Joshua Bright for The New York Times
Blog post by Colin Hung
The holiday season is upon us. It’s a time of great celebration, reflection and fun. It is also a time of tremendous stress. It seems that things move faster during the holidays. The days compress, evenings aren’t as relaxing and there’s something happening every weekend. Every year I feel more rushed than the last – both at work and at home.
I thought it would be appropriate to discuss the issue of work-life balance on this week’s #HCLDR chat. Achieving a good balance is tough enough during “normal” times but it’s especially difficult during the holidays.
Join us Tuesday December 10th at 8:30pm Eastern Time (North America) for our weekly #HCLDR tweetchat on this subject:
- T1: Is work-life balance in healthcare a problem? If so, is it getting worse or getting better?
- T2: How can you approach a colleague who is clearly struggling with achieving work-life balance / heading for burnout?
- T3: What can employers do to help staff with work-life balance? Good resources you’d recommend?
- Closing Thought=CT: What’s one thing you’ve learned tonight that you can take to your place of influence to help a patient tomorrow?
Hello. My name is Colin and I’m a workaholic. I’ve been in healthcare IT for 10 years and I work most nights and sometimes on weekends. I have tried to achieve a better balance with some success but still feel I should be working less and spending more time with friends and family. I’m sure I’m not alone in feeling this way and I can only imagine how much worse it is for people who provide care to patients/clients.
Achieving work-life balance when there is so much pressure to “do more” is extremely difficult and this is especially true in healthcare. Doctors, nurses, administrators and support staff are all expected to provide their best, day in and day out no matter how good/bad they are feeling. It’s tough to live up to those expectations. Dr. Karen S. Sibert summarized this challenge beautifully in her KevinMD blog post “Work-life balance in medicine: Is it possible?”
I’m expected to be in the hospital every day in time to set up my drugs and equipment, evaluate my patient, and have the patient ready to go into the operating room at 7:15 a.m. Since our practice does not employ “physician extenders” such as nurse anesthetists or anesthesiology assistants, I’ll be with my patients continuously until the day’s surgery is finished. Unless I have a life-threatening domestic crisis at home—something like an actively hemorrhaging child or rising floodwaters—no one is going to show up and offer to take over my cases so that I can go home.
It’s not easy to self-diagnose stress, poor work-life balance or even burnout. Most type-A personalities believe that we are immune to such things. There are many tools online that can help. The Canadian Mental Health Association has an online questionnaire that you can fill out that can help identify whether or not you have achieved a good work-life balance. The Mayo Clinic has a nice checklist to determine whether you are potentially suffering from job burnout.
Recognizing the problem of work-life balance is step 1. Step 2 is coping/dealing with the issue. Dr. Dike Drummond (aka TheHappyMD) has some fantastic recommendations on his blog: “Work Life Balance for Doctors – building your ‘OFF’ switch” and “Work Life Balance for Doctors – Three Steps to Saying No with Grace and Power”. My personal favourite is Step Two – putting your non-work priorities in your calendar well in advance and then refusing to allow people to book on top of those commitments.
In preparing this blog I learned that there are physician and nurse support groups that help professionals deal with the pressures of work and with the effects of burn-out. William Zeckhausen talks about these groups in his article: “Eight Ideas for Managing Stress and Extinguishing Burnout” via AAFP’s Family Practice Manager magazine. Peer support is at the heart of Brigham and Women’s Hospital’s (BWH) Center for Professionalism and Peer Support (CPPS) which was developed to provide clinician education programs, guidance and support. This innovative program has helped BWH prevent burn-out and has helped staff through extremely stressful situations that may have led the person to exit the profession.
I think we are just seeing the tip of the iceberg now, and I don’t want to create panic, [but] I think we need to be focusing on solutions… I really think people, you know, haven’t truly thought about this. I see it happening from my own personal background and knowledge where you don’t have other resources to draw on in the community so you are just reusing what you’ve got – and that tends to be in smaller communities and it tends to be in more rural or remote [communities].
– Anonymous Nurse from “Nurse Fatigue and Patient Safety Report” Canadian Nursing Association, 2010 Study
As healthcare gets more complex, as regulations get more restrictive and as patient volume/acuity grows, healthcare professionals are going to be under more and more pressure. Achieving work-life balance and preventing burnout needs to become a priority for healthcare institutions. Rather than wait for organizations to put the processes and support structures in place, we as healthcare leaders can start by helping on an individual level. We can reach out to colleagues who we see are out-of-balance, we can point people to trusted online resources and we can ensure that this topic doesn’t get buried.
