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COLUMNS
The Mental Well-Being of Clinicians Is a Top Priority
As healthcare providers around the world struggle to retain and hire staff in the midst of rising healthcare demands, how can the industry provide better support to prevent clinician burnout?
by Dr MJ Erickson-Hogue

Clinicians today are increasingly overwhelmed by the demands of their job.

Alarmingly, it is likely that this pressure will continue in the next ten years,1 with a growing global population, high patient expectations, the perceived burden of keeping pace with the latest digital health technologies, and the increase in research and patient data. As demand for healthcare increases year-on-year, healthcare providers are facing issues retaining and hiring staff around the world, including the Asia-Pacific (APAC) region. Against the surmounting health crisis, coupled with the prediction that there will be a bigger shortfall of nurses and doctors in 2030,2 it is imperative to turn the spotlight on caring for clinicians’ mental well-being.

However, according to Elsevier’s Clinician of the Future report in 2022, only 26 per cent of clinicians believe that the support given toward ensuring their well-being is a priority.1

The Psychological Stressors Associated With Clinical Practice and the Importance of Wellness

With mental well-being a key cog in a person’s overall wellness, it is seemingly difficult to ensure so in clinical practice, an inherently stressful industry. A common occupational hazard of professions that require emotional care is compassion fatigue, a result of physical, emotional, and spiritual exhaustion3 resulting from secondhand trauma of caring for patients with extreme stress.

Similarly, moral injury can also impact the clinicians’ mental well-being. While less discussed, it is the distress caused by “perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations”.4

It is a feeling familiar to healthcare practitioners, the sense of agony and guilt stemming from a decision that resulted in a less-than-ideal outcome. Moral injury, like compassion fatigue, leaves an emotional residue that can manifest itself, and without due care, lead to burnout.

Burnout leads to a decrease in productivity, an increase in turnover, an increase in avoidable medical errors and ultimately, poorer clinical outcomes for patients. Therefore, clinician well-being is crucially important, not only for us clinicians but also for patients.5

Driving a People-First Approach to Prevent Burnout

Wellness should not only be viewed as preventative care for clinicians but as a key focus in medical training and the whole healthcare ecosystem. Thus, burn-out prevention should be built into the foundation of healthcare systems.

Within the medical field, there exists a culture of presentism, where an inability to cope with physical and mental stressors can be treated as a weakness.6 To encourage healthcare professionals to seek early intervention support, it is critical for healthcare systems to put a stop to this undesirable culture and to provide support and a safe space for clinicians to express their feelings without feeling that it is wrong for them to do so.

Systemic research has shown that organisation-based interventions such as systems that allow for open discussions on well-being are more effective compared to individual or private interventions.7

Regardless, a holistic intervention is ideal.

Clinicians should also take steps to care for themselves on an individual level to maintain their psychological health to continue experiencing fulfilment in their profession. Implementing self-care routines can help clinicians recharge while ensuring they remain compassionate care providers to positively impact patient outcomes.8

Reducing Workload Burden to Minimise Burn-Out

Beyond the implementation of mental health initiatives in healthcare systems, the burn-out in clinicians is also due to the burden of heavy workloads and staff shortages.

Thus, to supplement culture change efforts, it is also important to support clinicians to circumvent overloads in their capacity.

Research released in 2022, revealed that 69 per cent of clinicians report being overwhelmed with the current volume of data1 and the same pool of people also predict that the use of digital health technologies will become a challenging burden in the future.

Tapping technological solutions can bring potential benefits, such as the use of streamlined, evidence-based practices on digital point-of-care web-based platforms like Elsevier’s Clinical-Key, which helps clinicians navigate large volumes of information with ease.

Consolidating mental health resources in the form of a Wellness Hub9 will also lower barriers for clinicians seeking help.

Conclusion

Against a backdrop of an increase in chronic diseases as well as the growing volume of data, there will be increased pressure on health systems across the world in the upcoming years. It has also brought to light the emotional toll caring has on medical professionals.

The past two years have been considerably challenging for a significant proportion of healthcare practitioners.

For clinicians to cope with the changing healthcare landscape, a stronger emphasis on mental well-being will be crucial for clinicians to overcome burnout and workforce shortages.

References:

  1. Elsevier. (2022). Clinician of the future: A 2022 report. Elsevier. Retrieved from https://www.elsevier.com/connect/clinician-of-the-future
  2. Almendral, A. (2022, January 28). The world could be short of 13 million nurses in 2030 - here’s why. World Economic Forum. Retrieved from https://www.weforum.org/agenda/2022/01/health-care-nurses-attrition-mental-health-burnout/
  3. Bhutani, J., Bhutani, S., Balhara, Y. P. S., & Kalra, S. (2012). Compassion fatigue and burnout amongst clinicians: a medical exploratory study. Indian Journal of Psychological Medicine, 34(4), 332-337.
  4. Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical psychology review, 29(8), 695-706.
  5. Dudley, J., & Lee, T. H. (2022, July 18). Patient experience and clinician well-being aren’t mutually exclusive. Harvard Business Review. Retrieved from https://hbr.org/2022/07/patient-experience-and-clinician-well-being-arent-mutually-exclusive
  6. Chandawarkar, A., & Chaparro, J. D. (2021). Burnout in clinicians. Current problems in pediatric and adolescent health care, 101104.
  7. Olson, K., Marchalik, D., Farley, H., Dean, S. M., Lawrence, E. C., Hamidi, M. S., ... & Stewart, M. T. (2019). Organizational strategies to reduce physician burnout and improve professional fulfillment. Current problems in pediatric and adolescent health care, 49(12), 100664.
  8. Skovholt, T. M., & Trotter-Mathison, M. (2010). The resilient practitioner: Burnout prevention and self-care strategies for counselors, therapists, teachers, and health professionals, second edition. Taylor & Francis.
  9. Elsevier’s Mental and Behavioral Healthcare Hub. Elsevier. (n.d.). Retrieved from https://elsevier.health/en-US/mental-health/home
About the Author

Dr. MJ Erickson-Hogue MD
Dr. MJ Erickson-Hogue MD, Senior Principal Clinical Editor, Point of Care, Digital Content, Elsevier Clinical Solutions.

Mary Jo-Ellen Erickson-Hogue, MD, FAAP is dual board certified in Pediatrics and Pediatric Emergency Medicine with over 15 years of clinical experience in the pediatric emergency department. She joined Elsevier in 2015 as a content medical editor for point-of-care resources published on Clinical Key that aid in clinical decision support for busy medical practitioners. Dr. Erickson-Hogue’s professional interests include wellness and preventative medicine.

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