Running on Empty: The Reality of Provider Burnout (Part 2)

Burnout in healthcare is real and it's affecting more providers than ever.

In this three-part conversation, Ashley  and Tarra get honest about the growing burnout crisis in medicine. From endless charting and packed schedules to the emotional weight of caring for others, the demands on healthcare providers have never been higher.

They break down what provider burnout actually looks like, why it’s becoming so common, and how it impacts both the people delivering care and the patients who rely on them.

If you're in healthcare, chances are you've felt it or you're getting close.

In this episode:

• What provider burnout really looks like
 • Why burnout is skyrocketing in healthcare
 • The emotional and physical toll of constant caregiving
 • Why the system makes it hard for providers to recharge
 • How conversations like this are the first step toward change

The Ashley Clinic

We Are Building a New Way of Staying Healthy

Several factors provided the inspiration for the creation of the Ashley Clinic.  Primarily, corporate medicine changed the focus from the patient centered care model to a business management platform. The healthcare industry now focuses on time and money management, resulting in inflated healthcare costs.  Many patients are discouraged with the current overpriced system, causing them to seek treatment later in their disease process, oftentimes worsening their outcomes. In the interest of patient centered care, health, and well being, Ashley wanted to provide a more affordable platform to the people in the community she grew up in. Utilizing her advanced education and skills, Ashley provides exceptional healthcare at an affordable cost. Additionally, Ashley uses alternative approaches to health maintenance by offering integrative medicine practices as well.

Website: 

https://theashleyclinic.com/

Email

hello@TheAshleyClinic.com

Phone

(850) 741-3146

Address

2400 S Hwy 29
Cantonment, FL  32533

Transcript

SPEAKER_01 0:00

Coming to live. Don't see it tonight. Burnout.

SPEAKER_03 0:16

Real time. Well, let's get the healthcare. We're going to educate the power and energy. This is healthcare without the bullshit.

SPEAKER_01 0:30

Years of burnout. But we were all in that system where it perpetuated when it was, they were saying, This is you signed up for it. Oh that's how we punch the money in the face. So we're done Tom Turkeys. Like, so we're now projecting for the new generation. But I think the new generation, I really honestly admire them. I do too. I really do. I'm so proud of you guys because they recognize early on what they will and will not tolerate. And they have they are good at setting boundaries. I love it. And that's the issue with the nursing shortage right now. Right. If there's not a nursing shortage, they just set boundaries. They have set boundaries. And old school seasoned C E P C the C-suite people, they're not willing to, they're not willing to compromise. No. No. They're not. I mean I think it's going to evolve because we now like the word the nursing shortage is all over the place. It's bullshit, is what it is.

SPEAKER_02 1:22

And it's and there's not a shortage of nurses. No, do you notice that?

SPEAKER_01 1:26

Schools have waiting lists for nurses to get in to become nurses. So you have people waiting in the wings to become nurses, and they're gonna wait, they're gonna become nurses. And then they get out into the field and they realize, oh my God, this is well, we gotta talk about nursing education. This is a lot harder than what I thought it was going to be. It's not grazing out, it's not cute little scrubs running around doing fun things. It's dirty work. It's tough work. Yeah. And then they get burnt out because they have been misled to think that it's some glamorous kind of thing and they're making a good living out of it. Nurses get paid for what they might have to do, not for what they do. Period. They get paid for, they are paid the little that they're paid to recognize a lab that's off. I need to call the doctor because this lab is off. I need to tell that. They're they're there first and recognizing a lot of things, and they're relaying this information. They're making a picture for that provider to say, oh yeah, we need to intervene here. Nurses know quite a bit. They really do. They're not fucking in closets and they're not that part. They're not doing that. No, they're laughing. Oh, for God's sake. They're not doing that. We are too freaking busy to go off and have sex in a closet. I can't. I mean, there have been a lot of people. I can't even go pee.

SPEAKER_02 2:39

Oh my God, who has time to pee? How do people how are they having relationships?

SPEAKER_01 2:47

It is not that.

SPEAKER_02 2:47

I mean, I'm I I think there has been some.

SPEAKER_01 2:51

Sure, there's been a couple. I know of one in my history of working in a hospital that that has happened. One I know about a lot. I got one. I got a lot. However, um, you know, that's a whole other topic. That's a whole other topic.

SPEAKER_02 3:07

But yeah, so but for the most part, that's not what we're doing.

SPEAKER_01 3:11

No. Nor are we eating. We're not eating, we're not drinking.

SPEAKER_02 3:15

We're not. No, we're eating pizza. Not at the nurse's station. You're not.

SPEAKER_01 3:19

No, you're not.

SPEAKER_02 3:21

Where is your water? Oh, is that the hydration station? Thank God for that. That's a great call. It fixed everything. Ridiculous. But you know, yeah.

