Stress in the health care workplace has generally been accepted as “just how things are” — or even touted as a badge of honor, for those who can manage it.
But fewer and fewer people can manage it. A survey of practicing physicians conducted by the American Medical Association in 2014 found that 54 percent met criteria for burnout, up from 46 percent in 2011. The rates among nurses, social workers, and psychologists are also quite high.
There are multiple drivers behind these statistics. Providers are feeling pressure to care for more patients, as reimbursement is declining; medical care is becoming more complex, with an aging population and influx of technology; and the wider adoption of electronic documentation has created new demands for care providers.
As members of health care delivery teams, regardless of our practice settings, we face constant flows of sensory inputs that demand our attention. At every turn, there are monitors, alarms, cell phones, and text messages. A study in the Journal of Experimental Psychology: Human Perception and Performance found that just hearing or feeling a phone alert makes people three times more likely to make a mistake.
Yet in the midst of all this, we must maintain our intense focus, to deliver skilled clinical care — while being present, making meaningful human connections, and showing deep compassion for our patients.
How can we address these significant and sometimes overwhelming challenges?
Traditionally health care work environments are not designed for reflective, mindful approaches to patient care and staff resilience. Most health care professions curricula don’t include ample focus on human-connection skills and strategies that support clinicians to engage with patients in a meaningful, undistracted, unhurried manner. There is also pressing need to focus on helping current and future health care workers to develop personal strategies for self-care and resilience.
The new IHI Open School course, PFC 103: Incorporating Mindfulness into Clinical Practice, is one very small step to bring this essential training to the health care workforce. There is increasing evidence that learning to practice mindfulness can result in decreased burnout and improved well-being. Mindfulness is a useful way of cultivating self-kindness and compassion, including by bringing increased awareness to and acceptance of those things that are beyond our control.
As health care providers, we are driven in our work with the purpose that we should be caring for others, yet often we view caring for ourselves as selfish in some way. If we don’t engage in self-care and are continually working ourselves to the limit, perhaps suffering from burnout, it is unlikely that we will have ample energy to help others in the ways we would like.
There’s increasing awareness that creativity, productivity, and extended high energy aren’t the result of prolonged engagement with stressful mental frameworks. Rather, they require a more balanced, caring approach to the management of personal energy and one’s responses to the environment and situations that arise.
It’s been shown that individuals and groups can be taught to process their responses to stressful conditions in productive ways that support well-being, resilience, and long-term health. That’s why health care organizations such as IHI are heavily focused on restoring joy and satisfaction to health care. To face the mounting challenges of delivering safe, quality care in a frenetic workplace, it is not enough to rely on clinical skills and the desire to do good. We need a workforce that is equipped with training to be more resilient, present-minded, and compassionate toward patients and themselves.
Kate FitzPatrick, DNP, RN, is Chief Nursing Officer at the University of Vermont Medical Center and is the lead author of the PFC 103: Incorporating Mindfulness into Clinical Practice IHI Open School course.
With more than 30 topics available, IHI Open School online courses are multimedia learning modules that teach practical skills to improve quality and safety in health care. The courses offer continuing education credits for nurses, physicians, and pharmacists as well as a Basic Certificate in Quality and Safety.
In the one-hour course PFC 103: Incorporating Mindfulness into Clinical Practice you'll learn how practicing mindfulness — that is, assuming an aware, nonjudgmental, present state of mind — can enhance quality and safety for patients and foster joy in work for clinicians, helping to prevent burnout.