A record number of Americans are choosing to quit their jobs. This phenomenon has been termed The Great Resignation by economists. The reasons for the Great Resignation are multifactorial and a subject of great debate, but some insight can be gleaned from the rise of a movement that has been called ‘antiwork’. This movement is probably best embodied by the immensely popular /antiwork Reddit forum, where aggrieved employees share stories of telling off their bosses and quitting their thankless jobs. Antiwork means different things to different people, with some advocating for the radical abolition of work altogether and others proposing a more modest reevaluation of the role that work ought to play in our lives. However, one unifying theme is that workers are feeling underappreciated, underpaid, and just plain tired of their jobs.
At first glance, the profession of medicine seems antithetical to the antiwork movement. Many in health care would attribute their current levels of success specifically to an ethos of hard work. When asked what drew them into their chosen careers, doctors and nurses will frequently cite a deep desire to care for their patients and a willingness to work as hard as it takes to provide excellent care. But antiwork is not necessarily synonymous with laziness or apathy. Rather, antiwork is about challenging our preconceived notions about our careers’ role in our lives.
Doctors and nurses are not by any means low-wage workers when compared with labor in the service industry. However, many in health care would probably agree that their work/life balance is dangerously skewed in the direction of work. Health care workers often put in hours that other professions would consider inhumane. Long shifts, overnight call, and working on weekends and holidays when most other people are enjoying time at home all comes with the territory of a career in medicine. Much of the work involves caring for patients in states of profound suffering who require constant attentiveness in high-stakes environments. As such, our work often exacts a profound toll on our own physical and mental health. Part of this toll may simply be an inevitability for any career that involves caring for the sick and dying, but part of the burden could also be alleviated by better staffing, more humane work hours, and other interventions that our profit-driven health care system is reluctant to make.
COVID exacerbated these underlying problems and brought them to a breaking point for many in medicine. For much of the pandemic, nurses and doctors were forced to work overtime without adequate PPE. Bedside care providers were quite literally risking their own health and safety to perform this job. Despite being given the dubious honorific of “health care heroes,” many health care workers did not see an increase in pay or benefits that they considered to be commensurate with their sacrifice. Many were actually furloughed or had their pay reduced as health care systems reeled from the blow of lost revenue from canceling elective procedures and clinics. While the health care system is recovering financially, the workers who actually provide care are, like everyone else, demoralized and exhausted.
For all these reasons, medicine has not been spared from the Great Resignation. So many RNs have already left their jobs that it has created an acute nursing shortage. Health care workers of all types will describe a pervasive environment of low morale and high burnout. This comes when many health care systems across the country are still feeling the strain of COVID-19 cases and need qualified health care providers more than ever. The combination of low supply and high demand for certain health care professions will likely lead to more bargaining power for individual workers.
The classic thinking has always been that a career in medicine is more than just a job; it is a passion, a calling, an anchor of identity. There is a pervasive stigma in medicine against the self-advocacy of the worker. Bedside care providers who push back against their work/life imbalance are often made to feel guilty for putting themselves before their patients. Antiwork challenges those assumptions and inspires health care workers to reevaluate what role they want their jobs to play in their lives. The empathy and work ethic that inspired most of us to choose a career in medicine are not inexhaustible resources, and they should not be treated as such. Doctors and nurses can and should use their newfound bargaining power to demand better compensation, improved working conditions, and protected time to enjoy life outside of the hospital or clinic. The past year of working in medicine has been so enormously challenging that it has caused many to question how much we are willing to sacrifice for our jobs. This is a painful but necessary process. Learning from some of the lessons of antiwork can hopefully help us find a new balance that still allows us to care for our patients while taking better care of ourselves.
Brendan James Flanagan is an emergency physician.
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