10 years in one place

In June 2023, I celebrated 10 years at Parkview Health.

These are the top seven lessons I've learned in my first ten years in healthcare. ⬇️

🌎1. The world is a much more complicated place than I originally thought.

🛐2. Changing your beliefs in light of new experiences is a sign of maturity, not weakness.

💁🏻‍♂️3. Empowering others is more fun than your own success.

🏅4. Work isn't a family. It's a team. That's better and more healthy.

💓5. Believing the best in people will enable some coworkers to soar, and others to fall.

🧑🏻‍🏭6. If you really believe in something, don't take 'no' for an answer. Find another way.

👩🏼‍💼7. Executives put their pants on one leg at a time. Don't be intimidated by big titles. Instead, help them. They have a tough job.

Thank you, Ann Lantz and Jeannine Nix for hiring me, Ben Miles, Curtis Smith, Dena Jacquay, and Sarah GiaQuinta, MD for leading me, and Kristen Riecke and Daniel Riecke for supporting me.

There are too many coworkers to tag, but special shoutout to Jon Swanson for seldom agreeing with me, but always helping me to become better.

#healthcare #tenyears #leadershipskills #healthcareleadership

One way to stop burnout

7 Organizational Steps to avoid burnout

❓As a leader, can you help coworkers avoid burnout?

7️⃣ These seven steps will help you decrease the level of burnout your team experiences.

1️⃣ Number 1: Provide a way opt-out

😞If a coworker violates their own conscience at work, they experience moral injury. This can lead to burnout symptoms, including emotional exhaustion, cynicism, and feeling like they can't make an impact at work.

🔥Once they are burned out, it's hard to get UN-burned out. So, one way we can avoid or decrease burnout is to clearly communicate to our team: "If you have a moral objection to this course of action, you can opt-out."

⛔Of course, you still have to get the job done. But finding a way to do it without violating anyone's values will avoid disengagement and turnover.

❓Does your leader let you opt-out?

hashtag#moralinjury hashtag#burnout hashtag#burnoutprevention hashtag#wellbeingatwork hashtag#healthcareleadership

Erin Alexander EMSN, MSN-Ed, RN, CNEn

How I am recovering from burnout

❓ Can you overcome burnout?

🤷🏼‍♂️ I've researched the topic of burnout among healthcare workers extensively. But this question is generally unanswered.

📚 There are excellent studies on the prevalence of burnout, depression, suicide, etc.

🏢 Articles abound that detail necessary steps ORGANIZATIONS must take to reduce burnout in their coworkers.

🙍🏼‍♂️But what about the solitary individual, a burned-out person? What can she/he do to recover?

😞Is it hopeless? Un-recoverable?

My desperate search was selfish. I needed to know--can I come back from burnout?

🔎Since I could not find answers in the literature, I had to find my own way.

I had to survive.

So, here are 14 things I have done (or stopped doing) in the last 8 months to claw my way back from burnout.

They are descriptive. These things helped me. They might not help you.

Number 7 is embarrassing:

⚖️1. I adjusted my expectations of myself. The most important one, by far.

🙆🏼‍♂️2. I gave attention to my nervous system (I educated myself, then started new practices). Sukie Baxter was a huge help.

🎯3. I decreased my focus and intensity at work. (What's the opposite of working harder? Working lighter? Working softer?)

🧘🏼‍♂️4. I meditated with the use of Kristen Riecke's Peloton app.

📃5. I made a bucket list and started checking off items. Ben Nemtin changed my life.

💺6. I took time off and made a plan with my doctor.

🚽7. I stopped checking emails on the toilet. (This one is still hard to practice, ngl. Kind of embarrassing and gross.)

🌍8. I adjusted my worldview (again).

📒9. I journaled events, thoughts, and feelings.

🧱10. I drew boundaries and eliminated/limited energy suckers (aka, I said "no" and unfriended some people on social media👋🏼).

🧭11. I performed self-discovery (there were personality-specific reasons why the situations bothered me so much).

🫧12. I found a literal safe space--a physical bubble where I could retreat and be free.

⌚13. I used the mantra "Things can change at any moment."

💞14. I confided in exactly three trusted people (in addition to my doctor and counselor): Kristen Riecke, Jana Vastbinder, and Jon Swanson.

