Ep. 17 | Beyond Burnout: The Misalignment between Hospital Administrators and Clinicians

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Nurses and other allied health professionals, including physicians, have been front and center of the tug-of-war between hospitals and travel/staffing agencies. Nurses, particularly have been lured with different types of offerings from premium pay, school loan reimbursement, sign-on bonus and other types of benefits. To some healthcare systems, this has brought some relief, but what happens after those sign on contracts expire?

While there are on going debates and discussions on how we can stabilize the nursing workforce, it’s imperative to ask every forum where this topic is being discussed:

How are we actually addressing the very reason why nurses left to begin with?

In this episode, I chat with Beth Kutscher, Senior Managing Editor of LinkedIn News, regarding why clinicians hate the word '“Burnout” and how this is an understatement of what clinicians are truly experiencing.

Key Points:

• The disconnect between administrators and nurses/doctors

• Health-care role that saw the most exits the past couple years (*Hint: it’s not nurses)

• Importance of integrating front line clinicians in any innovative ventures

• LinkedIn as a platform to create meaningful discussions and engagement on current issues

• Path to Recovery Newsletter

Guest Spotlight: Beth Kutscher

Beth Kutscher is the senior healthcare news editor at LinkedIn and is responsible for overseeing the news and content strategy for a global healthcare audience. Her role includes both developing original articles and videos as well as working with contributors within the healthcare industry to spark relevant and timely conversations on the site. Prior to LinkedIn, she was most recently the California bureau chief at Modern Healthcare magazine, where she covered digital health as well as regional business news on the West Coast.

Connect with Beth:

LinkedIn: https://www.linkedin.com/in/bkutscher/

Newsletter: Path to Recovery

References:

Why doctors and nurses hate the word 'burnout'​

Could leadership training for doctors and nurses fight burnout? This new venture is betting on it

Health care isn’t working for clinicians anymore. Here’s where they’re going

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This episode was recorded via Squadcast and edited via Descript.

