Coffee Break - Jennifer Bickel

EP 17: Beyond Burnout: Transforming Healthcare Culture

Summary: 

Customized well-being support programs are crucial in healthcare, recognizing the diverse roles and challenges within and emphasizing the absence of a one-size-fits-all solution.

In this episode, Jennifer Bickel, the Chief Wellness Officer at Moffitt Cancer Center, dives deep into the intricate world of wellness and explores the silent crisis of burnout among healthcare professionals. Jennifer shares her experiences and the challenges that come with balancing work, family life, and self-care, shedding light on the guilt many professionals feel when prioritizing their own well-being. She talks about the significance of resilience and tailored support systems, emphasizing that there’s no one-size-fits-all solution to burnout. Renee and Jen also discuss the vital role of leaders in healthcare to lead by example, showing vulnerability and prioritizing their well-being to foster a healthier work culture. Jen shares the importance of story-telling alongside data in enacting change, the dangers of a siloed approach to wellness, and the need to understand and address the specific injuries brought on by different roles in the healthcare industry.

So, get ready to reflect, learn, and perhaps even change how you approach wellness in your life and work.

About Jennifer Bickel:

Dr. Jennifer Bickel, FAAN FAHS, is a Senior Member in the Department of Neuro-Oncology at Moffitt Cancer Center. She is a neurologist with over 15 years of clinical and research experience in headache medicine. As a former Headache Section Chief at Children’s Mercy Hospital, she developed and led a large multi-disciplinary team that provided comprehensive care to thousands of patients with headaches a year.  Dr. Bickel has been nationally recognized for her work in headache advocacy, research, and education.  She is also a medical acupuncturist with a focus on headache and pain relief.  She is a leader in the American Academy of Neurology including serving as the chair for the Wellness Subcommittee and on the editorial advisory board for Neurology Today.  She has received multiple awards in her career for clinical care, mentorship, and leadership.  Dr. Bickel serves as the Chief Wellness Officer at Moffitt, where she oversees the development of systems and programs that promote the well-being of our clinicians, researchers, and other team members.

CB_ Jennifer Bickel: Audio automatically transcribed by Sonix

CB_ Jennifer Bickel: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Renee Thompson:
Plants thrive and grow in a peaceful, nourished environment, right? Well, it's the same with human beings. But what if that environment is not so peaceful? What if it's toxic? Welcome to Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. In this podcast, you'll get practical, evidence-based strategies to help you cultivate and sustain a healthy and respectful work culture by tackling an age-old problem in healthcare: bullying and incivility. I am your host, Doctor Renee Thompson.

Renee Thompson:
Hi everyone. Welcome back to the Coffee Break podcast. As you know, this podcast is really designed to equip leaders with the skills and tools that they need to eradicate bullying and incivility. Because when we ignore bad behavior, bad things happen to our people. And, you know, we talk a lot about well-being. But I'm going to ask the question back to you. Like, what does that mean? Truly, what does well-being mean? And how does it impact everything that we do, especially in healthcare? And today I am really excited that we have the chief wellness officer from Moffitt Cancer Center, Doctor Jennifer Bickle, on our show today, who's going to talk about what does well-being really mean and how you can achieve it. So, Jen, thank you so much for being on our show today. Thank you for being here.

Jennifer Bickel:
Absolutely, Renee, it is an absolute pleasure to have this discussion with you today. Thank you.

Renee Thompson:
Well, Jen and I talked about a month or so ago about well-being because she and I were both on a call. It was the Moffitt Cancer Center Hospital Board of Directors meeting, and I'm on the board of directors. And Jennifer talked about well-being. And I said, oh, I got to talk to this lady. And so we scheduled a conversation. And, of course, after I heard what she was doing and just really doing some remarkable things around wellness, that I knew she had to be a part of this show. And Jen works with senior leaders across her organization to ensure staff well-being is incorporated into all decisions. It's not just a little side thing that they do. She has real-world experience in assessing burnout across healthcare organizations and in developing effective, evidence-based strategies to reduce clinician burnout. For innovative strategies to improve physician and healthcare worker well-being. Have been nationally recognized in publications and in presentations as an academic professor and a neurologist. See, that's why we get along. Because I'm an old neuronurse, so I love the brain. She just won awards and mentorship, leadership, and clinical program development. She currently serves as a member of the National Academy of Medicine's Action Collaborative for Clinician Well-Being and is also a Berkeley Certified Executive coach. So again, welcome to Coffee Break, Jen. And I have to start by asking you, how did you get involved in clinician well-being? Because when I think of a medical doctor physician, you're taught the concrete to be objective and use the data, and you're all about diagnosing and treating patients. And here you are, the chief wellness officer. How does that happen?

