Addressing the Realities of Instructor Burnout
Susan Sportsman, PhD, RN, ANEF, FAAN Managing Director Collaborative Momentum Consulting
Introduction Burnout among healthcare workers is not a new phenomenon. When the author was a new graduate (in the era before laptop computers and cell phones), there was significant emphasis on addressing prevention, recognition, and support for individuals experiencing symptoms of burnout in healthcare education and practice. While the specter of workplace burnout persisted, our focus shifted towards technology and innovation in healthcare. Then, in 2020, the world experienced the COVID-19 pandemic. Over the next two years, as efforts concentrated on prevention and treatment strategies for this often-fatal illness, healthcare workers across all disciplines struggled with caring for affected patients. Shortages of staff, medicine, supplies, and other resources exacerbated the situation. Consequently, burnout resurfaced as a significant concern. Faculty who taught healthcare workers also experienced burnout. They faced an escalating shortage of colleagues who were prepared to teach, anxious students, and, for a time, the suspension of face-to-face classes and clinicals. Many of these faculty members were also working at clinical sites as caregivers or in other clinical roles, experiencing the same stressors as others in clinical settings. Symptoms of burnout were everywhere. Although the crises brought about by COVID-19 has eased, burnout still impacts healthcare workers, including faculty. Understanding the phenomenon and implementing strategies to reduce or ameliorate the symptoms from a variety of perspectives is critical for faculty and student well-being. Faculty have the additional burden of preparing new graduates to manage stressful work environments. What can be done? Both institutions and individuals bear responsibility for addressing burnout.
FADavis.com
1
Definitions 1.
According to the World Health Organization, the symptoms of burnout are caused by unmanaged, chronic workplace stress occurring in any job or sector and results in the following conditions: § Mental and physical exhaustion § Mental distance from the job Importantly, burnout may include an array of specific symptoms as part of the generalized conditions listed above. Not everyone will experience the same set of symptoms. Experts agree burnout manifests through three primary symptom sets: 1. Exhaustion, characterized by feelings of being drained or unable to cope, being tired or depressed § Cynicism about the job § Reduced efficacy in the workplace 2. Disengagement from work-related activities, indicated by heightened stress levels and feelings of frustration 3. Diminished work performance, impacting routine tasks, fostering negativity, and lack of concentration and creativity In 2018, Thomas, Bantz, and McIntosh noted that eight out of ten Americans reported experiencing job stress and 74% of nurses were reporting acute and chronic stress. Burnout can occur due to a variety of organizational, interpersonal, or individual factors that can ultimately lead to weariness if ignored. However, these authors expressed concern that, despite the long-reported shortage of nursing faculty, there was little research regarding burnout in this group. To address this lack of a specific profile of symptoms, their study found the following factors contributed to nursing faculty burnout. Before the COVID-19 Pandemic 2.
Table A: Contributors to Faculty Burnout by Thomas, Bantz, and McIntosh (2018)
§ Shortage of qualified nursing faculty (creating an increased workload) § Lack of adequate preparation in the faculty role § The student population and attitudes § Student to faculty incivility § Balancing faculty role with care provider role during clinical supervision § Additional stressors for tenure-line faculty of balancing teaching with scholarship § Multiple demands on faculty: teaching, clinical supervision, scholarship
§ External demands (e.g., requirements) § Requirements to work and maintain certifications § Lack of administrative support § Lack of collegial support § Lack of personal/professional life balance § Multiple demands
§ Faculty-to-faculty incivility § Lack of sleep and exercise § Lofty goals and objectives
While this research study focused on nursing faculty, it is likely that the experiences of other healthcare faculty may be similar.
2
After the COVID-19 Pandemic 3. As COVID-19 surged, retreated, and surged again throughout the world, educators at all levels realized the impact the epidemic was having on students in all stages of their education. The Chronicle of Higher Education (2020) conducted a survey of 1,122 post-secondary faculty from all disciplines to evaluate how the pandemic had affected them from a mental and emotional perspective and if the faculty’s experiences might alter career decisions. Highlights of this research are outlined in Table B.
