Blog
Leadership, Burnout,
and the Realities of Work
Practical posts drawn from healthcare leadership,
coaching, and real-world experience.
The Three Biggest Reasons I Burned Out in Healthcare
Burnout rarely has a single cause. For most of us, especially those working in healthcare—it’s the result of a complex, layered set of stressors. That was certainly true for me.
Still, when I look back on my own burnout story, what pushed my heart into an irregular rhythm that required electric shock, what led to my diagnosis of depression and anxiety, three core factors stand out above the rest.
1. The Innate Intensity of Working in Healthcare
Some people say, “It’s not life or death,” to keep things in perspective at work. But in healthcare, it is life or death. Every day.
As an ethics leader in a large health system, I worked closely with teams that were often at the bedside of patients who were dying, or had just died. My phone rang at all hours with urgent, complex, often heartbreaking decisions that couldn’t wait.
The emotional weight was heavy. The decisions were high-stakes. The cost to my nervous system, over time, was immense.
2. An Irresponsible, Absent Leader
For the first several years of my healthcare career, I was fortunate to report to strong, supportive leaders. Then, everything changed.
When I was reassigned to a new leader, I saw the writing on the wall. While I liked this person personally, I knew they had a history of inaction and detachment. During the height of the pandemic, they didn’t step foot in any of our hospitals for over a year—not even for a meeting or lunch.
Meanwhile, my teams and I were in patient rooms every day, dealing with critical shortages, ethical dilemmas, and rapidly evolving crises. When I needed backup, I got silence. When I needed collaboration, I got resistance—or worse, indifference.
I was juggling life-and-death responsibilities, while needing to remind this leader (repeatedly) to approve basic things like mileage reimbursement.
That disconnect made me feel betrayed. Angry. Alone.
3. My Own Personality
The third major factor in my burnout was my own personality.
I’m an Enneagram One. If you’re not familiar with the Enneagram, Ones are known as “reformers.” We’re principled, responsible, and deeply driven to improve systems and uphold what’s right.
That personality served me well for years—until it didn’t.
When the pandemic hit and my leadership support disappeared, my intense sense of personal responsibility turned inward. Everything felt broken, and nothing could be fixed. I kept pushing, trying to hold everything together, even as the system around me changed.
This perfectionistic streak, which once helped me lead effectively, became a liability under the pressure of a global health crisis and institutional difficulties.
Bonus Factors (Honorable Mentions)
Of course, burnout is never just about one or two things. Other contributing factors included:
Long-term understaffing
A decade of being on-call
The cumulative effect of grief and personal loss
Subtle shifts in the organization’s mission
A growing sense of helplessness in the face of systemic breakdowns
But ultimately, the three biggest drivers were:
The emotional intensity of healthcare work
A lack of leadership support when I needed it most
A personality that couldn’t “let up,” even when I was drowning
The lesson? Don’t underestimate the role of leadership in burnout. My job and personality were intense for years—and I didn’t burn out. The turning point was the leadership vacuum.
If you’re a healthcare leader, please hear this: your presence matters. If you’re navigating burnout yourself, know that your experience is real—and it’s not your fault.
What I’ve Learned from Six Months of Burnout Conversations Across the Country
In the last six months, I’ve spoken to more healthcare professionals than ever before. From a college of nursing in Tennessee to Med Surg nurses in Illinois, from dialysis providers in Florida to oncology nurses in Colorado, from home health leaders in Southern California to committed teams here in Indiana and across the border in Ohio—I’ve had the privilege of hearing directly from the people doing some of the hardest, most meaningful work in our country.
And here’s what I’ve learned.
Burnout is Everywhere.
The live polls I conduct during keynotes and workshops consistently show burnout rates between 80 and 90 percent. That’s shocking on the screen. But it’s the one-on-one conversations after these events that hit me the hardest.
A young nurse in described the bullying she experiences from seasoned coworkers. A Chief Nursing Officer told me they’ve been overworking for so long they no longer know how to function differently. These aren’t isolated incidents. They are symptoms of a broader problem.
Healthcare isn’t just “hard.” It’s complex, heavy, and morally exhausting. It’s navigating constant change, being asked to do more with less, and often being mistreated by systems (and leaders) that don’t support you. Burnout isn’t a personal failing. It’s a predictable result of an environment built without regard for human limits.
Healthcare Professionals Are Losing Themselves in the Work
Over and over, I meet people who love what they do. They love their patients, their team, their mission. But that love often comes at the cost of their own identity. They answer every call light, every phone call, every shift request… and stop answering to themselves.
One sign of this loss of self is the neglect of personal aspirations. During my presentations, I ask: “How many of you have a bucket list?” In the general population, around 40% of people do. In healthcare? I see hands go up from 1 to 5 percent. That difference says something powerful. Many of our best caregivers are too overwhelmed to dream.
I believe this can change. Self-care and service are not mutually exclusive. In fact, we care best for others when we’re also caring for ourselves.
