Tag: burnout

Medical Errors Linked to Physician Depression

A new study has linked depressed physicians to an increase in medical errors, further highlighting the need for interventions aimed at bolstering physician well-being.

As the conversation about physician burnout and what to do about it continues steadily on, a new study published in JAMA Network Open has linked depressed physicians to an increase in medical errors.

Researchers from University of Michigan Medical School in Ann Arbor conducted a systematic review and analysis of 11 different studies, which involved more than 21,000 physicians. As a result, they found that physicians who experienced depressive symptoms were 1.95 times more likely to make medical errors than their mentally healthy peers, and that the association between depressive symptoms and perceived errors was bidirectional.

“Given that few physicians with depression seek treatment and that recent evidence has pointed to the lack of organizational interventions aimed at reducing physician depressive symptoms, our findings underscore the need for institutional policies to remove barriers to the delivery of evidence-based treatment to physicians with depression,” the study’s authors wrote. “Investments in patient safety have been associated with significant reductions in health care costs, and the bidirectional associations between physician depressive symptoms and perceived medical errors verified by this meta-analysis suggest that physician well-being is critical to patient safety.”

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Is The Nurse’s Glass Half Full?

Can the power of positivity really help nurses, when there is still so much wrong in both the world of nursing and healthcare as a whole?

From Nurse Keith’s Digital Doorway

It’s no secret that there’s a multitude of unhappy nurses out there in the world. From mandatory overtime to unhealthy nurse-patient ratios, I admit there are very valid reasons for this seeming epidemic of discontent. So, is the nursing glass half-full or half-empty? I guess it depends on who you’re drinking with (and perhaps what you’re drinking).

Reasons To Be Cheerful—Or Not

This blog post isn’t really about the aforementioned multitude of reasons that explain nurses’ rampant unhappiness. A new study mentioned recently on Twitter states that a full one-third of nurses are unhappy with either their jobs or their careers. I get it.

There are also nurses who say, “I love my work, but I hate my job“. I get that too.

Sadly, it’s a given that too many nurses work in environments that are unhealthy, unsupportive, demanding and back-breaking, and that’s indeed a sad state of affairs.

It’s Who You Talk To

Taking into consideration the relative level of discontent in the nursing profession, your worldview can be significantly influenced by who you talk to and who you spend time with. The tenor of the conversation amongst your nursing colleagues will, of course, influence your perspective, so think about who your conversational partners are—and who they could be.

If your Thursday morning coffee klatch is regularly attended by jaded nurses who spend the hour railing against the hospital and gossiping about doctors and interns (and one another), there’s a definite downside to the time you spend at that particular table.

And if your idea of a good time is focusing on what’s wrong rather than what’s right (or how to fix what’s wrong), then there are plenty of nurses who’ll eagerly buy you another round in order to keep you waxing negative, thus justifying and solidifying their own negative bias.

“Bartender, another round of ‘Negatinis‘, please.“

Let’s Be Realistic

Like I said towards the beginning of this post, I get it. There’s a lot that’s wrong with the picture in both nursing and the wider world of healthcare. That’s a given. At the same time, there are nurses, doctors, administrators and theorists who really want to make it right. Fighting the good fight to make things better is a noble cause, and many are called to engage in that particular battle. Kudos to them.

Simultaneously, there are nurses who, tired of the mainstream game, have dipped their toes into entrepreneurship, carving out satisfying careers that defy the very notion of what it even means to be a nurse. Kudos to them, too.

Meanwhile, some nurses are creating new opportunities for themselves within the mainstream healthcare system, leveraging their skills as coaches, consultants, IT gurus and all manner of novel yet robust professional roles. Kudos all around.

There’s a place for everyone at the table. In fact, you can even build your own table if the current ones don’t quite match your vision of what your career could be.

Nurse’s Choice

So, you can talk to the jaded, cynical and burnt out nurses who just want to see the glass as perpetually half empty, or you can interact with the nurses who are the positive role models and forward thinkers of the profession who definitely view the glass as perpetually half full.

It’s tiring to hang out with the jaded and cynical complainers, but it can be energizing (and fun!) to hang out with the optimistic nurses who are actively making their careers the best that they can be.

Who are you talking to and spending time with? Are you drinking the bitter and cynical dregs of nursing station coffee? Are you pounding down “Negatinis” with unhappy abandon? Or are you drinking from the cup of optimism, sharing with your colleagues a vision of what’s possible, even as you acknowledge the stark realities of 21st-century healthcare?

