Tag: burnout

Categories : HospitalsTags :

Don’t Teach us Resilience – Fix the Problem, Doctors and Nurses Say

On By ModernMedia
Source: Pixabay CC0

A unique collaborative study on hospital clinician wellbeing by teams at 60 of the best US hospitals, was published in JAMA Health Forum. The study found that physicians and nurses, even at hospitals known to be good places to work, experienced adverse outcomes during the pandemic and want hospital management to make significant improvements in their work environments and in patient safety.

The solutions to high hospital clinician burnout and turnover, they say, are not resilience training for clinicians to better cope with adverse working conditions but organisational improvements that provide safe workloads and better work-life balance.

Researchers sought information in 2021 from 21 050 physicians and registered nurses practicing in 60 Magnet recognised hospitals in 22 states. Forty-seven percent of nurses and 32% of physicians experienced high burnout. Twenty-three percent of physicians and 40% of nurses said they would leave their jobs if possible. Less than 10% of physicians and nurses reported experiencing joy in their work.

Many clinicians are downright hostile to programmes – like resilience training – that are designed to adapt them to poor work conditions; clinicians want the working conditions improved.

Linda H Aiken, PhD, study lead author

Not having enough nurses to care for patients, having little control over workloads, lack of confidence in management to resolve problems in patient care, and concerns about patient safety were all associated with higher burnout, job dissatisfaction, and intent to leave among both nurses and physicians.

Lead author Linda H Aiken, PhD, at the University of Pennsylvania said, “Physicians and nurses largely agree about what hospital management could do to address their burnout, job dissatisfaction, and plans to leave their current jobs; they want improved staffing, modern working conditions in which they can spend more time in direct patient care, greater control over their workloads and work schedules, and a higher priority on patient safety.”

Eighty-seven percent of nurses and 45% of physicians said improving nurse staffing was very important to their own mental health and wellbeing. Other high priorities for clinicians were health breaks without interruption and reduced time spent on documentation. Aiken added, “Many clinicians are downright hostile to programmes – like resilience training – that are designed to adapt them to poor work conditions; clinicians want the working conditions improved.”

Clinicians are concerned about quality and safety of care. Half of physicians and nurses lack confidence that their patients can safely manage their care after discharge highlighting the need for improvement in discharge planning. Patient safety remains a concern with 26% of nurses and 12% of physicians giving their own hospitals an unfavorable patient safety grade. Thirty-nine percent of nurses and 33% of physicians feel mistakes are held against them contrary to recommendations of the National Academy of Medicine to search for and correct system deficiencies that cause most medical errors.

The study was carried out by Penn Nursing’s Center for Health Outcomes and Policy Research in collaboration with the US Clinician Wellbeing Study Consortium composed of 60 Magnet Hospitals. The study took place in 2021 during the COVID pandemic, a time when all US hospitals were severely challenged. Previous research shows that clinicians in hospitals with better work environments prior to the pandemic had better outcomes during the pandemic. The Consortium committed to this study to learn from their experiences during the pandemic how to sustain and further improve their favourable work environments to better withstand external threats and to rebound rapidly.

Source: University of Pennsylvania School of Nursing

Categories : General Interest Mental HealthTags :

Working with Robots Increases Job Burnout for Humans

On By ModernMedia
Photo by Tara Winstead on Pexels

Having jobs be replaced by robots is a common fear for workers in all sectors of the economy. Working alongside robots may contribute to job burnout and workplace incivility, but self-affirmation techniques could help alleviate fears about being replaced by these machines, according to research published online in the Journal of Applied Psychology [PDF].

Researchers found that workers in the United States and parts of Asia feel job insecurity from robots, even in industries where robots aren’t being used, and those fears may not be justified, said lead researcher Kai Chi Yam, PhD, an associate professor of management at the National University of Singapore.

“Some economists theorise that robots are more likely to take over blue-collar jobs faster than white-collar jobs,” Dr Yam said. “However, it doesn’t look like robots are taking over that many jobs yet, at least not in the United States, so a lot of these fears are rather subjective.”

Researchers conducted experiments and analysed data from participants in the US, Singapore, India and Taiwan.

Working with industrial robots was linked to greater reports of burnout and workplace incivility in an experiment with 118 engineers employed by an Indian auto manufacturing company.

An online experiment with 400 participants found that self-affirmation exercises, where people are encouraged to think positively about themselves and their uniquely human characteristics, may help lessen workplace robot fears. Participants wrote about characteristics or values that were important to them, such as friends and family, a sense of humour or athletics.