People Want to Talk About Burnout
One of the most common responses I hear after my talks is, “I’m just glad to know I’m not alone.” That sentence carries so much pain and relief.
When we finally make space to talk about burnout, the floodgates open. People want to share what they’ve seen: the outcomes that shook them, the mistreatment that crushed them, the exhaustion they’ve learned to normalize. In my 1:1 coaching sessions, I spend 98% of the time listening. Not because I don’t have insights to offer, but because they’ve been holding it all in for so long.
And once people feel seen, they begin to recover.
Let’s Talk About Healthcare Burnout
If you're a healthcare leader or team member reading this, I want you to know two things:
You are not alone.
You don’t have to stay stuck.
We need to keep this conversation going—in hospitals, clinics, leadership meetings, training sessions, and conference rooms. I’d be honored to bring that conversation to your organization. You can learn more about my keynotes, workshops, and coaching at PatrickRiecke.com.
Save the Date: Fort Wayne, September 23
If you're in or near Fort Wayne, Indiana, mark your calendar for a full-day event called:
Let's Talk About Burnout: What Helps, and What's Next
📅 Monday, September 23, 2025
📍 Parkview Mirro Center
It’s going to be a powerful gathering of healthcare workers and leaders ready to move the conversation forward. Registration details will be available soon, but for now, just save the date—you won’t want to miss it.
This New National Report on Burnout Echoes What I've Been Saying
For two years, I’ve been standing in front of healthcare leaders and teams saying the same thing: burnout isn’t a personal failure. It’s a predictable outcome of a broken system.
Now, a major voice in healthcare is echoing that truth. The Institute for Healthcare Improvement’s new publication, Guiding Principles for Improving Health Care Workforce Well-Being, confirms what many of us have known from experience: resilience alone won’t save us. We have to change the culture.
If you’re a healthcare leader trying to retain your people, or a professional struggling to stay afloat, I invite you to read this document. And if you’ve read my book, Let’s Talk About Healthcare Burnout: A Prevention and Recovery Guidebook, you’ll recognize a familiar voice echoing through IHI’s findings.
Here are a few powerful points of overlap that jumped out at me:
1. Burnout Isn’t a Character Flaw. It’s a System Failure. And we need better language.
The IHI puts it plainly: burnout, moral injury, and compassion fatigue are not the same—and none of them are solved by telling people to be more “resilient.” One quote in particular hit home:
“Rather than addressing the work cultures that lead to moral injury, burnout, and high turnover, many in the workforce are expected to be resilient… [which] can trivialize the intense, painful, and profound efforts required to survive trauma in work environments that neglect employee wellness.”
That’s a powerful reminder to leaders: if your staff is struggling (and so many of them are), your wellness initiative shouldn’t be asking them to “bounce back.” It should be redesigning the parts of the system that broke them.
2. We Can’t Fix Burnout Without Leaders in the Room
One of the most aligned messages between this report and my work is the idea that leadership must engage personally in the work of healing the culture. Well-being isn’t just a staff issue, it’s a leadership issue. IHI’s examples of retreats that included senior leaders, nurses, and providers in the same room reflect what I’ve seen in my coaching and keynotes: when leaders show up vulnerably, change begins.
3. Belonging and Trust Are Not Buzzwords—They’re Burnout Prevention Tools
Whether I’m coaching a department head or presenting to an entire hospital system, I emphasize the same truth: people don’t burn out in places where they feel safe, heard, and connected. The IHI report backs this up with frameworks like “Listen-Sort-Empower” and practical tools to elevate frontline voices. Their conclusion? If your staff doesn’t trust you, your wellness program isn’t working.
4. We Need a Both/And Strategy
Perhaps most compelling was the report’s call for a dual approach: organizational change and individual support. I couldn’t agree more. We need structural shifts—like workload adjustments, policy changes, and cultural reboots, but we also need resources for people trying to survive today. That’s why my work includes both personal burnout recovery plans and leadership tactics. We can't afford to choose one over the other.
If you haven’t read Guiding Principles for Improving Health Care Workforce Well-Being from the Institute for Healthcare Improvement, I recommend giving it a look—especially if you’re serious about improving clinician well-being, reducing turnover, and restoring a sense of purpose across your teams.
And if reading it sparks something in you, whether you’re a burned-out professional or a decision-maker ready to lead change, let’s talk. My book, Let’s Talk About Healthcare Burnout, is a great place to start. But real change begins in conversation.
Let’s start one.
Burnout in Healthcare Leadership: Why Overwork Should Never Be the Standard
Healthcare burnout is surging, especially among nurses and leaders. Here's why applauding overwork is dangerous—and what smart, strategic leaders should do instead.
Healthcare burnout is not a buzzword, it’s a breaking point. And far too many nurses, physicians, and healthcare leaders are sprinting straight toward it, or already neck deep.
I’ve spoken to hundreds of healthcare professionals, and I’ve heard too many stories like these:
“I worked 24 hours straight—into the weekend.”
