Stress in the healthcare setting is high. Studies across the healthcare professions show increasing stress levels, and as many as 30% - 60% of providers report burnout.1 Burnout contributes to a poor quality of life for healthcare professionals who are experiencing it. In addition, stress and burnout can lead to “reduced quality of care and safety” for patients and can have ramifications “in terms of increasing medical errors and malpractice cases.”2
For physicians, the causes of burnout are many—loss of autonomy, increasing work load, frustration with the electronic health record, increasing regulations and decreasing reimbursements. But probably more responsible for burnout than any of these is the fact that physicians spend more time with their computers than they spend with their patients. Record keeping demands have chipped away at patient consultation time. Physicians are finding that personal interactions with patients have become shortened, more scripted and less likely to be emotionally satisfying—the formula for burnout.
Nurses, too, experience detrimental effects from stress, and they report exhaustion and burnout as a top concern in their profession. Nursing burnout often stems from increasing workloads, which can result in less personalized patient interactions and subsequent perceptions by nurses that their contributions to patient care are becoming rushed and superficial.
We have heard about how diet, exercise and a balanced life style can help reduce stress levels. More recently, we hear how enhancing compassion in care can restore satisfaction to the practice of medicine and nursing, contributing to professionals’ and patients’ health. To investigate further, a group from LAMMICO consulted with Stanford University’s Center for Compassion and Altruism Research and Education (CCARE), pursuing new strategies to promote provider wellbeing.
How can bolstering compassion make a difference to someone who is tired, disheartened, or spiraling toward burnout? Is practicing compassion just another thing to remember, an added task on an already-too-long list? Is striving to heighten compassion an overly optimistic and ultimately unproductive endeavor? Research reveals this is not the case. Studies now show that strengthening compassion not only contributes to good patient outcomes, it also promotes a sense of resilience in the health care professionals who aim to do it.
Conclusively Positive Effects of Compassion
Studies confirm that when patients perceive their healthcare providers as compassionate, they do better. Randomized controlled trials have demonstrated that patients with fibromyalgia have less pain, diabetic patients remain in better control, hypertensive patients have lower blood pressure, and oncology patients have decreased anxiety and depression.3
Research also shows that healthcare professionals who learn about and nurture their compassion feel better about themselves and their practice. For example, the Mayo Clinic conducted a year-long study of three physician groups. One group of physicians—the control group—made no changes in their usual behavior. A second group of physicians was freed from clinical duties for one hour every two weeks; they could use the hour as they wished. A third group attended one-hour sessions every two weeks where they shared patient stories, had discussions on mindfulness, and learned simple ways to introduce more compassion and empathy into their practices. Participants in the third group felt more engaged in their work and were at less risk for burnout. These changes were sustained one year after the study ended.4
Why does compassion have favorable influences? The autonomic nervous system quickly responds to compassion in interactions. By measuring physiologic changes in subjects who either received empathetic or compassionate messages or reacted with compassion to another person’s circumstances, researchers found such contacts had beneficial effects, including lower blood pressure and cortisol levels, more stable glucose levels, and increased endorphins.5,6
What You Can Do Today
One way to reduce burnout is to focus on personal interactions with patients, probably one of the aspects that made you consider healthcare as a career in the first place. Try practicing this brief exercise as you see patients; it does not take much extra time, and it occurs solely in your own thoughts: Pause before you walk into the hospital or exam room and say to yourself, “May I be of help to this patient.” This strengthens your awareness of the patient as a person requesting your help and affirms the privileged position you are in to offer this help. This exercise allows you to temporarily step out of the rush, be mindful of the moment and savor each encounter.
1. Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clinic Proceedings. 2015;90(12):1600-1613.
2. Oskrochi Y, Maruthappu M, Henriksson M, Davies AH, Shalhoub J. Beyond the body: a systematic review of the nonphysical effects of a surgical career. Surgery. 2016;159(2):650-664
3. Kelley JM, Kraft-Todd G, Schapira L, Kossowsky J, Riess H. The influence of the patient-clinician relationship on healthcare outcomes: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2014;9(4):e94207.
4. West CP, Dyrbye LN, Rabatin JT, et al. Intervention to promote physician well-being, job satisfaction and professionalism: a randomized clinical trial. JAMA Internal Medicine. 2014;174(4):527-533.
5. Cosley BK, McCoy SK, Saslow LR, Epel ES. Is compassion for others stress buffering? Consequences of compassion and social support for physiological reactivity to stress. Journal of Experimental Social Psychology. 2010;46:816-823.
6. Stellar JE, Cohen A, Oveis C, Keltner D. Affective and physiological responses to the suffering of others: compassion and vagal activity. Journal of Personality and Social Psychology. 2015;108(4):572-585.