Clinician burnout: A mental health ‘pandemic within a pandemic’
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For the last several months, health care workers have rightfully been hailed as heroes.
They have worked tirelessly through the COVID-19 pandemic, putting themselves in harm’s way to deliver outstanding care to patients.
Health care workers appreciate videos and personal messages of thanks they receive.
However, the best way to thank our nation’s clinicians is to provide resources and programming that support improved quality of life with the goal of reducing clinician burnout, a critical problem that I call the mental health “pandemic within the pandemic.”
‘The time is now’
By nature — and almost by reflex — physicians, nurses and other health care workers prioritize the care of their patients over their own self-care. They are passionate about their calling, but they also are more susceptible to chronic conditions, mental health problems and exhaustion.
Long before the pandemic, clinician burnout was a public health epidemic — one that had been building for years as many health care systems either offered piecemeal solutions or chose not to focus on the problem altogether.
COVID-19 has placed an even greater strain on these workers, and the time is now to act strongly.
My colleagues and I at The Ohio State University and Ohio State Wexner Medical Center are working to institute deliberate steps to take care of these heroes.
The Ohio State College of Nursing, Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, and Health Policy Institute of Ohio released a comprehensive plan to improve clinician well-being.
I see the issue of clinician burnout cropping up nearly every day in my work, but this topic is also personal to me.
More than 10 years ago, my daughter was diagnosed with appendicitis in Australia. Although the doctors there obviously wanted the best for her, I watched as a nonevidence-based approach to health care almost resulted in me losing my daughter.
Her group of providers obviously were burned out and not fully engaged, nor did they listen to what I believed was the underlying problem. It was clear even from the outside.
When you go through an experience like that, it makes you even more passionate about pursuing solutions that not only benefit clinicians, but also their patients.
We can begin to reverse the negative trend and damage of clinician burnout when health care systems prioritize creating a wellness culture that supports and implements programs that reduce burnout, providing confidential mental health screenings and establishing a statewide reporting mechanism to track clinician outcomes.
A necessity that requires investment
What is holding us back from solving this once and for all?
Unfortunately, health care is a cost-driven system. Decisions often are made due to budget constraints and factors other than patient care.
We must raise awareness and bridge understanding about the connection between clinician well-being and the goals of health care. I think many CEOs see this as a nicety, not a necessity that requires investment.
The evidence is clear: If we invest more in the well-being of our own clinicians, the return on that investment will be significant. When clinicians are happier, healthier and more engaged, their patients will be happier and population health outcomes will be better.
Battling clinician burnout also can help control the number of medical errors facing most hospitals. Medical errors are the third-leading cause of death in this country. Those errors often are committed by well-meaning, caring clinicians who simply are burned out, stressed and depressed.
By improving the working conditions of those clinicians, hospital and health care systems can improve clinician and patient outcomes, as well as cut costs resulting from a higher quality and safety of care with a reduction in preventable medical errors.
This is not a purely moral argument for prioritizing clinician and patient care.
Eliminating clinician burnout would have a huge impact on turnover and staffing. This would reduce costs related to hiring and recruiting, while keeping clinicians fully engaged and productive. Hospitals continually have issues with turnover, and a lot of that turnover comes from the fact that clinicians are burned out.
Another way to help control clinician burnout is to take away some of their administrative burdens. Something as simple as administering a flu shot can require a dozen clicks of a mouse.
This adds to visit time, and it frustrates patients and clinicians.
Why did most clinicians go into the field? They love to help people, and they love to spend time caring for people.
The joy has been removed from many clinicians’ roles because they are spending more time doing tasks and less time caring for people. That is yet another systematic problem that needs to be fixed.
Evidenced-based quality improvement
It is not surprising to me that we have yet to see major changes. I have been spearheading an evidence-based practice movement for more than 20 years, and we still see many barriers.
We used to joke that it takes 17 years to translate findings from research into clinical practice to improve care and outcomes. But really, 17 years is lucky.
Most evidence-based interventions never get translated into the real world to improve care. It is always: “This is the way we do it here.”
We often talk about quality improvement, but we do not talk about evidence-based quality improvement like we should.
It is not unusual for a group of leaders to gather in a room and say, “We have a real issue,” and then everybody throws their ideas at the wall. Whatever sticks often is implemented, instead of looking at the best evidence before implementation.
It is no wonder that Americans spend the most money in the Western world on health care, yet we rank so low in health outcomes.
We have a mental health pandemic inside of the COVID-19 pandemic. If we do not act now, we are going to see even higher spikes in all of these issues a year, 3 years or 5 years down the line.
In a historic time when our health care workers are giving everything they have to take care of us, it is time to prioritize care for them.
For more information:
Bernadette Mazurek Melnyk, PhD, APRN-CNP, FAANP, FNAP, FAAN, can be reached at melnyk.15@osu.edu.
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