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Best Practices for Mentorship and Burnout Mitigation

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4/19/2022

More than 75% of healthcare professionals have self-reported burnout as well as increased frustration and feeling overwhelmed at work. Andrea Sikora, PharmD, BCCCP, MSCR, FCCM, discusses what can be done and highlights three recent articles offering recommendations on how to prevent burnout and establish effective mentorship opportunities.

As burnout has become more pervasive, statistics on burnout among healthcare professionals have increased in the literature. “The healthcare profession is really facing a pandemic of burnout, and this pandemic was present even before COVID-19 came on the scene,” said Andrea Sikora, PharmD, BCCCP, MSCR, FCCM. “COVID-19 has really just served to fan those flames.”
 
More than 75% of healthcare professionals have self-reported burnout as well as increased frustration and feeling overwhelmed at work. More than 90% say they are stressed. Dr. Sikora, clinical associate professor at the University of Georgia College of Pharmacy and critical care pharmacy specialist at Augusta University Medical Center, presented these statistics at the Society of Critical Care Medicine’s 2022 Critical Care Congress as part of the session “Year in Review: In-Training.”
 
Dr. Sikora explained that burnout is a syndrome with three dimensions: feelings of energy depletion or exhaustion, increased mental distance from the job or feelings of negativism or cynicism related to the job, and reduced professional efficacy. The common link among these dimensions is that they all result from chronic workplace stress that has not been successfully managed, she said. Burnout rates of greater than 50% have been reported across healthcare professions, including physicians, nurses, and pharmacists. It is no surprise that burnout is particularly rampant among critical care professionals.
 
“When we think about the specific intersection of burnout in critical care, we also have to bring in the unique factors of the ICU environment, [including] elements of compassion fatigue from dealing with critically ill patients, moral distress from difficult decisions that are being made in very stressful situations, and perceived delivery of inappropriate care,” she said. “On top of that, you bring in the fact that critical care is an academic discipline, so many people taking care of those patients also have teaching roles. That’s another independent factor that comes in and contributes to burnout syndrome.”
 
When these factors combine, critical care professionals end up facing posttraumatic stress disorder or other psychological symptoms, while patient satisfaction and quality of care delivered at the bedside decrease. “These feelings lead to increased rates of job turnover and attrition from the field,” Dr. Sikora said, “which is not only unfortunate for the individuals leaving the field after years of training, but there are also increased costs to the institution.”
 
What can be done? Dr. Sikora highlighted three recent articles offering recommendations on how to prevent burnout and establish effective mentorship opportunities.

Igniting Change

“Igniting Change: Supporting the Well-Being of Academicians Who Practice and Teach Critical Care” was published in Critical Care Nursing Clinics of North America.1 The authors explain how working as a nursing faculty member and maintaining a clinical practice as a critical care nurse can lead to unique challenges and stressors that can threaten well-being.
 
Several strategies can be implemented to promote well-being. It is important for individuals to take responsibility for actions that can improve their physical and mental well-being, including exercise, proper nutrition, and sufficient sleep. Because of the role the workplace plays in causing burnout, institutional components must also be addressed.
 
“There are a lot of good things to be said for taking time for yourself and promoting wellness,” Dr. Sikora said. “However, those things can be very hard when you don’t have institutional support or feel that you don’t have institutional support to do that.” Institutional components include offering curriculum development; organizing events for faculty, staff, and students; laying the foundation for individuals to seek trustworthy support; providing professional development; scheduling retreats; creating a forum where individuals can seek feedback on their performance; and developing a wellness committee. Wellness committees provide wellness services to faculty, staff, and students and should be empowered to make recommendations on current workload and staffing processes to help mitigate burnout.
 
In addition to sleep, exercise, and nutrition, the article offered five ways individuals can promote their own personal wellness—journaling, maintaining physical health, balancing time for oneself versus time with others, self-monitoring for signs of stress or depression, and hobbies. “This article is unique in that it discusses the environments specific to those who are teaching, learning, and practicing within the critical care domain and what is going to be useful for overall well-being,” Dr. Sikora said. “Although this article was focused on critical care nurses, I think many of the lessons can translate to all the fields and professions that we have in critical care.”

