By Leanne Levin, PhD, MS, MA
Helping others to improve their quality of life is a common desire of people who are drawn to the human service profession. However, healthcare professionals (HCPs) often work under stressful conditions, where they prioritize the care of their patients and inadequately consider their own health needs. In 2020, hospitals across the United States assessed 20,947 HCPs’ stress levels using an American Medical Association (AMA) survey, and 49% were experiencing burnout. It is not surprising that within this context, the likelihood of medical errors and malpractice suits increases, culminating in detrimental outcomes for both the patient and the HCP. According to Christine Sinsky, MD, from the AMA, “Care of the patient requires care of the providers.” With the goal of enhancing self-care, HCPs should therefore track their symptoms of burnout and intentionally incorporate wellness opportunities into their weekly schedules.
Consequences of Burnout in HCPs Working with Chronic Illness Patients
According to a 2019 report, HCPs who work with chronic illness patients are at the highest level of reported burnout. Symptoms include emotional exhaustion, depersonalization and a sense of reduced personal accomplishment. Emotionally exhausted HCPs will begin to lack energy and may feel emotionally indifferent or oversaturated with emotions. This may manifest in an inability to meet job demands, decreased ability to pay attention and reduced interest in engaging with patients and coworkers. HCPs may even feel disconnected from themselves as a way to cope with ongoing stress, culminating in decreased compassion toward patients, poorer-quality interaction and increased cynicism. Other common hallmarks of burnout are a sense of reduced personal accomplishment, decreased self-worth and dissatisfaction with the job. Of relevance is that if burnout is not managed effectively, it can adversely impact both physical as well as mental health. It is therefore crucial for the HCP to proactively develop coping strategies and make informed lifestyle changes that promote wellness and sustainable self-care.
Self-Care Means Prioritizing Your Needs and Making Better Choices
The first step is to acknowledge that your needs matter and that you can proactively make intentional choices to enhance your health and optimize your relationships. Coping strategies and lifestyle options that can improve your self-care in a high-stress environment should address your social, personal and professional needs.
Seek a Social System
- Optimize your social support system – Studies show that positive social support is beneficial to mental and physical health. Effective social support enables people to receive assistance and care, particularly during times of stress. Support can be provided by family, friends, colleagues, organizations or even systems. Promoting a peer-support program in your organization may be useful, and you can find some practical suggestions on how to do this with the AMA’s Five Steps to Build a Peer Support program.
Seize Professional Growth Opportunities
- Participate in well-being debriefing sessions – Recent research emphasizes that self-care may be more effective if there is a shift from the individual to a collective perspective. Debriefing sessions help to carefully review and reflect on stressful experiences and normalize emotional reactions to difficult situations. Participants also learn coping strategies from one another. If your facility allows peer-facilitated informal groups, possibly take advantage of them.
- Attend executive coaching sessions – A typical executive coaching program may involve clarification and integration of values, professional goals and personal aspirations. It may also help provide strategies for attaining work-life balance, optimizing your strengths, addressing challenges and managing work stress.
Be Mindful, Relax and Have Fun
- Practice mindfulness-based stress reduction techniques – Including mindfulness, meditation, breathing, visualization or yoga into your weekly schedule effectively decreases stress. Mindfulness has also been shown to reduce the harm caused by chronic stress, improve sleep, increase concentration and enhance overall health. Mindfulness is purposely focusing your attention on the present moment and accepting it without judgment. Using all five senses to completely immerse yourself in an experience – something as simple as looking at a common picture as if for the first time or enjoying a hot drink – are perfect and practical suggestions for three minutes of wellness.
- Partake in activities that you enjoy – Intentionally doing more of what you love can help you look at your glass as half full versus half empty. Experiencing enjoyment beyond work will lead to a better quality of life and reinforce a necessary boundary between work and play.