“I’ve been on call for 25 years.”
“My boss called me in while I was on medical leave.”
“My family barely sees me. Even when I’m home, I’m still on the phone with work.”
These stories make me angry—not at the people telling them—but at the systems and senior leaders that allow this to happen.
Who’s Burning Out? Everyone.
Some of you reading this are the ones putting in those hours.
Others are leading the people who are.
Either way, it’s time for a reckoning in healthcare leadership.
I burned out as a healthcare leader because I believed I had to give everything. During a season when I had little to no leader support, it nearly broke me. That experience changed me—and now, it drives my work as a speaker and burnout prevention coach.
Recently, I asked a client a simple but revealing question:
“What did your leader say when you told them about your extreme hours and exhaustion?”
The answer? Not much.
Why Overwork Happens
Let’s be honest—people overwork in healthcare because:
They care deeply about patients, their teams, and outcomes.
They’ve built unhealthy habits, and now 60-hour weeks and being “on” all the time feels normal.
They’re led by people who have never been taught how to protect them.
When leaders ignore these warning signs, they don’t just lose good people—they contribute to a broken culture.
Don’t Applaud Burnout. Intervene.
If someone on your team is always “on,” always sacrificing, always fading—don’t applaud it.
Intervene.
Help them set humane boundaries.
Remind them of their value beyond productivity.
Protect their time off. Give them a life.
Does that make you a “soft” leader?
No—it makes you strategic.
As my coauthor, Dr. Erin Alexander, writes in our book Let’s Talk About Healthcare Burnout, when people feel safe and supported, their commitment doesn’t fade—it deepens.
Pressuring people to give everything to work is short-sighted at best, maniacal at worst.
What Kind of Leader Are You?
If a leader who reports to you is burning out, what do you do?
Do you step in, or do you stay silent, watching them waste away?
Healthcare leaders have the power to shift the tide of burnout, but only if we stop ignoring it and start talking about it.
If your organization is serious about preventing burnout in healthcare, I’d love to help.
Let’s talk about what it could look like to support your team without losing your people.
Speaking on Burnout in Palm Springs: Why the Conversation Must Continue
“Overcoming Burnout” Palm Springs, CA, May 2025
Two and a Half Years Later, I Found Myself in the Desert. Here’s Why That Matters.
The evening before my keynote at the California Association for Health Services at Home, I stood on the patio of my resort in Palm Springs, watching the sun dip behind the mountains. It hit me. This moment was full circle. Just two and a half years ago, I was completely burned out from my job in healthcare. That season nearly cost me everything: my physical health, my peace of mind, and my sense of self.
But somehow, through the slow, messy process of recovery, I had made it here—to a desert oasis, preparing to speak to hundreds of professionals who, like me, know the weight of burnout all too well.
The next morning, during my keynote, I asked attendees to respond to a live poll: “Have you experienced at least one symptom of burnout in the past 12 months?”
81% said yes. Another 8% said maybe.
That’s nearly 9 in 10 of those home healthcare workers who are going to work each day carrying some level of burnout.
The questions during the Q&A were as insightful as they were raw. One attendee asked—only half-joking—“Why would any sane person refuse sedation before having their heart shocked back into rhythm?” It was a fair question that I still don’t have a great answer to. Others wanted to know how to avoid their own collapse, why this happens so often, and how to support their teams.
When we talk about burnout, healthcare coworkers and leaders are listening, they’re exhausted, and they’re desperate for real conversation, not just another empty pep talk.
Burnout Is Everywhere—and It’s Not Slowing Down
California was my farthest destination so far this year, but it wasn’t unique. I’ve spoken in eight states in 2025 alone, and the message is always the same:
Healthcare burnout is real. It’s growing. And it knows no boundaries.
During hallway conversations at the conference, I heard the same themes I’ve encountered from coast to coast—overwork, under-support, and overwhelming bureaucracy. Attendees spoke about the strain of upcoming changes to California’s Medi-Cal program. Another described their team’s emotional exhaustion after repeated staffing crises. The details may change, but the story is familiar.
At a recent presentation for the Oncology Nursing Society in Denver, one attendee shared:
“Thank you to Patrick for saying it’s not our fault. We don’t hear that enough.”
Another said:
“I’m applying knowledge and skills from this session now to enhance my practice and mental wellbeing as an oncology nurse.”
That’s why I keep showing up. That’s why I’m still talking about this.
Let’s Keep the Conversation Going
If you’re reading this, there’s a good chance we’ve already met. Maybe you attended a session in Denver, Indiana, Tennessee. Or perhaps you were in the room in Palm Springs last week. My hope is that the message stuck with you: burnout isn’t your fault, and there are real strategies for recovery and prevention.
But we can’t let the conversation stop at the event.
If your organization is ready to take burnout seriously—whether you're in leadership or on the front lines—let’s talk. I’d love to bring this message to your team, your staff retreat, or your next conference.
Book a keynote or workshop at PatrickRiecke.com