Burnout in the medical profession - what does it mean for the New Zealand healthcare system?
“Tired, worn-out and uncertain”
Burnout is described as “emotional exhaustion, depersonalisation, and a reduced sense of personal accomplishment”.
This isn’t a new phenomenon - it has been going on for many years. However, by all accounts numbers are increasing.
Healthcare workers are more susceptible to burnout than other professions. Those working in psychiatry or mental health are at even greater risk.
Burnout can affect the health of those suffering, but also the quality of care given to the patient. This is a concern for health professionals as well as those who are receiving our care.
This is serious stuff!
We as healthcare professionals went into healthcare to care for people’s health. To make a difference. And many of us may be feeling that we aren’t achieving what we set out to do.
What can we do?
We need a new approach to health care.
When I left my role as a clinical nurse specialist some ten years ago, it wasn’t for the lack of money or being overworked.
I enjoyed my job working in mainstream psychiatry. I had a great team around me. And actually, I thought I was wonderfully well paid. Money was not the issue.
But I felt trapped. My job felt Sisyphean. Like we were pushing sh*t uphill.
It was a lot of work - with not much reward.
So when the patients were returning time and time again, not getting well, feeling frustrated and unheard - this was about my sense of reduced personal accomplishment. We worked within a reductionistist model - mental illness was all about something going on in people’s heads that was treated with talk therapy and medication.
One day, I remember feeling upset hearing a patient’s story and thinking - this is ridiculous - I’ve heard this story 100 times before - why am I upset?
Before I realised - this is exactly why I was upset - I had heard this story 100 times before and I wasn’t sure that what I would do would make any difference. Our healthcare system wasn’t working and people were suffering. Dying actually.
A thankless task
Interesting studies have looked at people being paid to build with Lego. What a cool study! Paid to play.
Here’s the thing:
In one condition the researcher put the Lego objects built by the participants in a box.
In another study, they pulled the Lego objects apart in front of the participant ready for the next build.
Guess who got tired of playing with the Lego more quickly?
Having your work taken apart in front of you was not rewarding.
How do we make medicine and healthcare appealing and interesting?
When we are in a job with little reward - we become unhappy and dissatisfied. We went into healthcare to make a difference. If we (health professionals) loved our jobs and felt we were making a difference we wouldn’t be leaving. As stated in this article:
“Burnout is not only about long hours. It’s about the fundamental disconnect between health workers and the mission to serve that motivates them”.
It’s not about the money.
Doctors and nurses are becoming burnt out, overworked and struggling to hold up a system that is falling down.
“Burnout manifests in individuals, but it’s fundamentally rooted in systems”
Our medical model has felt very authoritarian and paternalistic to me for several years, 'Here's your diagnosis, take these pills' - and despite us being a caring, dedicated bunch of nurses and doctors, it hadn't felt quite right for some time.
Our healthcare model needs to change.
Despite being a psychiatric nurse, DAO (Duly Authorised Officer & CNS (Clinical Nurse Specialist) with something close to 20 years of experience - I trained to be a Life Coach over ten years ago - because I wanted a new model that was empowering and forward-focused to use with the people I was working with.
Having a different focus - empowering people and seeing results - experiencing the job of seeing someone take care and ownership of their health is one of the more rewarding things we can experience as a healthcare worker.
I have bumbled my way through finding a niche for the last ten years or so - I know many health professionals have left mainstream nursing or medical practice to focus on delivering a different model of healthcare as they have had their struggles with the way we practice and manage chronic disease and mental illness.
We need to start empowering patients to take charge of their health and well-being.
Now I know this may cause some eye-rolling. And I know that many people can not or will not be able to do this.
But most people do.
They’ve just given the baton over to the medical profession.
Studies done by Felice Jacka et al. and many other studies done in mental health - have shown that people are willing to make changes - especially within mental health - because they feel better. My experience working with patients is the same. Given the right information and the right motivation - they are happy to make changes to improve their health.
More money? I don’t think so.
We’ve all seen the protests and the demands for more funding.
But I think we are barking up the wrong tree.
More money is not going to fix our healthcare system
More money is not going to bring more doctors or nurses
More hospital beds isn’t going to solve our health crisis (mental or otherwise)
And neither (sorry Mike) is having more therapists.
Our problem is that we are continuously picking up the pieces at the bottom of the cliff. And this is largely unrewarding for us as health professionals.
We need to change our focus and approach to a true preventative healthcare model.
People need to feel empowered so that they can make a difference when it comes to their own health care.
We need to start with parenting skills, nutrition in prenatal care, community care
We need to start with the basics - good food, regular movement, relationships & coping skills
We need to mitigate the effects of trauma (especially ones shown in ACEs to impact mental well-being.)
We need an uprising and a complete change in the way we approach health.
We went into nursing and medicine to care. To make a difference. And many of us may be feeling that we aren’t doing this so much.
But one thing to remember is that we are the system. We are the people and the bigger the group - the more we can work to transform our healthcare into one that is health-care - the more we can move the needle, and reduce the death and disease from preventative illness.
Thank you for being at least the slightest bit interested if not jumping in boots and all on this as we bumble our way through finding a new way of creating a healthcare model that heals
Helen is a registered nurse and life coach, specialising in mental health from a holistic perspective. She is passionate about supporting people to have optimal mental health and well-being.
Based in New Zealand, Helen is available for speaking, education sessions and one-on-one appointments.