Transcript

NOTE: This podcast was transcribed by an AI tool. Please forgive any typos or errors. In this Episode: [00:00:00] And I talked to hospital leaders and they were talking about things like, you know, pizza lunches or wellness initiatives or meditation apps. It didn't quite or were time off. It didn't quite square with the experience that I was hearing from nurses about the nightmares they were facing or the panic attacks. And as someone who had firsthand experience of what that felt like, I really thought there's a disconnect. And so, especially over the last six months, a lot of the articles that I've been writing have been about that disconnect between administration and what nurses and doctors and pharmacists are seen in their line of work. It, it's so much more than just the colloquial use of the word burnout. It is. You know, there are other words that they might prefer. And I think the other piece of this is that when you use the word burnout, a lot of times clinicians feel like it centers it on themselves. Like, I should have managed my wellness better, or if only I participated in more self care. But it's not about that. If the system is broken and you're facing trauma from the institutional failings, then it's not your fault. And so [00:01:00] they feel like they need a better term that encompasses all of that reality. Myles Parilla: Welcome to the insightful nurse leader. This is a podcast binders leaders for nurse leaders. show is focused on assisting leaders, become effective managers change facilitators. So whether you're a seasoned frontline leader, a budding charge nurse, an experienced manager or executive, don't want to miss this. Hello, and welcome to our 17th episode of the insightful nurse leader I'm excited to announce our special guest and this none other than Beth Kutscher. She is the senior managing editor at LinkedIn news, and she's also the author of the Path to Recovery newsletter in LinkedIn, Beth, welcome to the show. Beth Kutscher: Thanks so much for having me. Myles Parilla: Awesome. Well, we recently connected through LinkedIn what attracted me to Beth's, work is her publication or her [00:02:00] article about burnout. But before we dive in, let's talk about how, you got into this work and what motivates you to talk about healthcare. Beth Kutscher: Sure I've been covering healthcare, my entire career. So about two decades now. But I come from a family of healthcare professionals. My dad was a doctor, a nephrologist. My sister is a psychiatric nurse practitioner. Another sister works in health insurance. My husband is a physician. I was always the more creative one, but I found myself gravitating toward healthcare as a beat. and increasingly, especially over the last few years, I've really started to see healthcare for their human stories. so for example, I I've written publicly about this as someone I've been diagnosed with PTSD. And I was around that time, I was also interviewing a lot of nurses who were saying that they also were experiencing PTSD on the job. And, but when I talked to hospital leaders and they were talking about things like, you know, Pizza lunches or wellness initiatives or meditation apps. It didn't [00:03:00] quite, or more time off. It didn't quite square with the experience that I was hearing from nurses about the nightmares they were facing or the panic attacks, and as someone who had firsthand experience of what that felt like, I really thought there's a disconnect here. And so, especially over the last six months, a lot of the articles that I've been writing have been about that disconnect. Between administration and what nurses and doctors and pharmacists are seen in their line of work. Myles Parilla: mm-hmm well, that's very insightful. Thank you for sharing that. And thank you for your work in supporting our clinicians. You know, I resonate so much with that and we spoke about that initially, when we first connected, is that disconnect how. Non-clinicians or decision makers in or executives. What have you, with their offering? Because for me, as someone who have worked in the system before we have what we call the EAP employee assistant program, and, you know, there, there, there, you know, there's value in it. But then again, to your point, there is a huge gap between. Clinicians are actually [00:04:00] experiencing versus, you know, what is being offered. And it's, it's quite timing that we talk about this given to the fact that we just had a huge 15,000 nurses, you know, went on strike for what, three days or something like that in, in Minnesota. And you know, what's interesting to me is they're not striking because of wage, but they want to have more over their work, which I find very insightful. Beth Kutscher: Those strikes are going to be. They've been part of a national trend because we had hundreds of labor union contracts aspiring at hospitals around the country. But we're also at this critical moment where we're feeling so. Burnout, disenfranchisement, whatever word you wanna use, trauma, uh, moral injury. And so nurses are saying, this is an incredible opportunity for us because they have to renegotiate these contracts. Here's what we have the TA on the table. And it's interesting that you point out that it's not just about wages, but it's that, how do we actually address things like staffing, better patient care. I think at Kaiser, [00:05:00] it was mental health therapists who were threatening to strike in California because of weights for patients. So nurses are actually taking on almost an advocacy role for the holes that are in the healthcare system these days. Myles Parilla: Agree agree. So diving into our topic. So why do doctors and nurses hate the word burnout? Beth Kutscher: Because it's the disconnect burnout is, is such a, is one of those words that's thrown around colloquially in many offices, any office I'm feeling burnt out, I'm tired. Couldn't mean you just worked, you know, a 60 hour week and you're just, you need to unwind a little bit, but in healthcare, it's more than just the colloquial use of the word burnout. It is that complex trauma. I mean, a lot of nurses who are on the front lines of COVID and doctors, and I, I don't wanna forget the other allied health professionals as well. They felt like they were in a war zone. There are many articles where, you know, they said we had these patients, they were dying. We didn't have treatments for them. We didn't have the right protection for ourselves. there were no beds. People were languishing in [00:06:00] hallways or makeshift tents. The national guard might have been called in and they felt like they were in a war zone. And so now they're dealing with the long tail of this and it