Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
We delve into the critical issue of burnout in nursing with Andrea Coyle, a nurse practitioner. We explore the distinct symptoms of burnout, how they manifest differently across genders and generations, and the unique challenges faced by nurses today. Andrea shares insights into the specific struggles of baby boomers with technology, the work-life balance pressures on Generation X, the motivations of Millennials, and the early career stressors for Generation Z.
Complimentary burnout assessment: https://info.sehealthcaresolutions.com/burnout-assessment-kevinmd
Andrea Coyle is a nurse leader and expert in creating structures and processes that improve performance outcomes. She is the chief clinical and innovation officer, SE Healthcare.
She discusses the KevinMD article, “Nurse burnout: causes, symptoms, and solutions by gender and generation.”
Our presenting sponsor is Nuance, a Microsoft company.
Together, Microsoft and Nuance are leveraging their rich digital technology and advanced AI capabilities to tackle some of health care’s biggest challenges. AI-driven technology promises to revolutionize patient and provider experiences with clinical documentation that writes itself.
The Nuance Dragon Ambient eXperience, or DAX for short, is a voice-enabled solution that automatically captures patient encounters securely and accurately at the point of care. DAX Copilot combines proven conversational and ambient AI with the most advanced generative AI in a mobile application that integrates directly with your existing workflows.
Physicians who use DAX have reported a 50 percent decrease in documentation time and a 70 percent reduction in feelings of burnout, and 85 percent of patients say their physician is more personable and conversational.
Discover AI-powered clinical documentation that writes itself. Visit https://nuance.com/daxinaction to see a 12-minute DAX Copilot demo.
VISIT SPONSOR → https://nuance.com/daxinaction
SUBSCRIBE TO THE PODCAST → https://kevinmd.com/podcast
RECOMMENDED BY KEVINMD → https://kevinmd.com/recommended
GET CME FOR THIS EPISODE → https://earnc.me/49k4wp
Powered by CMEfy.
Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome Andrea Coyle. She’s a nurse executive. Today’s KevinMD article is “Nurse burnout: causes, symptoms, and solutions by gender and generation.” Andrea, welcome to the show.
Andrea Coyle: Thank you, Kevin. I’m so excited to be here.
Kevin Pho: So let’s start by briefly sharing your story and journey.
Andrea Coyle: OK. My story actually starts a long time ago, when I was a new nurse, probably one year into the profession. I started to feel frustrated, and started to feel like I had to vent before I’d go in and see the patients that I really had signed up to take care of. And at that time, over 30 years ago, I didn’t realize it had a name. Now that name is burnout.
And then if we go back about five years, during the COVID pandemic, at the very beginning, I worked in an education department and my whole team got furloughed. And so I had the opportunity to go work in a New York City suburb hospital in the first wave of COVID-19. It was crazy. Everyone knows everything that happened, especially in New York City.
And I started to have all these emotions and feelings that I couldn’t quite figure out. In the meantime, I was invited to be on a Twitter chat with Healthy Nurse, Healthy Nation. It’s an American Nurses Association company, if you will. It’s not a company, but it’s something the American Nurses Association does. And on this Twitter chat we started talking about self-compassion, and it was then that it hit me that I am suffering, I’m in the grips of burnout.
So I went back to my job after the furlough, recognized I wasn’t feeling and getting what I needed every single day. I didn’t have a sense of purpose or accomplishment. So I started to work at what’s called SE Healthcare. It’s a startup company, we’re software as a service, and we have platforms all on clinician burnout. And that’s what I’m doing. I’m passionate about helping the people that help the people.
Kevin Pho: So we always hear about nurse burnout, especially during and after the pandemic. What are you hearing from your nurse colleagues about what’s happening now, where we’re like three, four years out from the pandemic? Are you still hearing about stories of burnout within the nursing ranks?
Andrea Coyle: 100 percent. That’s a great question. And it’s funny, I’m starting to hear, we don’t even want to use the word burnout anymore, because we’re getting burned out on the word burned out. But for the sake of this, Kevin, we’ll call it burnout.
What I’m hearing is, it was really the genesis of the article, we have the multi-generational folks all in our workforce, and every generation has a different perspective of what burnout is. And that’s what’s interesting.
So our baby boomers, maybe the technology piece contributes to burnout. Our Gen Zers, our youngest gen, 98 percent of them are feeling burned out, and they’re new into the workforce, and the reasons are very different. Our millennials, millennials seek creativity, they want a coach, they want a mentor. So each generation is different, and burnout presents itself a little differently, and it feels different for the generations that are in the workforce.
Kevin Pho: All right. You talked about that KevinMD article, “Nurse burnout: causes, symptoms, and solutions by gender and generation.” So that’s really interesting to me. Go into more detail about how those different generations interpret and respond to those feelings of burnout.