Resources
“Nurse Fatigue and Patient Safety – Research Report”, Canadian Nurses Association, 2020 http://www.cna-aiic.ca/~/media/cna/page%20content/pdf%20en/2013/07/26/10/39/fatigue_safety_2010_report_e.pdf, accessed Dec 8, 2013
“Work Life Balance for Doctors – building your “Off” switch”, Dike Drummond MD, http://www.thehappymd.com/blog/bid/290292/Work-Life-Balance-for-Doctors-building-your-OFF-switch, accessed Dec 8, 2013
“Work Life Balance for Doctors – Three Steps to Saying NO with Grace and Power”, Dike Drummond MD, http://www.thehappymd.com/blog/bid/290781/Work-Life-Balance-for-Doctors-Three-Steps-to-Saying-NO-with-Grace-and-Power, accessed Dec 8, 2013
“Work Life Balance and the Schedule HACK Shortcut”, Dike Drummond MD, http://www.thehappymd.com/blog/bid/289962/Work-Life-Balance-Schedule-HACK-for-Busy-Doctors, accessed Dec 8, 2013
“Work-life balance in medicine: Is it possible?”, Karen S. Sibert MD, via KevinMD.com, August 13, 2012 http://www.kevinmd.com/blog/2012/08/worklife-balance-medicine.html, accessed Dec 8, 2013
“Job burnout: How to spot it and take action” Mayo Clinic http://www.mayoclinic.com/health/burnout/WL00062, accessed Dec 8, 2013
“Eight Ideas for Managing Stress and Extinguishing Burnout” William Zeckhausen DMin, Family Practice Manager, 2001 Apr;9(4):35-38 http://www.aafp.org/fpm/2002/0400/p35.html, accessed Dec 8, 2013
“The Center for Professionalism and Peer Support” Brigham and Women’s Hospital, http://www.brighamandwomens.org/Medical_Professionals/career/CPPS/Documents/Peer_Support_Overview_and_FAQ.pdf, accessed Dec 8, 2013
“Work-Life Balance Quiz” Canadian Mental Health Association, http://www.cmha.ca/mental_health/work-life-balance-quiz/#.UqS3gPRDv0c, accessed Dec 8, 2013
“Quality of work life among primary health care nurses in the Jazan region, Saudi Arabia: a cross-sectional study” Human Resoruce Health, 2012 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543175/, accessed Dec 8, 2013
“The Root of Physician Burnout” Richard Gunderman, The Atlantic, August 27, 2012, http://www.theatlantic.com/health/archive/2012/08/the-root-of-physician-burnout/261590/?single_page=true, accessed Dec 8, 2013
“More Employers Helping Nurses Pursue Work-Life Balance” Nursezone, March 24, 2012 http://www.nursezone.com/nursing-news-events/more-news/More-Employers-Helping-Nurses-Pursue-Work%E2%80%93life-Balance_39432.aspx, accessed Dec 8, 2013
“Can Doctors Have Work-Life Balance? Medical Students Discuss” Time Health & Family, Nov 15, 2011 http://healthland.time.com/2011/11/15/can-doctors-have-work-life-balance-medical-students-discuss/, accessed Dec 8, 2013
“Work-Life Balance: Tips to reclaim control” Mayo Clinic, http://www.mayoclinic.com/health/work-life-balance/WL00056/NSECTIONGROUP=2, accessed Dec 8, 2013
“Easing Doctor Burnout with Mindfulness” Pauline W Chen, MD, New York Times http://well.blogs.nytimes.com/2013/09/26/easing-doctor-burnout-with-mindfulness/?_r=0, accessed Dec 8, 2013
DAVID BORNSTEIN. “Medicine’s Search for Meaning, 2013” New York Times, New York. (September 18, 2013). http://opinionator.blogs.nytimes.com/2013/09/18/medicines-search-for-meaning/, accessed on Dec 8, 2013
“Almost half of U.S. doctors burned out by workload: Survey, 2012” Kaiser Health News, Menlo Park, CA. (August 21, 2012)
http://www.kaiserhealthnews.org/Daily-Reports/2012/August/21/marketplace-burnout.aspx, accessed on Dec 8, 2013
“Im concerned-how do I help? Beyond Blue http://www.beyondblue.org.au/resources/in-the-workplace/for-workmates-and-colleagues/im-concerned-about-a-colleague-how-do-i-help, accessed on Dec 8, 2013
National Alliance on Mental Illness http://www.nami.org/template.cfm?section=About_NAMI, accessed on Dec 8, 2013
Employee Assistance Program Wikipedia http://en.wikipedia.org/wiki/Employee_assistance_program, accessed on Dec 8, 2013
Image Credit
“Easing Doctor Burnout with Mindfulness” NYTimes article by Pauline W Chen, photo by Joshua Bright http://well.blogs.nytimes.com/2013/09/26/easing-doctor-burnout-with-mindfulness/?_r=0
hcldr 
Colin
As always this is another great topic and I am looking forward to joining the conversation and learning more. I know personally this i something I struggle with between working with healthcare providers not only in the US, but globally. Trying to maintain customer satisfaction when juggling multiple time zones and trying to accommodate everyone’s calendars is a struggle.
I know I have been a bit better at scheduling everything on one calendar, but I do find from time to time, that I will “bump” a personal commitment to make sure that I don’t lose out on a professional opportunity.
With the recent diagnosis and then passing of my father, it did remind me that life is short, it is precious, and we need to make the most out of all opportunities. It reminded me to pause, and ask myself, does this opportunity add value to my life, and likewise, does it afford me the ability to add value to someone else.
If the answer is not yes in both directions, then I do not accept the meeting or request.
We will see how long I can commit to this mantra. I hope it is something that I can make a habit.
Thanks for the wonderful topic and your commitment to sharing with all of us.
Andy
@cancergeek
cancergeek@gmail.com
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