“Most people are overestimating the capabilities of robots and underestimating their own capabilities,” Dr Yam said.

Fears about job insecurity from robots are common. The researchers analysed data about the prevalence of robots in 185 U.S. metropolitan areas along with the overall use of popular job recruiting sites in those areas (LinkedIn, Indeed, etc). Areas with the highest robot use also had the highest rates of job recruiting site searches, even though unemployment rates weren’t higher in those areas. The researchers theorised that people in these areas may have felt more job insecurity because of robots, but that there could be other reasons, such as people seeking new careers or feeling dissatisfied with their current jobs.

Another experiment comprised 343 parents of students at the National University of Singapore who were randomly assigned to three groups. One group read an article about the use of robots in businesses, the second group read a general article about robots, and the third read an unrelated article. Then the participants were surveyed about their job insecurity concerns, with the first group reporting significantly higher levels of job insecurity than the two other groups.

While some people may have legitimate concerns about losing their jobs to robots, some media coverage may be unnecessarily heightening fears among the general public, Dr Yam said.

“Media reports on new technologies like robots and algorithms tend to be apocalyptic in nature, so people may develop an irrational fear about them,” he said.

Source: American Psychological Association

Categories : Medical Industry Mental HealthTags :

Mistreatment at Med School Leads to Later Exhaustion, Regret

On By ModernMedia
Photo by SJ Objio on Unsplash

Medical students who experienced mistreatment during medical school were more likely to become exhausted or disengaged, have less empathy, and have career regret, a new study has revealed.

Among a large national sample of trainees, the 22.9% of respondents who reported mistreatment on the Association of American Medical Colleges’ Medical School Year 2 Questionnaire (Y2Q) had higher exhaustion and disengagement scores on the Graduation Questionnaire (GQ) 2 years later, reported Liselotte Dyrbye, MD, of the Mayo Clinic in Rochester, Minnesota, and colleagues writing in JAMA Network Open.

Furthermore, of those who had experienced mistreatment, 18.8% reported career regret on the GQ.

Conversely, medical students who experienced a better environment more likely to:

Have lower exhaustion scores: for each 1-point increase on the Y2Q, there was a 0.05 reduction in exhaustion score
Report lower disengagement scores on the GQ: for each 1-point increase on the Y2Q, there was a 0.04 reduction in disengagement score
Further, reports of having positive interactions with faculty on the Y2Q were associated with higher empathy scores on the GQ. For each 1-point increase, there was a rise of 0.02 in empathy score. Positive student-to-student interactions were linked to having lower odds of career regret during the last year of medical school.

“The potential protective effect of positive experiences within the learning environment may provide insight into strengths that organizations can amplify to mitigate burnout, decline in empathy, and career choice regret among their students,” wrote Dyrbye and colleagues.

The team noted the opportunity for potential interventions. “Although the most effective approaches to addressing mistreatment of learners remain elusive, the frequency of mistreatment varies between educational programs, suggesting there are likely to be levers within the control of the organisation that adequate commitment, leadership, infrastructure, resources, and accountability can lead to a meaningful reduction in mistreatment.”

Average age of the respondents was 28 years, 52% were women, 72.8% were single, and 91% reported having no dependents. The study also found that older medical students reported higher disengagement scores, and that women reported lower exhaustion (by 0.27 points) and disengagement (by 0.47 points) scores on the GQ.

However, women and older medical students had higher empathy scores compared with their male peers (0.74 points and 0.05 points, respectively).

The researchers observed that conflicting findings on burnout among women in medicine have been reported. For example, a longitudinal cohort study of resident physicians across specialties in the US found that female residents were “more likely to develop burnout and have worsening in the severity of their emotional exhaustion between the second and third year of training compared with male residents, even after controlling for various forms of mistreatment.”

Limitations of their own study, the researchers noted, included unestablished differences between the exhaustion, disengagement, and empathy scale measures that were used in the questionnaires; and the varying response rates between questionnaires: 55.5% for the Y2Q and 81.5% for the GQ.

Source: MedPage Today

Categories : Hospitals Mental HealthTags :

Heavy Workload Reduces Outcomes and Turns Positives into Negatives

On By ModernMedia
Source: CC0

Employee wellbeing in healthcare is reflected in patient satisfaction, and a new study found that a heavy workload, even positive challenges such as learning new things are experienced as increased stress.

Researchers from the Department of Psychology at the University of Jyväskylä in Finland explored how the staff of a healthcare district experienced increasing job demands, and how wellbeing at work was linked to these demands. The study also clarified whether the demands on employees were reflected in patient satisfaction.

