The Emergency Department is a High Stress Environment – But You Can Cope
With another year over and a new one just begun, I’m inspired by the idea of renewal. In my last post, I gave you some tips for how you and your emergency department (ED) staff can avoid burnout. Working the ED can be stressful. Knowing how to cope is additionally important because we may not acknowledge how challenging tackling change and striving for improvements can be. In the spirit of ongoing self-improvement, I thought you’d find this study out of Canada of interest. It was just published this September in the Emergency Medicine Journal.
Why burnout is bad
The researchers surveyed employees at small, medium and large hospitals to try to get to the root of burnout. Out of 300-plus respondents -- nurses and doctors were at higher risk than support staff. And when they suffer from burnout it isn’t just the employees suffering. When folks get burnt out they are more likely to be absent which can cause staffing issues. It can also lead to employees taking less pride in their work. And to top it off, it can negatively impact patient outcomes. Taking burnout seriously is important.
Who is most likely to become burned out?
Can people take small breaks during the day to socialize or pick up a hobby out of work to help? The study found coping techniques like those had no positive nor negative effect.
Interestingly, these factors also didn’t seem to increase burnout either: age, personal (non job-related) stress, nor how big or complex the hospital where they worked.
What did? Researchers found that both professional stress and how long employees worked at an institution seem to be related to burnout. People who worked 6+ years had a higher risk. And people with 11 to 20 years had a still higher risk.
So what can be done to prevent burnout?
The authors found an association between employees’ coping skills and burnout.
They used the Coping Inventory for Stressful Situations (CISS) to measure coping style. When faced with stress employees coped by being:
- emotion-oriented, or
When people practice task-oriented coping they deal "with the issue at hand; examples include outlining priorities or learning from mistakes. Emotion-oriented coping is experiencing emotional distress; examples include becoming tense or blaming oneself. Avoidance-oriented coping uses distractions, such as socializing away from work or doing a hobby."
It turns out that the people who coped in an emotion-oriented way were more likely to be burned out. While people who coped in a task-oriented way did better. Remember, avoidance didn’t have a positive or negative effect.
Isn’t how we deal with stress hardwired in our personalities? Science says, “No!” The study’s authors reported that “two recent Cochrane reviews and a recent paper suggest assertiveness training and cognitive behavioural approaches may reduce burnout. One study of 10 forensic nurses found that a coping skills intervention reduced burnout at the end of 6-month training compared with a control group.”
“Smith-Jentsch et al examined the determinants of assertiveness in the context of task-oriented team function. Based on a set of assertive behaviours that have been linked to effective team performance, they found effective use of team performance-related assertiveness involves a significant skill component. While both attitude-focused and skill-based training improved attitudes towards team member assertiveness, practice and feedback were essential to produce behavioural effects.”
The Bottom Line
Burnout is something that can be avoided. By investing in your employees it can help you avoid dealing with turnover and staffing woes and improve patient outcomes. Plus, who doesn’t want a pleasant workplace?
If I can help smooth the process improvement process for your emergency department or provide communication training, reach out. I’d be happy to help get your hospital on the right path in the new year.
Emergency Medicine Journal. M, Howlett. September 2015, Volume 32, Issue 9