SPEAKER_01 3:35

Those are whole whole thing. Um so yeah, yoga doesn't solve moral injury. I love that. I love it. It doesn't. Because it's true. Because it's like what actually does help with burnout and moral injury. It's the boundaries. It is. It's the boundaries. And this new generation is what is fixing. I'm so proud of them. You just don't have any idea. Even my daughter says boundaries. It's going to take decades to get there, but that's what they're doing. They're doing it and good for them. Say no to extra shifts. Residents. Residence or boundaries. Props to you guys. Good job, y'all. Yeah. I mean, saying no to extra shifts. I hate it when they say, well, you have mandatory overtime. Is that legal? Never have I ever, so I don't know. I've never. Yeah, we had mandatory overtime. You had to sign up for one extra shift. It's not in your contract, but you better do it, or you're going to get ridden up. For what? I've worked my 36 hours, but we had to have an extra shift because they didn't stack appropriately. That's not my problem. That's a management problem. I have not experienced that, so I don't know. I do like this one reconnecting with a purpose outside of healthcare. So one of the things about healthcare and policing and fire and military is you get to be almost completely awkward in the world. You give your soul. Yeah, you give your soul to your job and who you are. It defines who you are. And then you go into outside setting, you're like, Yeah, you're like the So, for instance, you have kids and you join groups with those how do you talk to people?

SPEAKER_02 5:03

And then the parents, the other mothers are like, Oh my god, did you see this and that and the other? Or my god, are you all doing this?

SPEAKER_00 5:09

And I was like, I put my finger in someone's butt yesterday. You know what I mean? I'm like, what? I'm so I carried a watermelon. Oh my what in the world is wrong with me?

SPEAKER_02 5:20

I I coded a baby yesterday for four hours. Um, I you know, and then how do you talk to those people?

SPEAKER_01 5:28

I'm like, then I'm completely awkward, so I have nothing to say. I mean, but I do have to-gave my cat mouth to nose resuscitation. Yeah. I purged my dog because I thought I had a bowel destruction. That's actually a true story. It is a true story. The Hades. Yeah. Hades. What is the name?

SPEAKER_02 5:50

But we don't have so how do you so when you I think what needs to happen is the the younger nurses, the younger docs, and I think they're doing these things.

SPEAKER_01 6:00

They're learning to get outside of the system and continue to be normal people. Yeah. And not getting wrapped up in it. So we're wrapped up in it. We're too we're too it's too late for us. We're I think we're doing it. I think we're doing better.

SPEAKER_02 6:14

I think we're learning.

SPEAKER_01 6:14

Yeah. I'm taking you can teach an old dog new tricks. I really, really do take lessons from the younger generation.

SPEAKER_02 6:23

I know probably my face probably doesn't tell you that, guys, but I really we're picking up what you're putting down.

SPEAKER_01 6:28

I really am. If I watch you guys years of stoicism that we cannot don't react to, I think y'all are doing a solid. Everything's fine. But you're never gonna get a reaction from me. Never. Except for cynicism. Cynicism's uh-huh. I like it. Oh yeah, okay, uh-huh. That probably means I like you. Yeah, we kick on you. We love you. But so I I like that. Uh peer support. That's a tough one for me. I don't know how I think that needs to be. We're not huggers. We've never been huggers, so we're like, good job. Yeah. You did good. I just now started hugging people to the side, and I'm like, oh, sweet Jesus, this feels weird. Okay, you didn't suck in there. Good job, baby sticker. Yeah. You want me to get you a chicken salad? I like it. I want a chicken cup with some crackers. Yeah. So, but I so I think I wish corporations would help with that. Okay, so they do have uh what a debriefings. That's new. They did not have that for us. That was talked about, but no one ever debriefed. We had to do it on our own. Yeah, we did talk about it. I remember talking about it, but we never that's not like the pit. We did not go in a room and talk about our feelings and do all those things. We talked about talking about it, but it never came to fruition. Now and the ER doc back in my day would say, Next, Greg Smith, you know who you are. You would say, You alright? Okay, and you're like, Yeah, I'm all right. All right, pick up the next two. Okay, let's go. And that was our debriefing. Yeah. And uh I really I mean, and I I mean, but props to those guys for even asking me. Yeah. Knowing that I'm not gonna be like Nobody asked them. What am I gonna do? Cry to them?

SPEAKER_02 8:10

No.

