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Apr 3, 2024
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1
Who is Responsible for the Wellbeing of Healthcare Workers?
Kayla Johnson
PHIL222 - Ethics in Health & Human Services
Bryant and Stratton College
Patricia Morriss February 10
th
, 2024
2
Introduction
The case study “Dealing with Burnout” follows Ana, a second-year resident who notices her work starting to slip and starts to experience depression (
Dealing with Burnout | IHI - Institute for Healthcare Improvement
, n.d.). The case goes on to discuss the culture of healthcare
and the lack of wellness for healthcare professionals and the way this culture can lead to negative
impacts on patients, such as medication errors, incorrect diagnosis, or even death. The ethical issue presented is whether a Healthcare organization should have an obligation to ensure the good mental health of its staff or if the burden of self-advocacy falls on the staff member.
Healthcare worker burnout is an all-too-common issue brought on by healthcare professionals' long and demanding hours and is characterized by depression, lack of mental reasoning, and reduced ability to make sound decisions quickly. At times, it becomes hard to recognize that burnout is happening until it has gone on for too long and negative effects have occurred. While it is important for healthcare personnel to be in touch with their feelings and emotional state, sometimes these factors can go unnoticed. A lack of self-awareness can be an issue in those dealing with burnout; healthcare organizations must ensure staff members are avoiding burnout and are in good mental health; they should implement safety measures and programs to ensure their personnel function safely and provide the best care possible. Utilitarianism supports this viewpoint, as ensuring the positive mental state of healthcare workers is in most people's best interest.
Burnout Leads to Poor Health Outcomes and Poor Patient Satisfaction
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One of the largest risk factors health professionals face when it comes to burnout is chronic lack of sufficient sleep. Burnout has been proven to lead to reduced motivation and subpar communication with patients and increases the risk of significant medication errors by 96% (Couser et al., 2022). Physicians operating in a start of burnout put their patients at significantly higher risk than those operating in optimal conditions. In a 2019 study comparing two hospitals that provided mental health support and working hours limits for their physicians and one that did not, patient outcomes in the facility with physician support consistently supported better patient health outcomes (Tolins et al., 2023). Due to the seriousness of the implications of burnout, healthcare providers have an ethical obligation to ensure they are avoiding burnout and are given the tools necessary to keep themselves at optimal performance. In the utilitarian point of view, allowing staff members to experience burn out and the symptoms that go along with it cause the staff member to experience pain. The ethical stance would be to ensure the staff members are experiencing the absence of pain.
Due to reduced self-regulation capabilities and reduced functioning of the prefrontal cortex, the area of the brain responsible for decision-making and stress regulation that burnout causes, patient satisfaction suffers greatly (Couser et al., 2022). When in a state of burnout, a physician cannot behave patiently and has issues explaining treatment plans and diagnoses to the patients. Additionally, physicians may begin to miss crucial factors to a patient's health. It would be in the best interests of the organization, the employees, and the patients for the employer to invest in their Health professionals' mental health and wellbeing. Therefore, employers keeping a
watchful eye on their employee's mental health is in the best interests of most people, and does the best for most people, making it the ethical choice under the utilitarian theory. Staff Turn Over
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Burnout among healthcare workers leads to high staff turnover, leading to the lack of continuity of care, increased distrust, and lack of ability to build a relationship with your health providers. In addition to the poor care outcomes that turnover causes, it puts a large burden on companies financially and, therefore, increases healthcare costs. Researchers estimated annual burnout-related turnover costs are $9 billion for nurses and $2.6 billion to $6.3 billion for physicians (Filipek, 2023). Healthcare organizations have the ethical obligation to keep services cost-effective to the patients, to do the best for most people, and to continue to ensure accessible healthcare. Additionally, ensuring these patients have access to healthcare is in line with the utilitarian ethical viewpoint that all people are created equal and should be allowed access to the same level of happiness. Inability to Recognize it in Oneself A large danger of burnout is that sometimes a person suffering from it is unable to recognize that is what is going on with them, often chalking up their feelings to being tired or working a few too many shifts in a row without further exploring the fact that they are experiencing a mental health issue. In these cases, it is up to the healthcare organization to step in and offer support before negative clinical outcomes become the consequence (Dealing with Burnout | IHI - Institute for Healthcare Improvement, n.d.). To limit these effects of burnout and continually check in on the well-being of the providers, organizations must honor time off, advocate groups, and offer wellness programs to their physicians. Making these moves has the potential to improve employment satisfaction, health outcomes, and overall morale, making this the ethically correct move under the utilitarian theory, and doing the best for most people.
Counter Argument
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Though the benefits of offering employer-sponsored wellness programs and organizations taking the lead on ensuring their provider's mental health is a top priority, some believe that avoiding burnout is the provider's responsibility, and they must self-advocate. Those who are in favor of self-advocacy argue that no one else can be responsible for someone's mental
health, and those on the outside cannot know how people are feeling, let alone if they are dealing
with burnout. While it may not be outwardly obvious that a provider is struggling with burnout, organizations still have the ethical obligation to ensure their providers are not at risk and put them in a position that would cause them to provide subpar care. Physicians are sometimes scheduled 19 days in a row, with on-call days in the mix (News Limited, 2019). These schedules lead to physician burnout and put physicians in the position to either put up with the schedule or resign. Having physicians in this state and feeling like resigning from their jobs does not lead to the most good for most people and, therefore, is unethical.
Conclusion
Physician burnout is a major issue plaguing the US healthcare system. Burnout leads to poor health outcomes, reduced patient satisfaction, and high staff turnover. Additionally, burnout
can be extremely hard to recognize in oneself. Healthcare organizations have the ethical obligation to ensure the mental and physical well-being of their healthcare professionals. Doing so creates the most good for the most people, ensures equality among people, and ensures the absence of pain, making this the ethical decision according to the utilitarian point of view.
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References
Couser, G., Morrison, D., & Brown, A. (2022). Getting Serious About People Over Profit: Addressing Burnout by Establishing Meaning and Connection. Physician Leadership Journal
, 9
(4), 29–35. https://doi.org/10.55834/plj.3310746535
Dealing with Burnout | IHI - Institute for Healthcare Improvement
. (n.d.). Staff.ihi.org. https://staff.ihi.org/education/IHIOpenSchool/resources/Pages/CaseStudies/
DealingWithBurnout.aspx
Filipek, D. (2023, July 21). Healthcare News of Note: Healthcare organizations continue to deal with turnover and workforce shortages
. HFMA. https://www.hfma.org/leadership/healthcare-news-of-note-healthcare-organizations-
continue-to-deal-with-turnover-and-workforce-shortages/
News Limited. (2019). https://go.gale.com/ps/i.do?p=OVIC&u=buff83694&id=GALE
. Go.gale.com. https://go.gale.com/ps/i.do?p=OVIC&u=buff83694&id=GALE
Tolins, M. L., Rana, J. S., Lippert, S., LeMaster, C., Kimura, Y., & Sax, D. R. (2023). Implementation and effectiveness of a physician-focused peer support program. PLOS ONE
, 18
(11), e0292917–e0292917. https://doi.org/10.1371/journal.pone.0292917
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