As I delve deeper into the world of healthcare worker burnout, there is one image that appears too commonly. Physicians say they feel like they are a hamster running on a wheel, or express a desire to “get off the hamster wheel.”
It seems that everyone can relate. I’ve opened conferences on improving practice workflow with a video of a hamster running on a wheel, going so fast he ends up trapped spinning around while the wheel keeps going, and eventually falls off. The audience members have a good laugh. Later, many will tell me privately how strongly that visual resonates for them.
How has this image become our shorthand for burnout?
I did some digging on Google, and found the following definitions:
- A circular cage for a hamster or other small rodent, which rotates vertically as the animal runs at the bottom.
- (figuratively,by extension) A monotonous, repetitive, unfulfilling activity, especially one in which no progress is achieved.
From the Urban Dictionary – when someone just keeps running in circles (and making the same mistakes) in their life, instead of progressing
It’s depressing to think that highly trained medical professionals are describing their work lives this way. I understood why when, on Wikipedia, I found this picture with the following caption:
As caregivers, do we accept a workplace with unrealistic external demands and broken workflow processes because we are “highly motivated” to care for our patients and don’t see an alternative?
We chose health care as a profession because we were “highly motivated” to make a difference, to do something significant for our fellow humans. We paid the price of sacrificing our 20’s with long hours of training to ensure that we could be trusted with other people’s lives.
Has our acculturation through medical or nursing training worn us down so that we simply accept whatever obstacles are put in our way? Too many of us experience burnout. It takes its toll in many damaging ways.
Drivers of Burnout
According to Maslach and Leiter in The Truth About Burnout, the drivers of burnout are six key mismatches between the worker and the workplace. Let’s see how our hamster running on the wheel is impacted by these:
- Work Overload – with too much to do, he can never get off the wheel
- Lack of Control – he can’t stop the darn thing, and runs till he falls off
- Insufficient Reward – he gets no special recognition or additional resources for this effort
- Breakdown of Community – if two or more hamsters are in the cage together, they often end up running over each other o n the wheel. You can find videos of these on YouTube
- Absence of Fairness – do hamsters feel it is unfair to put in all that effort with nothing to show for it, or do they simply enjoy it?
- Conflicting Values – Hamsters seem to value running on the wheel, physicians who are feel that productivity requirements are superseding quality care do experience a mismatch
It’s time to stop sacrificing ourselves. It’s time to create healthy clinical cultures that respect dedicated hard-working professionals.
Lean Done Right is an effective approach to creating that culture. It is based on two key principles – Respect for People and Continuous Improvement.
Respect for people means creating a workplace where we don’t have “highly motivated” people endlessly following the same routine and making the same mistakes, only at a faster pace until we collapse. We provide the right opportunities for the physicians on the front lines to get help implementing their ideas to fix problems effectively.
Huddles give us a chance stop and reflect, to address problems, to experiment with new ideas, to recognize and to appreciate our colleagues.
Designing flow cells around pull, rather than pushing more work into an already stressed system, results in a much less chaotic workplace. Flow cells and pull systems drive quality and continuous improvement. And yes, this does work in busy and productive hospitals and clinics.
What do you think?
Will you join us in transforming healthcare with Lean Done Right and returning the joy to patient care that we aspired to when we began our careers?
Are you ready to get off the hamster wheel?