WHO recognizes burnout as 'occupational phenomenon'

Nurse Leader Insider, June 5, 2019

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By Jay Kumar

The World Health Organization (WHO) recently said it now officially recognizes workplace burnout in the 11th edition of its International Classification of Diseases (ICD-11). This comes as the healthcare industry is seeing an increasing number of cases of physician and provider burnout.

The WHO defines burnout as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” A WHO statement made it clear that burnout is listed as an “occupational phenomenon. It is not classified as a medical condition.”

The ICD-11 says burnout is characterized by three dimensions:

  • Feelings of energy depletion or exhaustion
  • Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job
  • Reduced professional efficacy

A 2017 Kronos survey of registered nurses employed in hospitals found that 63% say they experience burnout. A report from Press Ganey released last fall found that resilience, seen as an antidote to burnout, varies according to demographics such as generation, role, and shift.

“Nurse burnout is a direct consequence of administrative processes that leave nurses overworked and underappreciated,” said Will Eadie, vice president of sales and strategy for WorkJam, a workforce management application used by healthcare providers, in an email. “Addressing these problems demands process-based, high-level changes.”

Eadie recommends making the following process updates to relieve pressure on nurses:

  • Increasing schedule flexibility. “When nurses don’t have the freedom to make changes to their intensive schedules, excessively long workweeks become normalized. By using a more agile scheduling system, healthcare providers can eliminate the feeling of being boxed into an unmanageable workweek.”
  • Improving internal communications. “When nurses feel excluded from high-level health system communications, it only compounds feelings of powerlessness. By consolidating communications on a single, navigable platform, healthcare organizations can provide nurses with an added level of connectivity, which can help them feel more engaged in their work.”
  • Providing better training. “Too often, nurses—particularly traveling nurses—are thrown into a new role without proper training on how to navigate job-related stress. The absence of on-demand, self-service training is a recipe for burnout. Instead, healthcare organizations should carefully evaluate their learning management systems to ensure these processes account not only for patient care, but for the nurses, too. Nurses should emerge from training with a sense of understanding and accomplishment.”

Matt Fairhurst, CEO and co-founder of in-home care workforce management platform Skedulo, said in an email that burnout is especially prevalent in healthcare organizations because of the high-stress, high-impact working environment.

“Not only is there an imperative to provide accurate and timely care, but clinicians and other caregivers must also abide by strict policies that govern how that care is administered and recorded,” he said. “To deliver the best care, healthcare professionals must empathize with patients and their families, often taking on emotional burden in sensitive and urgent situations. This leaves little room for the stress that accompanies inefficient processes and operational pain points that can come with working in these environments.”

Fairhurst recommends that employers seek out technology companies “that think about all of the operational challenges that come with delivering the best service, which requires a holistic approach across many stakeholders. For example, in home healthcare, you have schedulers, mobile clinicians, patients, and the back office. Each of these groups has a unique perspective on what creates stress and friction in the process. Making small operational changes can improve employee engagement because time is freed up to focus on delivering the best care to patients.”

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