More than a thousand employees took part in the study and evaluated their experiences in a survey measuring intensified job demands, work exhaustion, and work engagement. Additionally, nearly a thousand patients of the healthcare district evaluated their treatment by the healthcare staff.

In line with expectations, healthcare staff’s experiences of greater time pressure and workload were associated with greater exhaustion. An especially high risk of exhaustion was seen in those working in emergency care and nurses.

Additionally, experience of increased job planning demands shared by the working community was associated with greater exhaustion and lower customer satisfaction. This was particularly evident in the staff of leadership services.

“A surprising observation was that none of the intensification demands was positively connected with work engagement,” said Senior Lecturer Mari Huhtala. “In the light of previous studies, employees may find some demands such as learning new things positive challenges, especially when the demands are reasonable. However, this was not the case with the studied healthcare employees. It is possible the general workload in healthcare has led to these positive challenges being experienced as additional stress as well.”

Research data for the study were collected using an electronic survey in the third quarter of 2019. The study will continue in the third quarter of 2021 with the collection of follow-up data.

Source: University of Jyväskylä

Journal information: Huhtala, M., et al. (2021) Intensified job demands in healthcare and their consequences for employee well‐being and patient satisfaction: A multilevel approach. Journal of Advanced Nursing. doi.org/10.1111/jan.14861.

Categories : Cardiovascular DiseaseTags :

WHO Says Overwork is Killing 745 000 People a Year

On By ModernMedia
Exhausted man looking at laptop in a restaurant. Photo by Tim Gouw from Pexels

Long working hours led to 745 000 deaths from stroke and ischaemic heart disease in 2016, a 29% increase from 2000, according to a report by the World Health Organization and the International Labour Organization.

Published in Environment International, this is the first global analysis of the loss of life and health associated with working long hours. The global analysis drew on 37 studies on ischaemic heart disease with over 768 000 participants and 22 studies on stroke with more than 839 000 participants.
The WHO and ILO estimate that, in 2016, 398 000 people died from stroke and 347 000 from heart disease as a result of having worked at least 55 hours a week. Between 2000 and 2016, the number of deaths from heart disease due to working long hours rose by 42%, and those from stroke by 19%.

This burden of work-related disease is particularly significant in men (72% of deaths were males), people living in the Western Pacific and South-East Asia regions, and middle-aged or older workers. Most of these deaths were among people aged 60-79 years, who had worked for 55 hours or more per week between the ages of 45 and 74 years.

Long work hours are now known to cause about one-third of the total estimated work-related burden of disease, and so is now the risk factor with the largest occupational disease burden. This shifts thinking towards a relatively new and more psychosocial occupational risk factor to human health.

Compared to a 35-40 hour work week, a 55 hour or more work week is associated with an estimated 35% higher risk of a stroke and a 17% higher risk of dying from ischaemic heart disease, concluded the study.

Increasing numbers of people are working long hours, currently standing at 9% of the world’s population. Even more people are being put at risk of work-related disability and early death by this trend.

This report comes just as the COVID pandemic is feeding a trend towards increased work hours. In China, 18 health workers died from overwork-related illnesses in the pandemic.

“The COVID pandemic has significantly changed the way many people work,“ said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Teleworking has become the norm in many industries, often blurring the boundaries between home and work. In addition, many businesses have been forced to scale back or shut down operations to save money, and people who are still on the payroll end up working longer hours. No job is worth the risk of stroke or heart disease. Governments, employers and workers need to work together to agree on limits to protect the health of workers.”

“Working 55 hours or more per week is a serious health hazard,” added Dr Maria Neira, Director, Department of Environment, Climate Change and Health, at the WHO. “It’s time that we all, governments, employers, and employees wake up to the fact that long working hours can lead to premature death”.

The WHO pointed out the following actions that governments, employers and workers can take protect workers’ health:  

  • governments can introduce, implement and enforce laws, regulations and policies that ban mandatory overtime and ensure maximum limits on working time;
  • bipartite or collective bargaining agreements between employers and workers’ associations can arrange working time to be more flexible, while at the same time agreeing on a maximum number of working hours;
  • employees could share working hours to ensure that numbers of hours worked do not climb above 55 or more per week.  

Source: World Health Organization

Journal information: Pega, F., et al. 2021. Global, regional, and national burdens of ischemic heart disease and stroke attributable to exposure to long working hours for 194 countries, 2000–2016: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Environment International, p.106595.