The choice is yours, my friends, and I invite you to my table, where we serve Positive Punch and Optimism Smoothies.

Thirsty?

Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind NurseKeith.com and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is the host of The Nurse Keith Show, his solo podcast focused on career advice and inspiration for nurses. From 2012 until its sunset in 2017, Keith co-hosted RNFMRadio, a groundbreaking nursing podcast.

A widely published nurse writer, Keith is the author of Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century and Aspire to be Inspired: Creating a Nursing Career That Matters. He has contributed chapters to a number of books related to the nursing profession. Keith has written for Nurse.com, Nurse.org, MultiBriefs News Service, LPNtoBSNOnline, StaffGarden, AUSMed, American Sentinel University, Black Doctor, Diabetes Lifestyle, the ANA blog, NursingCE.com, American Nurse Today, Working Nurse Magazine, and other online and print publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, keynote speaker, online nurse personality, social media influencer, podcaster, holistic career coach, writer, and well-known nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives, and his adorable and remarkably intelligent cat, George.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Physician Burnout on the Decline?

Recent research indicates that physician burnout improved since 2014 and is now even lower than levels not seen since 2011.

Recent research indicates that physician burnout improved since 2014 and is now even lower than levels not seen since 2011, suggesting progress to combat this widespread problem is not only possible, but well underway.

The findings, which were published last month in Mayo Clinic Proceedings, come as a result of researchers surveying more than 5,000 physicians in the U.S. on burnout and work-life integration. According to the findings, 43.9% of respondents indicated that they experienced at least one symptom of burnout, down significantly from 54.4% in 2014, and less than the 45.5% who self-reported burnout in 2011. Satisfaction with work-life balance has also improved, up from 40.9% in 2014 to 42.7%.

The news isn’t entirely rosy, however. According to the findings, 41.7% of physicians who responded screened positive for depression, a steady increase from 2014 (39.8%) and 2011 (38.2%). The findings also indicated that more than 20% of physicians would not choose the same profession, if they could go back and do it again.

While the research indicates that progress has been made, it is very clear there is still much work to be done in terms of improving the lives of the nation’s physicians.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Combat Burnout and Stress with Yoga for Nurses

Yoga has been proven to be a stress reliever for those who practice it, and nurses are some of the most stressed out employees around. Give it a try.

Yoga, a mind-body practice that combines physical poses, controlled breathing, and meditation, has been proven time and again to be a stress reliever for those who practice it. In fact, a recent study has shown that yoga can be particularly helpful in preventing and managing stress levels and burnout in healthcare workers. And we all know that nurses are some of the most stressed out and burnt out healthcare workers out there.

If you don’t already practice yoga, or if you haven’t had time to go to a studio lately, grab a mat and some bolsters and straps, and give these yoga sequences for nurses a try right in your home.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Burnout Isn’t Just a Physician Problem

NPs and PAs are often touted as the solution to the growing primary care physician shortage, but at what cost? Burnout impacts them, too.

The growing primary care physician shortage has put an overwhelming strain on doctors in the United States, often in the form of burnout. A combined workforce of nearly 400,000 strong, Nurse Practitioners and Physician Assistants have been poised and ready to be, and often touted as, the most viable solution to the shortage. But at what cost? After all, NPs and PAs are not immune to burning out, themselves.

According to the International Classification of Diseases, which now classifies burnout as an occupational phenomenon, burnout is defined as “chronic workplace stress that has not been successfully managed.” Those suffering from burnout often experience feelings of energy depletion or exhaustion, increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job, and reduced professional efficacy.

Last fall, the Journal of the American Academy of Physician Assistants published the first report on national trends of burnout among PAs. The data revealed that 62.1% of PAs had enthusiasm for their work, while 21.4% reported some degree of cynicism, and 10.4% reported a low sense of personal accomplishment. The report also revealed that 12.8% had never left a position due to stress, but were considering quitting their current position due to stress, burnout, or a toxic workplace, and that 30% had quit once in the past due to stress. Another 11.7% of PAs had left more than one position due to burnout.

As for Nurse Practitioners, burnout in the nursing profession, as a whole, is well-documented. Nurses experience some of the highest risk and rate of burnout, with a third of all nurses in the U.S. reporting high levels of emotional exhaustion. Though Nurse Practitioners may outrank RNs, they seem to be experiencing similar levels of burnout. For instance, though the NP profession ranked #7 on U.S. News & World Report’s 100 Best Jobs list in 2019, it was also reported that NP experience above average stress and below average work-life balance.

