Healthcare Worker Burnout
By Pamela D. Wilson, MS, BS/BA, NCG, CSA
Healthcare workers experience high levels of daily stress and anxiety that result in caregiver burnout. Women healthcare workers, in addition to holding down a job, are often caregivers for children, aging parents, and sometimes spouses. Emotional burnout and physical exhaustion are factors that influence the ability of healthcare workers to focus on caregiving responsibilities while at work.
According to the Journal of Gerontology, (1) women healthcare workers who care for aging parents experience greater stress and more work conflicts than non-family caregiving peers. These caregivers report higher stress levels. While healthcare workers have a better understanding of medical conditions, they also feel guilty, powerless, and helpless when they feel uncertain about decision making for an aging parent or spouse.
Mental distraction resulting from personal worries and anxiety cross over into the healthcare workplace. The consequences of personal problems in the healthcare workplace are poor attention to detail, mistakes, incomplete work, poor teamwork, and poor client care. Even the most dedicated healthcare workers have difficulty maintaining composure and focus when personal problems feel overwhelming and burnout occurs.
Healthcare Workers Take on a Higher Degree of Family Caregiving Responsibilities
Holding a position in healthcare does not mean that one is more or less qualified to be a family caregiver. It means that one has a position in healthcare with specialization or focus in a single area.
Holding a healthcare position in a medical office, hospital, care community, or other setting is similar to being a college professor who biology, A teaching specialization in biology does not mean that the teacher is an expert on the entire human body or in the subject matter all college courses. Expecting a healthcare worker to be an expert in all things medical is impractical.
The healthcare needs of aging parents spill over into many other areas of life. Family caregivers perform a full list of tasks that include coordinating and overseeing medical care, day-to-day care including evening, night time, and weekend emergencies, special diets, medication management, personal care, household projects and repairs, grocery shopping, managing finances, and responding to last minute requests.
A perfect example of working in healthcare and not being an expert at all caregiving issues happened in my own family. At the time my mother’s health declined, my sister, who was a nurse working at the hospital, was the main family caregiver.
My sister carried the burden of being the only local adult child caregiver. The rest of us moved out of state. We called and visited as when possible. My sister, with her own husband, children, and career was left with the major responsibility of caring for our parents.
We assumed, like the research confirms, that my sister the knew everything related to care services outside of hospital situations. We were like other family members today who assume that since a family member works in an industry they must be an expert about everything related to the industry. The challenge was that my sister, wanting to be helpful, did not correct our mistaken beliefs.
She was qualified and dedicated to her position as a hospital unit nurse secretary on the cardiac unit. She did not have experience in the areas of oncology, the benefits of rehabilitation in a nursing home, home care nursing services, and a long list of other types of assistance that mom needed.
Without my sister’s commitment to the care and well-being of my aging parents, they would have declined more quickly. She visited to take care of issues as they arose. Her good nature and desire to help was commendable and appreciated. I don’t remember a single complaint during all the years of caregiving support she provided to mom and dad.
At the time both parents passed away, I suspect there had to be a sense of freedom from the constant worry and anxiety related to being constantly on call to caregive for my parents. Family caregivers have an ongoing hyper-sensitivity to the reality that something will occur and they are ready to act. My sister was no different.
Female healthcare workers find themselves in similar situations. Wanting to be helpful, they rarely object to family beliefs about their skills or abilities. They continue to accept additional responsibilities until the point of burnout and do not ask for help
Caregivers experience anxiety about never having enough time in the day. “Seventy one percent report not having enough time for their children, 63% report not having enough time for their spouse or partner and 63% report not having enough time for themselves. (2) As a caregiving advocate responsibility for large numbers of clients I felt the same way. Emergencies cropped up daily taking time I thought I had available for other efforts.
Burned Out Caregivers Want Support and Information
Research and surveys confirm that caregivers from all backgrounds, whether professionals working in healthcare or family caregivers, want more support and information. The obvious challenge is finding time to seek out, participate in, and use available information. After a long day at work who wants another project?
When a healthcare worker or family caregiver works 40 hours a week and completes caregiving responsibilities for another 20 or 30 hours, where does one find time for children, spouses, and self? There is no time and burnout occurs. The work and family balancing act is an ongoing challenge.
Concern exists about providing too much personal information to supervisors in the workplace about caring for aging parents. Healthcare workers are concerned that providing information about family concerns may place their work abilities in question, and they may be at risk of losing their jobs. Being able to take time off work to take an aging parent to a medical appointment is a worry.
Healthcare workers neglect their own needs. They show up for work, even when sick, because of concerns about lost income. The healthcare industry, unless one has an advanced degree or specialization, is typically a lower paying field. Many healthcare workers are employed part-time. Few have healthcare benefits.
