Recent Survey Sheds Light on Healthcare Burnout, and I Agree With It
Healthcare in the United States was in a state of crisis long before the pandemic hit. Understaffing, burnout, chronic stress, and low compensation rates were driving clinicians away from direct patient care.
COVID-19 accelerated the mass exodus of bedside providers. Daily news reports showed overcrowded hospitals and exhausted clinicians.
That raised the questions: Will there be nurses and doctors to care for me if I need to go to the hospital? How long can our healthcare system stay afloat if the outflow of weary professionals exceeds the inflow of new ones?
A Recent Survey Reveals Healthcare Professionals’ Thoughts
A July 2022 Bain & Company survey showed that one-third of US physicians, nurses, and advanced practice providers are shopping for a different employer, and 1-in-4 want to leave healthcare altogether. Of those who stated they plan to leave healthcare entirely, the most common reasons cited were:
Burnout
Personal health and safety concerns
Concern for the health and safety of family and friends
Financial insecurity
Inadequate resources needed to provide quality patient care
The survey excluded the vast sea of other professionals who keep a hospital running, such as pharmacists, respiratory therapists, social workers, physical therapists, or dieticians. I can attest from my working relationships with many of them that they would likely agree with the sentiments expressed in this survey.
Why I Left Hospital Nursing
I believe these results because I left bedside care before the pandemic. I loved the ICU's intensity, quick pace, and collaborative culture. I also took solace in providing dignified care at the end of life. However, I did not feel I had the resources to deliver the level of care I felt my patients and loved ones deserved.
Hospitals task bedside providers with increasing responsibilities amid increasingly diminishing resources. I’ve heard countless anecdotes from nurses who higher-ups have reprimanded for not attending to hospital-imposed low-priority tasks (such as updating your patient’s whiteboard) while they are actively fighting to keep another patient alive.
My fellow ICU nurses and I frequently had to take on three patients (instead of the standard two) due to understaffing. One day a physician jokingly asked me if a three-patient assignment was the new normal for our unit, and the only safe response I could think of was, “I don’t have a diplomatic answer for that right now.” (I fully admit that I lose my sense of humor when I’m under stress. Ask my husband.)
California is the only state to have mandated nursing staff ratios, even though evidence suggests that lower nurse-to-patient ratios improve outcomes.
It was not usual for me to eat breakfast at 5:30 in the morning and not get to eat again until 3:00 in the afternoon. When I did get a lunch break, it was often a rushed attempt to reheat my food and inhale it between crises.
And don’t even get me started on the Joint Commission’s stance against having water bottles at the nurses’ station!
How Do We Keep Clinicians at the Bedside?
A wise nurse once told me our hospital’s policies were “penny wise and dollar foolish.”
Hospitals have historically failed to recognize that it is cheaper to retain staff than to burn out the people you have who keep showing up. The cost of replacing an experienced ICU nurse can be as high as $64,000, compared to the median salary of $77,600 per year for a registered nurse in the United States.
Unfortunately, hospitals often miss the mark in their efforts to show staff appreciation. Instead of addressing the core issues driving people away, they often provide useless tokens, such as yard signs, t-shirts, mugs filled with candy, or pins.
Clinicians who responded to Bain’s survey felt these improvements could effectively decrease staff turnover:
Higher compensation
Adequate resources to provide the highest quality of patient care
A reasonable workload
Greater flexibility in scheduling
Improving Health Equity and Reducing Healthcare Burden
There are also larger societal issues that impact health and healthcare delivery, called social determinants of health. These include:
Economic stability
Education and literacy
Health care access
Access to nutritious foods
The ability to exercise
Clean air and water
Lack of transportation prevents some from attending routine, preventative, or follow-up appointments. An individual living in an environment that triggers their allergies and asthma will not feel better from more inhalers and antihistamines. A patient who is unable to afford their medications for heart failure or diabetes may have to return to the hospital more frequently. Someone who lives a distance from a grocery with fresh fruits and vegetables will have a difficult time adhering to a low-sodium diet. All of these factors cause vulnerable populations to be sick more frequently, adding a burden to the healthcare system.
I agree that practitioners must be fiscally responsible and judicious in the care they provide, but operating healthcare under a traditional business model incentivizes profits over patient care.
I believe that putting people first is a vital first step to fixing our broken healthcare system. We need to fix social inequities that make it more difficult for many to maintain wellness. But we also must create an environment in which healthcare providers are able to focus on patient care instead of burdensome and arbitrary mandates.