Table B: Highlights of The Chronicle of Higher Education Survey (2020)
§ The majority of those surveyed were experiencing elevated levels of frustration, anxiety, and stress. § More than 2/3 of survey respondents were struggling with increased workloads and a deterioration of work-life balance—particularly female faculty members. § More than half of all faculty were considering retiring or changing careers and leaving higher education, with tenured faculty even more likely to retire than others. Sacco & Kelly (2021) explored faculty academic and clinical roles during the COVID-19 pandemic, including perception of institutional support provided; faculty burnout, satisfaction, and well-being; and student support needs and well-being. Participants recognized the support from academic institutions and identified an increased need to provide emotional support to students. However, most noted negative effects on well-being. Zangaro, Rosseter, Trautman, Leaver (2023) also examined the level of burnout in nursing faculty. An internet- based survey was administered to nursing faculty in over 1,000 schools in the United States. Among a total of 3,556 participants, most of the sample exhibited moderate levels of burnout, exhaustion, and disengagement. Highlights of this research are outlined in Table C.
Table C: Highlights of Zangaro et al. Survey of Nurse Faculty (2023)
§ Nurse faculty experienced moderate levels of exhaustion, disengagement, and burnout. § Highest burnout was among 35 to 54-year-olds and assistant and associate professors. § Doctoral faculty reported highest levels of exhaustion, disengagement, and burnout. § Tenure track faculty reported higher exhaustion and burnout as compared to non-tenure. § Burnout and job satisfaction were inversely related.
Managing Burnout 4. If the last two-to-three years have taught us anything, it is that burnout is a threat that will continue to be probable for healthcare workers, including faculty. While the COVID-19 pandemic may no longer be a global crisis, the complex environment in which we live and the possibility of other infectious threats escalating into widespread concerns necessitate the development of strategies to combat work-related burnout. Reducing the potential for burnout requires a two-prong approach. Institutions must implement strategies to reduce the environmental stress and individuals must make caring for themselves a priority.
3
Strategies for Individuals 5. The Mayo Clinic provided a self-evaluation questionnaire below to help us all assess our risk for work burnout.
The Mayo Clinic Burnout Questionnaire
§ Do you question the value of your work? § Do you drag yourself to work and have trouble getting started? § Do you feel removed from your work and the people you work with? § Have you lost patience with co-workers, customers, or clients? § Do you lack the energy to do your job well? § Is it hard to focus on your job? § Do you feel little satisfaction from what you get done? § Do you feel let down by your job? § Do you doubt your skills and abilities? § Are you using food, drugs, or alcohol to feel better or to numb how you feel? § Have your sleep habits changed? § Do you have headaches, stomach or bowel problems, or other physical complaints with no known cause?
Fortunately, evidence-based strategies are available for individuals to implement that can address these symptoms. Simple, but effective solutions may include:
§ Spot the symptoms in yourself. § Know when you are working too hard. § Avoid blaming yourself. § Seek support from colleagues and friends. § Take regular breaks. § Use mindfulness. § Exercise § Meditation
§ Sleep § Avoid unnecessary job stressors. § Learn to say “no.” § Change your perspective: a “crisis” may not really be a crisis. § Be kind to colleagues and students. § Teach your students these strategies and role model this behavior.
The administration at all levels of the workplace (Boards, Presidents, Vice Presidents, Deans, and Chairs) has the responsibility to create a workplace that reduces the potential of burnout among their employees. Kelly, Berkman, et al. (2021) suggest that strategically changing workplace conditions to foster worker well-being not only improves worker health but can also bring about beneficial organizational outcomes such as improved job performance (including increased productivity) and lower levels of employee burnout. Their suggestions below, are applicable in all workplaces, including healthcare organizations: 1. Give workers more control over how they work. 2. To the extent possible, allow for flexibility in when they work. Responsibilities of Institutions 6.
4
3. Increase the stability of employee work schedules. 4. Provide opportunities for employees to identify and solve work-related problems.