Supervisors have similar concerns. Supervisors want to express empathy for the personal family concerns of employees, but crossing the boundary from being a supervisor to a friend is worrisome. Knowing too much about an employee’s personal problems can be uncomfortable. This knowledge can negatively affect workplace relationships. It is human nature to judge others for decisions and actions when information is known and worry about an employee’s personal problems interfering with work quality.
Supporting Healthcare Workers Who Are Caregivers in the Workplace
The most practical type of support is offered directly in the workplace. Support may be implemented in a variety of ways to avoid crossing supervisor and employee boundaries. This support can be facilitated by human resource managers or other staff. Support and may include classes, discussions, on-line training, programming, or support groups.
This support may be offered to all healthcare staff as part of a company initiative to support caregiving in the workplace. This support also has the benefit of helping employees feel valued. Healthcare positions are stressful and other aspects, like workplace bullying, exist in the healthcare industry. Healthcare workers in lower positions are often treated poorly by physicians, nurses, and management.
Company leadership support of the importance of positive work environments has a positive effect on patient care. Reducing turnover should be a key effort. Collaboration between internal staff reduces workplace stress. Turnover also may be reduced by providing support addressing feelings of overwhelm tied to being a workplace and a family caregiver.
The positive spillover of workplace programming is improved family caregiving skills and confidence to manage personal home situations. Increasing personal self-esteem and confidence translates back to the workplace. The responsibility of caring for patients is significant. Interactions with family members may be unpleasant. Training and support makes healthcare workers feel valued.
Without training that supports interpersonal relationship skills, many healthcare workers make unintentional statements to patients or family members that must be smoothed over by management staff. A comment that “this is the way it is because the person is old,” may be viewed as inconsiderate. This is similar to a physician having poor bedside manner.
While being honest is important, the method in which information is presented by the healthcare worker to family members makes a difference. Relating this back to workplace skills, a performance review can be positive or negative based on the presenter’s style. Making these type of comparisons may support learning in the workplace.
Ideas for Workplace Caregiver Training
- Offer a lunch and learn educational session about common caregiving topics. For example, a simple 30-minute course about managing emotions in the workplace or interacting with stressed out family members.
- Provide articles about a caregiving topic to support discussions. Ask healthcare staff and ask them to share and discuss experiences related to the topic.
- Create an “I need a solution” box where employees can anonymously write about concerns in the workplace for discussion. Employees wishing to be known and present the request for a solution can do so. Those wishing to be anonymous are not penalized for not wanting to speak up.
- Identify on-line classes or programming that can be offered during the lunch hour.
- Supporting computer and Internet access by having an on-site work room where computers can be used for workplace training – not personal use.
- Encourage participation in online support groups through social media programs like my private Facebook group for professionals to offer support outside of the workplace for family caregiving issues.
The goal of workplace training sessions is to make discussing caregiving responsibilities and workplace concerns more comfortable. The lunch and learn opportunities are not venting sessions or complaint sessions. They are solution sessions to build healthcare staff self-esteem and confidence in the ability manage a variety of situations. Encouraging problem solving and positive thinking has value in the workplace and in personal life.
A side effect of workplace solution training sessions is building employee camaraderie to arrive at a better understanding of teammate responsibilities and behaviors. Supporting compassion and empathy within the team may be beneficial when an employee needs time off for a personal issue. A teammate may be more likely to volunteer to pick up a work shift or to help in another way if they know about the background of a co-worker.
Healthcare workers benefit from support and training. Many are burned out, experience absenteeism, and and will walk out when situations at home become too overwhelming. Training and workplace support reduce turnover.
By providing workplace support, employers have a greater likelihood of retaining employees. Employees who feel confident and valued are better able to manage personal and caregiving problems in the home. These same employees will also provide better client care in the workplace.
(1) DePasquale, N. et. al. “Combining Formal and Informal Caregiving Roles: The Psychosocial Implications of Double-and Triple-Duty Care,” J. Gerontol B Psychol Sci Soc Sci, 2016, Vol. 72, No. 2, 201-211 doi:10:1093/geronb/bgui139
(2) Aumann, K. et. al., “The Elder Care Study: Everyday Realities and Wishes for Change.” Families and Work Institute supported by the IBM Corporation and the Alfred P. Sloan Foundation, 2008 p.3.
©2018 Pamela D. Wilson, All Rights Reserved.
Pamela D. Wilson, MS, BS/BA, CG, CSA, is a national caregiving thought leader, caregiving expert, advocate, and speaker offering online support and programs for caregivers seeking support and advice for the care of aging parents, spouses, and other family members. Pamela supports adults, age 50+, with positive aging advice and online programs to advance health literacy and self-advocacy. Collaboration with professionals in the specialty areas of estate planning, elder law, and probate, financial planning, and healthcare raises awareness of and sensitivity to stressful family caregiving and healthcare issues.