hasn't really ebbed that much in many hospitals. And so they're seeing this, they don't know how to, it's so much more than just the colloquial use of the word burnout. It is, you know, there are other words that they might prefer. And I think the other piece of this is that when you use the word burnout, a lot of times clinicians feel like it centers it on themselves. Like I should have managed my wellness better, or if only I. Participated in more self care, but it's not about that. If the system is broken and you're facing trauma from the institutional failings, then it's not your fault. And so they feel like they need a better term that encompasses all of that reality. Myles Parilla: I totally agree. know, recently read this article that you published in involving Dr. Russell Hallman, and he talked about the structural violence and that was, his term. And. most [00:07:00] organizations, you know, address the individual wellness and, and all those other programs. But the reality is the things that it's outside of the clinician's control is the environment. And that's we need to address, basing on your interactions with your interviews with your, and other clients. Were there any, recommendations that were that hospitals could adapt Beth Kutscher: Well, one of the recommendations from, Dr. Holman was this idea of, we need to give business acumen to clinicians. So he was talking about masterclass type courses, you know, nine minutes in length. So just training, how do I approach the C-suite and speak in their language and bridging that gap? I think, I think it's still T B D on what's actually gonna be most effective. I think this is early days. I think there's a reckoning happening now because, a lot of this is unsustainable. I have to actually have an interview coming out with the, Oregon health and hospital association talking about how hospitals are in danger. They're on the brink [00:08:00] financially and they're operating at huge losses. And so, and a lot of that is staffing and labor Myles Parilla: mm. Beth Kutscher: the same time. You know, if, if they can't fill these roles and staff adequately, then more people are going to quit. And that's something that LinkedIn is shown in its data again and again. So the, the power balance is tipped a little bit. How that shakes out, I think there's gonna be a lot of discussion on that to come. Myles Parilla: mm-hmm yeah. that's true. You know, as a clinician or prior clinician, myself, what's interesting is that burnout and staff is not actually a new term for us or for me at least. it's just been, Accelerated during the past couple years. And, and it's really interesting how it has really impacted healthcare at large. Beth Kutscher: You know, that's, it's funny, you mentioned that, uh, because I did an interview with a nurse. Researcher a week after I did that piece on why doctors and nurses hate the word burnout. And, you know, she was saying that there been periods [00:09:00] in history where there were staffing shortages. She points to 2006, for example, but nurses were still loved being nurses. You know, they talked about the love of the job, the satisfaction they felt. Now nurses are just, they're ready to walk away. They're ready to do something else. Um, we've seen, I think it was, it was more than 45% of nurses made a career transition in 2021 compared to 2019. And when we say career transition, this is LinkedIn data showing people that change jobs entirely. So not just went from one hospital to. But said, okay, I was a nurse and now I'm going to be something completely different. Maybe, you know, join a digital health company and be, you know, director of clinical operations or something like that. And this is really, I won't say it's the first time in history. We don't have that longitudal data, but this seems to be unique time in history where more nurses are willing to walk away from nursing, which we haven't seen. In past years that, you know, researchers have said that they've been surveying nurses, you know, every few years, and this has really shown [00:10:00] a huge drop off in job satisfaction. Myles Parilla: Mm-hmm mm-hmm I think going back to the term truly it's deeper than burnout. I think people have reached their limit of, am no longer tolerating this and I'm done. Beth Kutscher: Correct? Absolutely. Myles Parilla: So based on LinkedIn data, LinkedIn news data, the role that saw the most exit during the pandemic are pharmacists and this is interesting to me being a nurse because I thought, well, this limited view is I thought there were nurses, right but it's interesting to me to find out that there's actually at 47.3% followed by nurses at 46.7%. Can you share more background about this and why do you think pharmacists have this much people resigning? Beth Kutscher: I think it comes back to the autonomy piece we were talking about earlier. I think pharmacists also felt like they were cogs in a large wheel except instead of hospital systems. A lot of that churn was happening in on the retail pharmacy side. So they were trained to do one job.[00:11:00] The tipping points seemed to come when the COVID vaccines were rolled out because now they had to deal with all their usual duties. Plus. Also this huge historic vaccination campaign that was when, where they were on the front lines. And. It was just, you know, they didn't have enough again, they didn't have enough staff. And so the people who remained, felt flooded with patients, they were, you know, wearing multiple hats. I interviewed one pharmacist who said that at her local pharmacy, she saw fewer people working in the pharmacy section than when she'd go into her local coffee shop and order breakfast. There were more people serving coffee and taking orders in at the pharmacy. When you might need to counsel patients where you're dealing with insurance issues, supply chain issues. So you had a lot more, you had. Angrier patients, or customers who were coming to the pharmacy. And they also felt that that level of burnout, if we just can't keep up with the demand. Myles Parilla: Mm-hmm . Wow. do you think with a lot of focus right now, and we see trends right now in healthcare, right? That there's a trend of retail [00:12:00] healthcare. we have a trend of online pharmacy PBMs trying to, you know, partnering to lower costs. Do you think there is a role. For tech companies with this impact in, pharmacy, Beth Kutscher: That is the, the great debate that's going on right now. is how can tech solve this? Can tech solve this issue and who's gonna do it well, the great debate seems to be a lot of this happens. In it's silo where clinicians are kind of brought on at the end and for execution. Whereas a lot of clinicians