Are you feeling burnt out in your role as an NP or PA? How do you combat work-related stress? Tell us in the comments below.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Suicide Risk Among Nurses Higher than Non-Nurses

Nurses are at a higher risk of suicide than the general population according to the findings of the first national investigation into nurse suicide in over twenty years.

Nurses are at a higher risk of suicide than the general population according to the findings of the first national investigation into nurse suicide in more than two decades.

The study, which was published in Archives of Psychiatric Nursing, found that suicide incidence was 11.97 per 100,000 female nurses and even higher among male nurses, with suicide claiming 39.8 per 100,000. Both figures are significantly higher than that of the general population, which is 7.58 per 100,000 women and 28.2 per 100,000 men. Overall, the suicide rate was 13.9 per 100,000 nurses versus 17.7 per 100,000 for the general population.

In all, over 400 nurses per year die by suicide, and according to the study, nurse anesthetists and retired nurses were at the highest risk.

“We are overworked and stressed, and on the edge of the breaking point at any given moment,” said Ariel Begun, BSN, RN, who was willing to speak with us regarding the alarming rate of nurse suicides. “In the last 10 years I have seen the expectations of nurses increase and the staffing and quality of supplies decrease. Nurses have been told they need to do more with less for years and it keeps getting worse.”

When asked how the healthcare industry and its employers can better support the mental health of nurses, Begun had a lot to offer.

“First, fix the systemic problems in healthcare. Starting with patient to nurse ratios being lowered, and increased staffing for support of the department and to ensure someone is available to help in emergencies. We should not consider barebones staffing to be the norm. We also need to provide better resources for nurses to care for patients without having to use the cheapest thing on the market. Additionally, we need better hours and shift options. We should not need to work to the point of jet lag mental conditions, where our basic thought capacity is diminished to the point where we have trouble remembering to care for ourselves.

“Guilt is also a driving factor for nurses. We don’t call out when we are sick because we know the department will be hurt by us not being there. We don’t get decent breaks and we work to the point of dehydration and kidney failure potential. Toss in Neurogenic Nurse Bladder, a condition that develops because of the nurse’s lack of bathroom break time. Can’t pee, I might miss a call from the doc, or my patient might code while I am away.

“In regards to mental health specifically, it would be nice to have group support sessions where nurses can get together and talk about the issues they have. Resources for home-work balance need to be available, too. I always thought that a group yoga session would be a nice thing to have as a way to get your day started in a healthy manner. The first lesson I learned in nursing school was, now is not the time to try to quit any vices you have, in fact you might as well double down on them, because they are going to be what helps you get through your day. Nurses are taught to do the things that we then need to teach our patients not to do. Nurses are not taught coping strategies for how to handle their stress. They are only taught that it is a thing and you can’t escape it.”

If you are having thoughts of hurting yourself or others, we encourage you to seek help by calling the National Suicide Prevention Lifeline at 800-273-8255 or by texting 741741 to have a conversation with a trained crisis counselor via the Crisis Text Line.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Physicians and Suicidality: Identifying Risks and How to Help

Despite often being known as the healers, those who aim to save lives, it is estimated that as many as 400 physicians die by suicide in the U.S. each year.

Our physicians are unwell. Despite often being known as the healers, those who aim to save lives, it is estimated that as many as 400 physicians die by suicide in the U.S. each year. The profession has the highest suicide rate of any job, and one that is reportedly 1.4 to 2.3 times higher than the suicide rate of the general population—a rate that is, itself, up 33% since 1999.

The American Foundation for Suicide Prevention reports that physicians are less likely to seek help due to several barriers, including time constraints, not wanting to draw attention to self-perceived weakness, and fears regarding their reputation and confidentiality.

Knowing the risks and warning signs associated with suicide can help physicians identify colleagues who may need help, but are not asking for it.

A recent systemic review found that physicians whose career is in transition, such as having recently completed medical school or residency, or those who are approaching retirement, are often the most vulnerable, and that anesthesiologists and psychiatrists are at a higher risk of attempting suicide. Other identified factors of risk include being female, identifying as a member of the LGBTQ+ community, or those who have a prior history of mental illness or substance abuse.