What is on your list? Comment below:

#selfhelp #personaldevelopment #mindfulness #humanresources #healthcare #mentalhealth #depressionawareness

Initial Reviews

❓How many times have I presented on grief or spirituality? About one million.

🤔How many times have I presented on the topic of Overcoming Burnout? Exactly ONCE.

📈That's why, when reviews came in from the OHIO ASSOCIATION OF GERONTOLOGY AND EDUCATION conference this week, I was blown away and humbled by the comments.

💬This is what the attendees had to say:

✅By far the BEST presentation of the conference. It was a relatable topic WITH action steps

✅Working as a care manager for a health insurance company was very stressful ... it was difficult at times to feel sympathetic, especially since I had several people on my caseload pass away because of the [Covid-19] infection. I understand the feeling of having to opt out.

✅Would love to have him share his story with our organization. Always looking for stories to inspire and make everyone feel the “normal”

✅I really enjoyed the topic and I found the information useful. I have too been dealing with burnout on and off the last few years.

✅Rev Patrick had a good sense of humor which engaged me after the lunch break and made the topic of burnout more interesting

✅I really appreciated the personalization of his delivery- the transparency is commendable

✅This topic is very overlooked at times and I really appreciated his discussion and his personal experiences.

✅Outstanding!

Apparently, I need to keep talking about hashtag#burnout.

#overcomeburnout #healthcare #continuingmedicaleducation #humanresources

I am not good at “letting go”

👐🏼 “Life is one long process of letting go.”

But I have failed to live by this mantra.

⚙️ Instead, I have believed that, given enough time, I can fix any broken situation.

🪛 That I can improve things. Repair things. That I can figure it out, and make a difference in the world.

The problem is, I have often been right. I have helped detangle many complicated situations. I have improved systems and communities. I have blazed trails that others can travel.

😷 But then, Covid arrived. And most days, the only trail I blazed went backward. I wasn't prepared, none of us were. And my perceived effectiveness plummeted.

🙅‍♂️ I did not. Let go. I doubled down on effort, trying to "solve" the worldwide pandemic, at least for my corner of the world. Valiant efforts, but it was killing me.

Until last fall.

Sometimes your physical health taps you on the shoulder.

👉 My physical health got my attention, but it was pointing to something else.

🧠 My mental health.

🤔 Finally, I realized that my midwestern, German-Catholic, white male entitled, “can-do” attitude had delivered in an unpleasant way.

🏆 I was a 44-year-old ordained pastor with a successful career. A multi-published author with a perfect family.

😔 But I was depressed for the first time in my life.

😤 The problem with depression is that it does not respond well when you work harder, plunge ahead, and keep on keeping on. The tools I had always relied on were, suddenly, ineffective.

😔 I needed grace. Surrender. Vulnerability. Self-compassion.

👐 In two words, I needed to let go.

(And I still need to.)

#mentalhealth #burnout #healthcarecoworkerburnout #depressionawareness

My first speaking engagement on Burnout

Was in April 2023—here are my reflections:

✅First conference workshop in the books!

😑I shared my story.

✔️Three years of pandemic leadership.

✔️Ethics policymaking.

✔️Leadership ups and downs.

😥I developed at least two new diagnoses last fall: AFib and Depression.

😣My counselor helped me see that both were connected to the stress I was under.

🆘Friday was my first in-person attempt to help others with this important topic. And it was great.

🗣️The crowd was fantastic, the conversation was affirming, and the reviews were humbling (100% said the material was helpful and relevant to them and one leader has already reached out about a follow-up opportunity to serve their front-line coworkers).

Title: "Moral Distress and Burnout: A Roadmap for You and Your Team"

OHIO ASSOCIATION OF GERONTOLOGY AND EDUCATION

#workshop #moraldistress #burnoutprevention #healthcareleadership

What leads to burnout?

❓What happens when moral distress goes unaddressed?

😷Moral residue.

If coworkers experience moral injury, distress, and residue repeatedly, what happens?

🔥Burnout.

📉Burnout leads to poor patient outcomes, absenteeism, a lack of engagement, and problems retaining talent.

😔Not to mention anxiety and depression for our coworkers.

#engagement #talent #moraldistress #healthcareethics #burnout

Have you experienced Moral Distress?

😒 Have you experienced moral distress and/or burnout?

😩 Do you feel emotionally exhausted?

