Maddison arrived for her bi-monthly checkup. Her hands slightly trembling, she sat down across from me, adjusted her skirt, and said, “I-I-I think I’m ready to try therapy.” This was significant! She had resisted for months despite an ongoing anxiety disorder.
As I quickly checked my practice’s computer system, my heart began to sink. Her insurance didn’t cover psychotherapy, and even if it did, there were no openings on the social worker’s schedule. Actually, we had lost one of our best therapists last week.
I explained the predicament to Maddison, who appeared confused and then panicked. Her escalating emotions filled my cramped, windowless office with tension. “I need meds then. For my attacks. Please!” Maddison demanded.
I wanted to help her, but I knew medication wasn’t the best solution. Instead, I started explaining a few simple deep-breathing techniques. I glanced at my watch; Maddison noticed and recognized that her 20-minute appointment with me was over.
She became desperate. “Please. You know my…” She began iterating through her volatile past. I heard myself explain why medication wasn’t the answer as she stormed out.
I sat in silence, alone for a moment. My heart pounded against my chest. I felt sick, tired, and like a failure. I wanted to help Maddison (she wanted to help herself!), but there wasn’t enough time, resources, or support.
Clinician Burnout & Its Consequences
According to the National Institutes of Health, 67% of psychiatric providers are experiencing high levels of burnout. Clinician burnout occurs when you compassion fatigue with time pressures, a chaotic workplace, misalignment of values, and a lack of autonomy.
Overall, the symptoms of burnout resemble those of post-traumatic stress disorder and can include intrusive thoughts, nightmares associated with work, insomnia, chronic irritability, fatigue, difficulty concentrating, avoidance of patients or work events, hypervigilance, and angry outbursts.
The consequences are devastating, impacting not only the clinician herself but also the lives of their patients and the healthcare system as a whole. For example, research demonstrates that providers with burnout are more likely to make a medical error and experience malpractice litigation. In addition, their patients are less satisfied and less adherent to prescribed treatments.
Finally, clinician burnout is expensive. Estimates suggest that burnout costs the healthcare system $213 million annually due to clinicians either retiring early or working fewer hours.
Creative Solutions to Address Burnout
This month is mental health awareness month. It is an important time to reflect on the importance of mental health care (i.e. mental wellness), both for patient and clinicians.
A 2013 study investigated characteristics of clinicians who aren’t burned out. This study found that clinicians who had at least two hobbies outside work and spent more time exercising and relaxing were much less likely to experience symptoms of burnout.
It is especially important for psychiatric clinicians to monitor their own mental wellbeing as they are caring for those living with mental health conditions. During this month, consider these creative solutions to prevent, mitigate, or correct you burnout systems:
- Begin a new fitness routine and gamify your progress using a tracker and wellness app like SuperBetter.
- Explore new hobbies such as jewelry making, hiking, wine tasting, making your home a smart home, becoming a sous vide culinary expert,
- Create a multi-disciplinary anti-burnout team at your organization that explores and measures the scope of the problem in your organization. You can also develop campaigns that address your unique challenges.
- Join a local meetup group on a topic of your interest! There is everything from cooking, to hiking, to learning a new language.
- Treat yourself to a day at the spa of your choice or do it all from home with a spa gift basket or gift card.
- Explore unique career options such as telemedicine that facilitate a more flexible schedule or the ability to work from home.
About the Author
Melissa DeCapua, DNP is a board-certified psychiatric nurse practitioner who graduated from Vanderbilt University. She has a clinical background in child and adolescent psychiatry as well as psychosomatic medicine. Dr. DeCapua currently works at Microsoft as a user researcher, using her knowledge of human behavior to guide product development. She is a strong advocate for empowering nurses, and she fiercely believes that nurses should play a pivotal role in shaping modern healthcare. For more about Dr. DeCapua, check out her blog at melissadecapua.com and follow her on Twitter @melissadecapua.