Four Strategies for Reducing Emergency Clinician Burnout

Posted on Mon, Nov 30, 2015
Four Strategies for Reducing Emergency Clinician Burnout

It’s a busy Monday in the ER. Gastroenteritis has hit the local assisted living center, flooding your facility with patients, many of whom are lining the hallways in stretchers. You’re trying to clear the waiting room when you hear that patients from a multi-vehicle MVA are in route – and you still haven’t gone to the bathroom. How can emergency clinicians handle “typical” days that aren’t very typical without giving in to stress and compassion fatigue?

It’s no secret that the ED is a challenging work environment, but part of the reason that we’re attracted to it is the adrenalin rush of that challenging environment. Still, it’s important to recognize the signs of burnout in your staff – and yourself.

According to the Maslach Burnout Inventory (MBI), there are three classic symptoms of clinician burnout:

  • Emotional exhaustion – You’re completely worn out after work and can’t seem to recover at all in your time away.

  • Depersonalization – You’re having trouble connecting with patients, and find yourself constantly blaming others. Your general attitude has turned negative and cynical.

  • Reduced accomplishment – You’ve lost confidence in your skills as a doctor and start to believe your care won’t do any good.Tips for Preventing Clinician Burnout

Here’s my advice to leaders in the field:
  1. Whenever possible, use lean principles to develop more efficient systems in the ED to, hopefully, mitigate the chaos. Eliminate waste in processes and the supply system, and involve hospital leadership in the effort. This Lean ED Checklist can help pinpoint opportunities for improvement.

  2. Develop a shared governance practice model to put the decision-making ability in the hands of front-line staff. This gives the team a sense of ownership and empowerment, which can balance the chaotic nature of the work.

  3. After particularly trying days, develop a debriefing program for staff. Hold brainstorming “post mortem” sessions led by counselors to discuss difficult cases or difficult days. These sessions help staff cope with the stressful environment that they, at times, both love and loathe. 

  4. Lastly, check your own pulse. Take 10 minutes to breathe deeply and develop a plan of attack. To be an effective clinician – and leader – you have to be able to keep your cool. Lean on your personal and professional support systems and use “emotional intelligence” coping mechanisms when appropriate. For more information about emotional intelligence, read a recent blog post on the topic.

In times of chaos, project a calm demeanor to your staff. Lead by example to help staff adjust – and flourish – when high volumes lead to high stress.

Sabrina Griffin, RN, BSN, CEN, is the Divisional Director of Clinical Services in EmCare’s Alliance Group.

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