“We’ve got no food. We’ve got no jobs. Our pets HEADS ARE FALLING OFF!… What are we doing here, Harry??”- Lloyd, Dumb and Dumber
I think I’m finally ready to share this. I wrote it over a year ago. As the status does not change I become more and more passionate about it.
There is an illness infiltrating the medical field that many are not aware of. Only this illness is not infecting the patients, its affecting the doctors, nurses, and other healthcare personnel. It’s insidious and most don’t even realize it’s taking place in their lives.
There are predictable symptoms and progression, just like a disease process. Statistics say almost half of physicians had a least one symptom of burnout and only 54% would choose medicine again as career path. – We are regretting going into healthcare.
One end of the burnout spectrum is joy and on the other end is suicide and drug use. It’s predictable, it’s linear, and it’s killing the people behind the number one industry in America.
It’s an imbalance of life vs. workload. The less demanding your job is, the less amount of time you need to fill your “cup”. This “cup” is our most precious asset (besides time)- our energy. Our energy is what makes us human. It gives us life. When we don’t have energy, we can’t smile, can’t laugh, can’t have empathy, can’t care for others or ourselves. We lose our humanity and become zombies.
Let’s say you get paid to take photos of nature- I picture this person as a care-free, low stress, creative soul. They leave for work when they want to- or maybe they get the thrill of capturing that sunset but it’s worth it for them to be out after dark. They look at their work with pride and crack open a beer and laugh with their friends. Their imaginary work life is what I want when I grow up. They don’t need much time to fill their “cup” because it’s also being filled why they work.
But the more on-the-job stress that is added, more time is required to fill your “cup”. So the ER nurse who is running her butt off, fueled by a heart-attack-inducing energy drink and adrenaline, is saving people- one after the other. Her non-work life probably requires a lot of physical rest to give her adrenal glands a reset, a creative outlet, and help doing every day chores. Someone to help with laundry and dishes and cooking. Because if she spends all of her free time trying to keep up with every day living- her “cup” never gets refilled. She goes back to the ER to do 14 hour shifts where she doesn’t get to sit down, she gets 10 minutes to shove a doughnut in her mouth at midnight, and water (?) – she will just apologize to her kidneys and pray they hang in there until the fourth day when she will actually get the chance to drink. If you’re in the medical field you are probably shaking your head in agreement at this point. If you are in the corporate world where you get an hour for lunch, you get to take off to get your kid from school, you get to go to a doctor’s appointment, you get to call in sick, or you get to drink and pee whenever you want; consider yourself informed of what is actually going on behind the scenes of healthcare. Basic human needs are ignored here. It’s like stepping into a third world country.
Where I live there is still an underlying assumption that the woman takes care of the household and the children while the man is out making money to support his family. But since women started working outside the home during the war- we have discovered we can be successful workers too. I won’t go into my personal experiences of making less than my male peer for doing the exact same thing- dare I say better because I’m hard wired as a woman to pay attention to detail. This is not about men vs women because we are made to have our own set of strengths, complimented by the others weaknesses. But we have to bring to light the 1950’s culture that is still going on in the workplace.
In 2009, 19% of surgeons were women. In 2015, 19% of surgeons were women(1). (I’m focusing on the operating room because that is my personal experience- I acknowledge not all healthcare environments are this culture). Ninety-one percent of nurses are female (2). So by default, in my facility, we have a 1950’s model of the Panam situation in Catch Me If You Can where the men are flying the plane and the women are the servers.
I could do a whole blog post on the types of women that go into nursing and their personalities. It’s my impression that a lot of nurses want so badly to be perfect, to care for, to serve, to sacrifice for, and to please -at all costs- their physicians and patients. It can take a tremendous amount of energy for some nurses to stand up against injustice because of this ‘aim to please’ mentality. So these women are in a culture to serve and please (mostly) men. Healthcare is constantly changing and becoming more demanding for these employees and they are still being asked to do the laundry and the cooking and cleaning at home. They never get time to recharge. A lot of households are moving away from this trend but I still see it where I live. And what about single parents?
But I won’t forget the surgeons – they are being exploited too. They are no longer running their own practices- they are owned by the hospital. They are being pressured to bring in certain amounts of revenue. When you do the math and see the numbers (or else they will be replaced by the next eager surgeon on the assembly line) they have to work all day, operate on anyone they can, and take call all the time. They never get a chance to recharge. They work from 7:00am to 8:00pm and get calls in the middle of the night. They come in on Saturdays to do non-emergent cases because they can’t get to them during the week. They are hiring PA’s to follow up with their patients because they don’t have the time to see their patients themselves. And bringing their nurses and scrub techs along with them into the late nights and weekends.
