Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective

Abstract

Burnout in healthcare professionals can lead to adverse effects on physical and mental health, lower quality of care, and workforce shortages as employees leave the profession. Hospice professionals are thought to be at particularly high risk for burnout. The purpose of the study was to evaluate workplace perceptions of interdisciplinary hospice care workers who provide care to patients at end of life. Six focus groups and one semi-structured interview were conducted with mixed group of social workers, managers, nurses, hospice aides, chaplains, support staff, and a physician (n = 19). Findings from the groups depicted both rewards and challenges of hospice caregiving. Benefits included intrinsic satisfaction from the work, receiving positive patient and family feedback, and teamwork. Challenges reflected issues with workload, technology issues, administrative demands, travel-related problems, communication and interruptions, difficulties with taking time off from work and maintaining work-life integration, and coping with witnessing grief/loss. Hospice workers glean satisfaction from making meaningful differences in the lives of patients with terminal illness and their family members. It is an expected part of the job that certain patients and situations are particularly distressing; team support and targeted grief support is available for those times. Participants indicated that workload and administrative demands rather than dealing with death and dying were the biggest contributors to burnout. Participants reported episodic symptoms of burnout followed by deliberate steps to alleviate these symptoms. Notably, for all except one of the participants, burnout was cyclical. Symptoms would begin, they would take steps to deal with it (e.g., taking a mental health day), and they recovered. At an organizational level, a multipronged approach that includes both personal and occupational strategies is needed to support professional caregivers and help mitigate the stressors associated with hospice work.

Psychosocial and Organizational Processes and Determinants of Health Care Workers’ (HCW) Health at Work in French Public EHPAD (Assisted Living Residences): A Qualitative Approach Using Grounded Theory

“…It is completed by the detection and problem resolution system, which supports the first system by regulating the observed shifts. Lehto et al [ 45 ] draw similar conclusions following their observation in the Midwest of the United States on the importance of being able to intervene in the determinants of work for the quality of work life. According to our observations, the first system seems to be very hampered by the dispersion of decision-making centers, which makes it very difficult to react, and by the distance from the activity, where the opportunity for field expertise and its recognition is lost.…”

“…This only underlines the importance of continuing to study and strengthen the protective processes revealed. The recent work of Lehto et al also mentions these barriers [ 45 ], and on a related issue, a very interesting analysis of individual strategies of emotional and cognitive regulation has recently been carried out in this sense [ 46 ], which in a way recalls the work of Lazarus [ 47 ] on coping strategies in relation to stress. The latter lacks the consideration of interpersonal and organizational dynamics.…”

Feasibility, Acceptability, and Outcomes of a Yoga-Based Meditation Intervention for Hospice Professionals to Combat Burnout

“…Two thirds of HPs who experienced at least one meditation went on to do a meditation on their own, a finding that suggests that HPs valued having access to these meditations. We know from focus group interviews with HPs that they did not want company-sponsored personal burnout interventions to be something time consuming that HPs were expected to do on their own time [ 2 ]. For example, some HPs mentioned not wanting to have to use personal time to attend company picnics or to complete online training modules.…”

“…Focus group interviews with HPs at the same organization as the current study found that when HPs start noticing that they are feeling burned out, they take self-care steps such as mental health days to recover [ 2 ]. HPs indicated that workload and administrative demands were the major source of burnout, and that dealing with death and dying would periodically start to feel overwhelming, either because of a particularly distressing event or just unrelenting buildup [ 2 ]. The meditations in the intervention are tools HPs can use when life events present a need, such as before or after a stressful patient visit.…”

“…Prior research shows that burnout is a serious and pervasive challenge for healthcare professionals overall, including nurses, physicians, and medical school students [ 1 ]. Burnout in HPs has also been identified to be a serious problem, compounded by workload stressors and administrative demands [ 2 ]. Hospice work is characterized by a multidisciplinary team approach, where interprofessional communication and seamless coordination are essential to ensure optimal delivery of care.…”