Burnout in Healthcare: Reflections on Feelings of Stress and Overwhelm

Burnout in Healthcare: Reflections on Feelings of Stress and Overwhelm Posted By:
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The Journal of Healthcare Management recently published an article titled, “You Cannot Function in ‘Overwhelm’: Helping Primary Care Navigate the Slow End of the Pandemic” written by Sullivan and colleagues. The article presents the quantitative and qualitative findings of a survey distributed to primary care provider (PCPs) across the United States from March 2020 to March 2022. The purpose of this work was to identify organizational-level factors affecting the decline in mental health among PCPs during the COVID-19 pandemic. The results are presented as shifts in the nature of distress experienced during the time period in which the study was done. Although this work focuses on PCPs, I can only imagine that healthcare professionals (HCPs) working in any setting during that time period could also identify with at least some of the adversity described.

The title itself caught my attention and immediately brought to mind research professor, leadership expert, and author Brené Brown’s perspectives (which are referenced in the article) on “overwhelm” and “stress.” Attempting to paraphrase the authors’ and Brown’s descriptions of these 2 states, I would describe stress as a state where you are able to remain functional under pressured demands in your environment, whereas overwhelm is a state in which the pressured demands in your environment are so severe that it brings you to the brink of shutting down.

For specific problems, Sullivan and colleagues provide proposed solutions, a couple of which I examine here.

Feelings of Overwhelm
A solution offered by the authors is for individuals to recognize the point at which stress changes to overwhelm and for organizations to provide adequate vacation time and other leave options. To this point, I would say, “Let us take this even further.” Move toward an approach of preventing progression to the point of overwhelm. In addition, even in clinical care settings where resources may run lean, time away for clinical team members needs to have the appropriate infrastructure built in so that the preparation for and re-entry following time away itself does not create additional distress.

Years ago, I did an outpatient internal medicine clinical rotation with an HCP who had not taken time off in quite a while. They noted the amount of time they had to spend preparing to leave and then catching up when they returned was just too much—it “cancelled” the benefits of taking time off. That has stuck with me since, and I’ve found anecdotally at least that this is a reality experienced by many.

Mental Health Support
The authors offer various solutions that promote confidential support for mental health that meets HCPs where they are. Furthermore, they point to facility actions that can be taken to help mitigate stigma for those who pursue mental health support. To both items, I offer a resounding, “Yes!” HCPs should not be placed in a position of declining support for their well-being out of fear of losing their license or facility appointment on clinical staff. As Dr. Tait Shanafelt said, “We should be setting professional norms that medicine is an emotionally demanding profession and that it’s common at times to need help.”

I appreciate Sullivan and colleagues’ work in conducting this research and bringing to the surface many excellent points that can serve to improve the experience of PCPs, with high potential to improve the experience of HCPs in other care settings as well.


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Filed under: Miscellaneous

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