By John M. de Castro, Ph.D.
“Through practicing mindfulness we become more aware of subtle changes in our mood and physical health, and can start to notice more quickly when we are struggling. Rather than waiting for a full meltdown before we take action, we can read the signals of our minds and bodies and start to take better care of ourselves.” – The Mindfulness Project
Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. This is the fatigue, cynicism, emotional exhaustion, and professional inefficacy that comes with work-related stress. Healthcare is a high stress occupation. It is estimated that over 45% of healthcare workers experience burnout with emergency medicine at the top of the list, over half experiencing burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity.
Burnout is not a unitary phenomenon. In fact, there appear to be a number of subtypes of burnout. The overload subtype is characterized by the perception of jeopardizing one’s health to pursue worthwhile results, and is highly associated with exhaustion. The lack of development subtype is characterized by the perception of a lack of personal growth, together with the desire for a more rewarding occupation that better corresponds to one’s abilities. The neglect subtype is characterized by an inattentive and careless response to responsibilities, and is closely associated with inefficacy. All of these types result from an emotional exhaustion. This exhaustion not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion.
Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses. Hence, preventing existing healthcare workers from burning has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout. One of the premiere techniques for developing mindfulness and dealing effectively with stress is Mindfulness Based Stress Reduction (MBSR) pioneered by Jon Kabat-Zinn. It is a diverse mindfulness training containing practice in meditation, body scan, and yoga. As a result, there have been a number of trials investigating the application of MBSR to the treatment and prevention of health care worker burnout.
In today’s Research News article “Outcomes of MBSR or MBSR-based interventions in health care providers: A systematic review with a focus on empathy and emotional competencies”
http://www.complementarytherapiesinmedicine.com/article/S0965-2299(15)30014-5/fulltext
Lamothe and colleagues summarize the published literature on the effectiveness of Mindfulness Based Stress Reduction (MBSR) for healthcare worker burnout. They found that the preponderance of evidence from a variety of different trials indicated that MBSR treatment is effective for burnout. In particular, the research generally reports that MBSR treatment significantly improves mindfulness, empathy, and the mental health of healthcare workers. It was found to significantly relieve burnout, and reduce anxiety, depression, and perceived stress.
Hence, the published literature is highly supportive of the application of MBSR for the prevention and treatment of healthcare worker burnout. It appears to not only help the worker, but the improvement in the empathy of the worker projects positive consequences for the patients. In addition, the reduction in burnout suggests that MBSR treatment may help to reduce healthcare workers leaving the field, helping to relieve the systemic lack of providers. These are remarkable and potentially very important results.
Mindfulness training makes the individual more aware of their own immediate physical and emotional state. Since this occurs in real time, it provides the individual the opportunity to recognize what is happening and respond to it effectively before it contributes to an overall state of burnout. Indeed, mindfulness training has been shown to significantly improve emotion regulation. This produces clear experiencing of the emotion in combination with the ability to respond to the emotion adaptively and effectively. So, the healthcare worker can recognize their state, realize its origins, not let it affect their performance, and respond to it appropriately, perhaps by the recognition that rest is needed.
So, keep health care professionals from burning out with mindfulness.
“It helps people to undo some of the sense of the time pressure and urgency that makes it so hard to feel present for your patient, and it helps your patients feel like you’re really there, really listening and that you really care. What you learn is to undo the distractedness that comes with worrying about what happens next, and the concern with what’s already over and done with. It doesn’t take more time; it takes an intention and practice to do it successfully.” – Dr. Michael Baime
CMCS – Center for Mindfulness and Contemplative Studies