Preventing Burnout in Health Care


Hello and welcome to. Let's talk a series of podcasts produced by the Hazel and Betty Ford Foundation on the issues that matter to us and the issues that we no matter to you as well well substance use disorders prevention research treatment and recovery support. I'm your host William Moyers and today we're coming to you from on the road. At the campus of the Ford Center in Rancho Mirage. California joined by my friend and colleague Josias Jesse. Welcome Joseph Thank you William Pleasure to be here. You're the the executive director of medical and professional education and our topic for today is preventing burnout in healthcare professionals. You mean to tell me that healthcare professionals channels can burn out. It's hard to believe William but healthcare professionals can in fact burn out over the course of my career and I'm sure over the course of your career and others one one thing I've seen more than ever as how hard health professionals work day. In and day out we put in long hours where essentially surrounded by individuals who are suffering hiring who are living with challenges. And we're trying to help them see the light at the end of the tunnel. Were trying to help them find that resilience find that happiness find some balance. It's in their lives so that they can be as productive as possible. And so one thing that I've really found important over. The course of my career is working with healthcare providers. That are are stressed out that are burned out because I quite frankly don't Wanna see them resort to unhealthy habits. I don't WanNa see them have to end up in treatment if possible. I'm I really want them. To find some active balance in their lives. Based off of what they're doing in the workforce and then what they're doing their families and what I've noticed is you. Yeah you probably see this. In a lot of our settings you see a lot of healthcare providers and treatment I see lots physicians. I see lots of nurses I see lots of pharmacists. I see lots of physician assistance. I see lots of social workers. I see lots of addiction counselors people that love helping others at neglect to themself. And so they're coming into the office early every day. They're on the computer charting outside of their small group in one on one individual session times the working late hours into the evening. They're going going home taking care of their significant others their children and they're doing that over and over and over again and I found this so important Britain is I work a lot of the time with family law lawyers judges and working with judges. I would watch them day in and day out in the courtroom and what they would see in front were people that were living with addiction. It's like eighty ninety percent of the cases presented in courtrooms involve alcohol or drugs of some sort. And so here they were. They would hear these stories. And what would they do would go home at the end of the day and they would stuff the emotions and stuff the feelings and come back the next day and do it all over again and they would live with things like like vicarious trauma they would live with things like like sadness and remorse. They wouldn't get to see a lot of light at the end of the tunnel. It's not like individuals for coming back to the judges and saying thank thank you so much judge you really helped influence and impact me. They're usually not seeing individuals the best of times and so we started providing educational experiences for judges judges first and foremost to help them with sentencing people to treatment as opposed to sentencing them to prison or jail. As you know drug courts have been incredibly successful zestful over the years and helping not just reform people but helping them get clean and sober stay clean and sober. Then you would look at a different professionals like clergy right people would go to their churches or their synagogues and they would share with individuals about their drinking and about they're using people that would run these churches or synagogues or her or other religious experiences within stuff those emotions and listen to all these horrible things all day and sometimes they would drink at the end of the day. And like if you're or a judge or a lawyer or clergy person and you're hearing the stuff day in and day out and you start drinking. What are you living with your living with shame? You're living with guilt. You're living with remorse. You're living with secrets. And so we started seeing all the stress and some burnout in clergy. She judges and lawyers. And then you'd see your your peers your healthcare providers working these long hours all day to and I would see it in medical settings things all the time too and it would always start in the home and they try to keep it quiet right significant others try to cover up the addiction or cover up the mental. Oh health illness and then it would progress to the point where would make its way to the office and in the office. You're surrounded by support staff. You're surrounded by assistance. You're surrounded by others. Oh doc didn't have any alcohol on his breath that was from the night before or oh you know. He's got black circles under his eyes. Doctor just worked so so hard here so we had this this underlying alcoholism and drug addiction. That was taking place and people were trying to cover it up over and over again in the sad reality. -ality is that people would would only seek help when they were caught when they would actually have board action against this well they would have consequences and and so we started doing things like clinical diagnostic evaluations to help people get medical write ups and psychiatric right Alps clinical right ops. We started talking to them about setting leading belt the boundaries and about taking care of themselves we started sharing with them the consequences to what could in fact happen if they don't stop drinking they don't stop using using. We started showing them other individuals that were going through the same struggles. I mean if you work with healthcare providers when you put them in a group together they tend to call each other out on their be asked. They tend to hold each other accountable. They tend to be able to relate better. You have specialty groups nowadays like birds of a feather for pilots lots of pilots and treatment. You've got specialty. Groups nowadays called the other bar lots of lawyers in treatment you've got specialty groups called Kadusha S- meetings for medical it professionals and then you've got professional groups for other individuals like police officers firefighters. I A lot of twelve step meetings. Let's say I have a loved one. That's it's going into surgery tomorrow. If I'm sitting next to a surgeon that's practice while under the influence and they're sharing about that in my twelve step meeting. I might be having second thoughts about my loved one going into surgery tomorrow. I'm so we have these safe environments these specialty meetings that are all over the world for people to share their stories as well so and and looking at our peer groups looking out burnout and looking at stress and looking at addiction which again is so prominent in our field and and healthcare as a whole we simply we wanna make sure that they realized there are resources available and now we're there for them and that it's okay to ask for help right and that it's okay to ask for help because you know here we are. We think we know everything we think we have all the answers and all this training and