Some clinicians react to the term "work-life balance" in a hospital setting as though it were the punchline to a bad joke: When does anyone have time for "life" when work is all-consuming — especially with the nursing shortage in U.S. hospitals fueling frustration and burnout.
The key to self-care in the current healthcare environment is to toss out the idea of balance and realize there is no scale, said Laxmi Mehta, MD, a cardiologist, chief well-being liaison and faculty director of the Gabbe Health and Well-Being Program at The Ohio State University Wexner Medical Center in Columbus.
Instead, focus your attention on work-life integration, she said, noting the first step for healthcare professionals experiencing burnout is to "self-reflect on their own priorities."
"Some people want to work more, others want to work less and have time for family and hobbies," Dr. Mehta told Becker's this week. "The solution comes down to how you fit the pieces of the puzzle together. It's different for everyone. What works for me is different from what will work for you because my priorities are different than yours. My priorities are different from all of the other people on my team."
It is clear to Dr. Mehta that finding one's ability to manage work responsibilities and personal interests is not a one-size-fits-all concept. Yet whether in healthcare or business, it is achievable, according to research published in the Harvard Business Review. The study included interviews with people who described their jobs as "highly demanding, exhausting and chaotic, and they seemed to take for granted that working long hours was necessary for their professional success."
Once a professional commits themselves to finding a happy balance, they can get there, but there is no finish line, especially at times when hospitals are slammed with crises such as the current "tripledemic." It is an ongoing process that combines a professional's decision to think differently and change the way they work and a managerial focus on scheduling flexibility, the Harvard Business Review article said.
"Achieving better balance between professional and personal priorities boils down to a combination of reflexivity — or questioning assumptions to increase self-awareness — and intentional role redefinition," according to the Harvard Business Review article. "Research suggests that this is not a one-time fix, but rather a cycle that we must engage in continuously as our circumstances and priorities evolve."
Bottom line, clinicians need to take time to focus on what's important to themselves, Dr. Mehta said, adding "things vary by day to day and one of the things you learn over time is that you can't do it all. You have to find out what matters most to you and recognize which items you can and should say 'no' to."
She added that one should never feel guilty for saying "no" or asking for help. "Be realistic with your time. Seek help, whether it's by talking to colleagues at work or getting help for things outside of work that don't have to be handled by you."
Focus on quality
Kathryn Brandt, DO, chair of primary care at the University of New England College of Osteopathic Medicine in Biddeford, Maine, said she reframes the concept of balance by thinking about what defines "meaningful work."
There is a lot of "busywork," such as data entry and information processing, that has to be done when a healthcare professional is not tending to patients. She called the administrative work "a time sink, energy sink, and thankless," noting that it is often "in conflict with good medicine or patient care."
Dr. Brandt said "seeing patients and doing meaningful work with them does not feel like as much of a hit to work-life balance, even if it takes a lot of time."
Another suggestion from Dr. Mehta, who also chairs the American College of Cardiology's Clinician Well-Being Workgroup, echoed that sentiment. She advised clinicians to focus on the quality — not the quantity — of time spent on activities both in and outside of work.
It can be the little things, she said. During the workday at Wexner, for example, staff are invited to take timeouts. They can participate in an ongoing Mindfulness in Motion program, grab a treat from a staff wellness food cart as it passes by and even play with a dog during a work break through the facility's Buckeye Paws program.
Caregivers cannot do it alone
Finding a way back from burnout is not easy, but in a hospital setting it is critically important because clinicians' actions have ripple effects.
"Burnout can impact not only the individual negatively, both personally and professionally, but each person's behavior also impacts the team and the patients," said Dr. Mehta, who has been leading staff well-being efforts at Wexner for several years. "We cannot neglect caring for the caregiver."
Dr. Mehta said healthcare professionals have to be their own advocates as well. For example, she said nurses have to speak up and talk to their scheduling manager. There are flexible options and solutions to burnout that do not include "quiet quitting," she added.
Dr. Mehta also said department leaders should actively "manage" their teams' needs and hospitals have to look at their employee wellness programs and put people in place to make sure clinicians benefit from those initiatives.
"In order to be successful caring for your employees, the hospital needs people in place who are dedicated to those efforts. It's not going to happen on its own," Dr. Mehta said. "You need someone to examine what you have in place at your hospital and figure out what you can do to grow your wellness program."