5. Ensure adequate staffing, so that workloads are reasonable. 6. Be supportive of employees’ personal and family needs.
7. Create a work culture in which employees can develop supportive relationships with their colleagues. More specifically related to healthcare, the American Association of Critical Care Nurses (AACN) has provided an evidence-based approach to providing a healthy work environment in healthcare, specifically in acute care settings. In 2005, AACN released the Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence , which outlines six standards which healthy work environments can use to improve their own work settings. These standards include: 1. Skilled Communication – Nurses must be as proficient in communication skills as they are in clinical skills. 2. True Collaboration – Nurses must be relentless in pursuing and fostering true collaboration. 3. Effective Decision-Making – Nurses must be valued and committed partners in making policy, directing, and evaluating clinical care, and leading organizational operations. 4. Appropriate Staffing – Staffing must ensure the effective match between patient needs and nurse competencies. 5. Meaningful Recognition – Nurses must be recognized and must recognize others for the value each brings to the work of the organization. 6. Authentic Learning – Nurse leaders must fully embrace the imperative of a healthy work environment, authentically live it, and engage others in its achievement. Further, the AACN website provides strategies for both organizations and individuals to use in order to meet each of these standards. The organization has conducted 5 large scale surveys of the nurse work environment between 2005 and 2021. The 2021 study was implemented ahead of schedule because of the concern that the pandemic had “ grossly exacerbated longstanding, systemic flaws inherent in healthcare work environments .” Although the four previous surveys asking acute care nurses to rate their work environment have shown moderate progress in meeting these standards, not surprisingly, a significant drop in the progress of moving toward a healthy work environment was noted in 2021. Burnout is still present and faculty members must continue to help students and colleagues manage burnout for themselves and others. References World Health Organization (2019). Burn-out an “occupational phenomenon”: International Classification of Diseases. May 28. https://www.who.int/ news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases. Accessed 2024. Thomas, C., Bantz, D., McIntosh, C. (2018). Nurse Faculty Burnout And Strategies To Avoid It. Teaching and Learning in Nursing . 14(2) 111-116. The Chronicle of Higher Education, Tugend, A. (2020). On the Verge of Burnout. Research Brief. Fidelity Investments. https://connect.chronicle.com/ rs/931-EKA-218/images/Covid%26FacultyCareerPaths_Fidelity_ResearchBrief_v3%20%281%29.pdf. Accessed 2024. Sacco, T., Kelley, M. (2021). Nursing Faculty Experiences During The COVID-19 Pandemic Response. Nursing Education Perspective. Sept-October. 14(2) 111-116. Zangaro, G., Rosseter, R., Trautman, D., Leaver, C. (2023). Burnout among academic nursing faculty. Journal of Professional Nursing . September- October, 48. 54-59. Mayo Staff (2023). Job burnout: How to spot it and take action. Healthy Lifestyle. Adult Health, Mayo Clinic . https://www.mayoclinic.org/healthy- lifestyle/adult-health/in-depth/burnout/art-20046642. Accessed 2024. Chatterjee, R., Tagle, A. (2021). Burnout isn’t just exhaustion, Here’s how to deal with it. NPR March 19. https://www.npr. org/2021/03/08/974787023/burnout-isnt-just-exhaustion-heres-how-to-deal-with-it. Accessed 2024. Kelly, E., Berkman, L., Kubzansky, L., and Lovejoy, M. (2021). 7 Strategies to Improve Your Employees’ Health and Well-Being. Harvard Business Review Human Resources. October 12. https://hbr.org/2021/10/7-strategies-to-improve-your-employees-health-and-well-being. Accessed 2024. American Association of Critical Care Nurses (2005). Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence. https://www.aacn.org/WD/HWE/Docs/HWEStandards.pdf. Accessed 2024. American Association of Critical Care Nurses (2005-2021). Healthy Work Environments. https://www.aacn.org/nursing-excellence/healthy-work- environments. Accessed 2024
5
© F.A. Davis
Page 1 Page 2 Page 3 Page 4 Page 5Powered by FlippingBook