Burn Out the Gateway Drug to Moral Distress

Burnout in healthcare is becoming a real pandemic. Athletic Trainers needs to take more notice or else it is going to manifest into something worse.

From the Journal of Healthcare Management:

Clinicians are experiencing levels of distress that put their health—and the health of the greater population—at risk. Over the past several decades, burnout has emerged as one of the primary constructs by which healthcare provider distress has been measured. Professional burnout presents with three core components: emotional exhaustion, depersonalization (including cynicism), and a sense of professional inefficacy.

Burnout has been associated with increased turnover, reduced job satisfaction, and poorer patient outcomes.

The average cost to replace a nurse may range from 1.5 to 2.5 times their salary.

Besides burnout, other terms in the literature used to describe clinician distress include moral distress and moral injury. Both moral distress and moral injury have been associated with negative health outcomes for clinicians.

Moral distress was first defined as knowing the correct clinical decision but being prevented from making it because of internal or external constraints. The definition has expanded to include patient, unit, and system causes that encompass clinician complicity in wrongdoing, lack of voice, wrongdoing associated with professional values, and conflicting moral demands.

Moral injury was initially defined in the service member/veteran literature as conducting, witnessing, or failing to prevent actions that challenge sincerely held moral, religious, or ethical beliefs, but now also includes the experience of betrayal by authority figures in high-stakes situations.

Resilience is the means through which one maintains the capacity to resist giving up or stopping in adversity. In organizational practice, building up resilience is spoken of as a solution to clinician distress. Despite efforts to boost individual resilience, recent research has identified a high risk of burnout even among resilient clinicians.

Decreasing burnout and increasing resilience in clinicians has been the goal of many workplace programs in healthcare; unfortunately, interventions to date have focused on individual practices and programs. The implication is that burnout and resilience are in the realm of the individual clinician to address. This view is concerning, given findings that link systemic contributors to clinician distress such as the regulatory environment, administrative burdens, workplace culture, and negative leadership behaviors.

Usset,T. et al. Factors Associated With Healthcare Clinician Stress and Resilience: A Scoping Review.

Shelby 7/2024