Burnout in healthcare - exploring the system and our expectations.
Many new health care workers are given a small, white, rectangular card when they are first hired.
Some place the laminated card in their pocket, others on their bedside table. Most have no idea where it is now. The card would announce how to recognize burnout, and often list things to ‘look out’ for when working in their exciting new field.
Be sure to be on the lookout for: exhaustion, isolation, irritability, difficulty concentrating, loss of interest.
Card in hand, they go to work. Years pass. Breaks get dropped; lunches uneaten. ‘I haven’t microwaved my meal in years’ a co-worker proudly exclaims, eating cold soup. Nearly everyone on the shift comes in early, leaves late, and is underfed, tired, and angry.
Then one day, a supervisor comes down to the floor and happily announces to everyone ‘You have all been working so hard, you deserve the day off. You’ve done enough. Thank you. You can stop.’
Except, of course, that never happens.
In health care, no matter how much people give of themselves, it will never be enough. There will always be more. More people, more paperwork, more tasks, more need.
Burnout occurs when one feels abused, exploited, worthless, and that their contributions are meaningless.
A health care worker is employed in an underfunded system that does not have the capacity to appropriately care for everyone who uses it. Not only will contributions never be enough, but the work environment may not get better in the near (or far) future.
That is the reality of the work. And it should not be ignored.
And yet, burnout is not inevitable or guaranteed. Recognizing the difficulties of a workplace does not mean that there is no hope, or that working in such a field is pointless.
But if you are working in healthcare, and your survival tactics are working harder in the hope that things will improve, you are most likely on a collision course to burning out and injuring yourself in profound and very real ways. The health care system will take everything and anything you give it and will only demand more.
How does one stop from burning out? From fizzling out and feeling empty?
Expectations play a large role in how we react and are affected by our workplaces. And while it may seem to be the antithesis of what healthcare is, lowering those expectations we have placed on ourselves may often be the only way to survive.
Healthcare can often seem at odds with the goal of ‘helping people’.
A patient who presents in cardiac arrest is extremely likely to die. A patient who presents with a mental health crisis is extremely likely to return with the same issue. A health care worker who expects change, or blames the lack of change on themselves, is setting themselves up for disappointment and frustration.
Less is more. Each person working in healthcare is one piece of a larger puzzle, representing a small sliver of the pie. It is unfair to expect to be the whole pie.
If our expectations are to save the dying or cure the ill, it is very likely we will find ourselves angry, lost, and feeling empty.
Lowering expectations of what we want from our workplace, and what we expect to happen to patients can lead to a more sustainable work environment.
You are not, as an individual, going to change the revolving door of health care. Being satisfied that an under-housed client was provided with a sandwich and a brief reprieve from the elements is very different to hating the fact they are here again today and will be here again tomorrow.
What to do?
- Ask yourself, what is my role? Not what I feel is expected of me, but what is the role I have been hired and trained to do. Hold yourself accountable to that role, and if you find yourself going beyond that, STRONGLY consider stopping or deferring the task to someone else, if possible.
- Set and uphold boundaries. Perhaps you pride yourself in going above and beyond what is asked of you, but is it necessary, helpful, or (most importantly) sustainable? Planning to survive working in health care for twenty-five years requires a different mindset than planning on working for five.
- Less is more. Often by doing less, we can provide more compassion, better care, and be part of teams for longer.
- Be realistic about what you can provide. Learn to trust others in your workplace, even when you know they would not do the job to your own standards.
We never have to accept the status quo, but we do need to learn how to live within the status quo.
Lowering expectations does not mean lowering standards of care, empathy, compassion, or quality. It instead means setting goals that give us joy, and not allowing failures of systems to feel like failures of ourselves. When we show up to work, can we be satisfied with what we did? Yes, people die, yes, there are failures and yes, people fall through the cracks, but we can still come into work and offer good care.
Lowering expectations means being satisfied with what we can reasonably provide. It allows us to not blame ourselves for failures of systems. It allows us to work in a field we love while balancing our passions with sustainability.
