The past couple of years have not been easy for anyone. Life as we knew it was turned upside down when the pandemic hit, and most people had to carry on with work, family, and financial obligations while attempting to navigate a completely different world. For many, and particularly for those working in the healthcare field, this understandably resulted in burnout.
“I help people in burnout. I basically help them find their happiness and enjoy going back to work, because, let’s admit it, these past 2 years have been hard,” said Mary Buffington, MSN, RN, OCN, ONN-CG, CLC, burnout coach and founder of the Burnout Ward. “If you’re feeling burnt out, I want to reassure you that you are not broken or defective. You are a person experiencing a high level of stress, and that has a toll on our bodies.”
In the best of times, navigation is a challenging field, she emphasized at the 2022 AONN+ Midyear Conference in Austin, TX. Navigators are often asked to pull resources out of thin air while navigating a complicated, sometimes politically charged environment made up of organizations with differing priorities and individuals with different personalities.
But after COVID, the navigator’s entire work environment changed. In addition to helping patients prepare for and undergo cancer treatments while connecting them to vital resources, it was suddenly on the navigator to convince and encourage their patients to come in for treatment at all. Navigators had to tell their patients that, even though it was scary to come in, it would be less scary than foregoing their cancer treatment; no one expected to have those conversations.
“It’s been a challenging time, and not just in our work lives, but in our personal lives as well,” she said. “When you think about all that weight on us, it takes a toll.”
High Stress at Work
According to Ms Buffington, the majority of people have experienced stress at work (and/or have witnessed it in a colleague) in the past several months. “Work stress is happening,” she said. “We need to stop pretending that this is not the elephant in the room.”
That work-related stress can significantly impact a person’s ability to perform their job, sometimes to the point where they dread going to work, important things begin to slip their mind, or they feel so overwhelmed that things start slipping through the cracks.
“And working in healthcare, we have stressors that are not faced by most people at work every day,” she added. “We’re dealing with people going through some of the most challenging times of their lives.”
“You Are Not Alone”
One of the most crucial things to remember about burnout and stress is that you are not alone, she emphasized.
In addition to conducting an on-the-spot survey of AONN+ attendees during her presentation (the majority of whom reported experiencing work stress recently, as well as revealing that it had impacted their ability to perform their jobs), Ms Buffington shared that a recent survey of 1501 adult workers found that 79% had experienced work-related stress (which leads to burnout) in the month before the survey. The groups uniquely prone to work-related stress and burnout were teachers and healthcare workers.
She pointed out that it is common for cancer providers to tell their patients that certain people can have a predisposition for cancer, or that certain environmental factors can increase a person’s risk for cancer. She asks navigators and others working in healthcare not to forget that they happen to work in a field with an increased risk for work-related stress and burnout.
What Is Burnout?
According to the WHO, burnout is characterized by 3 dimensions:
- Exhaustion. This can be physical or mental, but it is typically characterized by a person feeling too depleted to enjoy work or life in general
- Depersonalization. This often presents as apathy. “When you’re drained, it’s hard to connect with other people,” she noted
- Decreased personal accomplishment. “When you’re in fight or flight mode, you don’t have the energy to go out there and do the things necessary to achieve your goals,” she added
Importantly, burnout is not a medical condition, but it can cause medical conditions. This matters, because research has shown that many people in roles with a high risk for burnout actually achieve high scores in terms of mental well-being; they may be optimistic, hopeful, and have purpose, but a volatile or stressful environment can drag them down.
The Physical Effects of Stress
It is also important to note that burnout is not only a mental experience, but one with myriad physical effects. When a person has a stress response, the sympathetic nervous system is triggered, which typically results in one of the following physical responses:
- Fight (stand up to the threat)
- Flight (run away from the threat)
- Freeze (unable to move, feeling paralyzed by the threat)
- Appease (attempt to decrease the risk of the threat)
When the sympathetic nervous system is triggered, neurotransmitters like adrenaline spike, resulting in things like insomnia, increased heart rate and blood pressure, as well as gastrointestinal upset.
“So this isn’t just your body responding,” she said. “An entire neurochemical cocktail is flooding your body to make it react.”
When a person deals with constant work stress, it can eventually overwhelm the body and mind, often leading to lifelong side effects like chronic pain and injuries, cardiovascular disease, insulin resistance and type 2 diabetes, as well as mental illness, and substance abuse.
How Can We Turn It Around?
The human body is brilliant, and while it is designed to handle stressful situations, it is not designed to be under stress constantly.
The things we have no control over can sometimes feel incapacitating, particularly for those working in the healthcare field. Knowing how complex the US healthcare system is, how difficult it is to navigate, and how easy it is to fall through the cracks can begin to feel hopeless for navigators in particular, but according to Ms Buffington, shifting your narrative and reclaiming your locus of control can boost resiliency.
“When you start to feel like you can’t change anything, remember, you can change yourself,” she said. “You have complete control over who you are, what you want to do, and the life you want to create. You can teach an old dog new tricks.”
Based on research she conducted, Ms Buffington created a model for her clients on building inner resiliency around 4 pillars:
- Self-preservation. Taking care of your physiological needs (food, water, shelter) and psychological needs (ie, putting your phone away from your bed at night to decrease the temptation of checking it), as well as feeling safe (ie, taking self-defense classes)
- Self-love. Tearing ourselves down has a long-term impact; rather than focusing on what you did wrong, try telling yourself that you did a good job today. Ms Buffington encourages her clients to work on building self-approval through compassion, forgiveness, and “enoughness.” “I’ve worked with nurses around the country throughout the pandemic, and it amazes me how many people speak so poorly to themselves,” she said. “They don’t need bullies when they have a bully with them 24/7”
- Self-care. This does not have to be an expensive retreat or spa day. This can involve talking to your manager about your long-term goals, asking a colleague you do not get along with to grab coffee and talk about how you might get on the same page, going back to school if you want to learn something new, or wearing clothes that actually fit, rather than trying to squeeze into something constricting, she said
- Purpose. What gets you out of bed in the morning? This might be the people in your life, your pets, traveling or fishing; it is different for everyone. Live your life doing the things you want to do, with the people you want to do them with, she said
According to Ms Buffington, when we commit to self-preservation, self-love, self-care, and purpose, we become resilient. We might feel more stable in one area than another, but working on these 4 pillars of inner resilience can help us to deal with the hardships that inevitably show up in all of our lives.
“This model is designed to help you easily find ways that you can address your health, your well-being, and your spirit without it feeling so overwhelming,” she said. “It’s not easy to change things, but if you keep showing up for yourself and doing small things, that’s where the magic happens. That’s where things start changing and improving for the better.”
