We see headlines every day: Healthcare workers are Exhausted, dissatisfied and leaving the labor market. Surveys show that this is currently first question In the minds of hospital CEOs.staff shortage Negative impact on patient safety and bottom line.In response, health systems and hospitals are scrambling to provide better compensation, provide rest days, establish a wellness program and encourage workers to meditate, keep a gratitude journal, exercise, eat well, sleep better, and seek professional mental health support to deal with stress. Let’s pause here. We must wake up. While these actions are noble and may provide modest relief, we ignore the bushfires raging around us.
Current narratives, reviews and even research burn out Focus almost entirely on “resilience” and “well-being.” The solution being implemented essentially defines the problem as existing within the individual. In other words, the method is primarily designed to increase each healthcare worker’s tolerance for stress. It’s as fitting as telling every worker in a nuclear power plant with a radiation leak to put on another layer of hooded overalls and get back to work. Is the real problem we are not resilient enough, or are we basking in a toxic environment every time we walk into a building? No matter how many hard-earned bonuses, vacations, massages, or wellness apps are offered to employees, nothing will meaningfully change if they step into a disruptive environment every day. Their emotional, physical, mental and spiritual damage will not go away by building more resilience. We must resolutely confront oppressive institutions and the environment in which they operate.
a major factor contributing to physician and Nurse Burnout is a feeling of loss of autonomy. People feel helpless, unable to make decisions, change circumstances, or make a difference. Healthcare workers were not heard, valued or empowered to act. Nor are they provided with professional development to acquire essential skills to navigate change, culture, conflict, teamwork, or work in crises. Instead, they are relegated to very narrowly scoped task masters, shouldering productivity demands and bureaucratic burdens, competing for limited resources, and expecting self-sacrifice, tireless, and flawless. My son, who works on a security team at a community hospital, told me that verbal and physical assaults occur every day, not only involving attacks on health workers by patients and visitors, but health workers themselves. Sadly, this is commonplace in the US healthcare system.Even sadder is the rate suicide Doctors are the highest of all occupations and twice as many as the general population.
The root cause of the suffering of healthcare workers is best described in this word structural violence, coined in the 1960s as a means of describing social structures or institutions that leave individuals unable to meet basic needs or are severely marginalized. The exact same dynamic exists in healthcare – people work in an environment (structure) that leads to harm (violence). It’s no different than a nuclear reactor leak injuring workers inside a power plant. As we eat more omega-3s and talk to our therapists—or double down on our radiation suits—our spotlights need to shine brightly on dysfunctions in our workplace. It has to be remedied from the inside out. We’re going to get old long before any outside agency comes along to solve the problem for us.
In my decades as a physician executive, I have seen a disconnect between the executive suite (myself included) and those on the front line. I see executives very eager to empower the front line, but they struggle to follow through with concrete actions. What better way to show that you care about healthcare professionals than to declare that everyone here is a leader in their own right, and then start treating them that way? Healthcare’s most valuable resource is its people. However, leadership training is usually only for those with flashy titles and ranks, and the vast majority are left behind. Our organization should simultaneously provide top management with the skills to engage, include, and empower the frontline, while training all employees on how to build culture, how to manage change, how to resolve conflict, and how to build respect and trust in the workplace.By developing leadership skills everyone, the organization spreads problem-solving skills across the enterprise, builds worker trust in the institution through inclusion, and harnesses the creativity of the entire workforce. It will take all of this to fix our broken system.
The workforce crisis is not hopeless, but requires bold action and a bigger picture to alleviate these real pressures and unsustainable problems. Developing caregivers with leadership skills is a tangible action that builds a culture of trust, demonstrates respect, promotes inclusion, and is our best bet to begin mitigating the violence our environment creates against us.
Photo: People Pictures, Getty Images
