By Nancy Collins, PhD, RDN, LD, NWCC, FAND
Wound care is a stressful profession, and sometimes your empathy bucket becomes empty, but job burnout is not a proper professional or legal defense.
A group of my professional friends were having lunch together and catching up when one friend disclosed that she was taking a month off of work. We all looked at her agape and at the same time exclaimed “a month?” We had a dozen questions for her. Was she ill? How did she arrange this? What did her supervisor say? Would she still have her job at the end of the month? And most importantly, why was she taking a month off?
She replied that she was burnt-out and needed a break. You can imagine that this response elicited just another round of questions. Does someone get a month off because they are tired? Was that what she was saying? In retrospect, it is clear that she was more than tired. She was nearing personal and professional exhaustion and not treating her patients with her usual caring nature. She was a good practitioner, but had to take care of a few things for herself before she could get back to caring for others. She had obtained a doctor’s note for a mental health break and was cleared for this by her employer because she was indeed a valuable employee. But is her case the exception or the rule?
Putting a Name to It
No one likes to admit they are suffering from job burnout, that is until they are in front of a courtroom and need to offer some sort of plausible explanation for the poor care reflected in the medical record. In that instance, it seems that feeling overwhelmed by the job is a rational thing to admit. No one pointedly says they have burnout. They use euphemisms—such as the word overwhelmed—to explain why a patient slipped through the cracks, or the patient’s turning schedule went awry, or a dressing change was not done on time. And maybe they were truly overwhelmed, but is that a suitable defense?
A Recent Case
In a recent legal case, a wound care nurse testified that she was feeling stressed out by both her job and her home life. She explained that her patients were not listening to her, just as her children were not listening to her. Her patience was thin, and yes, she was tired but she was doing the best that she could. She admitted that she was questioning her role in the long-term care facility as the wound care nurse and wondered if perhaps there was something “better” suited for her.
She certainly had a lot on her plate and seemed genuine in both her distress and her efforts to get everything done properly. The plaintiff attorney pointed out that the bottom line was that everything was not done properly and the patient’s wounds worsened. The defense attorney was quick to counter that the wound would have worsened no matter what because of the patient’s medical condition, but because we don’t have a crystal ball, we will never know for sure.
Digging a Little Deeper
This scenario is seen in every healthcare facility in the country in some form today. We don’t need a courtroom or attorneys to recognize that some of our co-workers, or even ourselves, are angry, frustrated, bored, irritable, uninterested, or just plain drained. We may commiserate with each other over our lunch break, but nothing substantive really happens. Until a lawsuit is filed that is. This is why we need to change the conversation and have real solutions instead of platitudes for colleagues who need a mental health break or some time to recharge.
Questions to Ask
According to the Mayo Clinic, job burnout is a special type of job stress—a state of physical, emotional, or mental exhaustion combined with doubts about your competence and the value of your work.
Could you be experiencing job burnout? Ask yourself the following questions:
- Have you become cynical or critical at work?
- Do you drag yourself to work and have trouble getting started once you arrive?
- Have you become irritable or impatient with co-workers, customers, or clients?
- Do you lack the energy to stay consistently productive?
- Do you lack satisfaction from your achievements?
- Do you feel disillusioned about your job?
- Are you using food, drugs, or alcohol to feel better or to simply not feel?
- Have your sleep habits or appetite changed?
- Are you troubled by unexplained headaches, backaches, or other physical complaints?
If you answered “yes” to any of these questions, you might have burnout and may need some intervention.
Burnout occurs for a wide variety of reasons, and finding the underlying reason is the key to addressing it effectively. The answer is not always so deep and complicated. Some people really are not well suited for wound care. Others may have an undiscovered medical problem, such a thyroid disorder. Many others may have a home-work imbalance that they need to address. It might mean that more sleep, exercise, or downtime is needed.
From the facility’s leadership point of view, it is important to create an environment where employees can take a mental health break without repercussions. Frustration often comes from feeling a lack of control. Giving employees a say in how to best get the job done always is appreciated rather than micromanaging them. Mentoring and adequate training also helps, as well as creating an environment where job rotation is possible. No one likes to do exactly the same thing every single day for months on end.
The bottom line is that the time to explain that you are feeling job burnout is not after a lawsuit is filed when you are called on the carpet. That does not justify poor care or incomplete medical record documentation. It does not make the patient’s loved ones feel sorry for you. All it does is tarnish both your and your facility’s reputation. Deal with it now. You will be glad you did.