feel like they need to be in the room from the onset because the tech industry doesn't understand the healthcare workflows. it's a, it's a very, very different culture and the ones that are gonna do it well are the ones where the two are married at the top from the beginning. And. We'll we'll kind of see how it, how it shakes out. There's a lot of questions ethically about whether healthcare technology is going to close the gap in disparities of care [00:13:00] and increase equity, or whether the opposite's gonna be true. Are they going after younger, healthier people who are already pretty tech savvy? What does it mean for people who aren't as tech savvy, uh, is squeezing costs out of healthcare? Is that really the right way to go? There's plenty of room for innovation, the truism of healthcare is that it's clunky and outdated, especially the consumer facing piece, but it's also a system that is by nature, a system of human touch and interaction. it's a, it's another really interesting space to. Myles Parilla: That's interesting that you said that because you know, even down to my level, Back when, you know, I work in organizations where they're integrating or an electronic medical record system. some of the initiatives at the top level do not necessarily involve a clinician. in the implementation phase there's a lot of questions and frustration on the clinician side of things. And how it impacts their work, [00:14:00] because there's a lot of things that are either redundant or doesn't make sense from a clinician standpoint, which goes back to your point on, you know, it has to be married at the top and integrating those, key players as well. Beth Kutscher: Artificial intelligence is another really good example where, you know, tech likes to do things in stealth mode and they're they consider their algorithms to be proprietary. Whereas the medical profession. Does everything open and, and the nursing profession does everything open to peer review? You know, they, everything needs to be rigorously studied. Well, the two of those goals are at odds. And so. In coalitions, tell me, they don't know when they're given a clinical decision support piece of software. They don't know if it's garbage in, garbage out as the saying goes or, you know, or what they're looking at because it can't be peer reviewed. And my husband is a sleep medicine. Doctor talks about this a lot with all these new gadgets that claim to track your sleep. Um, consumer grade technologies, he doesn't, you know, patients will come to him and say, oh, you know, this is saying that I only spent this much time in deep sleep [00:15:00] or this much time in REM sleep. But he says, I don't know how these large companies, whether it's apple fit, but how they define what inputs they're looking at to define what is REM sleep? What is deep sleep? How do they, what are they looking at? So he doesn't know how that tracks against his medical grade, you know, sleep center devices. And I think these so there're tons. So when you talk about technology, there's tons of different ways to slice and dice it. There's the healthcare delivery piece. There's the quantified self piece. Um, there's a clinical decision support piece. each of those, I think has its unique challenges. And so, you know, if you take like Amazon buying one medical, that's just one piece of a much larger pie. Myles Parilla: yeah. Thank you for sharing that. going back to the profession itself, viewing this from LinkedIn side. Do you see any specific trend clinicians are transitioning to? Beth Kutscher: Most. In our data, which I think you're, you're referring to with the job transitions, the plularity of them, the bulk of them 45% stayed [00:16:00] within the healthcare industry. So not quite the majority, but certainly the largest group. A lot of the people that changed jobs, there was a little bit of noise in that data because some people went into retail, which is retail pharmacy. And because pharmacists made the most job changes. But I would say, I think it's safe to say that people want. Continue what they know, they trained in one field and for the people that left, not because of burnout, but because. It was just the right time in their careers. They saw a unique opportunity to make healthcare better. So they saw these new entrants, the tech companies circle it and they thought I can do this too. Or they were saying, I wanna find greater meaning in my career. And maybe I can make a greater difference if I go into management versus bedside. So I think you're seeing a lot of people just wanna take more ownership of their role in the healthcare industry. how do I have impact? I think I, I interviewed A black physician who were saying that, you know, what she's heard from people is in the community is that, you know, people of color were hit disproportionately with COVID[00:17:00] and, you know, they watched many of their loved ones die in while they were on the front lines, taking care of them. And I think in those communities, question there wasn't quite that same disconnect of I'm on the front lines. And here are the patients. So it was very meaningful of how do I actually get involved in public health, for example, or maybe entrepreneurship. And so I think, I think there's a, there's a fair amount of altruism. It's not just, you know, I'm throwing in the towel and I quit. And I don't mean to just offer that as the only narrative of what's going on, because I think it's, it's very layered. Myles Parilla: Yeah, totally agree. Have you seen or encountered a recommendation from your interaction with a few clients regarding what does real autonomy integrating that in healthcare? Because we're talking about looking at the structure of how we run healthcare organizations, you encountered a great recommendation that is actually, easy to implement or rather, feasible to, I. To optimize autonomy [00:18:00] for the frontline so we can retain more nurses. Beth Kutscher: It's a very good question. And I'm not sure I'm the right person who has the answer to that. I think you'll hear, you'll hear a lot of different things. Um, some people will say, like I said before, it's it's education, it's leadership training. some people might say you should start a business or have a side hustle. I think, uh, the like American nurses association is really, um, interested in this topic of, of nurse innovation and, and highlighting that. I know that whenever I write about clinicians getting involved in digital health or entrepreneurship, it always gets a really good high level of engagement. I don't know if we have the, the data yet to say what, what the tipping point is. I think we're just beginning. Myles Parilla: Agree. So, you know, even