How integrative practitioners can address workplace burnout

Photo Cred: Stacey Gabrielle Koenitz Rozells/Unsplash

By John McCormack

Flight attendants routinely tell passengers to put their oxygen masks on before trying to save others. This logic holds true for integrative health practitioners who are trying to navigate burnout in their own practices and to help other healthcare professionals in the industry as a whole deal with unrelenting workplace demands.

Stress has reached disastrous levels. In May, the U.S. Surgeon General, Vivek Murthy, MD, issued a warning that points to an “urgent need to address the health worker burnout crisis across the country.” The warning highlights the fact that healthcare workers “faced systemic challenges in the healthcare system even before the COVID-19 pandemic, leading to crisis levels of burnout. The pandemic further exacerbated burnout for health workers, with many risking and sacrificing their own lives in the service of others while responding to a public health crisis.”

The experiences of Erica Burger, DO, MPH, a psychiatrist who practices at Driftless Integrative Psychiatry in Lansing, Iowa, and Brittany Ferri, PhD, OTR/L, an occupational therapist and author based in Rochester, New York, illustrate why it is important for integrative health practitioners to take care of their own workplace stress before providing services and advice that can help other health workers better deal with burnout.

Burger, for instance, addressed her own workplace stress quickly after she entered the medical field.

“I took a job with a big healthcare system right out of residency, and it was an outpatient psychiatry position. I worked in three different counties, none of which I was living in. It ended up just being a recipe for burnout from the get-go,” Burger said.

The fact that her medical training didn’t prepare her for the realities of everyday life in the healthcare field added salt to the proverbial wound.

“You climb throughout medical school and residency. But once I graduated residency, I got to the top of that ladder and there was a pretty profound sense of disappointment when my expectations didn’t match reality and I realized I needed to figure out what would be a better setting for me to work in,” Burger said.

As such, Burger re-imagined her career by starting her own private integrative psychiatry practice, where she now treats patients in a manner that aligns with her personal values.

“The insurance model for [conventional] psychiatry reimburses providers more for prescribing medications than for doing therapy,” Burger said. “There was a really big part of me that wasn’t being fulfilled practicing medicine in that way. I really valued autonomy and being able to offer healing modalities outside of the standard options. In the integrative space, there’s so many more dimensions to healing and people getting better than just medication.”

In addition, to create a more palatable work environment for herself, Burger had to “do a lot of unlearning, because the typical healthcare culture dictates that you work yourself to the ground,” she said, adding that she now typically works three days a week.

Similarly, Ferri also made adjustments to her career to deal with unbearable stress.

“Very early on in my clinical rotations, I was definitely feeling a lot of emotional attachment to patients and really bringing their emotions home with me at the end of the day,” Ferri said.

Ferri also wrestled with the fact that the reality of the work was quite different than what was presented to her in school.

“One of the biggest issues is the picture that OT school paints as to the work that you’ll do,” Ferri said. “There’s a lot of disparity. They don’t really put as much emphasis on how much documentation and administrative work you’ll have to do. A lot of people enter the field, thinking that that’s a very small part of the job when, in fact, it can take away from patient care … it can definitely make burnout worse because you feel like that’s valuable time you could be spending with patients.”

As the use of electronic medical records has become more common throughout the industry, the incidence of documentation burden has increased and led to burnout syndrome, according to a review published in Studies in Health Technology and Informatics.

Because of this stress, Ferri transitioned to “more writing and program development … just as a way offload some pressure, and still get work experience,” she said. “Then I, I ended up enjoying it and finding that it really was a pretty good way for me to still use my skills and manage that burnout in a different way.”

Providing peer-to-peer support

Both Burger and Ferri have also found that now that they have addressed their own workplace stress issues, they are in a unique position to help other healthcare workers.

“I have a particular interest and passion for helping healthcare professionals experiencing burnout, trauma, depression, and anxiety and now spend a lot of my time in practice helping physicians, dentists, therapists, and physician residents through ketamine assisted psychotherapy work, often through personal ketamine retreats,” Burger said. This psychedelic medicine treatment is used to treat depression, anxiety, and post-traumatic stress disorder.

Ferri also devotes significant professional time to helping her healthcare colleagues better cope with stress. “I started doing some writing about burnout and self-care for providers, which ended up being really rewarding because I am helping myself while also helping other people,” she said.

As integrative care practitioners Burger and Ferri are not alone in their quest to help health workers deal with workplace stress. According to an article on the Society of Critical Care Medicine website, practitioners can help other health workers combat burnout through an array of services including wellness programs, acupuncture, herbal medicine and more.  

Ashely Allen, NP-C, MSN, a nurse practitioner with Allen Health & Wellness in Townsend, Delaware, for example, helps clients, many of whom work in the healthcare industry, to reduce stress by focusing on the hypothalamic pituitary adrenal axis.

“I perform salivary testing to identify any abnormal pattern in their cortisol rhythm,” she said. Based off of this and an extensive in-depth interview, I work one-on-one with clients setting goals and finding areas of opportunity to help to allow for balance. Many times this will include setting a specific sleep/wake cycle, ensuring adequate nutrient and hydration intake, decreasing screen time, allowing time for lunch breaks, setting healthy boundaries at work, and working on vagus nerve exercises to help the body be in more of a ‘rest and digest’ state.” 

Been there, done that

In addition to offering services, integrative health practitioners are in a good position to draw on their own experience with burnout and offer the peer-to-peer advice that could encourage healthcare workers to:

Dial it down a notch. “Many healthcare professionals feel that they need to stay in jobs because it looks good on their resume and can help their career advancement. It’s important to recognize when it might be time to take a step back. There’s really no shame in that,” Ferri said.

Understand that your stress could negatively rub off on patients/clients. “Health workers need to look at stress from a lens of patient welfare. If you feel like your burnout’s impacting the treatment that you’re giving, you’re neglecting patients, or you’re really just not being as present as you should, or you might be coming off a bit more cynical or sarcastic, obviously, you don’t want your stress to result in giving patients substandard care,” Ferri said. 

Get in touch with your soft side. “The culture of conventional medicine really fosters individualism and that we solve challenges by working harder. Often, we have pretty good success at that type of problem solving. Showing vulnerability, though, is not necessarily part of the culture nor is it usually nurtured in healthcare,” Burger said. “Being vulnerable requires an incredible amount of courage and so a lot of my work with healthcare professionals is to encourage them to get really curious about these different parts of them. I encourage healthcare professionals to get really curious about the vulnerability that we all have as humans.”