🤷🏾‍♀️ Do you wonder if you're making a difference the way you wish you could?

🤦🏽‍♂️Have you seen things or done things at work that you deeply regret?

+++

92% of Critical Care RNs expect a SHORTER career due to Covid.

One-third to one-half of RNs and physicians were burned out BEFORE Covid-19

👩🏻‍⚕️Around 2/3 of RNs are burned out now (globally)

+++

RNs the most profoundly affected by Moral Distress and Burnout

⚕️However, every healthcare discipline has been affected

There is hope.

Healthcare and other industries must learn to support their coworkers facing these dilemmas. If we don't, the cost will be enormous.

#healthcare #burnoutrecovery #moralinjury #medicalethics #cne

What is moral distress?

What is Moral Distress?

Moral Distress occurs when we

take an action or witness an action

that violates our personal values.

🙊🙉🙈

In 1984, Andrew Jameton defined “moral distress” as a phenomenon in which one knows the right action to take, but is constrained from taking it.

🥺

Veteran's Affairs (VA) psychiatrist Jonathan Shay coined the term “moral injury” in the 1990s.

The VA says that moral injury can occur in response to acting or witnessing behaviors that go against an individual's values and moral beliefs.

👉Ex. 1: A healthcare leader advocates for or approves a zero visitor policy, resulting in loved ones being separated at the time of death.

Or

Being required to abide by that policy without the authority to override it

👉Ex. 2: A bedside nurse is required to do CPR for a patient she knows is not going to survive. The physical experience violates her values of allowing a peaceful death.

🫵What examples would come to mind for you?

#moraldistress #moralinjury #healthcareworkerburnout

My Burnout Journey Begins

Moral Distress and Burnout are personal for me

Here's why...

⬇ Read to the end to discover what I did this week

My first overnight on-call (nearly 10 years ago)

I was called in at 2am

🏥 A young man lay alone in a small ER room

He drove his car off a bridge

🚑 The first responders fished him out of the water

They did CPR on the short ride to the hospital

As I stood, alone, in the thin rectangle of a room with him

Only one of us was breathing

😥In fact, we didn't even know who he was

John Doe

So, I knew

Working in health care is hard

It has been hard for ten years

😷 Except the last three have been...

Extra

🕖 60-80 hour weeks

Overwhelm, rising death tolls

😣 Ethics consults and committee meetings were more intense

Writing ethics policies about scarce healthcare resources

🙅‍♂️ Restricting visitors (against my beliefs)

Leading a team that responded to as many as a dozen deaths in one day

😠 Leadership conflict

Personal tragedies large and small piled on top of the mountain of workplace stress

Bad things happen

But when you feel helpless

Powerless.

It's different

In the middle of it all, I watched a good friend die on the same day she gave birth to her first child

We took the lead in support of her young husband and the baby

💔 Brokenhearted

Earlier this year, our son came down with appendicitis while we were in Puerto Rico

The remote island of Vieques, to be specific

🛩 Midnight airlift to San Juan

Emergent flight back home for surgery (he's fine)

🌊 Our house flooded in July, and was just recently fully repaired

It's fair to say that life has sucked since March 2020, at work at outside of work

So, I woke up on September 5, 2022

My 44th birthday

And something was wrong

With me

My heart was out of rhythm

💓 The Apple Watch confirmed--AFib

My first time

In the ER, I was cardioverted (shocked with 250 joules)

Without sedation (my choice)

All the follow up you expect

Then, a month later, another first

😐 I was diagnosed with depression 😐

My first time

I beleived everything was unrelated: AFib, work and life stress, and depression

I said as much to my counselor

She cocked her head, smiled a bit and said, "Really?"

Stress

Became moral distress

Became burnout

🛣 There is no straight road back from all this

But I've leaned on my team, and they have helped

I have adjusted my expectations of myself

I have listened to my doctor and therapist (and bride)

And I took this week off

🗓 A mental health week (not just day)

I made a list of rest-and-rejuvinate activities

📉 I honored the fact that my energy is low

I made a point to enjoy good things

I journaled and prayed

And I made a list of everything I wish had not happened over the last few years

Every line began with "I am sorry that..."

Then

😞 I forgave myself

I took some deep breaths

⌛ And recognized that "getting better" takes time

#mentalhealth #ethics #healthcare #hospital #workplacewellness #burnout