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From Burnout to Trauma: 7 Things Health Care Systems Need to Triage Employee Well-Being

As employee burnout continues to intensify throughout the country, nowhere else is it more severely experienced than in the healthcare industry.

From overworked nursing staff to overly strained cafeteria employees, healthcare workers are tasked with juggling multiple roles to accommodate systemic deficiencies that leave them feeling stressed, under-appreciated, and depleted. A certain amount of turnover is to be expected in this work environment, but across the country, hospitals have been seeing healthcare staff reshuffling or leaving in droves.

Between 2019 and 2021, turnover grew by 34% among healthcare workers, and as we transition out of the pandemic, they're either leaving unmanageable work environments or renouncing their professions altogether.

As such, describing this phenomenon as “burnout” doesn’t do justice to the structural shortcomings at play within hospitals and organizations. Feeling stressed or burned out is, unfortunately, the new normal among employees across industries, particularly healthcare, and it no longer makes sense to call it a passing fad stemming from pandemic-related stressors.

Burnout has officially evolved into a systemic crisis that wellness benefits like health insurance or a gym stipend can’t solely reverse.

When Did Burnout Become Complex Trauma?

In May 2022, the U.S. Surgeon General issued an advisory about healthcare worker burnout and turnover. It projected a “shortage of more than three million essential low-wage health workers in the next five years and a projected shortage of nearly 140,000 physicians by 2033.”

NSI Nursing Solutions, Inc. echoed these findings in its 2022 NSI National Healthcare Retention and RN Staffing Report. After surveying nearly 600,000 healthcare workers across 32 states over the past two years, the report found that 81.3% of hospitals are reporting vacancy rates in filling their registered nurse positions—some greater than 10%.

By the end of 2022, a vast majority of hospitals are expected to reach an RN vacancy rate of 17%.

Senior Managing Editor Beth Kutscher at LinkedIn News spoke to multiple frontline healthcare workers who said the term “burnout” is no longer adequate to describe their current predicament. Omolara Thomas Uwemedimo, MD, MPH, a physician who now specializes in health equity initiatives, told LinkedIn she prefers the term “complex trauma” to describe what healthcare professionals have faced over the past two years.

“That is a lot more difficult to treat,” said Dr. Uwemedimo. “Burnout is not burnout. It’s the threshold where you decide not to tolerate inhumane work conditions.”

Employee burnout as it’s colloquially called often refers to “a state of chronic job stress that results in overall exhaustion, frustration, and a defeatist attitude that negatively affects an employee’s personal and work life.” That may have been the case a few years ago, but as organizations like hospitals have adjusted to economic and structural shortcomings, working conditions have worsened for essential and frontline workers.

Conditions are so stark, in fact, that today’s healthcare workers often experience symptoms of PTSD and generalized anxiety that are akin to what deployed military medical personnel experience after being discharged.

Even in supportive working environments, healthcare workers have faced adversities that are unique to their roles, including:

  • PPE shortages
  • Escalating death rates and end-of-life care management for patients and families
  • Exposing themselves and their families to viral diseases on a daily basis
  • Incidents of on-the-job violence and abuse

Even still, as shortages increase, healthcare workers are expected to pull extra shifts and experience even more complex trauma. In high-stress units like emergency medicine and intensive care, prolonged working hours have resulted in escalated levels of burnout amongst many healthcare workers.

Not only is burnout of this degree associated with an increased risk in patient safety incidents, but it also causes healthcare workers to experience diminished job satisfaction, quality of mental health, and morale, leading them to leave their current roles.

This isn’t a problem that healthcare workers are able to solve on their own, no matter what type of health insurance they have or how many individual wellness challenges they have the extra energy to complete. While well-funded and personalized wellness programs and mental health benefits are an effective baseline, healthcare employers must combat this issue from the top-down and think bigger.

Preventing Healthcare Burnout and Complex Trauma on a Systemic Level

“Employers can and should view high rates of burnout as a powerful warning sign that the organization—not the individuals in the workforce—needs to undergo meaningful systematic change.”
McKinsey Health Institute

While many health systems are currently addressing burnout symptoms among their workers, they’re not assessing the causes. Wellness initiatives that promote mindfulness and self-care in high-stress work environments can offer respite after a tough working day, but those programs can only do so much to stave off anxiety, depression, PTSD, and other serious mental health conditions that many healthcare workers are living with every day.

The complex trauma being experienced in health systems nationwide presents a formidable challenge for organizational leaders, but also a transformative opportunity. Health systems can break the cycle of complex trauma by making structural changes within units that foster a more balanced work environment.

Not only does this have the potential to create deeply positive impacts on healthcare worker trauma and improve retention levels, but it can also set healthcare organizations up for long-lasting success.

