Demands placed on clinicians by the health care system contribute greatly to burnout and dissatisfaction. In addition to necessary system-level solutions, strategies like mindfulness, meditation, and strengthening one’s own skills and abilities have also shown promise in helping individuals build resilience in both their personal and professional lives.
Stress on Clinicians and Trainees
Clinicians face many complex responsibilities in their daily lives and must make potentially life-saving and life-altering decision each day they show up for work. Strenuous reporting requirements, long work days, and understaffing leave many clinicians with less time with patients than ever before. Enduring enormous work stress can be overwhelming and can be compounded by personal stressors.
While there has been prolonged investigation into the prevalence of clinician burnout, slow progress has been made in actually implementing solutions that help clinicians thrive. While system-level solutions, including buy-in and purposeful investment from leadership, is critical, individual strategies, like mindfulness and strengthening one’s own skills and abilities, also show promise in helping clinicians develop resilience and cope with work-related stressors.
Mindfulness and Meditation
Studies suggest that meditation results in anatomical changes in the brain that lead to significant reductions of worry, state anxiety, and depression. While the practices to cultivate mindfulness originate from traditional Eastern meditation, these practices have increasingly been used in health care settings. Research suggests that formal programs which place an emphasis on learning techniques for mindfulness and open communication can be a useful tool to both clinicians and trainees. Leadership is instrumental in creating a culture that sustains resilience and supports clinician well-being. Organizations and universities could consider implementing programs that allow for practicing clinicians and trainees to learn techniques for practicing mindfulness in their daily lives. Click here to view nine tips for mindfulness. Mobile applications are also available to help tailor mindfulness to anyone and everyone’s needs. Web-based cognitive behavioral therapy may also help prevent suicidal ideation and reduce insomnia, anxiety, and depression in clinicians and trainees.
Click here for a roundup of mobile applications to help guide your own mindfulness and meditation.
Resources on Individual Strategies
Steps Forward – American Medical Association
STEPS Forward is a series of learning modules from the American Medical Association designed to help practices achieve the Quadruple Aim for health care. Over 50 free online modules are available around patient care;...
While organizations play a critical role in combating clinician burnout, strategies like mindfulness also show promise in helping clinicians build resilience.
Coping with Stress and Building Resilience
Resilience is a multidimensional characteristic that embodies the personal qualities that enable one to thrive in the face of adversity. Resilience can be built and fostered and is a dynamic, evolving process of positive attitudes and effective strategies. Four main aspects of resilience have been identified: (1) attitudes and perceptions, (2) balance and prioritization, (3) practice management style, and (4) supportive relations. Personal qualities associated with resilience include the ability to engage the support of others, optimism, faith, the belief that stress can be strengthening, and striving towards personal goals. Psychological resilience in intensive care unit nurses has been independently associated with a lower prevalence of posttraumatic stress disorder and burnout.
Exercise, fitness, and nutrition are also important when coping with stress. Stanford’s WellMD website offers helpful tips, exercises, and stretches to help individuals remain physically active even while at work. Stanford also offers helpful tips for work-life integration and finding balance.
Steps Forward from the American Medical Association offers a variety of modules for preventing physician distress and suicide, improving resilience, and for promoting well-being in residents and fellows. You can explore their website in greater depth to find activities aimed to help individuals enhance their professional well-being. CME credits are available for most modules.
The American Nurses Association recently launched its Healthy Nurse, Healthy Nation Grand Challenge which aims to broadly connect and engage individuals and partner organizations to take action within five domains: activity, sleep, nutrition, quality of life, and safety.
Skills and Abilities
As clinicians follow the trajectory of their careers, they must deal with technological flux and continually changing interpersonal relationships.
Challenges along the Journey
The world of the health care novice is vastly different from that of the expert clinician. Stressors occur at every step along the professional journey and they change over time. To effectively deal with the challenges of clinical life in today’s health care environment, mastering the art of teamwork is as important as mastering technology. The ability to recognize and mitigate stressors and respond to them in a healthy way as they arise plays a major role in clinician well-being and resilience. Those who embrace lifelong learning regarding both interpersonal skills and technology will be better equipped to manage new challenges. Individuals can develop new skills and strategies at each career stage. Organizations, too, will benefit from the provision of needed training in these areas.
The historical model that set physicians at the top of the decision-making pyramid is shifting. Health care has moved toward team-based care that recognizes the equally important roles of nurses and other allied health professionals. Clinicians who cling to an image of themselves as solo healers may fall prey to burnout and moral distress. In addition, overarching institutional structures and payer models put more restraints on clinician autonomy. Health care providers and institutions benefit from the creation of environments in which all team members can contribute their maximum value.
Traditional, siloed education processes may not effectively teach clinicians how to function in today’s model of team-based care. Successful teams depend upon both the skills of the leader and those of the members. Knowing how to fit into a team and how to leverage support from it helps health care professionals feel less isolated and frustrated. The development of communication and collaboration skills is essential to establish effective teams and maintain healthy work environments.
Clinical and Technical
Technological advances have led to improved tools for learning, communication, data gathering, organization, real-time patient monitoring and record keeping. Conversely, technology has also led to a disruption of traditional routines, more time spent at screens, the expectation of faster work pace, and potential overexposure to information. These aspects of technology can make the health care professionals feel distanced from both patients and colleagues.
The same new communication tools that allow health care professionals the flexibility to perform documentation from home may also be new sources of stress. “Work after work” does not allow clinicians to fully separate from their jobs so that they can rest and renew in an emotionally calm and safe home environment.
Clinical technology rapidly evolves, which results in equipment and software upgrades that require continual learning. This can make workers feel unable to keep up, anxious and uncertain. When it comes to resiliency in the face of technological flux, an individual’s outlook is pivotal. Workers who perceive technology as a threat, rather than as a helpful tool, are more likely to suffer burnout.
Overall, multidimensional interventions, which take into consideration the clinical skills and interpersonal abilities of health care professionals, are most likely to help prevent clinician burnout and support resilience across the span of clinicians’ careers.
While organizations play a critical role in systematically implementing strategies to reverse burnout and promote well-being, individual strategies, like practicing mindfulness, also show promise is helping clinicians manage stress and build resilience, manifesting in better patient care.