To help tackle healthcare worker burnout, start talking about it

The Covid-19 pandemic significantly worsened the already growing mental health crisis among healthcare workers. In their scramble to support their workers’ needs, leaders learned that the most important step is to begin a conversation.

In healthcare, there is a pervasive culture that hides silent pain, said Felicia Speed, Fresenius Medical Care North America’s vice president of social work services, at the MedCity INVEST conference that began Monday. This is why healthcare organizations must openly address mental health issues in a compassionate way.

Speed spoke on a panel about tackling healthcare staff burnout that was moderated by Dr. Anne Dabrow Woods, chief nurse, health learning, research and practice at Wolters Kluwer.

As the pandemic grew increasingly dire, Waltham, Massachusetts-based Fresenius Medical Care North America deployed its social work team to observe and identify signs of burnout and depersonalization among staff, Speed said. These signs can include workers suddenly wanting to isolate, becoming sarcastic or not wanting to communicate with patients.

The social workers began conducting mental health huddles to give staff a space to talk about the loss, anxiety and grief they were experiencing. They also talked to the clinical workers about compassion fatigue.

“[We tried to help our workers understand that] to have compassion fatigue, you first had to have compassion,” Speed said. “At one point in your life, or at the beginning of this year or at the end of 2019, you cared, you had compassion…you love people, you want to take care of people. So how can we get you back to that place?”

Dr. Peter Buecker, an orthopedic oncologist and chief medical officer at Elizabethtown, Kentucky-based BehaVR, echoed this sentiment on the panel. Healthcare workers tend to compartmentalize their feelings of loss or grief, he said. Though burnout can be hard to track, organizations must monitor their staff’s behavior.

“It speaks to the hospital culture, the unit culture — you have to know who your people are,” Buecker said.

If someone who is usually chipper is seeming exhausted or moody, leaders should pull them aside, acknowledge the strain everyone has been under and ask if they need help. The toughness mentality that exists in healthcare can really work against the entire team, he added.

This notion of toughness at all costs exists even at the most harrowing moments. Many clinicians feel as though they just have to move on after a traumatic event, like losing a patient, said Lesly Kelly, a nurse scientist at Chicago-based CommonSpirit Health, during the panel discussion.

Amid rising deaths from Covid-19, CommonSpirit Health instituted post-code pauses and honor walks to give clinicians a chance to take a moment and memorialize patients, she said.

Another issue CommonSpirit uncovered was that providing a host of mental health resources isn’t enough — you need to be able to guide workers as they figure out what kind of support they need.

“It’s hard to understand what you should be paying attention to,” Kelly said. “Should I be doing mindfulness? Should I be looking at programs? How do I cut through the noise?”

The health system created a multidisciplinary group just to help staff focus on psychological first aid and streamline the various evidence-based resources available. The group aimed to help staff members get to a place of feeling safe and being able to deal with the effects of the pandemic in the short term, she said.

It is only now that the health system is moving to more long-term mental health activities, she added.

These efforts will need to be ongoing as the mental health crisis among healthcare workers is nowhere near over. Here’s the full discussion: