can lead to difficulty with managing a healthy work-life balance.⁷ Sometimes the increased volume of patients may impact the professionals’ ability with clinical reasoning skills.  There may be a lack of autonomy to meet productivity standards.⁷ In order to reach productivity standards, some therapists may need to see patients during their lunch breaks or even past their own schedule.  Increased number of patients can also lead to inefficient documentation and lack of time to complete such tasks.  Especially as a result of the current pandemic, these situations can be drastically amplified and can place more unwanted determent to healthcare workers.

Lack of Workplace Support

Healthcare workers are empathetic, selfless, and dedicate themselves to providing care to patients whatever means necessary.  However, sometimes when we give everything that we have, we don’t necessarily see the return from an organizational standpoint. Organizational influences may affect the burnout rate including excessive workload, inadequate rewards, poor interpersonal working relationships, and unfair treatment.^11,12 Healthcare workers may experience feelings of lack of respect, feeling over worked, and underappreciated in their own respective role.  Recognition of such issues may help employers to find ways to reduce burnout and enhance engagement with their own respective work.^11-13 Promoting professional development, engagement, and creating a positive organizational culture would be beneficial to help employees experience decreased burnout .¹⁴

Considerations to manage burnout syndrome

Utilizing coping strategies may be helpful by learning how to maximize productivity, time management strategies, goal setting and professional development activities.⁷ Coping strategies may prove to be a preventable measure that can be implemented to make sure the individual is equipped and prepared throughout the longevity of their careers.⁷ Strategies may include maintaining work-life balance boundaries, self-awareness, reflection, and concentrating on the positive aspects of the occupation.⁷ Designing a framework to address occupational health can be effective and available to employees.¹⁵ Having the ability to attain such resources may be extremely beneficial to address psychological health among healthcare workers.

Early Recognition

There are many strategies that can be used to help identify whether healthcare professionals are experiencing any form of burnout.  The implementation of outcome measures may be beneficial to supply an objective tool for administration to detect any signs or symptoms of burnout.  Outcome measures including the Maslach Burnout Inventory (MBI), Job Content Questionnaire (JCQ), and Short Form 36 (SF-36) can help to determine the level of burnout experienced by healthcare workers.⁹ Gathering data can prove to be extremely insightful to how healthcare workers are experiencing their everyday lives. These instruments can be beneficial to help determine if there is a greater need for some healthcare workers, so they don’t succumb to burnout syndrome.

Self-Care and Support Systems

Healthcare systems should implement more on-going support to address emotional health and job satisfaction.⁸ Support systems can be formal or informal to provide a therapeutic environment to improve emotion and mental health.⁷ Support resources are beneficial they can help individuals create a framework to help manage stress.¹⁵ There is certainly a heightened awareness of addressing mental health among healthcare workers.  Many institutions and facilities have taken strides to accomplish this task, however, we may need to implement more strategies to provide care to those who are providers of care. 

A Call to Action 

The recent events of the COVID-19 pandemic have certainly contributed to the rate of burnout experienced by health care workers.  The sheer volume of patients has risen exponentially and placed tremendous strain to the health care system.  In response, it become imperative that we create a workplace environment that is engaging and promotes professional efficacy. This paper is a call to action that we prevent burnout among all clinicians. It is imperative that we take into consideration the personal well-being of our colleagues especially under the current circumstances that we are facing together.  This author strongly urges the reader for everyone to be proactive and put an end to the burnout epidemic. 

Article written by Eric Trauber, PT, DPT, OCS, CSCS, FAAOMPT

References

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