Jennifer Bickel:
Renee, it's so funny because you mentioned that you shared love of neurology. Right? So, I'm a neurologist.

Renee Thompson:
Yes.

Jennifer Bickel:
And to me, this is basic neuroscience that we've got doctors, nurses, people who go into healthcare are some of the most highly trained brains out there, right? And if we really want to tap into all of that knowledge, that innovation, that curiosity, that empathy, that compassion, they cannot have burned-out brains. Right. And so this is actually really about neuroscience optimization. And so I don't look at this as being separate than what I was trained to do. I look at this as a pure extension of taking what I learned and applying that on a system-based level. Right? So, we have to create environments in which we allow people's brains to work at that full potential.

Renee Thompson:
Wow, right away, I kept thinking about the whole left brain, right brain. And I actually use this as a strategy when I'm working with leaders who are trying to be better communicators with their teams. And I always say, you have to consider that there are percentage of people in your audience who are left-brained, they're analytical, they're data-driven. They want the evidence; they want the numbers. But then you have the right-brained, creative people who they want the story; they want to the emotion they want. But what you're saying is they're really the same. Like they're two halves of the same brain.

Renee Thompson:
Yeah. Yeah, that's pretty powerful.

Jennifer Bickel:
Absolutely. And one of the things about wellness, kind of getting to what you're talking about there, is how do you message it for stakeholder buy-in based on how they attribute value, right? And so, for some people, they need everything about burned out turned into data, which I do a lot of data. I show the data about turnover. I show the data about intent to leave. I show the data connecting the burnout. But then there's also the storytelling and about the importance of this. And the truth is that we have all been in the room at some point with the doctor, who is maybe doing everything right, but they weren't quite there, right? They weren't quite present with us. Right? Or the nurse who seems to come in and give the medications but isn't quite present isn't quite there. We sometimes know through those stories that we've experienced what burnout feels like, even if we don't know the definition. Right? And we can see how it's affected the care that we've received as patients and our family has received. We can also see it in our colleagues. But then there's also plenty of data.

Renee Thompson:
Yes. And to your point, we have that data to support why this should be a strategic priority. Uh, however, mixed in with that, you have to share the stories. It can't just be something data-driven. You have to share those stories, too. Because, as human beings, we are both. But I do have to ask you this question because this comes up all the time. It comes up with a lot of the work that we do with culture work, and we do a lot of we call it our like culture change initiative or department culture change initiative, where we actually go into an organization, we work hip to hip with the leadership team and then their entire team. And it's only been, I would say, within the last 2 or 3 years that we've really involved physicians and providers right from the beginning, and that's a whole other conversation. However, this is what I have learned throughout my 32-plus years as a nurse. Physicians deal with their own issues and their way nurses. And there's a problem. They have their issues, and they have their strategies that they tackle in pharmacy tackles their problems. And we are still so incredibly siloed in healthcare. So how do you take something as broad as well-being and make sure it's not a if you're a physician and you're burned out, we have this program for you. But if you're a nurse and you're burned out, oh, we have something. How do you make sure that it's all part under the same umbrella?

Jennifer Bickel:
I think that this is incredibly complex, and I think that this is rooted in a lot of the ways in which we've trained our professions and in which we sometimes alienate each other. I have to share that I was raised by nurses, my mom's a nurse, grandma's a nurse. My two older sisters are nurses. Right. I think that, for me, it was always about the nobility of being in healthcare. Right? The honor of being in healthcare. And so I've always worked in disciplinary settings. That being said, is that what I always think about it is the fact that well-being is a right to everybody in the organization, no matter what their role. But that doesn't mean the approach is the same for everybody, right? But what it does mean is that we can be specific in the fact of this role comes with these certain injuries. Right? This rule comes with these certain risks. How do we provide support for that is tailored but is not elite, right? And I think that sometimes we get confused. Right. Because I think that sometimes we say, well, what we do for pharmacists won't work for a nurse because nurse has this specific needs, or what works for a nurse won't work for a physician because a physician has this specific need. So when we talk about wellbeing or burnout, there's a lot of passion there.

