The topic of clinician burnout is on center stage in our healthcare landscape. Although the problem is certainly not new, some of the causative factors are. In the not-so-distant past, clinician burnout was attributed to the breakdown of personal coping skills in response to the emotional and physical toll of patient care. However, in this new era of burnout, the contributions of the diverse healthcare system are part of this equation. The multitude of stressors brought about by current day healthcare delivery models, including technology, financial imperatives, performance expectations, and resource constraints, are additive to the dynamics that have impacted nurses and other clinicians for generations.
Given its prevalence, ECRI Institute, a well-respected healthcare safety organization, listed clinician burnout as third on its list of the top 10 patient safety issues for 2019.1 Clinicians were defined as physicians, nurses, allied healthcare workers, and trainees. ECRI cited the negative impact on overall patient-care quality and safety along with clinician risks such as depression and suicide. Among the causative factors, ECRI highlighted pressures on clinicians due to time constraints, increasing workloads, patient complexity, and resource limitations. Most significant was their advice on solutions: “If burnout is to be addressed effectively, organizations must listen to providers' concerns about workload, performance criteria, and suboptimal resource allocation and fix these problems at a system level.”1
The Joint Commission also addresses this issue in “Developing Resilience to Combat Nurse Burnout.”2 Although some precipitating factors for nurse burnout, such as short-staffing, were listed, the primary focus was on promoting strategies to help nurses become resilient.
Most would agree that resilience is an important attribute to be intentionally developed in all clinicians, but resilience alone will not solve burnout without the requisite changes to the system that triggers it. A singular focus on resilience as the fix could portray the clinician who is not resilient enough as the problem.
What healthcare systems need is intelligent design that enables clinicians to perform the top-quality work that is expected. Simply demanding a high level of service without the necessary resources may work for a short time, but such a model is not sustainable...nor is the current flight of talent that threatens the integrity of healthcare delivery.
Until next time,
LINDA LASKOWSKI-JONES, MS, APRN, ACNS-BC, CEN, NEA-BC, FAWM, FAAN