How to Spot Signs of Healthcare Burnout in Nursing Homes

Job burnout occurs across all industries. However, we most often hear about burnout in the healthcare industry. It’s an overwhelming feeling of exhaustion that can have short-term and long-term impacts on overall health, especially if it goes unaddressed.

The National Library of Medicine, the term burnout was coined in the 1970s and consists of three dimensions:

• emotional exhaustion,
• depersonalization, and
• a reduction in professional efficacy and personal accomplishment.

In long-term care settings, burnout is especially prevalent. A big reason for this is understaffing. Skilled nursing facilities (SNFs) have the highest rate of nurse burnout – around 37%. To provide some perspective, hospitals burnout falls at around 34% and then 22% in other settings, such as clinics.

These facilities are consistently relying on overtime and double shifts. When direct care staff reach their breaking point, the next step in the vicious cycle begins: turnover.

What are the common causes?

Burnout is the result of a combination of issues that are occurring on a larger scale within the organization. Factors that cause burnout include:

• Buildings being consistently understaffed
• High-stress work environment
• Unrealistic staff-to-patient ratios
• Emotional and physical exhaustion (especially when lifting/turning residents)
• Long hours and mandatory overtime/on-call
• Feeling guilty or feeling unable to take time off work
  
  

Breaking down the cost of burnout

Burnout in long-term care affects more than just the individual – it can impact the care that residents are receiving on a daily basis.

A feeling of emotional exhaustion can be a cause for increased medication errors. There could also be higher instances of neglect due to unreasonable resident-to-staff ratios. For example, if a Certified Nursing Assistant is solely responsible for the care of 40+ residents during their shift, calls lights will not be answered in a timely manner, which could lead to increased risk of falls or more prevalent bedsores.

Ultimately, burnout can lead to poor resident experiences, which affects a facility’s Star Ratings (a ranking system set by the Centers for Medicare and Medicaid Services). Lack of resident safety can force residents to seek care elsewhere.

A 2022 study found, “full-time employees [in the post-acute care setting] actually cost facilities 1.9 to 2.2 times their hourly wages. Organizations spend 26% more on full-time nursing assistants, compared to contingent labor, according to the report”.

Both hospitals and long-term care communities spend a significant portion of their budget on recruitment, productivity, and training costs due to burnout.

How to recognize and prevent burnout

1. Be willing to acknowledge that this is an organizational problem, not an individual problem.

Of course, this can be difficult to come to terms with. We know that each healthcare organization has its own unique set of strengths and weaknesses, from management to budgeting to proper recruiting and onboarding. LTC leaders that are at the corporate level are probably not as familiar with day-to-day struggles. That’s why it’s crucial to talk (in private) with your direct care staff. This leads us to point #2.

2. Take a closer look at your culture.

Whether it’s a CNA or a Nurse Supervisor, asking them to be open and honest about issues is a huge step. Employees may feel uncomfortable voicing their concerns on certain issues for fear of retaliation, either by another employee or by management. Be willing to have an honest conversation with your staff – this includes accepting criticism with open ears. Ensure them that they’ve been heard and that the problem will not be brushed under the rug.

3. Find Realistic Solutions

You’ve got your list of things to improve upon. You’ve asked your staff to come forth with issues. But now what? Find a team of people within your organization that are committed to taking action. This could be a committee or something more informal. Regardless, this group should be willing to discuss issues and provide realistic changes/solutions that are correlated with burnout. For example, talking points may include overwhelming workloads, ratios, 1:1 communication, and offering flexibility.

How PRN staff may prevent burnout

GigWorx Healthcare Staffing is a new approach to agency, and working with us allows you to:

• Utilize PRN staff to relieve your full-time staff.
• Fill gaps in your schedule with no minimum hourly requirements.
• Only pay for the staffing you receive.
  
  

The bottom line

Burnout happens. Burnout is also preventable. However, it is only preventable if leaders are willing to take a closer look at deep-rooted organizational issues, empower their staff to feel comfortable enough to speak up when something isn’t right, and making real changes.