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By Sarah C. Threnhauser, MPA

Unfortunately, health and human service provider organizations can “do everything right”, but your staff can still “burn out.” Burnout is the result of long-term and poorly-managed stress, which results in physical and mental exhaustion, detachment, and feelings of ineffectiveness. Symptoms of burn out may include chronic fatigue, forgetfulness and impaired concentration, increased physical illness, isolation, pessimism, increased irritability, lack of productivity, and feelings of apathy and hopelessness (see Job burnout: How to spot it and take action and The Tell Tale Signs of Burnout … Do You Have Them?). Burnout is common across many industries—but it has been shown to be a particular issue in the health and human service space. The Mayo Clinic found that half of physicians have at least one sign of burnout and the Medscape Physician Lifestyle Survey found that 59% of emergency physicians, 56% of obstetricians, and 55% of family and internal physicians, suffer from higher levels of burnout (see Staff Is Your Biggest Investment & Your Greatest Asset – Unless They Burnout).

The impact of staff burnout can be felt throughout an organization; this increased stress can result in decreased productivity and the creation of a negative workplace culture. It can also have a reverberating effect on consumer treatment and clinical outcomes; when staff are experiencing burnout, they are not able to deliver the best possible care for consumers. While burnout isn’t something that employers can always control, the sources of that long-term stress—emotional exhaustion, work-life balance dissatisfaction, working without a sense of power or purpose, understaffing, and inadequate time with consumers—are things that organizations can address.

By providing a culture where employees are supported, organizations can help to curb burnout and improve retention and productivity among their workforce. After speaking with several executives leading health and human service provider organizations, I have three key programmatic approaches executive teams can implement to address burnout within their organizations:

  1. Develop A Plan To Provide Employee Wellness & Support
  2. Build A Positive Culture
  3. Hire The Right Staff

Develop A Plan To Provide Employee Wellness & Support

Supporting a high performing team starts with an employee engagement strategy with clear goals and steps to ensure that employees feel valued and engaged with their jobs. There are a lot of management principles that can help achieve this kind of engagement and manage burnout—foster open communication, provide positive feedback and motivation, encourage innovation and be open to new ideas, and trust employees and provide opportunities for growth all come to mind. The goal is to create a culture where employees feel supported and valued at work and have resources and flexibility to manage their personal health and wellness outside of work.

Employee Wellness & Support Advice
Peggy Terhune, Ph.D.
Peggy Terhune, Ph.D., Chief Executive Officer, Monarch
On a scale of 1-10, the tangible effects of burnout on staff is an 8. I would say the primary causes are the staffing crisis, low compensation for direct support staff, and people working multiple jobs. We provide a lot of time off, but we also find that people are diligent, and put stress on themselves. We can say, “it doesn’t have to be done now”, but the staff wants it done now. Amazing how many people in our profession want to do it all, do it right, and do it now.
Kathy Carmody
Kathy Carmody, Chief Executive Officer, Institute on Public Policy for People with Disabilities
Burnout among I/DD direct and professional staff directly impacts the lives of people they support. The biggest cause of burnout among I/DD staff is the direct support workforce crisis which results in fewer personnel to meet the daily needs of people and the ripple effect upon supervisory, administrative, and executive personnel who often step into direct support roles to assure continuity and quality. Thankfully as a field, there is close attention paid to the possibility of burnout and many organizations have enacted employee wellness, support and recognition initiatives aimed at reducing burnout, demonstrating appreciation, and empowering staff with tools to safely respond to signs of burnout.

Build A Positive Culture

Drill down to the very basics of success, and it doesn’t really matter what the issue is at hand—culture is both a preeminent concern and the key to success. Managing burnout is no different. Ask yourself, do you have an organizational culture that builds and supports positive, trauma-informed connections between staff, consumers, and the organization? If not, you might have a recipe for toxic stress and eventual burnout.

Culture Advice
Todd A. Landry
Todd A. Landry, Chief Executive Officer, Lena Pope
We most frequently see burnout in our teachers (particularly in the charter school) due to the complex issues (mostly trauma related) that the children and their families have which evidence themselves in school settings as “behavior issues.” For some of our teaching staff, this leads to additional stress on them and subsequent burnout. For our counseling staff (mostly LMSW’s, LMFT’s, and LCDC), most of the burnout is due to secondary trauma. In both cases, we have tried to counteract the underlying causes of burnout with increased support and training on self-care.
Johnel Reid
Johnel Reid, Vice President, Public Affairs, Centerstone
Our goal is to build a culture that attracts, develops, and retains talented individuals who are committed to our mission. The work that we do is very demanding, but at the same time, it is very rewarding. We recognize the potential for burnout, and one of the primary causes of turnover especially among our clinical staff, is burnout. To help prevent burnout, we emphasize a high-level importance on staff self-care and incorporate several initiatives to make Centerstone a great place to work.

Hire The Right Staff

Not all potential staff are right for the job, and one competency that is sometimes overlooked is a new hire’s deep commitment to the job and the ability to accept and manage stress as part of that commitment. Many provider organizations attempt to ensure that all team members are rewarded with challenging and meaningful work without taking a moment during the hiring to ask, will this person find our mission challenging and meaningful, and worth the effort?

Hiring Advice

Karen O. Yarberry, M.A., L.P.C., Executive Director, Jefferson Hills
A primary cause of burnout with our middle managers is that they relay to us that they do nothing but try to hire for open positions and fill shifts for the open positions. This makes them unable to do what they love: developing and providing quality programs and services, mentoring staff, and ultimately changing children’s lives. Hiring is extremely difficult these days. We may receive many resumes for a position, but the candidate’s level of real interest in the position or our organization is questionable. The number of “no shows” for interviews, and even for the first day of work after spending so much time onboarding them, can be extremely frustrating. While we cannot prove it, we suspect a tangible effect of burnout and high turnover is less engagement of the children in their treatment, which can lead to an increase in negative treatment outcomes.
Ted Dallas, President & Chief Operating Officer, Merakey
The work is rewarding but also extremely challenging – and it’s not for everyone. The key is finding people for whom the impact that we can have on people’s lives is a source of renewal and job satisfaction. Without that, the challenges inherent in the job from dealing with individuals with very complex issues can lead to burnout and high rates of turnover.

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