Stop Calling It Burnout

Thank you for posting this. The workload is fast becoming unsustainable and has only got worse in the last 20 yrs. And while i like the word change i honestly dont see it making a difference to management. Hopefully it might make it easier for an individual to cope knowing that the "burnout" was not necessarily an individual/personal issue but one of unrealistic demands of the corporate world of medicine.

This video is exactly right. Through unions, laws, or choice of workplace, we need to encourage a more reasonable working environment that features better staffing, resource/break nurses, more aides, etc. Squeezing of the employees seems to be happening more and more in many industries, but it's especially painful watching patients suffer because we don't have time to provide good care. Unfortunately, the aggressiveness and f-bombs on display in the video are a bit too colorful for my social media pages, so I won't be sharing the video. I suggest a new version of the video be made that shows passion and wisdom without dropping f-bombs, etc. Such a video might be shared with more people, or perhaps even be shown at a staff meeting or union meeting. But the message of the video is right on the money, for sure.

I called BS a long time ago on the idea that if someone (and then more and more and more "someones") struggled to accept and navigate the increasing divide between patient care ethics and the business of healthcare, there is something wrong with that person (and that person and that person and that person) or they are all individually weak in some way.

The business of healthcare doesn't only clash with nursing ethics, some of its own demands themselves are mutually exclusive.

I wouldn't put most of this in the same terms as ZD does (war, victim, etc.) and he also goes unnecessarily and inappropriately overboard in generalizing about the sacrificial virtues and altruism of healthcare workers. At the same time, it certainly doesn't take a rocket scientist to see how convenient it is to apply these words "burnout" or "burned out" to individual people who grow weary, fed up, troubled, stressed, conflicted, etc. in reaction to recent lunacy.

He sounds a little bit like he just learned about this "moral injury" thing - but that whole concept isn't completely new to nursing. We know about moral distress, ethical dilemmas, ethical conflicts and all the manifestations related to being conflicted when ethical principles clash or ethics and legal principles clash, or when we feel we are not able to do the job in the ways we are taught are right/correct/ethical. All of that is old news and we've all been taught to dutifully expect that internal conflict will arise at times. For the most part IMO we have been decent at navigating and processing basic (and sometimes complicated) nursing dilemmas that are not personal to us.

But the problem now isn't huge case-study-type ethical issues in medicine/nursing where, in worst cases an ethics committee will weigh in; instead the problem is constant demands that contradict each other in settings where success is already sabotaged by conflicting interests and failure can easily be ascribed at the individual level.

Old tools don't work for that. Time with loved ones or getting a massage or doing something fun or taking a vacation or finding a new job or using meditation don't empower people to learn how to more healthfully and vibrantly thrive at being treated like crap.

So I give him credit for publicly calling BS on "burnout" and on the idea that it is an individual's personal-fortitude problem.

After three decades of bedside nursing, I can't wait to get out of inpatient nursing. ZDoggMD articulated my point succinctly.

44 minutes ago, JKL33 said:

I called BS a long time ago on the idea that if someone (and then more and more and more "someones") struggled to accept and navigate the increasing divide between patient care ethics and the business of healthcare, there is something wrong with that person (and that person and that person and that person) or they are all individually weak in some way.

The business of healthcare doesn't only clash with nursing ethics, some of its own demands themselves are mutually exclusive.

I wouldn't put most of this in the same terms as ZD does (war, victim, etc.) and he also goes unnecessarily and inappropriately overboard in generalizing about the sacrificial virtues and altruism of healthcare workers. At the same time, it certainly doesn't take a rocket scientist to see how convenient it is to apply these words "burnout" or "burned out" to individual people who grow weary, fed up, troubled, stressed, conflicted, etc. in reaction to recent lunacy.

He sounds a little bit like he just learned about this "moral injury" thing - but that whole concept isn't completely new to nursing. We know about moral distress, ethical dilemmas, ethical conflicts and all the manifestations related to being conflicted when ethical principles clash or ethics and legal principles clash, or when we feel we are not able to do the job in the ways we are taught are right/correct/ethical. All of that is old news and we've all been taught to dutifully expect that internal conflict will arise at times. For the most part IMO we have been decent at navigating and processing basic (and sometimes complicated) nursing dilemmas that are not personal to us.

But the problem now isn't huge case-study-type ethical issues in medicine/nursing where, in worst cases an ethics committee will weigh in; instead the problem is constant demands that contradict each other in settings where success is already sabotaged by conflicting interests and failure can easily be ascribed at the individual level.

Old tools don't work for that. Time with loved ones or getting a massage or doing something fun or taking a vacation or finding a new job or using meditation don't empower people to learn how to more healthfully and vibrantly thrive at being treated like crap.

So I give him credit for publicly calling BS on "burnout" and on the idea that it is an individual's personal-fortitude problem.

I can't thank you enough for your response. You've brilliantly blown the muck off a piece of this that's been bothering me but I couldn't bring into focus. I never noticed before I've been lumping the intrinsic conflicts of the profession with the personal (although systemic) mistreatment and trying to use the same tools to deal with both.

But I do see the parallels between the experience of some in combat and some (most?) in health care professions. From having lived with two individuals with PTSD, one from Vietnam and one from being at Ground Zero on 9/11, I can say the fundamental schism with both them and me is the same. We all tried to do the impossible, having been intensely schooled and pressured to believe our efforts were our duty, and failing to successfully deliver was personal failure. The difference comes in that soldiers are taught it's their duty to sacrifice themselves if necessary, but health care workers are fed the denial that the tools to ensure their safety and well being are available to them. Further, the healthcare system itself denies complicity in the mistreatment, and deceptively markets its support of workers with the same glossy photos and lofty words it uses to market itself to consumers.

On a different note, I wonder what's going to happen as younger people enter the professions with what appears to me to be different expectations of and response to the demands of the workplace. Maybe it's just my limited view, but I see people with a cost/benefit outlook on their employment much more in line with the model I see employers using. I see a generation with lower expectations of decent treatment by and longevity with employers and more reliance on ongoing evaluation of the value of the specific workplace to them.

Anyhoo, I'm off to my own battles today, thanks again.

He offers some potential solutions in this Twitter thread.