Elizabeth Barrette (ysabetwordsmith) wrote,
Elizabeth Barrette

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Burnout in Doctors

This study reveals that doctor burnout raises the rate of medical errors.

Things that would actually reduce burnout and other stress:

* FIRST, DO NO HARM. If the medical industry would just do this consistently, it would be so much better.

* Fire abusive employees. You do not need them making everyone else sick and driving people to quit.

* Require every medical facility to have a quiet room, healing garden, and/or other resources to relieve stress. Educational materials and an Emotional First Aide would be even better.

* Teach emotional first aid to everyone. Include how to recognize signs of emotional upset or injury, how to treat yourself, how to treat others, and when expert care would probably help more than minor first aid. This will reduce the chance of things getting bad in the first place, and increase the chance of people recognizing a serious problem before anyone else gets hurt. Make plans for handling emotional upheavals or emergencies so as to minimize the risk to self and others.

* Offer a variety of self-care options such as yoga, tai chi, meditation, an exercise room, massage, etc. Some hospitals get donated tickets to local performances for staff, which is an excellent idea that should be replicated. These activities promote physical, mental, and social health.

* Upgrade the cafeteria or other food service to include fresh healthy ingredients, preferably organic, preferably with a high percentage of brain-boosting and mood-boosting foods. Ensure plentiful time per shift to eat, drink, and use the bathroom. A healthy diet is a strong resilience factor that protects against many stressors.

* Upgrade the noise control measures to protect staff and clients from noise pollution, which damages mental and physical health. This includes everything from noise-absorbing wall or ceiling panels to programming equipment to send an alarm to a nurse's station instead of blaring a siren into the public air. We have pretty good technology for this, people are just sloppy about using it.

* Make sure employees have adequate time off for vacation, parental leave, and other purposes. Working without a break is a leading cause of burnout.

* Set a maximum 8-hour shift limit as an industry standard for most jobs. One exception would be that particularly grueling jobs, such as working a children's cancer ward, should have no more than a 4-hour shift (per other heavy labor). Another would be that tasks which cannot be subdivided (such as major operations that may take 12+ hours) should earn extra time off between those overtime shifts. Facilities that require on-call staff should treat them as fire stations do: set shifts of 12 or 24 hours and give them what amounts to a communal apartment so they can be comfortable between work tasks.

* Never schedule staff to work during multiple holidays or family occasions in a row. Ask if employees have a weekly worship day or annual holidays they need to work around; preferably, hire employees of different religions so they can easily cover for each other. Ensure family-friendly scheduling and leave time. This could be a consistent schedule or a flexible schedule, depending on employee preference. People need people. If you cut them off from friends, family, and life outside work then they WILL burn out, get sick, and/or quit.

* Invite staff to indicate whether or not they want extra hours as available. When more staff are needed, first call the ones who want to work more, then the ones who don't care, and only as a last resort the ones who don't want it. While we're on this topic, distinguish between soft off-duty (not at work, but available in an emergency) and hard off-duty (sick, home with an infant, at a wedding, out of town, or otherwise utterly unavailable).

* In keeping with the above, every health facility should have a surge plan to accommodate emergencies by pulling in more staff, activating backup facilities, and dropping elective activities rather than simply overloading whoever happens to be at ground zero when the problem occurs. This includes planning to rotate out the staff who were on duty at the start of the event, so they do not get exhausted and accidentally kill someone 12 or 24 hours later.

* In case of severe loss, the affected staff should be taken off duty and offered counseling, time off, or whatever they need to recover. Let's simply admit that nobody who just had a child die under their hands is really fit for work 5 minutes later, and people who just lost a family member probably aren't fit to hold someone's life in their hands 4 days later. This may not always be feasible in a mass-casualty incident, but it should be the standard operating procedure during normal times.

* Require facilities to hire enough staff that they can meet recommended ratios of caregivers to clients. Just reducing overwork will reduce burnout.

* Give health workers the option to do other tasks at work which are life-affirming rather than stressful, such as teaching CPR, if they wish to do so.

* Encourage health workers to develop a range of specialties, so that they can switch from high-stress to low-stress jobs periodically, much the way police officers switch from Homicide to Property Crimes or Community Outreach.

* Address both employee and client loneliness through social programs. Host a reading club, life skills or self-care classes, spiritual studies run by the chaplain, sport teams, volunteer groups -- anything that gives people a place to go, things to do, ways to meet each other and make friends. Connected people are healthier people all around. Making these things free at a health facility makes them easier to access, links people who may have things in common, and encourages folks to drop by more often which lowers barriers to help-seeking.

* Offer opportunities for vocation validation. Many clients would love a way to say "thank you" more than just a quick verbal exchange. Would you like us to notify the EMTs who pried you out of your car that you have survived and been released? That leaves the decision up to the client, but enough of them will agree that it's likely to boost job satisfaction. Does your business donate gift cards, performance tickets, or other things for the public good? Consider thanking your local caregivers with a donation to their facility.

* Adjust the educational dynamics so that health workers are not crushed by debt. If they don't feel they can leave when it gets too much for them, that raises not only burnout and medical errors but also substance abuse, mental illness, suicide, and other problems the medical industry would prefer to avoid.

I realize that most of these are antithetical to the way the industry is, and the way capitalism is, but I wish to point out that problems humans cause are problems humans can solve. If anyone actually cares to. Mostly, people just prefer to abuse and murder each other. But some of these things are options that can be applied on a small local scale -- even if it's something as subtle as noticing that your doctor moves stiffly when standing up and you say, "Hey, yoga really helped me with flexibility and our studio has openings if you're interested."
Tags: how to, news, safety
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