Andrea Coyle: Interestingly, it’s a great question as well. Interestingly enough, the younger generations, their burnout comes from work-life balance. Those generations really, they actually have boundaries.
I just did a presentation at the Mayo Clinic and a millennial said to me, she has good boundaries. And I thought to myself, I’m a Gen Xer, I don’t have boundaries, work comes first. The baby boomers, work comes first. And so it’s work ethic. There’s so many things that contribute to what this looks like and feels like.
Kevin Pho: So talk more about your KevinMD article. What are some of the symptoms that these nurses may feel that may be suggestive of potential burnout?
Andrea Coyle: Exhaustion. Exhaustion is one of them. A big one is lack of self-efficacy, not feeling like I’ve had the time to deliver the care that I want to deliver to the patients, because they deserve their best, I’m not feeling my best. And that’s a big one. Workload, doing more with less, that’s a huge one.
And oftentimes, Dr. Kevin, I feel like it’s more than burnout. I think it’s a human energy crisis. I think there’s more to it than burnout. There’s everything that’s going on in the system that you’re working in, but then there’s everything outside the system.
Kevin Pho: So how is the health care industry responding to this? You mentioned that there’s like three cohorts, there’s the Gen X, there’s the millennials and Gen Z, each with a different potential etiology of why they’re burning out. How in general are hospitals and medical institutions recognizing this and potentially addressing each particular cause?
Andrea Coyle: One thing is, our surgeon general, Dr. Vivek Murthy, put a call to action out two years ago that hospital systems, it’s in their best interest that we start to measure burnout, and we start to use data to help drive decisions on how we’re going to help people that are suffering from burnout.
So SE Healthcare, that’s exactly what our company does. We measure burnout, we drill down to the reasons for burnout, and then we help organizational leaders prioritize where they’re going to put their energy on how we can really start to mitigate and decrease burnout.
The other thing that organizations are doing is hiring wellness officers. So you hear a lot out in the industry that there’s a lot of chief wellness officers, and they’re putting together support groups, microlearning sessions. What SE Healthcare does is we have microlearning sessions, and it talks about, for nursing, how important it is to have shared governance. Shared governance affords nurses a voice. When nurses feel valued, or any clinician for that matter, when they feel valued, or when they feel like they’re a part of something bigger than them, that’s a sense of purpose and accomplishment, and that will decrease burnout.
So organizations really are putting a big emphasis on this. Magnet hospitals, there’s over 6,000 Magnet hospitals across the globe, they have required standards hospitals must meet, and it’s all around nurse well-being. Pathway to Excellence, PTAP, which is transition to practice, they’re all putting standards into place that organizations have to meet, so that nurse well-being is top priority.
Kevin Pho: So give us a case study example, could be a hypothetical example, of those concepts in action that would prevent those three different age groups from burning out. What would be an example of a success story?
Andrea Coyle: To me, one success story is a personal story. I was a professional excellence Magnet program director at an academic medical center. I was asked to be an interim nurse manager of a 62-bed digestive disease unit. And what we had in that unit was low morale.
And there’s something called the DAISY Award. The DAISY Award is an international award, it’s in 6,000 plus hospitals across the globe, and it’s meaningful recognition. When people feel that they are being recognized for good work, it decreases their burnout level, it improves a sense of gratitude and well-being.
So what we did in that unit is, we set a goal through our shared governance to nominate a nurse for the DAISY Award every single month. And that unit went on to have three winners for the DAISY Award, and they went on to increase their nurse satisfaction scores.
Kevin Pho: Now, you mentioned that for our youngest cohort of nurses, the Gen Zers, one of the biggest reasons why they’re burning out is work-life balance. How are medical institutions, and how are companies like yourself, how are they addressing that particular facet of burnout?
Andrea Coyle: Flexible scheduling is one way that nurse leaders are tackling some of the stressors that are contributing to burnout. Another thing that leaders are doing is, there’s virtual nursing, so we can leverage technology to help decrease some of the burnout. There’s a robot that Diligent Robotics has, it’s called Moxi the robot, and she can actually run errands for nurses, that will decrease workload and tasks for nurses. There’s a lot of ways that nurse leaders are leveraging technology.
Kevin Pho: So what are the dangers for medical institutions, hospitals, if they don’t recognize, let alone address, nurse burnout? I asked you earlier for a success story. What’s a story of failure? What happens to these hospitals where they simply ignore this issue of nurse burnout?
Andrea Coyle: When nurse burnout is not recognized, a lot of things happen. Number one, your top talent, experienced nurses, walk out the door. And what happens then is patient care, quality care, goes in the wrong direction, and then that just turns into a snowball.
And then what you have is an experience-complexity gap, where we have a lot of new nurses working at the same time, and all that experience that left because they’re burned out went out the door, and patient care suffers.
Kevin Pho: And what are you seeing in general? Are you seeing the majority of hospitals, are they taking nurse burnout seriously?
