Finding joy in work after hitting a wall
Elizabeth Eisenhardt, MD
Healthcare providers have been experiencing an emotional and exhausting process as they work to navigate the Covid-19 pandemic. The challenges and hardships from this pandemic stretched most humans to the end of their coping capabilities. Many health care workers felt stress and felt challenging emotional responses to the pandemic on both a personal and professional level, and yet were required and needed to be high functioning at work and at home. Interestingly, while we have a possible end to the pandemic in sight and some hope as we race to vaccinate all Mainers, many people are feeling worse than they did the same time last year at the height of the pandemic and its subsequent lockdown. Personally I find myself on the verge of tears more frequently when my patients ask me how I am doing now versus a year ago. Why don’t I feel better now during this time of renewed action against the pandemic? Psychologist Lisa Damour explored this phenomenon recently in her podcast entitled “My kids and I have hit a wall. How do we keep going? 3/25/21. In it she talks about how it is difficult for people to maintain hope even while the pandemic situation is more hopeful because we still don’t know what to expect and what the future will hold.
If we are having trouble finding hope, we need to re-discover and celebrate the joy we have in our work to combat our burnout.
The IHI ( Institute for Healthcare Improvement) feels strongly that finding joy in our work helps to prevent burnout. They published a paper on restoring joy to the workplace after asking colleagues over and over “what matters to you?” This single question enabled them to understand the barriers to finding joy in work and to develop a framework to overcome them.
In this paper, they outline four steps that leaders can take to increase joy in the workplace. The steps are as follows:
1.) Ask staff, “what matters to you?” They describe how having these important discussions help to engage staff and to identify risk of burnout.
2.) Identify unique impediments. What are the day to day pebbles that are causing annoyance verses the larger boulders that exist on an organizational level?
3.) Commit to a systems approach . What can be a small systems change that has large staff benefit?
4.) Use improvement science. Study and discuss any changes made with staff.
Wellness discussions should also center around academics and teaching burnout. It has been shown that low job satisfaction was associated with nonstatistically significant trends toward fewer peer-reviewed first-author publications, lower teaching skills confidence, and lack of institutional grand rounds presentation. Burnout was associated with a nonstatistically significant trend toward lack of institutional grand rounds presentation. Institutions may discover via these wellness discussions that their academic providers need to have better protected academic time as too often clinical demands creep in at the expense of teaching or research.
In my leadership role, I have held many what matters to you conversations. While sometimes challenging ,they have never failed to bring forth a clearer understanding of what staff need to find more joy in their work, and assist me in understanding my staff’s needs. These conversations are important to have with students and learners as well.
During one of these recent discussions, it was clear that staff were craving a safe space to express their emotional and experiences on a given week with their colleagues. In response to this need, our office created a weekly wellness huddle. We wanted to highlight its importance, thus we incorporated it into our Operational Excellence program and made it one of our Key Performance Indicators. Using this improvement tool we made it a priority to hold a weekly huddle around staff wellness. We documented staff responses to the huddle, and their direct quotes around the experience. It has developed into a bonding time with our staff, and many have commented that it has been helpful. In this strange time of seeing new hope regarding the pandemic, but not feeling it on an individual level, we are refreshed each week with our huddle and have formed tighter team work and increased empathy because of it.
I strongly encourage using the “What matters to you?” conversation and holding these conversations frequently to engage staff and faculty to develop improvement ideas which are then studied using improvement science.
Glasheen, J. J., Misky, G. J., Reid, M. B., Harrison, R. A., Sharpe, B., & Auerbach, A. (2011). Career satisfaction and burnout in academic hospital medicine. Archives of internal medicine, 171(8), 782-790.
Perlo J, Balik B, Swensen S, Kabcenell A, Landsman J, Feeley D. IHI Framework for Improving Joy in Work. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2017. (Available at ihi.org)
Shanafelt, T. D., West, C. P., Sloan, J. A., Novotny, P. J., Poland, G. A., Menaker, R., … & Dyrbye, L. N. (2009). Career fit and burnout among academic faculty. Archives of Internal Medicine, 169(10), 990-995.