Burnout is a syndrome due to chronic work-related stress, and most professions experience it. Nonetheless, the healthcare providers’ burnout is distinct since it affects both the caregiver and the patient. Nearly half of physicians, nurses, medical students, and residents experience it in the United States. The most common causes of this condition include lack of motivation, long working hours, and adequate compensation. Similarly, a bureaucratic health care system would contribute to this disorder.
Burnout has five stages: honeymoon, the onset of stress, chronic stress, burnout, and habitual burnout. Each step has its signs and symptoms, with the most common ones including job dissatisfaction, feelings of inadequacy, despair, and low motivation. The severe symptoms comprise headache, depression, anxiety, loss of a family relationship, decreased sexual drive and other activities, and even divorce. Burnout causes decreased quality of healthcare, medication errors, low patient satisfaction, and malpractice. Therefore, the main points of discussion in this paper are healthcare systems that challenge the efforts of curbing burnout. The main encounters include ineffective communication, inefficient conflict resolutions, bureaucratic tasks, and low staff motivation. Some of the obstacles are external and depend on different organizations. With effective leadership and sound healthcare systems, some of the causes and challenges of burnout can be resolved.
Burnout is a syndrome that results from chronic exposure to work stress. It consists of three qualitative dimensions, depersonalization, emotional exhaustion, and reduced professional efficacy, (Rothenberger, 2017). The disorder can occur in any profession, though healthcare workers are at a higher risk due to long working hours and high demands and expectations, which can drain them.
Correspondingly, professions involving extensive interaction with people such as caregivers and teachers have higher chances of developing the disorder; though the syndrome has been described in other occupations as well.
Stages, Signs, and Symptoms of Burnout
The first psychologist, who discovered the syndrome Freudenberger described the model as having 12 stages. However, after recent studies and research, the model was simplified, including five main stages (De Hert, 2020). The first stage of the model is the honeymoon stage, and its principal characteristic is enthusiasm. Inevitably after some time, the eagerness is followed by experiences of the job. At this stage, the process of coping strategies and mechanisms are initiated and the person goes into a stagnation phase characterized by stress. The second period of burnout starts with the awareness of some days or moments being more difficult than others (Reith, 2018). Life becomes only about work while social life, family, and home are neglected. The person starts displaying the common stress symptoms, which affect an individual emotionally and physically (Rothenberger, 2017). Then later the period of the chronic point appears, which causes frustrations where one gets a sense of powerlessness and failure.
At this juncture, the person gets the impression that their efforts are not paying-off, thus, failure to acknowledge the work done leads to feelings of inadequacy. Hence, this leads to the apathy stage, whereby the affected develops despair or disillusionment (Reith, 2018). Moreover, one does not see a way out of the situation, and they become indifferent and resigned. The last stage is the final burnout, where its symptoms pose significant physical and emotional issues that necessitate intervention. Consequently, each stage has its indicators, and they advance as one progresses to chronic burnout. They include job dissatisfaction, irritability, sleep disturbance, low social interactions, neglect of personal needs, and decision-making avoidance. The most severe signs include decreased sexual drive, signs of depression, anxiety, headache, and even mental breakdown (Melvin & Walsh, 2018). The outcomes are so severe and may cause great harm.
Significance of the Issue in Healthcare
Burnout is significant among healthcare providers, and the consequences include job dissatisfaction, absenteeism, and high personnel turnover among others. These effects affect personal life since they cause broken relationships, depression, and even divorce. Regarding caregivers, the condition leads to sub-optimal patient care, increased medication errors resulting in client dissatisfaction, and reduced healthcare quality (Reith, 2018). It can also result in malpractice that brings about legal and ethical implications to the healthcare provider and the hospital.
The Uniqueness of the Syndrome in Healthcare Providers
Burnout in healthcare is unique because it goes beyond the well-being of an individual medical worker. Studies have shown that health care professional burnout is detrimental to patient care and the general quality of care. For instance, the number of medical errors committed by a physician is directly proportional to the level of burnout and the high chance of being involved in malpractice (Reith, 2018). About the nurses’ high situation of the condition, it is associated with increased mortality of patients and a high level of hospital-acquired infection among both the employees and the patients. Whereas among the medical students, the syndrome causes alcoholism, dishonest clinical behaviors, and decreased altruism (Dubale, Friedman, & Chemali, 2019). At the institutional level, the syndrome causes increased staff turnover and feelings of resignation among the healthcare providers and also decreases the efficiency of the workforce. While the estimate of a loss of productivity among physicians is equivalent to eliminating seven medical school graduating classes (De Hert, 2020). Lastly, burnout has contributed to the shortage of nurses and physicians.