Jennifer Bickel:
And I think that sometimes people respond with that kind of first emotional reaction of, but that won't work for us. But I and I think then when we attempt to make the things the same for everybody in the organization, then we do miss the injuries that are specific to some of our roles. Right? Like all of us experience moral distress and moral injury, but it pops up in different ways and in different situations, sometimes based on our roles. So one of the things that I try to do is try to be specific about what area does is there a gap in. Right? So, for example, we had a healthy workforce already in place for the nursing, but we didn't have a robust one in place for the physicians in the ABPs. Right? So there were some gaps that were needed there. Some of our programming is for every single team member. Some of it is more geared towards people that are more patient-facing because of some of the risks and some of the learnings that are necessary for that, and then some are a little bit more role-specific. One other thing I think is so important to share in this is that the approaches the individuals need might sometimes be different. Like for example, you were talking about that data-minded person, right? So, for some people, it might be the fact that they need the research behind something before they're going to listen to it.

Jennifer Bickel:
So we have to be careful that when we are communicating the value of this and when we're trying to promote engagement, that sometimes we think about, like, for example, offering things at the seventh-grade reading level is incredibly important in some degrees for being inclusive, but that's not necessarily going to get you the buy-in of professionals. Right? So we have to sometimes be clear in what we're trying to do is communicate, right? And to get people to demonstrate the value. The other component of it that's really important is that though we may sometimes have different drivers and solutions to our burnout, we all suffer. All human beings suffer. And whenever any group thinks that they're unique in their suffering, their turns into this sense of persecution, which in turn makes the suffering even worse. And I'm sure, Renee, I have no doubt that you've seen this, right? And it's not always doctor versus nurses or social work versus whatever. Sometimes, it might be the fourth-floor unit versus the fifth-floor unit, or it might be night shift versus the day shift, right? That people sometimes get this narrative that we are the only ones who dot, dot, dot. That is the danger of becoming too isolated in our misery.

Renee Thompson:
Wow. You said so many things that just ticked off the boxes in my brain and my experience. And so I'm going to try to remember a few of them. What you're basically saying is this can't be a cookie-cutter. You can't say wellness for everyone, everybody. We're going to follow this program. And I don't even like to necessarily call it a program because it almost makes it sound like there's a start and a stop or, yeah, just go through this, and everything will be great. Really built into this strategic priorities in a different way other than a program. So it can't just be a cookie cutter, but you have to allow for the uniqueness of everybody's role because everybody's role is different. I even think about that support staff, that nursing assistant who has to meet the demands of, I mean, imagine all the nurses; they're getting pulled in so many different directions. The physicians and it's not to say that they can't say no, but the burden on them is just a little bit different, or that burnout shows up a little differently than a nurse. Then I think about a physician, an intern, a resident, the attending, the person who's on call. It just shows up differently. So I so appreciate that your approach to wellness and well-being recognizes that everyone suffers burnout in some way, but every role has their unique little piece that what you're doing is you're talking about it.

Renee Thompson:
You're incorporating it into the strategies that you're implementing. And and then just the other piece, the whole everybody thinks their job is harder than the other person's job, whether it's day shift, night shift, whether it's the and this is something that that does bother me. So if you're listening to this and you've said this or you've heard this, please address this, that this hospital could not function without their nurses. The nurses do way more than the physicians do. And then I've heard the opposite. We don't necessarily need nurses. We could do all of this ourselves. We're physicians. And it's almost as though you're there's a competition for who has it harder, who has who does more work. I try to remind people it's just a different role. The physician role is different than the nurse role, but it requires both. It requires a day shift and a night shift. It requires the ICU. The neuro ICU, the neuro step down, and the neuro med surge department to care for these patients. And I hear that all the time. And it's just interesting that you brought up that issue because I see it so frequently. So, how do you mitigate that? How do you then, what are some of the strategies that you have incorporated, especially at Moffitt, and where do you even begin? So, if you could talk a little bit about some of your strategies, that would be great.