Warning signs to look for include:

If a person talks about:

  • Killing themselves
  • Feeling hopeless
  • Having no reason to live
  • Being a burden to others
  • Feeling trapped
  • Unbearable pain

Behaviors that may signal risk, especially if related to a painful event, loss, or change:

  • Increased use of alcohol or drugs
  • Looking for a way to end their lives, such as searching online for methods
  • Withdrawing from activities
  • Isolating from family and friends
  • Sleeping too much or too little
  • Visiting or calling people to say goodbye
  • Giving away prized possessions
  • Aggression
  • Fatigue

People who are considering suicide often display one or more of the following moods:

  • Depression
  • Anxiety
  • Loss of interest
  • Irritability
  • Humiliation/Shame
  • Agitation/Anger
  • Relief/Sudden Improvement

Suicide is preventable. Help is possible. We encourage any physician that may be struggling with their mental health to seek help.

If you are in crisis, or want to speak to someone regarding a colleague who may be exhibiting signs of suicidality, we urge you to call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741741.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Optimizing EHR to Reduce Burnout? It’s Worth A Shot.

There is no one solution to fix physician burnout, considering it is a multifaceted issue, but optimizing EHR certainly can’t hurt.

Burnout, as we’ve reported over and over and over, is a pervasive problem impacting the physician workforce in the United States. There is no one solution to fix it, considering it is a multifaceted issue. However, the AMA has one suggestion—streamlining EHR.

EHR, which is often labeled as a factor of physician burnout, hasn’t exactly lived up to the hype surrounding it when it was introduced. It was supposed to be the wave of the future, a way to improve the healthcare experience for not only patients, but staff, as well. It’s done nearly the opposite, becoming a time-consuming burden for physicians and leading to breaches of patient data in a way that was never really possible with paper health records. However, it is seemingly here to stay, so optimizing it only makes sense, and one practice in Massachusetts may have cracked the code on how to do this.

In 2016, Reliant Medical Group, a 500-provider multispecialty practice in Massachusetts, ranked in the 97th percentile nationally for EHR usability. The system they have developed has reportedly resulted in a 25% reduction in physician in-basket message volume over an 18-month period.

How did they do it?

Establish A Comprehensive EHR Team

Reliant developed a team, which is comprised of five physicians, one physician assistant, and a nurse, who work in concert with 12 members of the IT division. This team meets weekly to identify ways to improve efficiency, and then the programmers go to work to implement changes.

Automate When Possible

Reliant created a system that can automatically gather and share patient information from multiple sources, such as affiliated hospitals and health plans. This has helped them to cut down on time-consuming tasks, such as calling around to other organizations for information.

Delegate Where Appropriate

A physician’s overflowing inbox is another source of burnout. Tweaking EHR so that other members of the staff, such as medical assistants, can gather and receive information without producing a message for the physician helps alleviate this. Within Reliant’s practice, only laboratory results are sent to the primary care physician’s inbox for review, while routine consultation notes are no longer delivered directly to the physician.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Seven Strategies to Prevent Nursing Fatigue

Almost all nurses have experienced nursing fatigue at some point in their careers; try these seven strategies to combat the effects of it.

By Deborah Swanson

Nurses are incredibly resilient. Each day, they wake up, throw on a set of scrubs and head into work to perform a demanding 12-hour shift—all while striving to provide the best possible care to their patients. Then, they get home and fall asleep, only to begin the process all over again.

But as a nurse, you know that this barely touches the reality of the situation. In the United States, most hospitals and clinics are woefully understaffed, which often forces nurses to work longer shifts and manage far more patients than they can actually handle. The unfortunate result is nursing fatigue, a common condition which can make you feel both mentally and physically exhausted for days, weeks, or even months.

Almost all nurses have experienced nursing fatigue at some point in their careers, so don’t feel guilty over it. Instead, you can try these seven strategies to combat the effects of nursing fatigue.

1. Leave Work at the Door

When you clock out from work, it’s important for you to clock out mentally as well. Leaving your work at the door is essential for avoiding compassion fatigue, a condition which results from repeated exposure to patient suffering while working in a high-stress environment.

In a 2017 study published in the European Journal of Oncology Nursing, researchers found that nurses were more likely to experience compassion fatigue when they were more self-judgmental. If you come home from work and feel guilty about all the things you could have done to make your patient’s life easier, you won’t give yourself time to recharge for the next shift.

2. Practice Different Forms of Self Care

Nurses go from patient-to-patient, checking their vital signs, administering medicine and assisting them with daily activities. As a result, it’s easy to get so caught up in caring for patients that you forget to take care of yourself.