Half of the physicians in the United States experience burnout and a 9% increase in physician burnout was recorded between 2011 and 2014 (Reith, 2018). The prevalence of the issue among hospital care nurses is 33%, while for direct nurses at nursing homes is 37%. Burnout among medical students and residents is approximately 66%. Although the other healthcare providers’ prevalence has not been well studied, it is similarly high as per the limited data (Reith, 2018). Thus, this shows the occurrence of the ailment is quite high.
Importance of Leadership in Addressing the Syndrome
Leadership is among the critical factors in addressing burnout among healthcare workers. Particular qualities of the administration impact the satisfaction and well-being of employees in an institute (De Hert, 2020). Therefore, the management should acknowledge exhaustion as a systemic issue and engage the staff to promote a culture of self-care. Good leadership encourages the welfare of human beings. Additionally, some of the causes of burnout among healthcare providers are organizational rules and working hours. It is only through governance that changes can be made to reduce the rates of fatigue.
Aspects of the Healthcare Systems that Contribute the Challenges of Addressing Provider Burnout
Inadequate communication and unrealistic expectations result in staff overload and feelings of isolation. When the job description and the requirements are unclear and not effectively conversed, employees tend to feel discouraged (Rothenberger, 2017). At times the healthcare systems’ requirement keeps changing, which makes it hard for the providers to meet the goals and objectives. Therefore, ineffective communication between the managerial staff and the healthcare system poses challenges in addressing burnout. When a member of staff has an issue but cannot discuss it with the manager due to poor reception and failure to mind their welfare, it then contributes to tension.
Poor conflict resolution policies of a healthcare system can stagnate the efforts for preventing burnout. Dispute resolution is one of the measures of promoting the well-being of employees and promoting peace needed in care delivery. If the healthcare system and leadership have deprived problem-solving skills among employees, it can curb weariness. The system should have favorable conflict resolution regulations that endorse unity, peace, and tranquility.
Insufficient compensation, lack of recognition, and limited staff motivation can reduce the efforts to prevent burnout. Healthcare providers have a noble job of serving humanity, and if they are not compensated as per the work done, they may end up in stress (Reith, 2018). When the healthcare systems do not recognize and appreciate the efforts of improving the quality of patient care done by the clinicians, the other measures may be diluted by lack of recognition.
In the third stage of exhaustion, one feels that working hard is not worth it anymore. At this phase, the healthcare industry should employ appropriate measures to give the caregivers the reason to continue. For instance, in this COVID-19 era, the sector should compensate its staff, motivate them, and recognize and support them by offering appropriate personal protective equipment and insurance cover to encourage them to continue fighting the pandemic.
Too many Bureaucratic Tasks
Most healthcare providers spend time complying with the external factors compared to patient care. Every four hours a physician spends with the patient, two hours are spent on clerical and administrative work. When the healthcare system imposes too many regulations, it should also provide more staff to prevent burnout. Some of the measures such as Medicaid and Medicare issues are sensitive and cannot be handled by a third (Dubale et al., 2019). Thus, this becomes a challenge in eliminating fatigue among healthcare providers.
Increased computerized work has served the healthcare systems by increasing efficiency, though it sometimes contributes to burnout. Since the healthcare organization adopted a new design and its benefits outweigh the risk, the personnel have to develop increased order entries, billing, documentation, and many other procedures (Dubale et al., 2019). When there is a system breakdown, the caregivers have to spend extra hours charting and balancing order entry which causes stress. Hence, increased use of electronic recording systems is an organizational challenge that causes burnout.
Long Working hours
Healthcare systems have the maximum working hours per week stipulated by their licensing and regulatory bodies. At times due to a shortage of staff which is an organizational issue, they are forced to work extra hours, which impairs functioning and causes weariness. (De Hert, 2020). Long working hours and workforce deficiency are some of the challenges facing most healthcare systems and establishments in various countries. The healthcare systems should look at aspects that challenge the fight against burnout and address them.
Implications of the Challenges
In as much as the healthcare system is employing measures to reduce burnout, the system should also look into the organizational challenges of fighting the menace. Some of the implications of difficulties are far-reaching to the structures and the countries. Stress among medical students may discourage them, they may also quit their careers resulting in a shortage of doctors and nurses. Thus, this scarcity is severe when the aging healthcare providers retire since it causes a shortage of medical personnel in a country. Moreover, the healthcare providers with burnout get depression, and some contemplate suicide due to high expectations from their employers and the organizations. Other healthcare providers cut their social relationships, which increases the divorce rates and their consequences on children.
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