Jennifer Bickel:
These are all important questions, right? And one of the things that I've noticed, and I actually noticed this about myself, and I figured this out through through counseling, right? As thought that in healthcare, we have a tendency towards self-sacrifice. Right? And that's how we serve. We sacrifice ourselves, and we serve. But the truth is that sometimes that can be really close to martyrdom. Right? And I think that sometimes when we hear those statements of I am the only, we are the only, right? I think that sometimes that comes from the sense of excessive self-sacrifice that they're not sure other people are sacrificing as much. Right? And so, and I think that is sometimes reminiscent of the cultural piece that can happen. So where to even begin and where to even start? This is the great thing about burnout is that there's so many different drivers, and there's so many different problems. That means that there's so many different ways to solve it. And so one of the things that I think is just important for anyone to listen is to know. And then I'll talk a little bit about what we do, but just something that's really important, that is really important in people's mindsets with this is a lot of times when you start anything for wellness, there's going to be a that's not it, that's not important enough, that's not it.

Jennifer Bickel:
Do this, right? If you just paid me more, if this just happened more, if this happened more, right? So any movement forward and wellness is going to be met with some skepticism because anything you do in wellness can't possibly hit all of the different drivers at any given time. But that's okay because if we don't act, that's not an option. We have to act, and we all have to act in a way that is within our sphere of influence. It's not just pointing the finger and saying what other people should do, but that what can I do? What can I act upon? And a basic, fundamental thing to know is, and to really remember is that we cannot control other people's well-being. We can only optimize the opportunity for well-being. Right? And so I share that before we even start talking about some of these things, because it's really important to understand that, that no matter what great idea somebody has, there's going to be somebody else who says, that's not it, right? There are frameworks to use out there. We'll talk more about those. But, uh, to stay within your sphere of influence and understand that what we're doing is trying to optimize the opportunity for well-being, not give someone or control well-being.

Renee Thompson:
Now, Jen, do you think it comes from a place? Because I've heard this all the time, and I talked to the leaders all the time, and they're so worried about their staff that they feel like it's their responsibility to fix this problem, to fix their burnout. And I know myself, and you're probably the same. We are fixers. If you work in health care, chances are you're a fixer. You want to solve the problem. But what you're saying is you can't come at it from that perspective. You can't be paralyzed by perfection to the point where nobody does anything, and you cannot take on someone else. You can't take on that burden. But as you said, create the opportunities for well-being to occur. And I just love that perspective. And so if you're listening to this and you're one of those leaders who worries, and it keeps you up at night, you know, the well-being of your team, we're giving you permission to stop beating yourself up.

Jennifer Bickel:
Yep. Absolutely. Absolutely. One of the things I say, Renee, all the time is that this isn't about me.

Renee Thompson:
Yeah, right.

Jennifer Bickel:
This isn't about me and my need to fix, right? These are not my patients, right? This is an environment in which I'm trying to move the needle to be able to improve things. Right? And so you were asking specifically about how do we help more aware of what each other's going through. Right. How do we raise up? We work in units; we work in teams. And sometimes, day after day, it can be isolating even when we don't know it. Right?

Renee Thompson:
Yeah.

Jennifer Bickel:
When I think about what the people who are, oh my gosh, like, I just have to share that throughout my career I've always been like it used to be eight months wait to get in to see me and the amount of people that would yell at my staff to get in, right. And I was just like, why would they? And then they would be so polite to me, right? And those are the sorts of things that just I've always been mindful and in thinking about those different roles. But one of the things is that you've probably heard about this, and a lot of the listeners might have this at their organizations, but to be aware of it is Swartz rounds is the opportunity to bring a multidisciplinary panel together and talk about different, maybe either case or different themes. And one of the biggest benefits we see out of that is people saying, oh my gosh, I had no idea a surgeon would feel that way, or didn't realize that a researcher would also feel that way, or she seemed so powerful. I'm surprised that this is happening, right? Or I didn't realize that the patients affected ABS so much. Right? So it's through those experiences that we get to be inspired by each other, but then also understand a little bit more about how there are so many people here that are connected to that mission and connected to their purpose here.

