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Stress in the hospital workplace is well recognized problem. Shanafelt et al in one study looking at the prevalence of burnout, marked by emotional exhaustion and a sense of depersonalization at least weekly among physicians, found it in 44 percent of those studied¹: more than 30 percent of pathologists who participated in that study reported burnout. In two recently reported studies by Garcia and colleagues examining job satisfaction, well-being and burnout, among pathologists and laboratory professionals, stress and burnout was prevalent in both groups.^2,3 Of the 408 pathologists surveyed by Garcia et al, most pathologists (91.2%) indicated that although they enjoyed their work as a pathologist, only slightly more than half (56.2%) felt appreciated by the institution they worked for.² Almost half (47.1%) of pathologists in the study felt a lot of stress on their job, with workload and call duties being the most common causes of stress.² Most (71.4%) reported feeling burnout as a pathologist at some point in their career with 32.9 percent indicating that it was a current issue.²

Similar findings were noted in surveys completed by 4,613 laboratory professionals.³ Most (53.4%) reported that they felt a lot of stress in their job, again most commonly due to workload or call duties. Even worse, 85.3 percent indicated that they had felt burned out at some point in their career with 49.9 percent indicating that they currently felt burned out.³

Clearly, the issues are real and for many, the added pressures and stress associated with working in the laboratory and hospital setting during the COVID epidemic, in addition to dealing with the personal life stresses that were a part of the epidemic, undoubtedly added to these feelings. Burnout is associated with increased likelihood of making mistakes and is associated with increased employee turnover. Targeted interventions are needed to both help improve the quality of the work environment as well as to promote professional and personal well-being.⁴ Work environments that just try to address the individual’s stress without also addressing the issues in the workplace that are responsible for creating the stress, are only partially addressing the problem. Some workplaces believe that they are addressing the problem by offering programs for their employees to help them deal with their stress and to build resilience; such programs should be offered but also run the risk, if one is not careful, of sending the message that if one is stressed, it is the individual’s fault somehow that they are stressed because they can not effectively manage their stress. Bottom line, to effectively address these issues, there needs to be plans in place to address both sides of the problem. The focus of the remainder of this article is on strategies that the individual can employ for dealing with stress and burnout.

Resilience is comprised of a group of personal qualities that allows an individual to adapt and thrive in the face of stress and adversity. Among strategies targeting the individual, resilience training has been touted to be useful in supporting one’s well-being. Although there are a variety of specific resilience strategies one can consider employing, the best results are attained by trying to address and consider the many varied aspects of resilience. Figure 1 lists 10 strategies one can consider in trying to build up one’s own personal resilience, both in dealing with stresses that are workplace related and for those we encounter outside our jobs.

1. Remain hopeful

We can not change what has happened in the past but we can impact and look forward to what is in the future. Accepting and trying to anticipate changes makes it easier to adapt to those changes and the challenges associated with them, when they come our way. Creating realistic goals can help focus our attention on what is most important and more realizable rather than getting caught up in wishful thinking or unrealistic expectations. Keep things in perspective.

2. Experience learning

Learning from our past experiences is important. Thinking about what coping strategies have worked for you in the past and which strategies have not is a useful exercise when encountering stresses or difficult times in the future. Some have found journaling about experiences and one’s reflections on those experiences can be helpful in guiding future behavior.

3. Stand up to one’s fears

Being optimistic and encouraging positivity are important. Regulating our emotions during challenging times is important. It is sometimes easy to let negative thoughts take over and distract from what is most important. Maintaining a hopeful outlook and always looking for the “silver lining” is a good counter approach. Positive thinking does not mean one should ignore the problems at hand; it does mean that one should understand that setbacks are temporary and one needs to be confident in one’s ability and one’s skills to address the challenges being faced. One can not always depend on someone else to fix the problems at hand.

4. Insulate one’s time

One needs to keep one’s priorities straight. Protecting time for yourself and what is important outside of work is important. It is easy to bring one’s job home. Cell phones and computers can very easily tie one to the workplace. The emails just keep coming. Protect your time so that you can spend it with your family, friends and the things you enjoy doing for yourself. Find the time for hobbies and interests.

5. Look for help when one needs it

It is OK to ask for help or seek out assistance when one needs to. It is important to know our limits. There is no shame in asking for help or guidance when we need to do so. Our world suggests that to do so is a sign of weakness; however, we all need to lean on each other from time to time. Just remember to return the favor to others who may reach out to us for help when they are struggling. Helping others can leave one with a positive feeling and a sense of efficaciousness.

6. Instill purpose

Make each day meaningful. Find the time to do something that affords you a sense of accomplishment and purpose on a regular basis. And remember that what we do at work in helping to take care of patients is important! The laboratory would not function if we did come together as a team and contribute in our own ways to the work that needs to be accomplished each day.

7. Engage proactively

Do not ignore problems. The better approach is to try and figure out what needs to be done to address the problems. Make a plan and take action. Not dealing with problems or challenges will not make them better or go away. Trying to address them may make them better and sometimes help them go away.

8. Nurture oneself

We need to take care of our own feelings and needs. Spend time doing things you enjoy. Exercise. Get some sleep. Eat a healthy diet. Try practicing stress management and relaxation techniques such as meditation, yoga, guided imagery, deep breathing or prayer. Practice self-compassion. We need to be able to forgive ourselves when we mess things up. This is particularly important in high pressure environments. No one is perfect!

9. Connect with others

Work to build strong, positive relationships with family and friends. These are the people who will often provide the support you need during hard times, people in whom you can confide, and people who accept you for who you are. Reach out to those in need; volunteer or help with community service projects or become an active part of a faith community.

10. Embrace challenges

Change and challenges are inevitabilities in life. Flexibility is key to resilience. Learning how to become more adaptable and to creatively address problems will better equip one for responding to difficult times.

References

1. Shanafelt TD, West CP, Sinsky C, et al. Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2017. Mayo Clin Proc 2019; 94(9): 1681-1694.
2. Garcia E, Kundu I, Kelly M, et al. The American Society for Clinical Pathology’s job satisfaction, well-being, and burnout survey of pathologists. Am J Clin Pathol 2020; 153: 435-448.
3. Garcia E, Kundu I, Kelly M, et al. The American Society of Clinical Pathology’s job satisfaction, well-being, and burnout survey of laboratory professionals. Am J Clin Pathol 2020; 153: 470-486.
4. West CP, Dyrbye LN, Sinsky C, et al. Resilience and burnout among physicians and the general US working population. JAMA Network Open 2020; 3(7): e209385.