Detecting & Preventing Burnout in Long-Term Care

PubMed Health defines burnout as “a psychological term that refers to long-term exhaustion and diminished interest in work. The symptoms of burnout are similar to those of clinical depression.” American psychologist Herbert Freudenberger originally coined the term in an effort to describe a set of symptoms, which include stress-related medical conditions (for example, ulcers or headaches), reduced job satisfaction, feelings of depression, anxiety, cynicism, boredom, discouragement and loss of compassion. Burnout may involve your issues, such as feeling under-appreciated or dreading going to work, but if you have begun to “go through the motions” or have become insensitive to the needs of those who depend on you for care, it is time for a time-out.

Burnout (we also hear it referred to nowadays as "compassion fatigue") is no mere occupational hazard. In healthcare, it is a system failure. It is in everyone’s best interest that burnout be detected as early as possible and then prevented at all costs.

Who is most susceptible to burnout?

As for who is most likely to experience burnout, Freudenberger singled out those who are “dedicated and committed to their positions, have poor work boundaries and who have an over excessive need to give.”

How do we detect burnout?

Look for the following:

· High levels of absenteeism and tardiness

· Extended sick leave

· Increase in worker’s compensation claims.

One study goes so far as to draw a link between burnout and higher tolerance for resident abuse.

How do we prevent burnout?

The ideal situation is to prevent it before it occurs. Consider these basic techniques if you detect burnout and wish to prevent or rectify the problem:

1. Training.

There is no such thing as too much training. Use educational opportunities to make expectations clear and priorities even clearer. All staff should be expected to attend at least some ongoing education programs. Something as simple as team-building or communicating about aggressive or abusive loved ones can yield large benefits. Even simple stress relief activities such as meditation or yoga can relax caregivers and improve their performance.

2. Scheduling.

It is often the lowest-paid caregivers who struggle most to juggle at least one other job but are also somehow expected to stay on top of the unpredictable daily events of their child’s school schedule. Low staffing levels and erratic assignments not only contribute to burnout, but they reflect poorly on management and the company as a whole. Caregivers should still be expected to honor their commitments but their comfort level will greatly benefit from having more control over their own scheduling or at least from seeing that their supervisor is willing to work with them.

While we're at it, effective central leadership is a key component to your average employee’s work experience. With many nursing homes, most management leaves at 5:00, and the evening and night staff are left to their own devices. Management needs to make sure that all staff have proper access to them and that they are aware of performance, good or bad, on shifts when they do not customarily come in.

3. Recognition.

There is nothing wrong with compliments, but there's more to making caregiver recognition part of an effective employee or supervisory relationship. Make job expectations clear and ensure employees are clear about what constitutes a job well done, but then also provide a unified, structured way for supervisors to reward staff.

4. Review

Let’s bring this full circle. Every job interview and every contact with a caregiver is an opportunity to prevent burnout. The right questions and methods help to highlight ‘red flags’ in a person's satisfaction with their job or responsibilities. It is a good idea to have loved ones themselves provide feedback if they can to provide first-hand experience as to the caregiver’s demeanor and reactions.

Our firm is always concerned with the phenomenon of burnout. We monitor staffing issues in long term care facilities on a regular basis to identify where we think care can remain consistently excellent for our clients. Our goal is to help you choose a facility for your loved one that excels at detecting and preventing burnout so that the care your loved one receives remains the same each day.