Our health care employees are suffering from the after-effects of COVID, the great resignation, stripped-down staffing levels, and the misrepresentation of human clinicians as factory floor machines. When frontline employees and senior managers are depleted, C-suite executive leaders become depleted too. And depleted leaders are at heightened risk of burnout.

When struggling with burnout, executive leaders tend to get caught up in reactivity patterns that profoundly affect employee workplace satisfaction, engagement, and retention. When executive leaders become reactive, they tend to under-communicate, struggle to integrate others’ feedback, lose perspective on their core values, and start seeing employees as problems to be solved rather than partners who can be empowered to find creative solutions.

The fact is burned-out leaders alienate employees from decision-making processes. As a result, communication pathways break down, and solvable problems become points of friction. As the quality and transparency of employee-to-leadership communication deteriorate, more employees quit or disengage, and the quality and safety of patient care go down.

Health care executives must ask five courageous questions to disrupt this destructive cycle. Take a moment right now to ask yourself:

1. Am I burned out? A recent survey indicates that 30 percent of health care leaders are experiencing severe burnout symptoms right now. How do you know if you are struggling with burnout? Well, take a moment to ask yourself, “Am I struggling to find meaning in my work? Does the bare minimum feel overwhelming? Do I feel angry and isolated?” If you answered yes to any of these questions, you may be struggling with burnout. Most leaders will burn out at some point. Ignoring burnout will not make it go away. Just like reading a painful financial report, taking the time to acknowledge the reality of burnout gives you the information you need to make a change in how you approach your work and care for yourself.

2. Am I overworking? And if so, how can I set boundaries, delegate tasks, and prioritize my self-care? It is tempting for executives to put their heads down and work harder. But working harder is a failing strategy. Don’t get me wrong, self-care is not the cure for burnout, but it will help you reduce overworking. When you stop overworking, you begin to see big-picture challenges and solutions more clearly. And you create more time to take small but powerful actions to improve your well-being. It’s ok to start small. Take a lunch break, say “No” to an extra commitment, or delegate a task that sucks your life out. Small actions pave the way for big changes in your well-being.

3. How can I communicate more effectively? Listening may not sound like to key to solving the health care crisis, but a failure to listen lies at the heart of much of the discontent within health care systems. Executive leaders overcome this barrier by learning to speak the same language as their executive team, senior managers, frontline clinicians, and environmental services employees. And learning these new languages requires listening. Even if you must sit on your hands and clamp your mouth shut while you listen, make the effort to do so!

Effective communication also requires transparency. Executives must honestly acknowledge the painful reality of their limitations and your system’s challenges. And then be willing to describe how you plan to respond. Your employees will benefit from connecting with you even when your actions and words are imperfect. Employees are resilient in the face of leaders’ imperfections, but they must be listened to and honored with the truth.

4. How can I empower my employees to find creative solutions? Employees are an underutilized resource for executives struggling to retain an engaged workforce. Let me be clear: This is not an invitation to shift the blame for systemic failures to your employees. But your employees hold key insights that will help you to find creative and sustainable solutions to boost morale, engagement, and retention. Frontline employees are acutely aware of what is broken in your health care institution. Take a risk. Listen to painful feedback. And empower your employees to partner with you as a problem-solving force for good.

5. How can I realign my organization’s policies with my commitment to well-being? Health care executives do not have the power to solve all the drivers of burnout in the health care workforce. And yet, contrary to popular opinion, our health care institutions are not powerless to address this complex challenge. Burnout can be influenced by local policies. Executives must honestly evaluate how organizational policies are impacting controllable drivers of burnout. This may include unrealistic performance expectations, inequitable workload distribution, or poor communication practices. But don’t stop there.

Realign your policies to reflect your commitment to well-being. Not sure where to start? Ask your employees what they need. Then focus your efforts on creating policies that promote patient safety, employee autonomy, scheduling flexibility, communication transparency, equity for the least powerful, and creative supports to enhance employees’ quality of life at work.

Thriving health care organizations are not built on the backs of depleted executive leaders. Caring for your well-being will empower you to make real-world changes to reduce vulnerability to burnout and build an organization ready to thrive in these challenging and uncertain times.

Nicola F. De Paul is a clinical psychologist and a health systems leadership consultant.