Burnout Isn’t Just in Your Head. It’s in Your Circumstances.

For many labs in the U.S., getting results for the coronavirus test can take between two and seven days. But last week, the Cleveland Clinic introduced a test that offers results in just eight hours. They didn’t stop there: For social distance and convenience, they’re offering a drive-through option.

The health of a society depends heavily on health care professionals, but the profession has a problem: burnout. Over half of doctors and a third of nurses feel it, and the consequences are dire. When providers burn out, patients are less likely to get quality care and more likely to die. When you schedule an appointment, I’m pretty sure you don’t want to see Dr. Burnout.

During a pandemic, the risks of burnout become even more acute: Medical professionals are braving high disease exposure, long hours and inadequate resources. That’s the bad news. The good news is that the Cleveland Clinic has been working for years on a solution to this problem, too.

The heart of burnout is emotional exhaustion — feeling so depleted and drained by your job that you have nothing left to give. In the U.S., over half of employees feel burned out at least some of the time. It doesn’t just hurt our productivity — it can harm our mental and physical health, too. There’s evidence linking burnout to weakened immune systems and even cardiovascular disease. It’s no wonder that burnout has been declared an occupational syndrome by the World Health Organization.

As an organizational psychologist, I’ve spent part of my career studying burnout in schools, fire departments, governments and hospitals. This week on my TED podcast, WorkLife, I explore what we’ve learned about how to fight burnout. My favorite model is demand-control-support: The basic idea is that if you want to prevent or cure emotional exhaustion, you have three options: reduce the demands of a job, provide support to deal with them or increase control over them.

This is a structural change: it’s about decreasing the load on the person doing the job. In health care, it often starts with decreasing digital demands. If you want to hear a health care provider curse, try asking them to estimate how many hours they waste a year clicking through electronic health records. At the Cleveland Clinic, they launched a task force to simplify the process. They also introduced some digital solutions to lift the burden of calling pharmacies for refills and insurance companies for tests: now they have automated refills and pre-authorizations.

Here is where cultural change comes in. One of the biggest barriers to support is that people are often afraid to ask for help. People are afraid of being vulnerable and of being a burden to others. They want to look competent and self-reliant. To make sure people get the support they need, it helps to remind them that asking for help is a sign of strength, not a source of weakness. In a study of offshore oil rigs, errors decreased after macho men learned that lesson. In fire departments, units with strong cultures of care had fewer accidents and fewer health problems. In hospitals, my colleagues and I have found that creating a nurse preceptor role — a professional whose job is to help other nurses — facilitates help-seeking.

This is about giving people the freedom and the skills they need to handle the demands of their jobs. It often starts with psychological change: When we’re feeling overwhelmed, it can help to apply some evidence-based techniques for regulating emotions. Two of the most effective strategies for gaining control over our emotions are reappraisal and distraction. An accountant feeling overloaded by finishing taxes remotely might reframe it as flextime or refocus on family time (looks like we’ll all be getting extensions anyway). A teacher feeling daunted by the challenges of delivering online classes might reframe it as an opportunity to build new skills or refocus on topics students have been excited to explore.

Another avenue for control is to name our emotions. In one experiment, people with arachnophobia went through a weeklong exposure therapy course. At the beginning of the course, psychologists randomly assigned some of them to simply label their emotional response to spiders. A week later, they were less likely to show a physiological stress response to a live tarantula — and more likely to approach it. Compared with a hairy spider, burnout is less disgusting and more depressing, but it can still help to label it. When you name your exhaustion, it becomes easier to see that it’s not a problem in your head; it’s a problem in your circumstances. You can start to pinpoint situations where it rises and falls — and start doing something about it.

But the best way to gain some control over exhaustion is to change the situation that’s causing it. The Cleveland Clinic tested an unusual solution: they sent thousands of physicians to communication skills training, and found that burnout decreased significantly afterward. Physicians felt less emotionally exhausted — and over the next few months, they felt a greater sense of accomplishment and less disconnection from patients.

It turned out that when physicians learned to engage with more empathy, they started hearing patients’ concerns instead of dismissing their complaints, which gave them more control in the conversation. The Cleveland Clinic’s chief experience officer, Adrienne Boissy, told me: “I can’t tell you how many times, over and over and over again, we saw them simply forget to say, ‘I care about you. I’m in this with you. We’re going to figure this out together.’”

Anyone can burn out in any job. But especially in a pandemic, we need to make sure we care for the caregivers.

Adam Grant, an organizational psychologist at Wharton, is the author of “Originals.” For more on fighting burnout at the Cleveland Clinic — and with firefighters, teachers, and journalists — listen to WorkLife with Adam Grant, a TED original podcast on the science of making work not suck. You can find WorkLife on Apple Podcasts, or on your favorite podcast platform.

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