Workforce challenges are a big part of healthcare burnout.
Indeed, “workforce challenges” ranked first on the list of hospital CEOs’ top concerns in 2022, according to the American College of Healthcare Executives’ annual survey of issues confronting hospitals. The survey results were released in February 2023.
The category of workforce challenges includes personnel shortages. This marks the second year in a row that workforce or personnel challenges has been the top-ranked issue. Before that, financial challenges ranked first in the survey for 16 consecutive years.
“Hospitals need to take both long-and short-term measures to address critical workforce issues so they can continue to provide safe, high-quality care now and in the future,” said Deborah Bowen, FACHE, CAE, president and CEO of ACHE.
“Longer-term solutions include strengthening the workforce pipeline through creative partnerships, such as those with colleges to grow the number of nurses and technicians,” Bowen added. “More immediate solutions include supporting and developing all staff, building staff resilience, organizing services to reflect the realities of the labor market and exploring alternative models of care.”
In the survey, ACHE asked respondents to rank 11 issues affecting their hospitals in order of how pressing they are and to identify specific areas of concern within each of those issues.
The American College of Healthcare Executives is an international professional society of more than 48,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organizations. ACHE’s mission is to advance their members and healthcare management excellence.
Millions of people suffer daily from burnout and workrelated anxiety, especially in high-pressure careers such as healthcare. In 2019, the World Health Organization recognized burnout as an “occupational phenomenon” that deserves priority research focus. A 2023 Work
In America survey by the American Psychological Association found that more than half of the U.S. working population is experiencing stress-related symptoms of burnout, such as emotional exhaustion, lowered productivity, and a desire to quit.
Many professionals—in healthcare, for instance—feel stuck, with no way out. Typical coping tools don’t always cut it— we’ve all tried to eat more plants, do more exercise, have more social time. It seems the stress is too much, even with the aforementioned remedies.
One reason these tools aren’t always useful is because we haven’t adequately defined the problem. “Stress” is an overloaded term; it’s a good idea to dig deeper into what that actually means for each individual. That way, we can apply the right evidence-based interventions. Psychological science has some powerful tools at its disposal, but the tools need to be deployed in the right context to be helpful.
Let’s look at a specific example, drawn from my team’s clinical experience treating those in high-pressure careers: in this case, the medical field. “Ted” was in his second year as an attending orthopedic surgeon in a major hospital system. He had made it through competitive and selective programs in college, medical school, residency and a fellowship. He chose orthopedics because he loved the feeling of “fixing problems,” such as by helping people get healthy and back on their feet.
But suddenly, almost overnight, Ted felt that his interest in his work had disappeared. He was exhausted, deeply unmotivated, and apathetic in a way he had never been before. Reading up on the science of stress and burnout, he thought maybe he needed to exercise more, get out of the house, or catch up from years of sleep deprivation. Shifting into the same problem-solving mode that had gotten him this far in life, he carved out time for the gym, tried to go to bed a half hour earlier each night, and cut out processed foods (a real challenge when most of his meals came from the hospital cafeteria).
It didn’t help. At first glance, Ted seemed like he was suffering from classic burnout symptoms related to work stress. In our sessions, though, it emerged that the driving force behind this mindset shift was more fundamental than that.
Ted had never wondered why “fixing” his patients’ problems was so motivating for him. But when he began to dig into his personal values in our sessions (using the techniques of Acceptance and Commitment Therapy (ACT)), he realized that his underlying motivation was to demonstrate his own competence—to others, but also to himself. Ted was struggling with significant impostor syndrome, which he self-medicated by choosing a field where he felt he could demonstrate concrete and direct impact. However, the field never truly satisfied his intellectual curiosity or emotional needs.
In fact, Ted had always been fascinated by oncology, but had built it up as being somehow above his skills and capabilities—an inaccessible specialty filled with MD/PhDs and biochem geniuses. He worked on his cognitive distortions through Cognitive Behavioral Therapy (CBT), and was able to address these automatic negative thoughts about his abilities. This therapy helped him gain an accurate reflection of himself that allowed him to pivot into a research field that incorporated both oncology and orthopedics. With this change in place, he found he was much more energized. His mood lifted and he was excited about going to work again.
Ted was able to use specific tools from psychological science to improve his situation, but only once he dug in to figure out why he was struggling. Gaining self-knowledge about your values, needs, and motivations lets you deploy a targeted combination of evidence-based approaches (such as CBT, ACT, and others), rather than relying on a one-dimensional diagnosis and treatment pattern.
This is a challenge we see again and again in our field: People want to know what “the science” says about fixing their problems, but it’s far more complex and individualized than that. The only commonality is that self-discovery is the first step; before you can know which direction to go, you need to know where you are.