When healthcare employers allocate resources to monitoring the systemic repercussions of complex trauma, wellness initiatives actually become more impactful and effective. The mere act of prioritizing employee mental health shows workers that their employers are working to alleviate burdens and are putting their wellness first.

What Do Healthcare Employees Need to Minimize Workplace Trauma?

The healthcare industry is inherently affected by factors that fall outside of an employer's control. However, that makes it even more important for health systems to focus on improving conditions for essential workers in any way they can.

According to the American Nurse Association, more than 100,000 healthcare jobs will be added each year after 2022, which is more than any other profession. Demand for these roles is at an all-time high, and health and wellness offerings need to equitably reflect, support, and empower new and long-time healthcare workers.

So, what can healthcare employers do within their organizations to assess what units need, determine which structural adjustments are possible, and implement a wellness strategy that will set their staff and business up for success?

1. Implement a wellness strategy centered around employee mental health and wellbeing

It’s essential that health systems listen to their employees through town halls, workshops, and employee/departmental interviews to find out what resources are needed and how to provide them.

Creating clear, time-bound measurable goals based on what employees report will open doors for creative solutions to structural problems. Employers need to view this level of complex trauma as a problem that threatens their organizations as much as it affects budgetary constraints.

2. Institute a zero-tolerance policy for toxic workplace behavior

Eliminating toxic behavior within healthcare units is crucial in creating psychologically safe work environments for staff. Not doing so opens opportunities for abuse and violence between coworkers, supervisors, and even patients.

Any toxic behavior should first be addressed on a frequent, consistent basis with opportunities for training and growth, if possible. However, if toxic behavior persists, staff (including senior leaders) should be encouraged to leave.

3. Foster a culture of inclusion

Healthcare organizations benefit from actively instituting cultures of inclusion and belonging.

When workers feel like they belong and their individual needs are being met, the impacts on engagement, productivity, and morale are considerable. Gartner reports that organizations with a culture of inclusion experience a:

  • 2% greater on-the-job effort
  • 5% increase in employee loyalty
  • Nearly 3% increase in individual employee performance

4. Infuse personalized wellness benefits that address all aspects of wellbeing

Organizations with wellness programs that are focused on workers’ needs for mobility, reskilling, upskilling, and redeployment are better positioned to predict and influence retention.

Further, the more organizations invest in personalized wellness programming, the less they have to spend on recruitment, rehiring, and retraining.

5. Offer flexible options for work methods and environments

Flexible work environments are tough to implement within health systems. While traditional medicine can’t necessarily be practiced remotely, healthcare organizations can still offer flexible solutions for how, when, and where their employees work.

By surveying work preferences at an individual level, healthcare employers can gain valuable insights and ideas that can foster more manageable workflows for staff. 

For example, perhaps certain employees might benefit from leaving early two days a week to pick up their kids and finish charting at home. Workers can also be given the opportunity to work from home in the mornings or certain days of the week to take virtual appointments.

6. Recruit leaders to serve as examples and practice empathy

Systemic change has to be addressed throughout an organization, including at the management level.

Supervisors and department heads must be trained to recognize anxiety and depression in their teams and take the necessary steps to help. This may include conducting mental healthchecks during team meetings, one-on-one sessions, or whenever someone is struggling.

It also requires supervisors to pay attention to their own mental health and wellbeing needs. Just as healthcare workers need to care for their own wellbeing in order to help patients, supervisors must have the resources they need to tend to their own health so they can sufficiently support their staff.

Healthcare organizations are breeding grounds for anxiety, depression, and other pervasive mental health ailments. Essential workers are so accustomed to taking care of others that they often put themselves last, and it doesn’t help when leadership is equally impacted.

A recent study from Harvard Business Review revealed that 94% of CEOs have received mental health support over the past year, yet over half of them are concerned that talking about mental health might impact their credibility. For your organization to make an impact on this systemic crisis, leadership must lead by example.

7. Provide accessible solutions and benefits that balance work and life priorities

In today’s work environment, healthcare shouldn’t just tackle mental or physical wellness.

Individuals experience wellness on six different levels—physical, emotional, social, financial, occupational, and purpose. To help healthcare workers feel fulfilled in each area of wellness, they need to be given access to solutions that honor their work and home obligations and set them up for success.

For example, offering childcare services and other family-focused benefits could provide healthcare workers with the support they need to integrate work and life. National surveys have shown that nearly 70% of healthcare workers struggle to access these essential services due to a variety of reasons, including limited benefit networks and social determinants of health.

Your mental health and wellbeing programming cannot be an afterthought or a box to check. Now is the time for healthcare organizations to break the cycle of complex trauma and put their workers first. If your company is struggling to tackle this crisis, reach out to one of our Wellness Consultants to determine a successful strategy.

At WellRight, we’re here to help.

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