Creating a Culture of Caregiver Support
Researchers urge proactive, positive programs to protect healthcare workers from burnout, trauma, and abuse.
By Megan Headley
This article originally appeared in Patient Safety & Quality Healthcare.
From the long hours to the pain and blame of medical errors to growing concerns over rates of workplace violence, healthcare professionals see demands unlike those faced by any other industry. It’s no wonder that healthcare workers face high rates of burnout and extreme levels of stress. How high? A 2015 Gallup survey found that a whopping four out of five healthcare workers were “struggling” or “suffering,” versus thriving.
One challenge is that healthcare workers don’t often seek the help they need to keep working safely and productively. In fact, a study published in the November 2016 issue of General Hospital Psychiatry found that doctors are less likely to seek help for depression, anxiety, and other concerns than the patients they treat. This was attributed partially to stigma and partially to state requirements, which mandate physicians to report any mental diagnosis to their state medical licensing board. Such requirements, the study found, lead physicians to worry that seeking help for mental health issues could lead to restrictions on their medical license.
The study’s lead researcher, Katherine Gold, MD, MSW, MS, of the University of Michigan Medical School, encourages medical schools, hospitals, physician groups, and medical professional societies to do more to help trainees and physicians understand that mental health symptoms can occur in anyone, especially in the medical field where expectations are so high. She encourages these groups to offer confidential, third-party, nonpunitive options for physicians and other providers to seek help when they experience symptoms.
Celeste Johnson, DNP, APRN, PMH CNS, a member of the board of directors of the American Psychiatric Nurses Association and director of nursing, psychiatric services at Parkland at Green Oaks Hospital in Dallas, agrees that it’s important to get physicians, nurses, and organizations to understand that there’s no shame in mental health problems, and that it’s crucial to put programs in place that give healthcare workers the tools they need to cope with trauma.
“Strategies that could support employees include reducing the stigma about mental health concerns, providing resilience training and care for the caregiver support programs, and providing health and wellness benefits, including policies that allow for time off for mental health concerns as well as for physical health concerns,” Johnson says.
For its part, Parkland is working to overcome the silence around mental health problems through universal screening for suicide risk. Since February 2015, it has screened approximately 1.7 million encounters, including employees seen in the employee clinic. “Suicide screening has opened the conversation about mental health with patients and with employees,” Johnson says.
While more systems are putting physician wellness programs in place, some groups are targeting the toughest problems with solutions aimed at helping medical professionals continue, or return, to work.
A framework for reducing burnout
Physician burnout is primarily a system issue—not an individual issue, wrote Drs. Tait Shanafelt and Stephen Swanson with Mayo Clinic in a February 2017 article in the American Journal of Medical Quality. It’s for this reason that more healthcare organizations are looking toward putting programs in place that give healthcare workers a place to turn when they are at their most vulnerable.
But finding the right approach can be challenging. In its 2016 Physician Wellness Survey, Stanford Medicine’s WellMD Center found that despite its focus on improving physician well-being, the organization continues to experience a decline in the health of its physician workforce that mimics the national trend. The survey revealed an increase in reported physician burnout from 26% to 39% between 2013 and 2016.