Kindling the Fire

“Kindling the Fire: The Power of Mentorship” was published in American Journal of Health-System Pharmacy.2 The authors focus on mentorship within the pharmacy profession, but Dr. Sikora said that the overall concepts can be applied to any critical care profession. “One of the best things about mentorship when it’s done well is not only does it provide practical, hands-on advice, but it also provides high quality connections,” she said. “One of the most important things for preventing burnout and for feeling efficacy in the field are these feelings of connections and loyalty over time.”
 
The article defines mentorship as a deliberate, effortful, and evolving relationship characterized by mutual growth and shared altruism with a primary goal of the mentee’s personal and professional development. Dr. Sikora said that she appreciated the detail put into this definition and spent time breaking it down to highlight how mentorship can in fact help prevent burnout.
 
She focused on the words “deliberate” and “effort.” True mentorship does not result from accidental interactions such as when a person sees someone in the hallway and offers some advice. Mentorship stems from one person seeking out another and both individuals making time to meet and investing in the relationship.
 
The best types of mentorships provide mutual growth and shared altruism for both the mentor and mentee. A give-and-take dynamic exists between two people, and one goal is for mentors to learn and grow from their mentees; not only mentees benefit from the collaboration. “What you’re doing in this dynamic is trying to do what’s best for the other,” Dr. Sikora said. “It’s important to realize the primary goal is the personal and professional development of the mentee, but it’s important to realize mentors are taking just as much from this relationship at times as the mentee is.”

Gender Inequity

Dr. Sikora said she chose “Gender Inequity and Sexual Harassment in the Pharmacy Profession: Evidence and Call to Action,” published in American Journal of Health-System Pharmacy, because it is action oriented.3 The authors acknowledge the lack of gender equity in leadership and recommend that processes be created to support female membership by offering diverse mentorship opportunities.
 
“Mentorship, although it can have these touchy-feely words like mutual growth and shared altruism, has extremely practical benefits,” Dr. Sikora said. “Numbers are very supportive of the fact that having a mentor makes you more likely to get a promotion you want, to be given awards and titles that you’re interested in, and results in higher salary and pay overall. It also decreases turnover and increases feelings of satisfaction and personal well-being.”
 
The article offers a view of mentorship based on the healthcare ethics principles of autonomy, beneficence, nonmaleficence, honesty, and justice. Autonomy can refer to the right of the mentee to function independently and successfully. Beneficence is the obligation to do good, with the overall goal being the mentee’s personal and professional success. Nonmaleficence is the obligation to not harm others, a key aspect of any effective mentorship. Honesty means that both participants in a mentorship should be truthful and authentically reflect and provide feedback, which are necessary for mutual growth. Justice is the principle of fair and equitable treatment of others.
 
The article also suggested best practices to support each of these ethical principles. Dr. Sikora said that this article “shows that what you put into a mentoring relationship is likely what you’re going to get back out. I think that’s really powerful to realize.”
 
The Society of Critical Care Medicine's (SCCM) 2022 Critical Care Congress featured presentations by world-renowned experts across disciplines on a wide array of clinical and research topics. If you registered, you still have access to sessions for a year. If you missed it, watch select sessions on the #SCCM2022 YouTube playlist and watch out for the On Demand.

 
References
  1. Roney LN, Beauvais AM, Bartos S. Igniting change: supporting the well-being of academicians who practice and teach critical care. Crit Care Nurs Clin North Am. 2020 Sep;32(3):407-419. https://pubmed.ncbi.nlm.nih.gov/32773182/
  2. Newsome AS, Ku PM, Murray B, et al. Kindling the fire: the power of mentorship. Am J Health Syst Pharm. 2021 Dec 9;78(24):2271-2276. https://pubmed.ncbi.nlm.nih.gov/34293082/
  3. Bissell BD, Johnston JP, Smith RR, et al. Gender inequity and sexual harassment in the pharmacy profession: evidence and call to action. Am J Health Syst Pharm. 2021 Nov 9;78(22):2059-2076. https://pubmed.ncbi.nlm.nih.gov/34232286/


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