all the schooling and and I'm supposed to be the subject matter expert. How do I reach out for help? How do I go to somebody and allow myself to be vulnerable and allow myself to say? Hey you know what I'm hurting right now and the fact of the matter is that it's okay ask for help. I mean oftentimes no matter what it is but particularly healthcare professionals are those who were successful in business successful in law they feel vulnerable vulnerable and asking for help right they do and I think that they're afraid to ask for help. And they don't realize that there are services available to them and it's not the end of the world it's not the end of the world. They need to seek help for addiction. I've had medical students go through. Our programs are Summer Institute for Medical Students whereby they're actually in treatment at our facilities so what. He's learning about addiction. The individuals living with it. Who then go on to residency and end up back in our facilities as patients to three years later interesting and they look me in the eye and they see Joseph thank goodness? I had that experience at your Sims program. Because I wouldn't have gotten here's the soon I might have never thought I had not a problem. I wouldn't have introspectively look inward and asked myself some questions. I went out of sought help. I might not have realized that it wasn't so alone. And so we see that nowadays we see I mean. I don't know fifteen. Twenty percent of our patient. Population could be licensed healthcare professionals. And I'm proud of that. Yes I'm really proud of that because I know that those individuals are going to have a profound impact on healthcare and on the world as a whole through getting helped sooner than later. Joseph we have a couple of minutes but talked talked a little bit about the impact that the opioid epidemic has had on healthcare professionals. And I think specifically about those who are working in emergency rooms or first responders who were out reviving driving people who are overdosing the streets and so on what has been the impact of the OPIOID epidemic. So if you if you look at Hazelden Betty Ford as a whole right seventeen sites in nine states right right now. Twenty four thousand patients. We're going to serve this year if you go and look at what. They're diagnosed with nowadays as far as substance use disorder goes. You're seeing. Opiates in like thirty. Thirty plus percent of our cases. That's a huge number if you turn back the clock ten fifteen twenty years ago. It's two three four times what it used to be. You're seeing the same same thing with regards to our healthcare professionals when I see healthcare providers come on in and their primary diagnosis is an opiate use disorder. I'm not surprised anymore. I always almost expect them to say alcohol use disorder or opiate use disorder. Because there's such ease of access to getting those. Opiates a lot of times. Opiates are being over prescribed. So they're more readily available than ever for a lot of our individuals that are healthcare providers they have the financial means to continue to support their habits or their usage. Wjr so that happens as well. I mean we go to George Washington University or to Washington. DC area all the time. And everybody's talking about opiates because they're killing people. I always viewed. Alcohol is the slow killer. Opiates has the Fast Keller. And that's just so sad that we've classified them in a certain way because at the end of the day if people don't get help for these use disorders they're gonNA die. You've got this progressive disease right now and I think for healthcare providers a lot of times. We think we're invincible. We think we know better. We think we no how to prescribe these medications or how much we can use. We treat ourselves a lot of the time I mean here. You've got an addicted professional. WHO's treating others who thinks they can treat eight themselves at the same time? It's the biggest oxymoron in the world. So I think our advocacy efforts are huge so that we can help other public. Health Officials President President National Institute of Drug Abuse National Alcohol Abuse and alcoholism Samsa Mercer all the other large public organizations. I mean their eyes have been opened but more people continue to die that we need to to do better and we need to do more and we need to do it now. I know they're going to be people who are watching or listening to this podcast specifically because they know they have an issue sure they have a family member who's a health care professional who has an issue. We've got two minutes give us two or three or four action steps that healthcare professionals can take to get help for themselves for somebody who works in their office or their healthcare profession. My number one recommendation is. It's never too late to get help. And you don't have to have this myriad of consequences you don't have to get a Dui you don't have to get reported to the board you don't have to get caught. You can seek out. Help help yourself. It's not the end of the world address. The issue now sooner rather than later and move forward with your life helping war individuals than you ever could have so so. I really want people to realize that stigma still alive. And well we look at people with substance use disorders at times negatively like a hindrance on the world. And that's just it's not true. Individuals substance use disorders are resilient people that want a better life for themselves and their families so with our healthcare providers. I hope they see that. I hope they see and realize that if they get help sooner than later they can help profoundly impact and influence thousands of individuals more so than they could if they continue to drink and to continue to use and the fact of the matter is is that oftentimes you know this. You've told me about this before. And we see it on. Units healthcare professionals are among the group that has a very high success rate right once they get into treatment they have their rates are recovery are are high correct healthcare professionals in particular one area that we've actually done a really good job studying with respect. The substance use disorders. A lot of other areas are lacking when it comes to individuals primarily physicians and pilots and we monitor them for five years for abstinence. You'll see seventy eight to ninety two percent abstinence rates after five which is remarkable. Why though I think they have the licenses that rests so a lot of times? It's the job but at the end of the day. My belief is that everyone's life is at risk so people say to me all the time. Well of course the the abstinence rate. It's going to be higher for people with licenses. It's their livelihood is in it everyone's livelihood when it comes to substance use disorders. One drink drink one drug one event could in fact lead someone to their death. We need to treat this thing seriously and realized that these are our brothers and sisters out there and if we don't take action and we don't take it now we couldn't fact lose them and that's a big deal. It's a very big deal. Joseph Esky thank you very much for taking the time to share your UH incredible professional expertise in that remarkable articulate passion. You have for these subjects executive director of Medical Professional Education for the Hazelden one. Betty Ford Foundation on behalf of everyone. Here let's talk. I'm your host William Moyers. Thanks for joining us again. And we'll see so

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