Jennifer Bickel:
And so we have about 300 people attend each one of those, right? And the topics range from the most recent one we did was creating safe spaces about leaders' own journals and some of their ups and downs in how they've learned to create the safe spaces, which is never a final destination. Right? It's an ongoing work. But then also, just a couple of months ago, we had a very powerful session about how suicide has impacted me. And our EVP of research, Doctor John Cleveland, himself actually shared his story around experiencing a colleague's suicide and how he had to receive counseling and help afterwards and all these important things. Right. So one of the big things I believe, and this is where all the leaders out there, you cannot expect your people to show vulnerability and your people to practice self-care unless you're modeling it. So when those leaders think, what is the best thing I can sometimes do for my people? Sometimes, it's the leaders actually saying, this is what I did to take care of myself last night. This is how I turned this off. I've realized that I'm not able to fix this situation, so I'm going to just try to work on accepting it, right? Because when we see our leaders excessively working and excessively doing, that makes us think that we should continue to do more, even if they're trying to tell us to take time off.

Renee Thompson:
You said something very powerful, and it really spoke to me because this is something that I became aware of probably over the last few months. And one of our previous podcasts, we talked about this burnout with leaders and how you can't tell your team you need to take care of yourself. You need self-care and take days off and do all that. If you're talking about how because I used to say this, I've had this company for 12 years. I used to say I've never taken a full day off. I've never even on holidays. I get up in the morning for a couple of hours and I thought, what am I doing? I'm telling my team, did you take time off? I want to make sure you're not working in the evenings. On the weekends, I'm like, I work every day, I can't, I no longer do that. And you talked about martyrdom before. I thought, oh my gosh, am I doing that? It's a little painful to turn that mirror back on yourself. To see how you're contributing to that. But even this weekend, I spent the whole weekend I had family in, and we had a wonderful weekend. And I chose not to feel guilty that I wasn't at my house working because I thought, no, I have to take care of myself if I'm going to be a good leader for my team. And that's exactly what you're saying is, you know if you can't be bragging about how busy you are and how you never take any time off, well-being is important to us here. It doesn't work.

Jennifer Bickel:
Right. And so, Renee, you are thank you for sharing that, because there are there's so many people listening that I'm sure have experienced the exact same thing. Right? And, of course, I've had to go through my aha moments of oh, gosh. Right? Like my husband being like, you do know how much you work. And I'm like, oh, I have four kids. So I'm trying to stay present and not always be off on my mind thinking when it is a process, it is not perfect. But you also mentioned this guilt of this discomfort and that sometimes we're working actually to avoid that discomfort. But sometimes we just have to like a lot of things in life. Sometimes, we have to be allow ourselves to be uncomfortable. Sometimes, we have to allow those things to happen. And sometimes our imposter syndrome speaks up, and we wonder, well, if I'm going to achieve this, maybe I shouldn't. And the other part to it, too, is there's this concept that's called self-evaluation and been studied predominantly in physicians by Mickey Troxel out of Stanford. And it really resonates with me. But self-evaluation is two components. One is prioritization of self-care. And the second is self-compassion. Right. So it asks questions such as, I gave up taking care of my own health due to my patient's needs, right? Or questions such as when I made a mistake, I felt more self-condemnation than forgiveness. Right? And it's basically those two components: self-care prioritization and self-compassion. And at least when it's been studied in physicians, we are far lower than the general public and self-evaluation. And that correlates very nicely with the increased risk of burnout. So this gets to why I talk about is in medicine and healthcare is a silent curriculum against self-care. And so we say do this, but if you watch, well then you're going to see that I don't do these things right and that it all becomes that silent hidden curriculum.

Renee Thompson:
Yeah. It's just like anything else. Your parents, your teacher, your boss, we're not going to listen to what you say, but we'll listen to what you do. And if and when you've shared this throughout that even being, and I'll just call it being a little vulnerable because we never think of that cardiothoracic surgeon or that neurosurgeon having any doubt about themselves or having those moments where they don't feel that they're doing a good job. And I'll just keep it general in that way, or nothing impacts them. They have I'll never forget when I was a neuroscience nurse, there was we would always get we were step down. So we would always get the patients post-op, and we were brain tumors, head traumas, and strokes. And I'll never forget this young boy. He was beautiful. He was 18 years old, and I walked in to talk to the family. The mother and father and his sister were sitting there, and I always started out this way. So tell me what you know about the surgery and about the type of tumor that he has. And it was an astrocytoma, and it was in an area like. And they said, well, they said they got a lot of it and that he would be okay. And I'm looking at them, and I'm thinking, oh my, I know that your son probably won't be alive in the next year.

