Burnout solutions in the time of Covid
The Burnout Epidemic: The Rise of Chronic Stress and How We Can Fix It
Jennifer Moss’ book The Burnout Epidemic: The Rise of Chronic Stress and How We Can Fix It, is an incredible presentation of data, research studies, stories and solutions. For any employee or manager looking to justify efforts to reduce burnout, this is a great place to start. While I also appreciate books on burnout written by coaches that focus on what we can do to help ourselves manage burnout, Jennifer’s book focuses on prevention. As a public health professor, I understand how we have to look upstream at the causes of burnout to prevent it and these start with workplace ‘hygiene’: the conditions in the workplace that prevent or cause burnout. Jennifer’s book is informed by her close working relationships with burnout researchers like Dr Christine Maslach and YMCA WorkWell expert Jim Moss, her husband. She has conducted her own research including a burnout survey with qualitative stories that informed her book.
In addition to Jennifer’s unique approach to focusing on the causes of burnout defined by Maslach (control, autonomy, rewards, values conflict, injustice and relationships), she also wrote her book during the Covid pandemic. She includes heartfelt stories of burned-out physicians who not only were working with increased risk and uncertainty and sometimes their own post Covid fatigue and fogginess, but also working in an environment where patients were dying more often than normal and their role as healers was less effective. The competitive environment of medicine is ruthless yet so many people enter this job because of strong altruistic tendencies. She also included stories of teachers during the pandemic experiencing so many logistical and emotional challenges, yet being so poorly rewarded for their efforts. Some of the solutions in these environments included new training for medical students in wellbeing and ecosystem interventions in education to have children share what made them happy and cultural values communication across schools, students, and communities.
A key message in Jennifer’s book is that well-being precedes productivity, performance and profitability. Well-being in managers is also related to better change management, retention and team contributions. She describes companies during Covid trying to prioritize well-being, failing but learning from their experience because they were constantly evaluating their offerings. Companies discovered that employees were not taking paid time off because the company did communicate the importance of it, or leaders did not role model taking time off. Closing company-wide helped employees really disconnect without any shame. Poorly attended well-being programs that were not safe spaces were replaced by personal development or the flexibility to find personal spaces for recovery. Jennifer included a lot of information about how perks and programs, including personal wearables that I have researched, can go wrong when they shame people into being team players without considering tailoring offerings to include the needs of all groups. We do not want well being to become another workplace burden. An example of a misplaced perk that particularly effects women was egg freezing that communicates that motherhood and work are not well matched and ends up being both sexist and ageist, as well as ineffective.
I particularly enjoyed the example of the positive psychology program that was researched and implemented in the Genesis Health System. It represents what I have advised to many companies related to burnout, that you need to experiment, and using research designs such as a ‘step wedge’, can allow you assess what works in different groups. This group assessed positive interventions such as gratitude, praise, acts of kindness, potlucks. And leaders role modeled from the top and encouraged connection before trying to implement change. I recommend learning collaboratives as a way to manage such experimental approaches. Groups of peers from different departments, or even different companies, support each other to conduct learning cycles based on a plan-do-study-act quality improvement design. In this way, companies can rapidly test what might work in a supportive learning environment.
Another company learned the benefits of sharing stories from its employees, a perspective that more organizations are adopting, which I also promote in my podcast. Not only does the storyteller feel seen and supported, but other people in the same situation see they are not alone. Stories seem a particularly important tool for leaders to develop empathy. Through stories they can start to learn what their employees are going through. In the example, a perfectionist working mother was struggling with her new role as home school teacher.
Jennifer Moss described the grandma’s intuition backed by science approaches that her Plasticity Labs had discovered including hope, optimism, self efficacy, gratitude, mindfulness, empathy and resilience. In particular, she shared the story of the New Zealand resilience researcher who faced her own tragedy with the death of her daughter. From this experience she learned that resilience comes from accepting that bad things can happen to anyone, that focusing on what helps rather than hurts is important, and seeking the benefits of any bad scenario. In particular, the concept of post traumatic growth resonated with me, in the wake of my own burnout, but also seems very relevant for our post Covid world.
A story that Jennifer shared that profoundly impacted me was the burnout and death by suicide of Dr Lorna Breen. A hard-working and dedicated physician, she was working overtime with Covid, suffering her own fatigue due to contracting Covid, and experiencing a higher number of patient deaths than normal. She was concerned that her mental health issues would result in her medical license being revoked. Having come from a school of medicine, I already knew about the high levels of female physician suicide and the impact of this on the ability of women’s health issues to be solved. But this personal story and the efforts of her family’s foundation in her honor to rectify the medical education and board practices that lead to burnout, touched me deeply. Having experienced suicide ideation, I could understand how burnout leaves you feeling like you can’t go on. Burnout has profound implications for your health, your family, and your work. I appreciate Jennifer Moss’ dedication to this topic and her thorough research and presentation of solutions. I would have loved to hear more of her own story but appreciated the stories she did share.