To be on top of your game each day, it’s critical that you do things for yourself on a regular basis. Some self care practices you can try include: going for a walk in nature, starting your day with meditation or signing up for a healthy subscription meal service.

If you tend to feel guilty about treating yourself, make your forms of self care double as a bonus for work. For example, do arm work every other day to help lift your patients or invest in the new pair of nursing shoes that you’ve been eyeing for months.

3. Use Your Vacation Days

You have vacation days, so remember to use them. Taking time off work is key to preventing burnout and will help you return to work feeling refreshed and rejuvenated. If your nursing unit schedules vacations at the start of each year, be sure to get your days in the books—even if you don’t have anywhere in particular to go.

In fact, planning a “staycation” for yourself may be the perfect getaway. You can recharge your batteries by relaxing at home, catching up on things you’ve been neglecting and spending quality time with the family.

4. Unload Your Brain after Each Day

After a particularly tiring shift, sometimes you just need to declutter your mind and get all your thoughts out of your head. One way to do this is by writing them down on paper or typing them into a Google doc.

Untangling your mind and getting the thoughts out of your head can lower your mental brain fog and allow you to relax after a shift. The process is simple: Just set a timer for 15 minutes and unload your thoughts. Once the time is up, delete your document or click out of it. Reading it over again will only put the words back into your head.

5. Change Your Work Environment

While it’s no secret that most hospitals and clinics stretch their nurses far too thin, some take it to another level by creating an environment that is downright dangerous. If your healthcare institution has a poor nurse-to-patient ratio and no system in place to provide help for nurses, it may be worth it to begin searching for a new job.

Though nursing is an in-demand field, finding the right fit can be trickier than it sounds. Don’t be afraid to explore different healthcare settings to find your ideal work environment. While you might take a pay cut in some instances, the change could be the key to preventing nurse fatigue.

6. Find a Specialty You Love

It’s much easier to prevent nursing fatigue when you truly love what you do. If being a registered nurse just isn’t working for you, consider switching to a nursing specialty that makes you happy to stroll into work each day.

While you could always take a nursing specialty quiz to help you nail down your career, one of the best ways to get a feel for a particular specialty is hands-on experience. Are you interested in a position as an emergency room nurse? Talk with the ER manager and let them know you’re ready to help. There are hundreds of nursing specialties, so be sure to explore all your options to find a job that truly ignites your passion.

7. Explore New Hobbies

Every nurse needs a hobby that allows them to decompress and wind down from work. Finding joy in a new hobby can combat nursing fatigue by giving you something to look forward to after a shift.

Some of the best hobbies for nurses often double as stress-relieving activities, such as painting, knitting, woodworking and jewelry-making. Be sure to explore hobbies that get your heart rate up. Getting involved in a pickup soccer game, going zip-lining with friends and enrolling in a martial arts class can help keep your mind off work while improving your mood.

Long shifts combined with understaffed nursing units are the perfect storm for nursing fatigue. While some healthcare facilities are working to address the problem, it’s important for you to be proactive about your health and happiness. With the help of these strategies, you can fight back against nursing fatigue and prevent it from affecting your personal and professional life.

Deborah Swanson is a Coordinator for the Real Caregivers Program at allheart.com. A site dedicated to celebrating medical professionals and their journeys. She keeps busy interviewing caregivers and writing about them and loves gardening.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

PTs Say Admin Burdens Impact Clinical Outcomes, Cause Burnout

A recent survey of physical therapists has found time consuming administrative tasks negatively impact outcomes, and contribute to clinician burnout.

A recent survey conducted by the American Physical Therapy Association has revealed that nearly 3 out of 4 physical therapists believe that administrative requirements and documentation demands negatively impact clinical outcomes.

The survey also found that these administrative mandates, such as the time consuming process of obtaining prior authorization, can delay access to medically necessary care by up to 25%–72.5% of survey respondents wait an average of 3 days or more to obtain a prior authorization decision.

These demands do not only negatively impact patients; 85.2% of those surveyed agree or strongly agree that administrative burdens contribute to clinician burnout.

The survey did more than point fingers, though. As it was performed by the APTA in an effort to take the temperature of physical to aid the association’s legislative and policy changes, it also asked respondents how these burdens could be alleviated. The top five items that PTs feel would create positive change in this area are as follows: standardization of documentation across all stakeholders (51.5%), elimination of requirement for Medicare plan of care signature and recertification (38.8%), standardization of coverage policies across payers (38.1%), unrestricted direct access per payer policies (36.1%), and standardization of prior authorization process (36%).

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.