Stress and burnout are currently very common among healthcare providers. The American Medical Association conducted a survey of practicing physicians in 2014 and found that 54% met criteria for burnout, up from 46% in 2011. This means that over half of all physicians are now suffering from burnout, a situation that is leading to a potential crisis in healthcare as burnout has been associated with an increase in errors, turnover, and even leaving the profession. The rates among nurses, social workers and psychologists are also quite high. There are many reasons for this, including pressures for all healthcare providers to care for more patients as reimbursement is declining, medical care is becoming more complex as the population is aging and patients often have multiple chronic health conditions, and there are demands for increased documentation as records are becoming computerized with electronic medical records. Many of these factors are related to system issues in healthcare, and are often not under an individual healthcare provider’s control. Nonetheless, there is increasing evidence that mindfulness courses can result in decreased burnout and improved well-being. We evaluated the impact of the UVa Mindfulness Center’s Mindfulness for Healthcare Providers course and showed that participants had significant improvements in burnout and well-being after participating. A study from the University of Rochester showed very similar findings, as have a number of other recent studies.
If many factors related to burnout are due to system issues, why are mindfulness programs helpful? There are a number of potential reasons for this. First, mindfulness can be very useful in bringing increased awareness to those things that are under our control and those things that are not. If we are not paying attention to this, we often find ourselves getting very upset over things we cannot control. Becoming mindful of this does not mean we quit caring, but it can help us acknowledge the frustration we may be feeling, and then decide where to spend our energy, both mental and physical. For instance, we may find ourselves becoming upset over the amount of time it takes to document patient care in the electronic medical record, and we can spend a lot of energy being upset and complaining about this, and feeling it is not fair. Often this does little but make us feel worse. An alternative is to become aware that this is frustrating, and then choose how to respond. We might take a class to become more skilled at using the EMR, or we might join a group trying to improve efficiency in our practice area, or we might decide we don’t want to try to change things and just accept them as they are. Mindfulness can be key in working through such a situation, from recognizing our emotions without judging them, to paying attention to alternatives, to having the skills to actually let things go if we decide that’s the best course.
Another way mindfulness can help is through cultivating self-kindness and compassion. As healthcare providers, we often feel that we should be caring for others, and that caring for ourselves is selfish in some way. Yet if we are working ourselves to the limit, and maybe even suffering from burnout, it is unlikely that we will have enough energy left to help others in the ways we would like. If we are not paying attention, we may then end up judging ourselves for not being able to live up to our own expectations. If we are mindful that this is happening, we might choose instead to have compassion for ourselves, to acknowledge that the work we are doing is hard, and to give ourselves permission to care for ourselves as well as for others. As we hear every time we get on an airplane, “if the oxygen masks deploy and you are traveling with someone who needs help, put your own oxygen mask on first before helping others with theirs”, advice many of us in healthcare would do well do also heed in our work.
These are a few of the ways that mindfulness can help improve stress and burnout, even in situations when many of the contributing factors are beyond our control. If you would like to learn more, the UVa Mindfulness Center is offering a Mindfulness for Healthcare Providers (MHCP) class starting on September 27 that will meet weekly for eight weeks. It is being taught by Matt Goodman, MD and Cawood Fitzhugh, BSN, MSN, NP. Feel free to contact them or Karen Rush at the Mindfulness Center at kr3s@virginia.edu if you have any questions about the course.
As a past MHCP participant, a nurse, noted “I feel very passionate about this and can speak from experience. Mindfulness changed my perception of my work and my wellbeing. The course was truly transformational for me.”
Filed Under: Monthly Musings