Renee Thompson:
How do I know this? But you're his parents, and you don't know this. I didn't feel the right to know this before they did. And then I do realize that or recognize that the physician, the surgeon, may have said exactly what it was, but they heard what they wanted to hear. But I didn't know that I had to leave the room because I was starting to become overcome with emotion maybe because I had a daughter who was 18 years, old too, at the same time, but for all of us and that's why I really so appreciate the Swartz rounds. And I'm actually going to put a link to that in the show notes. So, if anybody doesn't know what it is, they can click on the link and learn more about it. But it gives voice to the struggles, the internal challenges and struggles, and the fears and the vulnerabilities that we face in healthcare. But I always feel like we have to be on stage all the time, in front of the team or in front of our patients. We have to be on it. But there's this whole back end sort of churning that happens that this allows you to actually talk about it.

Jennifer Bickel:
Absolutely. When that's the thing inside Schwartz runs are one of the many ways of holding space and an organization to talk about these things that happen. And that's what I think about with leaders. What are another series we have is the Chief Wellness Office series, where every month, we had a different topic that's common in healthcare, whether it be moral distress identifying burnout related to health stigma. And we have about 30 minutes where we talk about some of the some of the research and the practical applications of it. But then we have 30 minutes of open discussion, and we typically have between 100 and 150 people live multidisciplinary, show up and be a part of those conversations and those themes that that commonly affect us in healthcare.

Jennifer Bickel:
I also think that sometimes leaders. This goes back to Renee, what you were saying earlier in the fact that we want to fix things. So when we have people and not just leaders, right? This is all of us. Right? Because that's, I mean, you don't go into healthcare because you're not trying to help people, right? So we always want to help them, but sometimes we actually just need to hold space for them to process and to go back to their own sense of resiliency and to really tap back in. A lot of times, people are not coming to us for us to solve their problems. They're coming for us just to have that space, just to be able to put it out there and to then get back to that place. And so there's so sometimes that can be a natural for us because, for example, let's say that there was a bad patient event and a nurse comes to you and is upset that maybe the first thing that you might say is, well, that's not your fault. You don't have to worry about that. So right there, we've made a judgment call about how that person should feel. And so we've actually closed the space. Right? But in that attempt, we think that we're helping. But actually, we've closed that space. And so what's incredibly important is that there are skill sets. And so stress first aid, for example, psychological first aid or stress first aid, is now being taught more. It comes from military background, but it's being taught more in organizations where rolling it out here more over the next year in order to teach people how to hold that space when someone is stressed and just leaves.

Renee Thompson:
Yeah, they just need somebody to listen to them. I've been learning this and I would say I'm paying more attention when somebody reaches out to me in some type of stressful state, and I'll just use the example with my daughters. I have two grown daughters, and my oldest daughter has two young kids. And so she'll frequently, and she's a little dramatic, I'm just saying. And she'll contact me, and it's, wow, she's upset. There's something going on, and right away, I want to fix it. I'm like, oh, we'll just do these three things, and you'll be fine. And I learned this over the years that people don't always want you to solve their problem. They just want either comfort. Because now my daughters know this, and they'll say, mom, I'm not looking for you to solve the problem. I just need comfort. Okay? Can you just comfort me, please? Sometimes, they just need that space, as you said, just to have somebody hear them and to listen and not immediately try to solve it or tell them it wasn't your fault. So don't let it upset you. And to your point, you can't tell somebody how they should feel. And leaders having and it sounds like what you're doing is really creating; you're being deliberate about creating those spaces with how you're showing up every month with the Swartz rounds and the other, what did you call it where you have the Chief Wellness series? I love that you're providing them something of value. You're probably some data and evidence and all of that, but related to that topic. But then you're giving people space to talk, which I think people are hungry for that right now.

