Article

The Relationship Between Clinician Burnout and Sepsis

Burnout and Healthcare Professionals

In today's rapidly changing, high-pressure healthcare system, burnout syndrome is increasingly widespread among both physicians and nurses.1 Characterized by emotional exhaustion, a reduced sense of personal accomplishment, and depersonalization, burnout is most frequently associated with excessive workloads, staffing shortages, administrative overload, work-life conflicts, and lack of meaning at work.The high prevalence of burnout among healthcare professionals (HCP's) is a major area of concern within the healthcare community due to its impact on quality of care, patient safety, and overall health system performance.1

The Challenge of Sepsis

Sepsis brings its own special challenges to HCP burnout, since it’s estimated that 30 percent of patients diagnosed with septic shock may not survive, and the need to respond to the signs and symptoms constitutes a medical emergency.2 According to multiple studies, approximately 25-33 percent of critical care nurses, who deal extensively with high-risk patients, have symptoms of severe burnout syndrome and up to 86 percent have at least one major symptom.3 

“Burnout not only means higher risk to patients where time is of the essence–-such as sepsis-– but can also lead to anxiety, depression, and ultimately even suicide in caregivers,”4 3 said Tom Heymann, Executive Director of the Sepsis Alliance, a leading sepsis awareness organization in the United States.

Insights from the Field

“This is not a profession for the faint of heart,” states Maureen Holtz, an advanced practice nurse and sepsis coordinator in Florida with decades of emergency department (ED) experience. “Compassion burnout is real—especially in the ED.” She pointed to the demands of too much administrative work and limited personal satisfaction. In fact, in studies of nurses, burnout and job dissatisfaction were associated with high rates of nurses leaving their current jobs or the nursing field .1

In dealing specifically with the signs and symptoms of sepsis, Amanda Gallugi, an ER nurse and Administrative Nursing Supervisor in Massachusetts, cited the “pop-up fatigue” of constant sepsis alarms. “You assume sepsis but you have to get a blood culture and administer two different types of antibiotics because sepsis kills,” said Gallugi. “It's terrifying how fast.”

In addition to the onslaught of medical record (EMR) data and sepsis alerts that are often a “huge distraction,” the burden of having a constant backlog of administrative tasks can be overwhelming.

“You have to deal with the patient aspect and then go back to charting the billing and reimbursement,” said Gallugi.” Both Holtz and Gallugi acknowledged from their own first-hand experience what multiple studies have shown: Too much administrative work and no personal satisfaction can lead to physical and emotional fatigue.1

“You're pulled in so many different directions, that it may be possible to miss small details potentially alerting you to sepsis onset,” said Gallugi. This can be especially deadly when dealing with sepsis, since every task—including alerts, team notifications, and the many systems that are monitored—can’t be ignored.4

Building Resiliency

According to the nurses interviewed, along with numerous studies on clinician burnout, there are strategies and resources that can alleviate the stressors that lead to burnout.

Foster a Climate of Support and Recognition

To combat the reduced sense of personal accomplishment and compassion fatigue, initiatives that promote positive reinforcement and recognition can instill a greater sense of engagement and purpose.1 “The medical profession can be punitive,” said Holtz. "It’s important that clinicians know they are doing a good job.”

“Even on a bad day,” said Gallugi, “I know I’m here to help patients.”

Improve Data Management

Artificial intelligence (AI) and the “smart use” of predictive analytics and EMR can help reduce the need for ongoing documentation and time away from patient care.3 Properly used, AI can also cut down on unnecessary sepsis alarms and notifications.

“Perfect artificial intelligence would clearly identify what's a sepsis bundle and what's not,” said Gallugi.

Provide Flexible Scheduling

Addressing excessive workloads, long work hours, nurse-patient ratios, and work-home conflicts have been shown to help improve morale and reduce feelings of a lack of autonomy among nurses.1 Both of the nurses interviewed for this article also pointed to the potential role of AI in helping to schedule workloads and better manage work-life balance.

While this is by no means a complete list of strategies to reduce burnout, an organizational culture that supports stress interventions and reduces task overload, has been shown to improve performance and emotional resilience in caregivers.When it comes to sepsis, this can be lifesaving.

 

References

  1. Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care, National Academy of Medicine, July 2017. https://nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care/ Accessed November 8, 2019
  2. The Sepsis Alliance, What is Sepsis, The Sepsis Alliance, 2019. https://www.sepsis.org/sepsis-basics/what-is-sepsis/ Accessed November 10, 2019
  3. A Critical Care Societies Collaborative Statement: Burnout Syndrome in Critical Care Health-care Professionals A Call for Action, American Journal of Respiratory and Critical Care Medicine, July 2016. https://bit.ly/2NNwCNC Accessed November 8, 2019.
  4. The Sepsis Alliance, Significant Threats to Patient Safety form Healthcare Provide Overload and Burnout Should not be Overlooked, 2019.https://www.sepsis.org/news/significant-threats-patient-safety-healthcare-provider-overload-burnout-not-overlooked/ Accessed November 10, 2019.

 

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