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‘Your overall well-being depends on your work setting’

Thursday, April 08, 2021

Renowned Duke University professor of psychiatry and behavioral sciences, Dr. Bryan Sexton was the first official speaker at the North Carolina Community Health Center (NCCHCA)’s opening of the Virtual Primary Care Conference on Wednesday, sharing research findings on work-life balance and burnout in healthcare settings.

Clinical staff such as nurses, physicians, and pharmacists have a 40 – 45 percent burnout rate when measuring just emotional exhaustion alone. Burnout is also associated with lower patient satisfaction, higher infection rates, medication errors, and even higher standardized mortality ratios said Dr. Sexton.

The global Covid19 pandemic has revealed a lot about individuals, he noted. Before the pandemic, at least 1/3 of health care workers were burned out before the pandemic “and now that number is closer to two out of three,” he explained.

His presentation, titled ‘Thriving vs. surviving during times of change: The science of enhancing resilience’ focused on studies in the field of psychology to explain burn-out and work-life balance as well as interventions to mitigate the challenges posed by both burnout and poor work-life balance.

Citing data from a five-year study that looked at healthcare workers’ well-being, Dr. Sexton said: “We ran a series of randomized controlled trials to show that we can cause wellbeing to improve. We can cause burnout to go down. We can cause sleep quality and sleep quantity to improve.” Predictors of an individual’s work-life balance include how often in the past week an individual might have skipped a meal, ate a poorly balanced diet, worked through a day shift without any breaks, arrived home late from work, or changed personal or family plans for work.

“The answers to these questions cluster together in an interesting way and they give us an idea of your work-life balance behaviors (infractions) or how often you make decisions that put work-life above your personal life and drain your battery and that tells us a picture of where your wellbeing will be like in the future,” said Dr. Sexton. Furthermore, he said one sure way to guess an individual’s work-life balance is to ask the two closest people they work with, further adding that work settings and people within an organization are very likely to influence each others’ work-life balance.

“We never thought that work-life balance was a group norm but there’s a social contagion to work-life balance that makes it so that whether you know it or not, what other people are doing for their work-life balance is related to the decisions that you make about your work-life balance and vice versa,” said Dr. Sexton.  Physicians and nurses were found to be the worst offenders on work-life balance, highlighted Dr. Sexton.  Other predictors of work-life balance include the amount of time an employee has been working on their job. “If you’ve been working for less than 6 months you’ve got a pretty good work-life balance” but it takes six months to be like everyone else, he said.

Dr.Sexton also referenced a Michigan study that found that 26 percent of one individual’s burnout was predicted by the people they worked with. “A quarter of your wellbeing is simply who’s to the left of you and who’s to the right of you on any given day at work. That is completely independent of your marital satisfaction, your spiritual existential crisis. That is not something that we knew going into this study,” said Dr. Sexton.

Burnout is a big driver of the way individuals behave, he said. In work settings where burnout is high there was found to be more bullying, publicly humiliating colleagues, turning one’s back, and even hanging up the phone before the conversation was over, said Dr. Sexton.  Just like burnout is contagious, so is well-being, he said, adding that an individual’s focus determines their perceptions and view of the world around them.  “Your focus determines your reality,” he emphasized.

But how do you make positive emotions more accessible when the negative ones are so prevalent?  Dr. Sexton introduced conference-goers to one very simple intervention, called “3 good things.”  Writing down three things that went well in a day helps make those emotions accessible, said Dr. Sexton, citing another study that found that people who wrote down three good things that happened in a day were happier and less depressed six months into this practice despite their environment.

Conference-goers learned about the effects of burnout on individuals working in clinical settings.


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