Content Warning: This article contains references to suicide.
Everyone needs rest, including health care workers. Healthcare professionals experience a high amount of burnout. The COVID-19 pandemic emphasized the need for a deeper look at the quality of life for physicians, nurses, pharmacists, social workers, and other health care professionals. Healthy workers are essential to the economy, and to society. Increasing access to paid leave time can greatly benefit healthcare workers to take care of their family and medical needs, and reduce burnout resulting from an overburdened healthcare system.
In healthcare, some workers feel a moral dilemma about not going to work, because their patients and co-workers rely on their presence. Brianna Jacobs, a social worker, describes having a complicated relationship with rest. During her job transition she relays that she is “learning to love her a lot more,” and that “down time isn’t a sin.” Rest does not equate to lack of productivity, and it does not have to be stressful.”
Kimberly Knight, also a social worker, emphasizes that her rest is her reconnection time and it is beneficial to her clients as well. “If I am not stable, I bring distress to my clients.”
Brianna has experienced burnout, and noticed having physical symptoms of silent migraines, a lot of stress, lack of sleep. “As healers in this field, I understand business, people have to make money. It’s an extremely hard field to work in if you’re not taking time for yourself.” Brianna mentions that she has to balance meeting other people’s needs, with her needs, and she makes sure that her clients develop the proper coping skills so they are not completely dependent on her.
Every business has a different approach to paid or unpaid sick leave. In Brianna’s previous position, she transitioned to salary and used her paid time off. However, her employer expected her to stay later on the weeks when she took a day off. Needless to say, her time off was not paid, just rescheduled.
“It’s about finagling your schedule. Moving your people around and creating a schedule that allows you to take rest but knowing that you’re not going to get paid for it.” Brianna celebrates her new position allowing her to get 10 days a year and holidays.
Kimberly Knight recently entered the field of social work after spending time working in the school system and public health. “In the school system, it is very hard to take time off, and you had to have a good reason,” she says after spending 14 years in education. She experienced burnout as an HIV disease interventionist, having no paid time off, no sick time, and extended hours of work. She worked in this field for two and a half years noting that she enjoyed her time in the beginning, but grew weary towards the end of her time in the field. As a new therapist, she is working at two clinics remotely; one part-time, and one full-time. “I can make my own schedule,” she says, “I have a lot more flexibility.” Because of this, she can take mental health days and spend time taking care of her father. Kimberly has the freedom to take care of her needs and the needs of her loved ones with her access to paid leave.
Dr. Clark Gaither, Medical Director of the NC Professionals Health Program (NCPHP), wrote in an article that large scale studies revealed that job related burnout rates were up to 50% in medical professions nationwide, and 70% for emergency medicine. Christina Maslach created the Maslach Burnout Inventory (MBI), which categorizes the burnout on three scales: depersonalization, emotional exhaustion, and personal accomplishment. Other underlying factors are: work overload, lack of control, insufficient reward, breakdown of community, lack of fairness, and conflicting values.
“There’s a detectable burnout rate in any profession, it’s just that some professions are higher than others, medicine being one,” according to Dr. Gaither, the author of Reignite and consultant on burnout recovery.
“The COVID situation served to intensify the hallmarks of burnout and amplify the underlying drivers of burnout.” Dr. Gaither started researching the topic after experiencing the symptoms, “I was going to have to leave the practice of medicine,” he recalls. He expresses being perplexed about how something he truly loved and invested so much time in could have turned into a feeling of dread. He navigated his burnout experience by reducing his work hours, which he acknowledges was a crucial part of his journey to his recovery. While spending less time working in medicine, he was able to recharge, revisit old hobbies, and form a better work life balance.
Dr. Gaither distinguishes burnout from stress. “The primary damage from burnout is emotional. It’s not physical, like stress. That’s why we see higher rates of depression and suicide among people who are burned out versus people who are overly stressed.” He posits that stress reduction programs will not mitigate the root cause, because it only treats the underlying symptoms. The source of burnout is a high stress, low reward, and over capacity work environment. People need time off to decompress, and rekindle interests and relationships outside of work.
“The solutions to stress and burnout are different,” he states, emphasizing that burnout can occur with stress, but stress can be present without burnout. With stress, there is an impetus toward hyperactivity,” he states. “Burnout people disconnect not only from those that they serve, but also what they have chosen to do. It conveys a sense of hopelessness and helplessness, which is a symptom of clinical depression.” Giving employees paid time to treat burnout promotes healthier work environments, and gives lower income employees in the healthcare industry access to the resources they need to come back to work in a better state of mind.
Dr. Gaither shares that minimizing unnecessary tasks in the workplace can give healthcare workers more freedom to prioritize tasks that promote a sense of reward and reduce work overload. “Burnout mitigation is not completely changing the workplace. It’s making easy changes that make sense.” Organizations fail to realize that burnout mitigation reduces costs and can even generate revenue. The byproduct of healthier healthcare workers is a decrease in turnover and less patient complaints. Dr. Gaither says that it can cost anywhere from $250,000 to $1.2 million to replace a physician depending on the field.
The National Academy of Medicine issued a statement of commitment reversing burnout and promoting clinician well-being. The North Carolina Medical Society and several other health institutions in North Carolina made the same pledge. It is important for the laws in North Carolina to support the push for healthier healthcare workers. Promoting paid leave and burnout mitigation can help healthcare providers take time to recalibrate. Companies can provide free mental health services on the work site, and encourage workers to use paid time to see the therapist without stigma. Paid time off combined with reducing underlying drivers of burnout in the workplace can result in more sustainability in healthcare practice.
American Medical Association (AMA) published an article that states physicians are at higher risk for suicide and suicidal ideation than individuals in other professions. Some signs of suicidal ideation are substance-use disorder, depression, emotional exhaustion, impaired relationships, and self-destructive behavior.
If anyone is experiencing a mental health crisis, suicidal thoughts, or any emotional distress, contact the 988 Suicide & Crisis Hotline.
Aminah is an integrative researcher, activist for Indigenous and Black issues, and advocate fighting violence against women and children. Aminah grew up in Pembroke, North Carolina and is a member of the Lumbee Tribe. Beyond being a Division I track and field athlete in college, Aminah has also channeled her energies into her education having studied Biology at East Carolina University and completing a Masters in Physiology and Biophysics with a concentration in Integrative Medicine from Georgetown University. Her research with Breaths Together for a Change centers blending wisdom traditions, Indigenous epistemology, with Western epistemology to test how mindfulness can reduce racial bias and heal historical trauma. She has served as a Domestic Violence and Sexual Assault victim advocate, a board member for the Missing and Murdered Indigenous Women NC Coalition, and created Good Medicine Woman LLC to address gaps in knowledge about Indigenous culture. She ran for NC House District 47 in 2022, and is an ECU 40 under 40 Leadership Award recipient.