The burnout epidemic is hitting healthcare workers hard

Many experts are calling attention to a so-called burnout epidemic among workers. Unfortunately, healthcare workers are being especially impacted. Both of us have seen that impact firsthand through our work with healthcare groups.

We interviewed workers to better understand why the burnout epidemic is hitting healthcare workers so hard. Here’s what we found:

“I end up feeling exhausted”

“I have the best job in the world,” says Carlos, who asked that his last name be withheld. His job as chief diagnostic medical physicist for a major health system requires him to ensure that the sophisticated medical equipment for the 700-bed hospital is always working properly. It’s a hectic job that keeps him on his toes most days. But some days the incoming requests are so fast and furious that Carlos silently declares them “laughing days”—because if he didn’t do that, he says, he “would just shut down.”

Like many of us, Carlos tries to be easily accessible to his colleagues, via landline, mobile phone, email, text, pager, or in person in his office. “But there are times I will get a call on my office phone, then someone else will call my cellphone, and I’ll be in the middle of two different conversations, and I’ll get a page about the same issue from someone else,” he explains. “Then as I’m on the phone, I’ll see so many emails popping into my inbox that it almost looks like my inbox is scrolling. And I’ll look up and someone else is standing in my door with something they need me to sign, and so on.”

Individually, most of the demands are reasonable and Carlos is naturally good at multitasking. But even a “people person” like Carlos can end up feeling fried by the end of the day when the demands come at him rapid-fire. “Those are the days that I almost can’t remember what I did during the day, and even though I do very little physical activity, I end up feeling exhausted,” he says.

Microstress and burnout

There’s a reason for that exhaustion. Carlos is suffering from what we call microstress: brief moments of stress in our professional and personal lives that accumulate day-to-day in ways that slowly suck the life out of us. Microstress is fundamentally different from the conventionally recognized forms of stress, which is often caused by a toxic person (a boss who is a jerk, an unrealistically demanding client, a difficult personal relationship). However, microstress can be just as debilitating.

And microstress is truly unrelenting for those in healthcare. While clearly impacted by the pandemic, workers in the healthcare industry faced high levels of stress long before. Some stress-inducing causes include insurance and electronic medical record demands, increasing volumes of patient throughput and cycle times (the time allowed to see a patient), the impact of healthcare mergers, and the relentless nature of 24/7 demands on clinicians and those supporting them. According to recent data from the Centers for Disease Control and Prevention, “the realities of our healthcare system are driving many health workers to burn out. They are at an increased risk for mental health challenges and choosing to leave the health workforce early.”

The causes of microstress

We first began to understand the phenomenon of microstress and its enormous impact through in-depth interviews with high performers across a wide range of world-class organizations. Our research initially focused on 300 high performers in multinational organizations, but in the past year we’ve also assessed a global sample of more than 11,000 individuals to further understand the most common sources of microstress. What’s become abundantly clear through this research is that microstress is not just the result of having a particularly bad manager or being part of a high-pressure workplace culture. It’s baked into our everyday lives.

Microstress might take the form of disagreement that you sense but remains unspoken in a conference call. It may appear when colleagues routinely fall just a little bit short. Or it can come from shifting expectations from your boss or from a manager from another department undercutting you in a meeting. Microstress is seldom caused by deliberately antagonizing interactions, but rather from brief interactions with other people who are, themselves, likely overwhelmed with demands on their time.

Additionally, microstress can come up in the personal parts of our lives. In fact, according to our research, draining interactions with family and friends are the largest source of microstress. Think about the disgruntled text from your child, when you can’t decipher whether they have a true issue or are simply venting over something they are through in 30 seconds but you worry about for an hour. Or the concern you might have for a friend going through a difficult time with a job or relationship. Or a sibling or parent struggling with a health issue that has you needing to step up in unexpected ways. Like the professional sources of microstress, none of these are unreasonable and they are all things we lean into as good parents, friends, and family members. But the velocity and number of these has exploded on us in the past two decades. The volume is beyond what our bodies were equipped to handle with more conventional fight-or-flight forms of stress.

The impact of microstress

Worse yet, microstress can create a chain reaction. Though the original source of microstress may be quickly forgotten, microstress triggers secondary and even tertiary consequences that can last for hours or even days. For example, consider the ripple effects when we exchange curt words with our spouse about some inconsequential chore or task before work. We may then spend all day thinking about the interaction. Once we get home that night, all may be forgiven, but the worrying has already impacted our day in ways that don’t disappear quickly. We may be distracted at work, not perform as well, or let our colleagues down.

But you don’t have to just endure microstress. You can become more intentional in managing your day-to-day interactions with microstress. Start small. Pick just one or two small interactions that cause you microstress to work on. See if you can make some improvements before tackling the bigger causes of microstress.

How to address microstress

In order to address microstress we need to address its systemic source. This means altering the way you interact with microstress.

Too often we distance ourselves from relationships with people who cause us stress, rather than look for a way to reframe the interaction. But this is not a good strategy. There is ample research to suggest how important relationships are for our long-term, overall well-being. And there’s also research that tells us that removing a negative interaction can have a bigger impact on our lives than adding a positive one. The solution is to turn negative relationships into positive ones.

Positive interactions are important, of course, but not just in the way you might imagine. In our research, we observed that some of the high performers—a group we came to call the Ten Percenters—were simply better at coping with microstress than the rest of us. Specifically, they are uniquely able to beat back the daily stresses while consistently performing well at work and living more full personal lives than most. In fact, they are excelling at work because they don’t allow microstress to dominate their lives.

So what do they do differently? One thing the Ten Percenters did was build “dimensionality” into their lives—they connect with people in a number of different spheres. People who told us positive life stories invariably described authentic connections with two, three, or four groups outside of work: athletic pursuits, volunteer work, civic or religious communities, book or dinner clubs, and so on. They often had a range of surprising relationships, ones that might seem improbable or a mismatch.

We interviewed a highly successful neurosurgeon who found himself playing guitar in a weekend rock band with twentysomethings after responding to a flyer on the bulletin board of his local music store. He called us and told us how much the ability to unplug with this group and be in a totally different social world mattered to how he was able to rise above stressors. In other words, though the people in this group were never going to be his best buddies, they were a critical source of resilience for him.

Of course, this approach does not completely address the burnout epidemic among healthcare workers. However, it offers a glimpse into how some workers are engaging in small moments of connection, which can be a kind of “force field” against the inevitable barrage of microstress.