There are so many things driving this increased demand on our healthcare workers. I’m not interested in those politics or statistics. I’m interested in the microcosm view of what is around me and what I see. I see tired nurses and techs and surgeons. They are burned out. They have no voice. They feel stuck. They can’t afford to call in and leave their already critically understaffed co-workers to die a slow death, picking up their workload. Financially they are strained and can’t afford a sabbatical. They are being pressured to be perfect and keep up efficiency at work to keep the surgeons and administration happy with their numbers. They are stressed out making their patients happy and provide empathy while being a an over-worked zombie. Heaven forbid they make a human mistake during all of this, they’ll be verbally abused for it. They have no time to work on themselves or grow in personal development because they are operating in survival mode all the time.
I’ve experienced burnout for years, myself. I found that I was surrounded by hateful and unhappy people; doctors, nurses, patients, ancillary staff. “Thank you’s” and “great job” were a rare gift. No one wanted to be there and a lot were struggling at being a human. I began to feel like my soul slowly was degrading, dying a slow death. My morals and values were slipping. I was working holidays and suppressing the guilt that I traded money for irreplaceable family joy and memories. I was overeating just to get enough endorphins to get me through my shift. I was lonely because none of my family understood how I felt. I was cynical. It almost didn’t matter what I did because I felt like most things were out of my control. I was being emotionally abused by my coworkers and physicians. My boundaries were no more. It was “normal” to be yelled at by so-and-so ‘that’s just how he is.’
I was trapped in a job I didn’t enjoy anymore in order to make the money to support the life style I had become accustomed to. We were so desperately in need of workers that I was unable to take a day off without a years notice. Sick and vomiting? Go to work, they’ll give you an IV. Didn’t sleep on your call shift? Work 24 hours post call since it’s double the pay. Going through a divorce and need a mental health day? Hah, that is laughable.
Hospitals are overworking, underpaying, and under supplying their employees. In the past we’ve had supplies and medications -that would add to patient comfort -taken away just simply due to cost. Everything needed to be faster to increase volume and revenue. There was always a person over my shoulder snapping their fingers.
I found myself exhausted even after an 8 hour shift. I decreased my hours from 65 to 40 per week. I worked less and had normal daytime hours, but why was I so tired? I had little emotional energy to give my family after I’d come home and take a power nap. Was there something wrong with me? I was depressed and unhappy despite having checked off all the boxes: well paying career, a family, dream house, nice car.
I attended a mandatory seminar where the phrase “burnout” was referred to as one of the many cause of poor communication in healthcare. I went to my car after it was over and just broke down and cried. I was burned out. I quickly did a google search to confirm my suspicion. I was horrified to read the next level on the progression of symptoms was drugs, alcohol, and suicide. Being female with access to controlled medications I was at a very high risk.
How did I get here? How did this happen? Every day I went to work I hit the ground running- going as fast as I humanly can to keep up with the usual pace. I was holding my body in a constant state of fight or flight to keep vigilance in case someone tried to die. My adrenal glands were trying to keep up with my sympathetic nervous system’s requirements. Not to mention, everything I did was not motivated out of goodwill towards the patient. I was doing and charting out of fear of how my actions would be judged in the case of a malpractice law suit. I liken every day to that caveman who has no tribe (everyone for themselves). You’re being sent out to defend for yourself against all the beasts of the world (lawyers, job security, mean doctors, unhappy patients). You keep your sympathetic nervous system in constant state of fear and it’s exhausting you to the point of giving up on life. That is the best way I can describe burnout.
I’ve managed to figure out a way to keep myself on the burnout scale closer to the “joy” end by cutting back significantly on my hours. I’ve taken up a creative hobby and side job. I’ve invested financially into passions of mine. I’m praying every day that one of them takes off so I can leave my Masters Degree and healthcare altogether. That may never happen but in the mean time I don’t lose hope.
There is no grace in medicine. Our administrators have turned their gaze from us to the dollar signs. People have forgotten healthcare workers are not robots- we are humans and we are trying the best we can with the information and supplies we have and we are dying a slow death because of it. Someone send help.
Disclaimer: I am not a researcher. While I did my fair share of Masters thesis reference pages – I do not care about format. I’m just concerned about giving credit where I find my statistics. I’m not consumed with spending a large amount of time finding accurate and recent data – that’s not the point of this opinion blog post.