I’ve been reading a great deal about fatigue and burnout, especially in the
health care professions. For many of us, our careers began with high passion
and energy, and a desire to “be all” for our patients, all the time. The health
system we work in focuses reward on high patient satisfaction, perhaps at the expense
of our happiness, while work environments and demands may have transformed our
passion into feelings of exhaustion and lack of reward. I’ve noticed, while
listening to many fulltime practicing midwives, that workplace stress and
overall professional unhappiness are rapidly increasing.
contributes to professional unhappiness? The list of contributing variables is
long and confounding: more women seeking care through the ACA without enough
providers to match the demand, challenges incorporating electronic health
records and effective e-communication systems in care delivery, extended work
hours, low pay, ineffective advocacy from those who influence decision-making, unattainable
performance enhancements, lack of recognition for good work by peers and
leadership, and the list goes on. How can we help ourselves when the systems we
work in are so challenging?
consequence of prolonged, unaddressed workplace stress is more health
professionals prematurely leaving the profession. Plus, exhausted or stressed
providers are at increased risk for unintentional patient error, inability to
effectively engage with patients, incomplete documentation in medical records,
decreased ability to provide evidence-based recommendations, and insufficient
time or caring to engage patients in informed decision-making.
know from numerous studies exploring midwifery in a variety of countries that
midwives are experiencing exhaustion and burnout at higher rates than ever
before. In the United States, we have no current information about satisfaction
in the workplace or midwifery burnout. Last year, I presented an education
session at our Annual Meeting about this topic. After the meeting, ACNM formed
a small team to discuss research options and resource development.
am pleased to share that Brie Thumm, a PhD student from the University of Colorado,
is designing her doctoral study to focus on workplace stress in midwifery. Our
team is excited for her work ahead, and anticipates a national survey of US
midwives in spring of 2016. ACNM will be identifying current trends in the
profession and unique needs of members in order to frame recommendations and
provide resources to reduce workplace stress.
events are not coincidence. As I was writing this blog on a recent flight to
New York, I sat beside an 83 year old man who worked for Purdue Pharma for 50
years. He volunteered as a leader in many projects in his early years,
including investigating the use of Betadine with NASA astronauts. He told me how
much he loved his job for so many years, and I asked what pearls he could offer
about work place stress. He suggested trying new ways of approaching how you do
your work, volunteering to lead projects that impact change, thanking
co-workers and leaders for work well done, and not being shy about positive critique
with recommendations to management on how to improve the work environment.
Lastly, he said, if you are spending more time at work than home, the joy and
fun of the job will transform over time to anger and stress. It will take a
toll somewhere in your life.
can we do when we recognize personal levels of exhaustion? The most common recommendation
is to take steps toward stress reduction. When I was recently diagnosed with heart
disease, a dear friend and midwife Jennifer Averill Moffitt introduced me to
the value of mindfulness-based stress reduction. I enrolled in an online course
designed to be self-paced for the participant. I have also embraced 3 books
that each provided unique insight into mind-body health: The Places that Scare You, by Pema Chodron (thank you Juliana
Fehr), Wherever You Go There You Are,
by Jon Kabat-Zinn (thank you Melissa Avery), and Courage, the Joy of Living Dangerously, by Osho (thanks to my
student, Michelle Clausen). Each of these books has provided life-changing
approaches for being internally focused, providing options toward a new way of
suggestions are: turn on the music! Classical arrangements enhance relaxation.
Try starting a reflective journal, being mindful of where you want to make
changes. Yoga and meditation, both focusing on breath and quiet reflection,
also help. If you are avoiding talking about serious issues, perhaps it is time
to start that difficult conversation. Exercise, eat healthy, and be in nature. Assess
sleep patterns and ways to improve rest. All of these positively impact our
health, brain, and spirit! Starting with one idea may lead to life changes.
chat on the plane reminded me that we are the captains of our ship. Most
literature states we consciously make over 35,000 personal choices every day. These
choices impact our overall health and happiness. It takes mindful intention to
change and embrace our personal needs. Take stock of your own personal
well-being and take steps toward health and happiness.
you will be attending the ACNM 60th Annual Meeting & Exhibition,
don’t miss the opening general session with Joan Borysenko, PhD, who
will be presenting on Mindfulness, Genes, and the New Brain Science: Midwifing Mind, Body, and Spirit. We
need you healthy and happy in order to provide a strong and growing workforce
of midwives that delivers midwifery-led care for all women.