Physician Stress

Physicians Burnout Quality Of Life And Compassion Satisfaction

Healthcare organizations and child welfare organizations have long struggled with high employee turnover. This problem translates into high costs for recruiting and training new employees as well as potential degradation of the quality of care for clients. Research in the field suggests that the turnover itself is a symptom of a deeper problem, which is employee burnout.


Compassion satisfaction and physicians burnout

The issue of employee burnout in care professions emerged in the work of Mary P. Van Hook, Ph.D, et al., who conducted a study of child welfare workers in Central Florida in 2008. They published their findings in Quality of Life and Compassion Satisfaction/Fatigue and Burnout in Child Welfare Workers. Their study identified high levels of compassion satisfaction, compassion fatigue and vicarious trauma.

Compassion satisfaction relates to the satisfaction a person derives from being able to help other people. The converse, compassion fatigue and vicarious trauma, are emotional states that stem from worked-related, secondary exposure to extremely stressful events. The symptoms are typically rapid in onset. They include trauma that result from being afraid and difficulty sleeping. People experiencing compassion fatigue and vicarious trauma may also relive unpleasant work-related experiences.

Compassion fatigue and vicarious trauma often lead to burnout. Burnout is a collection of feelings that typically include hopelessness and emotional exhaustion. Child welfare workers experiencing burnout may have difficulty in dealing with work. They are deeply affected by a sense that their efforts make no difference. The onset of burnout is typically gradual, however.

Burnout and retention of child welfare workers

Burnout is associated with retention challenges for child welfare workers. Contributing factors include emotional exhaustion, stress and role overload as well as conflict. Organizational issues can exacerbate the burnout problem, e.g. inadequate supervision, unreasonable workloads and unreliable coworker support.

Child welfare workers experiencing burnout tend to suffer from a lack of job clarity. This leads to decreased work satisfaction. Low salaries and limited opportunities for advancement may further taint the organizational climate of the child welfare worker. The organizational context might relate to the agency as a whole or individual offices.

The impact of working with traumatized clients

Compassion fatigue and vicarious trauma is a significant risk for people with clients who have experienced trauma. Clients in the child welfare system exemplify this unfortunate reality. They frequently experience or are exposed to violence and other traumas. For the child welfare worker, the repeated exposure to clients experiences of violence can shift the employee perceptions of the world, as well as themselves. It tends to increase their own sense of vulnerability and disrupt their sense of safety, trust, self-esteem and sense of control.

The experience can negatively affect relationships with significant others. Studies across the sector have also identified vicarious trauma risk among sexual abuse and family violence counselors, those who counsel trauma survivors and health professionals. Evidently, the risk arises from both direct client contact and supervision of employees who work with traumatized clients. Younger employees tend to have higher levels of vicarious trauma. At the same time, length of work experience did not appear to correlate with higher levels of vicarious trauma. Employees with a history of personal trauma are at increased risk for secondary trauma.


Healthcare workers and burnout

Healthcare workers also experience high rates of burnout, though the drivers of burnout are more related to organizational issues than patient care and secondary trauma, per se. The impact of the COVID-19 pandemic may alter this finding, however. For example, in April, 2020, Dr. Charlotte Breen, the Medical director of New York-Presbyterian Allen Hospital emergency department, committed suicide. Her death is thought to be the result of the stress of dealing with a massive influx of dying patients from COVID-19.

The recent Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide, reveals a profession in crisis. Fifty-five percent of the 15,000 MDs surveyed reported high levels of physician burnout. Forty-two percent of doctors from 29 specialties reported unresolvable, job related stress. An overwhelming emphasis on bureaucratic tasks was a driver of burnout. Other contributors included Spending too many hours at work (33%), Lack of respect from administrators, employers, colleagues or staff (32%) and increasing computerization of practice, e.g. Electronic Health Records, or EHRs (30%).

Medscape reported that the perceived impact of burnout varied by age group. Fifty percent of baby boomers reported burnout has a strong/severe impact on my life versus 46% of Generation X MDs and 36% of Millennials, who felt burnout was a serious problem, respectively. Only 28% of baby boomers said burnout has little or no impact on my life.


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