Combating Burnout by Creating Cultures That Heal

By Professor Lynda Holt MA, RGN, DipHE, CPBP, FinstLM, FRSA – CEO, Health Service 360 (www.healthservice360.co.uk)

It can be tempting, but unhelpful, to catastrophise about the state of the care sector when reading the Health and Social Care Committee Report on Workforce Burnout and Resilience in the NHS and Social Care. We know staffing is beyond challenging, and many in the sector are already feeling the ‘emergency levels’ of burnout. We also know that chronic excessive workload is a major contributing factor to burnout.

Don’t get me wrong, there are some solid recommendations throughout the report, even if some have been rebuffed by the Government Response. But the challenge with it is two-fold.

First, most of these issues were a long time in the making – exacerbated by the pandemic, and Brexit for sure – but not entirely new and there really isn’t a quick fix. The population is aging, the demand for care increasing and both vacancy levels and turnover are high, but not universally.

Second and perhaps more important, is that it is very easy to get into a spiral of helplessness and feel you have no power to change things and in doing so you give away your agency, you are less likely to take any action and things feel increasingly out of control. Again, there are some great examples of innovation, as well as places where staff feeling valued and supported.

So rather than feeding the despair, what you really need is to understand what you can do, what you have some control over and what will make it better for you and your people right now. Of course, have your say on policy if that’s your thing – but don’t use it as an excuse to do nothing to make things better where you work if you need to.

If it feels like I’m adding to an impossible burden, I apologise – but you see every single one of us makes a difference, every day; and every single one of us has the power to change the things we have control over. Some days this might simply be ourselves and they way we show up, what we choose to absorb and what we don’t. In making that choice we gain back a little control, reduce the overwhelm and slide fractionally away from burnout.

Burnout is just as much a local issue as it is a ‘national crisis’. In a UK 2020 study 41.8% of people claimed they were on the brink of burnout before the pandemic. So what can we do to aid recovery and bring those we work with, and maybe ourselves, back from the brink?

The evidence, pre and during the pandemic, suggests that workplace culture is a major contributing factor when it comes to burnout, stress and wellbeing. In the care sector many of these cultures are small, but impactful. It is each one of us that makes up the culture in the place that we work, and the majority of people aim to fit in the culture they find themselves in, sometimes at a very high personal price.

If you lead people, manage care or actually work with others, you have a responsibility to work towards workplace cultures that heal and not hurt. This can feel like a big ask at a time when you are feeling the strain, or believe it can’t be fixed. But here’s the thing, healing if not the same as fixing.

Healing is about courage, vulnerability and hope. It’s about being brave enough to explore culture, to understand where people are at, and then plot a course towards recovery, laced with possibility and some contingency for the rough sea you might encounter on your journey.

For recovery to take place healing has to happen. The culture within your workplace is probably the biggest factor in this healing. By culture I mean ‘the way we do things around here’, behaviour, attitude, levels of respect and trust. Get your culture right and people will follow you anywhere, get it wrong – or fail to address issues causing harm, and you’ll never get out of choppy waters.

A healing culture makes space for recovery, it is not a cure for burnout, but it reduces the likelihood of it occurring or worsening. People have the opportunity to process what they’ve experienced and find resolution.

This requires a few basic human needs to be met:
1. They need to feel safe, that they can trust you, their colleagues and the process, that there won’t be any repercussions for them personally
2. They need to feel they belong, that they are seen and heard for who they are, and that they, and their views or concerns, are valued
3. They need to feel significance, that their work matters and their contribution makes a difference

Any one of us can start this process by modelling healing behaviour and making it safe for others to do the same. Pay attention to those around you, listen, communicate, and trust yourself to act with courage and compassion. But, and it’s a really important but, you need to get yourself out of rough waters first, it’s no good trying to pull others out of the sea when you are drowning yourself.

Find yourself some anchors, look after yourself, your mental well-being and your energy levels first, this is the only way you get to recovery. Think about the things that energise you, that you get lost in, that calm you, and that make you feel like ‘you’ – make sure you keep some of these in each and every day – even if it is only for a few minutes.

 

Here are three simple, but not always easy, steps towards recovery:
1. Reflect
2. Reconnect
3. Recommit

 

Reflect:
Explore what’s happened, give people space to talk. If you pay attention, they will tell you what matters to them, how to make it better, and what not to do.
Reconnect:
In terms of healing cultures, belonging is the single most important thing. People want to be seen and their work recognised. They want to feel connected to something bigger than themselves, both in the work they do and their social interactions. They want to feel like they matter, that those around them care.
Think about the way you treat people, the possibility you create, connect people with the difference they make, with what they are part of and how their work matters and they will face choppy waters with you.
Recommit:
Be explicit about your expectations, (whether or not you are the boss), open the door for conversations about behaviour and boundaries, what’s ok and what’s not. Involve people in their own recovery, what do they need, what’s possible, create agency, a voice and enough freedom to act on what you or they can control – this is what keeps us on the journey.
Use these three steps for the big stuff and the little stuff. Keep it safe, be consistent, honour what you’ve committed to, ask for help when you need it and make it ok for others to do that too.

None of us can sit and wait for the storm to pass, we all need to act when and where we can to reduce the burnout faced across the care sector. Good luck on your journey.

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