Andrea Coyle: I would say the majority of hospitals do take this seriously. I also believe there is a call to action for hospitals to assess the burnout, measure their burnout. That’s why I’m so passionate about SE Healthcare. We actually measure burnout for hospitals and give that qualitative and quantitative data back to nurse leadership.
Kevin Pho: And how do you measure burnout?
Andrea Coyle: Yep, Dr. Kevin, it is an assessment. Nurses can do a self assessment. One question, rate your burnout. Talk about your top three stressors in the clinical environment. And then you can use artificial intelligence and break it down to what exactly are the main contributors in the environment. And it could be broken down to unit level.
Kevin Pho: One of the things that you talked about in your article was the difference between male and female nurses when it comes to that perception of burnout. So talk more about that.
Andrea Coyle: Yes, men and women do actually experience burnout differently. Women often will experience the exhaustion piece first, where men will often experience depersonalization, meaning the people that they signed up to take care of, they’ll now become cynical and critical of those patients.
Kevin Pho: And what are some things that institutions can do, again, to address those individual factors, those gender factors, when it comes to burnout?
Andrea Coyle: I think again it goes back to what we keep talking about. It’s being curious and figuring out what those feelings are, how they manifest, and once we know that, then we can start to have these really courageous conversations with people.
Kevin Pho: Are we moving the needle since the pandemic? Do you think that we are making headway in general when it comes to addressing nurse burnout?
Andrea Coyle: I definitely think we’re making headway, 100 percent. Especially because it is top priority in health care, period. And I think that’s evidenced by chief clinical officers, wellness nurse coordinators, healthy work environment committees. I think there’s a lot of evidence out there, and a lot of people working together, a lot of great thought leaders thinking together on how we can tackle this very real challenge that we have in health care.
Kevin Pho: So let’s say we have some health care administrators listening to you on this podcast, and their institution is not actually instituting some of the suggestions that you’re mentioning here on the show. Tell us some of the first steps that they should do if they want to seriously address nurse burnout.
Andrea Coyle: The first step is really sit down and listen to your team. Do purposeful, intentional leader rounding. If you recognize some of the nurses, physicians in your environment that are missing work, they’re not coming to meetings, they’re not engaged, low engagement scores are a key indicator that there is burnout in the environment.
Kevin Pho: Do you ever get pushback from health care administration, perhaps some say your suggestions are too expensive? I know a lot of hospitals, they have their own revenue issues, and there may be some economic instability. Do you ever get that kind of pushback?
Andrea Coyle: Yes. So again, SE Healthcare, we do get pushback. It’s too expensive for us to measure, assessment, and then once we measure and get all these data points, then we have to act on it, which then means we might have to spend more money.
But you know this, Dr. Kevin, as well as I do, the amount of money that it costs to bring in a new physician or a new nurse is astronomical compared to bringing in something like SE Healthcare, bringing in virtual nursing, bringing in Moxi the robot, bringing in these technology pieces. And not only is it money, but it’s the experience that I talked about. We’re letting that good experience walk out the door, and there’s not a price tag on experience.
Kevin Pho: Does that message get through to some administrators? Because I know that a lot of these health care leaders, sometimes they are relatively shortsighted, and their job security is based on not so much what’s going to happen in the future but what’s happening now. How do you respond to that?
Andrea Coyle: I often say the biggest return on investment is to make sure your providers are well, so that your patients are well. And I try not to say this, but at the end of the day I think administrators know what I’m saying. When our care providers aren’t at their best, the patients don’t get the care they deserve. And that quality care, those metrics, as you know, they’re all related to incentives. So we’re not going to get the incentives from CMS, we’re not going to get the market share that we need, and at the end of the day the patient suffers.
Kevin Pho: We’re talking to Andrea Coyle. She’s a nurse executive. Today’s KevinMD article is “Nurse burnout: causes, symptoms, and solutions by gender and generation.” Andrea, we’ll end with some of your take-home messages that you want to leave with the KevinMD audience.
Andrea Coyle: I think the biggest take-home message that I’ve come up with is, number one, you have to recognize the signs and symptoms of burnout in yourself, and you have to recognize them in the people that you’re working elbow to elbow with. It’s really important.
It’s also important to be able to have courageous conversations with yourself and with the people that you’re working with. It’s OK to say, hey, Dr. Kevin, I recognize you haven’t been yourself, can we talk about that? And then you and I can have a really curiosity-driven conversation that’s courageous and helpful to both of us. So that’s a big takeaway.
The other big takeaway is, I think about this for myself and for others, is you’ve got to keep people inspired, you have to keep people interested, you have to keep them involved, and you have to keep people informed. And those are really big messages.
Kevin Pho: Andrea, thank you so much for sharing your perspective and insight, and thanks again for coming on the show.
Andrea Coyle: Thanks, Kevin. I appreciate it.
Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