for me, as someone who, publishes my podcast episodes on LinkedIn, I also see quite a few people, in their journey of consultancy and, or, going to a, different avenue to publish their work or to create a content or create a video, to be a, thought [00:19:00] leader in that regard. For those leaders or for those nurses healthcare professionals are venturing in that route. Do you have any recommendations or what recommendations do you have in order to build a better presence on the LinkedIn platform? Beth Kutscher: I think being active and vocal in the healthcare community that we've built on LinkedIn is a good place to start. I think so with the nurses strikes, so I'm gonna tie the question you asked before that, to another question you asked at the beginning, been, there's a lot of discussion on LinkedIn and whether that sort of collective bargaining is going to filter down to physicians, for example. so how do we get together and add our clout? Because, you know, we're. Million doctors in the us and 4 million nurses. And how do we, how do we show that? And we're essential, both those groups and all the allied health professionals are essential to the healthcare system. And yet they're treated like cogs in a wheel. So how do you bring that agency back? think a lot of those closed door discussions are happening between [00:20:00] peers. I mean, that's how it starts. I mean, that's how these movements start. social media can be very powerful, in one identifying the problems, figuring out solutions. I'm just one person who's connecting all these others. that's what I see my role is, so you're asking me, well, what can we do? I'm not sure, but I like to believe that LinkedIn is providing the platform. to have these conversations and what I always say, that's unique about LinkedIn compared to other social media platforms. And, and here's my plug and cuz I work here, but you know, it's, it's really the 360 of the healthcare industry. And I know that there are other groups, professional associations, for example, where clinicians kind of get together with people who have the same training and, and licensure. Certainly there's, there's something to be said about that, but being able to actually speak to people who are on the administrative side, people who are in insurance people who, different, different parts of the profession. Um, I often like say that's kind of like the, how we work together beats because it's all these different stakeholders who are all trying to make healthcare better. there is that altruism piece. That's why people [00:21:00] get into healthcare. and this is a place for them to, to get together and figure. Myles Parilla: mm-hmm. awesome. Well, thank you for sharing that. Do you have any advice on how to create better and more meaningful engagement on linked? Beth Kutscher: Sure. We always say right to start a conversation. So, um, people really want to talk about these issues, debate them. And I think the best way is to pose something that people actually, you know, start with a question. What do you want people to weigh in on? And, That will really get people talking. We have a poll feature, you could do that, but also engage with other people. So it shouldn't just, it should be bidirectional. If you see something that's of interest to you, comment, if you think it's a be of interest or somebody else at mention them, because LinkedIn is one of those places where you get out of it, what you put in. Myles Parilla: totally agree. Well, I'm definitely enjoying my time on LinkedIn and definitely a lot of thoughtful conversations there and some of them are actually your publication. So thank you for that. Beth Kutscher: Absolutely. Yeah. And subscribe to my newsletter. It's a, it's a great way to see [00:22:00] what people are talking about. Myles Parilla: Oh, speaking your newsletter, can you talk more about the Path to Recovery. Beth Kutscher: Sure. so. the, sort of the thinking behind it is the COVID pandemic. Didn't create a lot of the issues that we are talking about, whether it's staffing challenges or getting tech involved in healthcare, but it was an accelerant and it fundamentally upended how clinicians. See their relationship with this system that employs them, that they work for. huge numbers of clinicians are disenfranchised. How does, how do we write this ship? You know, how do we get back on our feet? Whatever analogy you wanna use. And it's a place to talk about what I think of as the great debates in healthcare these days, whether it's talking about, you know, why the word burnout is in adequate and what could be better. it could also be something like physician assistance, changing their name to physician associates. I mean, I was, surprised at first, although I'm, I'm less and less surprised every time I write about it, just how strongly people feel about, different. Groups, practicing within the scope of their licensure, I think could, because that's one of the creative [00:23:00] solutions people are talking about. Well, maybe, you know, we'll have nurses. Do more, you know, give more authority to this group or that group. And so now, healthcare creates these artificial turf wars, the future of medical education, um, or nursing education. Um, I wrote about, some of the creative ways, Maryland hospitals are training young nurses these days or, or up and coming nurses. That, again, hundreds of comments of people talking about that, because it's so challenging to find clinical placements these days as a huge nursing instructor shortage. So. It's I, I see it as the, a place to talk about how we get to a point where healthcare is, there's joy in working in healthcare. Again, Myles Parilla: awesome. Well, thank you so much for this time, Beth. How can our listeners connect with you? Beth Kutscher: I'm always on LinkedIn so they can feel free to email me. They can at mention me in posts. describe to my newsletter comment. Those are the best ways to get in front of me. Myles Parilla: Awesome. Well, thank you so much for this insightful conversation Beth Kutscher: Absolutely. Thank you. Myles Parilla: to reading more about your, newsletter. Beth Kutscher: you so much. Myles Parilla: All right. Have a great day. [00:24:00] Thank you for listening view the complete show notes and all the links mentioned in today's episode, Myles Parilla consulting.com forward slash podcast. And before you go, make sure you follow or subscribe to this podcast so you can receive the latest episodes soon as they're released. And if you're enjoying the show, leave a rating and review in Apple podcast. Thank you again for joining. This is your host Myles Parilla and you're listening to the insightful nurse leader. you next time.