Jennifer Bickel:
Absolutely. And when these are some of the most important ways that we change that culture, right, and provide some of those tailored resiliency supports. But there's one other big aspect that I want to make sure to cover. And that's the thing, is that people who go into healthcare part of the way that we're paid is, of course, our salary. Right? But one of the ways that we're paid is through the meaning in our work, the connection with our patients. And so whenever we're taken away from the meaning in our work, away from what gives us joy, that increases the risk of burnout. So we might have a great leader. We might have a great culture. But if a nurse is spending all day doing paperwork, or doc is spending all day doing prior authorizations, then you decrease that meaning, and you actually decrease one of their currencies, one of the ways that they're paid. Right. And so we have to be, as we think about this, it is upon the responsibility of systems and leaders to make sure that we're looking at workflow efficiencies, not as a nice thing to have, but as a retainment tool to burn out or to reduce burnout rate.

Jennifer Bickel:
So, we have to be mindful whenever we implement a program. What are we implementing? Whenever we ask an essential healthcare worker to do non-essential work? Why? What is important about it? What do we have to do? How are we using a human factors approach where we're dual designs, right? So we have to all of these things basically going back to that top of the license, meaning the work is incredibly important. And for leaders who are interested in code, thinking about those things, that there's a lot of different frameworks out there. I have to mention the National Academy of Medicine National plan is fantastic, but the IHI also has a great framework for being able for local leaders to be able to do rounds and ask people about how they find joy in their job and then to help them to work in areas in which that joy is more likely to occur. So we have to just remember that we are fueled, we get our energy by purpose. And so we have to maintain not just culture, not just resiliency support, but purpose.

Renee Thompson:
And you're bringing up a topic that actually my team and I have been focused on the last couple of years is all the work that we do. So think about yourself as a physician and all the tasks of doing your work. Okay, a nurse, everything. I think about my company and my team and everything that they do and get really clear on what are those things that bring you joy, we call it; I've learned this from a coaching program that I've been in – it's your desire zone. It's in your desire zone versus what's in your drudgery zone. And your drudgery zone may be somebody else's desire zone, but it's so important that we take a look at the work that's being done and take a step back and say, is this the best use of this person's time? As you said, some of the paperwork and documentation I've been reading and watching a little bit more about how AI can help, or virtual healthcare professionals can take some of that burden because I don't know about anyone who's listening, who's ever had to do an admission assessment on a patient or discharge teaching. I would gladly take another patient if someone else would do all that paperwork for me because it can be grueling, but how can we be a little bit more innovative? But getting back to what you're talking about, you have to at least start asking those questions to be able to even consider.

Renee Thompson:
Is there a different way of doing this so that people get back to and I'll say, what's in their desire zone, but what is bringing them joy, the meaning. People don't get into healthcare to get rich. They get involved in healthcare to make a difference, to really see that patient come in with problems and leave with improvement so that they can be a functional in their lives again. And if you're an executive at an organization and you're listening to this, and you're not having conversations about this, you're missing a big piece of what it means to have wellness and well-being so important. All right. As we wrap up, Jen, if let's say there's a leader who's listening right now who has nothing in place, their well-being, wellness, we don't even know what that word is. I don't know. Is there anything that you would recommend they do if they wanted to start down this path that we've talked about today?

Jennifer Bickel:
I think that's a fantastic question because I think that we're at a point right now in healthcare that you no longer have to convince people well-being matters, but now people are like, okay, but what do we do? What does that look like? And I will tell you that the worst thing that people can do is I say that misinformed wellness initiatives are anti-wellness. So. When someone just says, okay, I know what we're going to do, we'll go ahead and plan this potluck, and it'll solve it'll do these things right. So one of my one of the first things that leaders need to do is really to step back and say, what do I know about this? Right. Instead of moving through with this because there is a field out there, there's evidence to be learned, right? So there are frameworks out there, whether it be the AMA, Joy in Medicine framework that the IHI finding Joy in the workplace or the National Academy of Medicine National plan, you don't have to spend a lot of time just to be able to look at those. And all of them have concrete examples of evidence-based programs that can be implemented. So my first thing is don't just brainstorm and think about something to do right but be able to actually look to the literature a little bit more and look about what could be successful. I think the other component of it goes back to one of the things that I was saying at the very beginning is that wellness is not about telling other people what they should do.