Embrace Personal Growth
- Learn self-reflection skills – During self-reflection, either through thinking or writing in a journal, you can gain an understanding of what assisted or inhibited you from coping effectively in previous situations. You can then proactively employ familiar positive strategies and introduce additional ones to enable you to manage stress more effectively.
- Move towards your goals – Setting realistic goals and actively taking steps to achieve them reinforces a sense of accomplishment.
- Locate mental health resources – If you are stressed or burned out, additional mental health support may be necessary. Many hospitals offer these resources, or they can guide you on how to access both face-to-face and virtual therapists.
Make Delicious Nutritious Choices
- Eat healthy foods at regular times – When we are working under stressful conditions, it may be challenging to be intentional about food and drink choices, but nutrition is a critical part of health and wellness. Try to schedule regular nutritionally balanced meals at predetermined times. Also, make a commitment to yourself to take your lunch break, because this brief time-out helps you feel recharged and is beneficial for overall wellbeing.
Take an Extra Step Toward Physical Health
- Create exercise opportunities – Physical exhaustion is one of the signs of burnout and staying physically active assists with maintaining health. In addition to a regular exercise program, possibly sneak a few minutes of exercise into your work day by parking a little further away, using the stairs and taking intentional brief breaks from administrative tasks to stretch or do ‘chair marches’. Track the number of steps you take each day and use this as an incentive to add a few more. Also, if you have an opportunity to schedule a walking meeting with a colleague rather than sitting at a desk, seize the moment.
A Final Point to Ponder
Being compassionate to yourself as an HCP is no less relevant than the compassion you comfortably express to your patients. You diligently create care plans for those living with chronic conditions, and it is just as relevant to compile a daily schedule that includes critical appointments with yourself to assess and address your physical and emotional needs. Preventing and managing burnout is a necessity for your loved ones, patients and yourself; so aim to move onto the track of self-care and validate every step that you take.
American Medical Association. Half of health workers report burnout amid COVID-19. Accessed March 26, 2022.
American Medical Association. Rethinking how physicians learn to prevent, manage chronic disease. Accessed April 10, 2022.
Dyrbye LN, Shanafelt TD, Sinsky CA, et al. Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care. NAM Perspect. Published online July 5, 2017.
Eisenberger NI. An empirical review of the neural underpinnings of receiving and giving social support: implications for health. Psychosom Med. 2013;75(6):545-556.
Gerada C. Clare Gerada: Doctors and their defences. BMJ. 2019;364.
Lewis S, Willis K, Bismark M, Smallwood N. A time for self-care? Frontline health workers’ strategies for managing mental health during the COVID-19 pandemic. SSM - Ment Health. 2022;2:100053.
Năstasă LE, Fărcaş AD. The Effect of Emotional Intelligence on Burnout in Healthcare Professionals. Procedia - Soc Behav Sci. 2015;187:78-82.
Shapiro SL, Astin JA, Bishop SR, Cordova M. Mindfulness-based stress reduction for health care professionals: results from a randomized trial. Int J Stress Manag. 2005;12(2):164.
Southwick SM, Sippel L, Krystal J, Charney D, Mayes L, Pietrzak R. Why are some individuals more resilient than others: the role of social support. World Psychiatry Off J World Psychiatr Assoc WPA. 2016;15(1):77-79.
West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-529.
Zenasni F, Boujut E, Woerner A, Sultan S. Burnout and empathy in primary care: three hypotheses. Br J Gen Pract J R Coll Gen Pract. 2012;62(600):346-347.
About the author: Leanne Levin, PhD, MS, MA, is an Assistant Professor in the Department of Medicine at New York Medical College, where she additionally serves as Director of Communication and Interprofessional Skills. She also is on the faculty at Fielding Graduate University in the Clinical Psychology doctoral program. Dr. Levin, who works with chronic illness patients as well as their caregivers, is currently co-chair of AACVPR’s Psychology and Nutrition Group and will assume the chairmanship this fall.