Jennifer Bickel:
And if you're listening and you're like, shoot, I haven't really prioritized my own wellness. Then, if that's not the case, then frankly, you don't. You really shouldn't be starting with anybody else's until you've started with yourselves, right? Like, I one time was teaching a seminar and had about 40 executives in the room, and they were frustrated that nobody was ever using the yoga classes. Nobody was ever using the meditation. Right. And by the way, there's no shortage of unused wellness programs, right? So that's the whole thing is that it's not about building another program always. And so but I asked the room if anybody in the room had ever used one of those programs, and none of them had it had. It had not even occurred to any of them to use it. Right? And so starting with yourself and starting with understanding that this is a field that has evidence and has solutions and has frameworks, and then looking into those and seeing what in this is my sphere of control, do I want to focus on top of the license? Will it work? Do I want to focus on a culture, right? Do I want to focus on making sure that my people have resiliency support? Right? There are so many different areas that an individual could focus on. I'm hesitant to say what the number one step should be because we're all at different parts on that spectrum, right? But maybe if I were to simplify it, the number one step would be learn more about what wellness is and what it isn't and take care of yourself.

Renee Thompson:
Yeah, that is incredible advice because I'm one of them who I just want. Give me a step one, two, three so I could do it and then check it off. And you can't do that. You can't do that with bullying and incivility and culture change and all the work in. When we work with groups, we tell them it's going to take a year to get to this place where people like bullying and incivility are immediately rejected, and kindness, and respect and professionalism are now the new norm. And I tell them all the time you have to trust the process. You can't start fixing the problem before you actually take a step back and evaluate the problem. And that's what you're saying. And so true for wellness and looking at your team's well-being. And it really does start with you. And so, I just want to thank you for being here for sharing your knowledge and what you've learned over the years, especially in your role. And I am so grateful for organizations like Moffitt Cancer Center. And I know there are many out there who have actually put a stake in the ground to say this is important to us, and we're going to put the resources behind it to make sure that we create. And I'm going to use your words, the opportunity for people to improve their well-being. But I think it's especially now, it's always been important, but especially now. So, I just want to thank you for being a guest here and for sharing your wisdom.

Renee Thompson:
We will have ways that you can connect with Jen in the show notes. We'll have her LinkedIn profile. You can connect with her and see all the great work that she's done. We'll have her Twitter handle that you can connect with her, and we'll put some of the other links in the show notes, Swartz rounds, and some of the other initiatives and organizations that Jen recommended. And I just want to end by thanking all of you listeners who have carved out a little piece of your time to really take a look at how you can cultivate and sustain a healthy work culture, and just end with a reminder to all of you that bullying and civility and burnout happen because they can. And it takes dedicated leaders, like all of you, to do something, to actually address it and help to cultivate a healthier work culture. So, thanks everyone for being here, and take care. Bye.

Renee Thompson:
Thank you for listening to Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. If you found these practical strategies helpful, we invite you to click the subscribe button and tune in every other week. For more information about our show and how we work with healthcare organizations to cultivate and sustain a healthy work culture free from bullying and incivility, visit HealthyWorkforceInstitute.com. Until our next cup of coffee. Be kind, take care, and stay connected.

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Things You’ll Learn:
  • Highlighting a vital necessity, the conversation emphasized tailored well-being support programs for the varied roles in healthcare, acknowledging the absence of a universal solution and emphasizing the importance of awareness and understanding of each role’s distinct challenges.
  • Dr. Bickel and Renee stressed the influential impact of leaders leading by example. 
  • By demonstrating vulnerability and prioritizing their self-care, leaders initiate a ripple effect, inspiring their teams to do the same.
  • Beyond mere statistics, the inclusion of healthcare professionals’ real-life experiences alongside evidence-based research can form a more compelling and holistic strategy for addressing burnout.
  • Effective wellness initiatives require evidence-based research and self-prioritization.
Resources:
  • Connect with and follow Jennifer Bickel on LinkedIn.
  • Follow Moffitt Care Center on LinkedIn.
  • Discover the Moffitt Care Center Website!
Disclosure: The host may be compensated for linking to other sites or for sales of products we link to. As an Amazon Associate, Coffee Break earns from qualifying purchases.
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