SPEAKER_01 8:10

You signed up for it. Right. So but thanks, thanks guys for back in the day for at least being like, hey, you good, you need a minute? Nope. Uh when you probably knew I did better than I did. Um, and so I do I am appreciative for the times that I was asked. I will give them that. I'm gonna give them that. Thanks. But it didn't come from my company, you know? It didn't come from who I was working. Nobody and I think the ER is hard to have debriefing. Like I think they should work on that, but I don't know how to make that happen when 9,000 other things were happening. But they really should, or at least case of the month. Like, let's sit down and have a case of the month. But then again, then we talk about this. We had a round. Yeah, rounds would I don't know, rounds would have been helpful, I guess. That all fell by the wayside, though. Yeah, that's something again four or five weeks later. But it was help, those were helpful things. So the helpful things always seem to fall by the wayside. But I will say, like, doing a debriefing that is not in the moment is not as helpful. I I don't think personally. Because once I've left those doors or left that moment, I really don't want to talk about it. No, I'm talking about like whenever you have a really traumatic code. I am too. That's what I'm talking about. And then they all gather in the room like 10 minutes after this only happened, I think, twice that I know of when I worked in the ER at that particular ER, twice. And it was usually children death. And they would go in there and they would debrief and everybody would cry and pat each other on the back and talk it out. But that's the only times I've ever I've never had that happen. Not one time in my life have I ever been debriefed. We should have had a debriefing. I had, and I think I've talked about this before. So when Sophia was two and she uh was in her little daycare, there was this little boy in her daycare, and his hair was all on his face. And then one day he comes to school and his hair is cut up, and he looks you could see his face. He's so cute. Oh my god. And he had a little bunk on his forehead where someone had thrown a frisbee and pumped him on the it had a little scratch right there. Wow. So it was like November, it's cold outside. And I had done trauma for so long, I no longer cried. You could, I mean, literally never cry. Joey'd be like, you never cry at anything. What is wrong with you? And I'm like, I don't know, it's just what I do. I've had paramedics say, I don't know how you do what you do every day. You're just like nothing. I'm like, I don't know, I just do it. Somebody's gotta do it right. So anyway, so this little boy said we're taught. Yeah, somebody's gonna just do it. So then I had this uh, we get this code call. It's November, it's uh a kid that drowned. I'm like, okay, great. Guess who it is? Little boy in her class. He had crawled out the doggy door, fill in the pool, and drown. And um we coated that baby until he was warm and dead, because that's what you do for babies warm and dead. You don't coat, you know, they can't be cold and dead. They gotta be warm, you gotta warm them up and then keep coding, coated, coating. And sometimes, you know, because the coldness keeps their brains okay, and you just, you know, anyway. So we finally call it. Eyes are, you know, fixed and dilated, and we call it. And at that moment I was fine and left and went home. And I don't know, maybe seeing Sophia maybe messed me up a little bit. I don't know. But then I wake up at three in the morning and cry and cry for three days and can't quit. Three days, because then all of those other children that I had done with trauma, all of them come back. All of them. Mommy screaming, come back. Mommy screaming. I think I've blocked a lot of that now because I can't hear that anymore. It'll come back. I don't want it to. But it's pretty fucking terrible. It is. It is parents screaming, it's terrible. Sobbing, begging, the pleading. The the bargaining. Oh god, the bargaining. That's really tough. Yeah, I agree. So right. So how do you not end up with it? But we never debriefed on that. We never talked about it ever. I just cried for three days on my own. I've been driving down the road, go to Waterburg and just crying. So I was like, what's wrong with that? I don't know. I just cried. Right. Well, that's what was wrong with me. Because we never were able to process all of that. We didn't have that. And I think that is a line that should be. I agree. We should absolutely have debriefs on traumatic uh codes, traumatic traumas, all those things. Traumatic trauma. You know, what's also interesting, like, why is there no like psych involvement really in the ER realm? They're very, they're a very separate entity. But you know, like, I don't know. I mean, I'm sure some huge institutions probably have a really good relationship with their psychiatric partners, but most of the ones that I've encountered or seen, like they are a separate entity and we are just pushing and shoving back and forth. But like, I wonder why there isn't, I mean, everything like why we don't have an on-site psychologist for staff or something like that. I mean, we should. We all have ADD and ADHD as it is. If you work in an ER, that's what you got.

SPEAKER_00 13:03

But I think that someone like someone that is just there. I mean, what if I don't know what their purpose would do?

SPEAKER_01 13:08

I could see that it could be uh an expense that's not needed, but there needs to be something. Even if we I mean we have social workers there. We do, we don't have social workers in AR anymore. Not at every facility. Do we have pharmacists in the AR anymore? Some facilities, but not each of them, not all of them.

SPEAKER_02 13:30

Okay, yeah. I I think that it needs that's I mean, that's what the next it's therapy that understands healthcare culture.

SPEAKER_01 13:38

Yeah. But that has to be done on the outpatient. Like we can't do that, but leadership that listens to frontline workers, what permission to grieve what the job has taken. So for all of us salty dogs, like that is what you should be given the permission to grieve what the job has taken from you. I think a lot of people don't understand also, too, is that when you aren't in healthcare, how do I put this? We see the worst. So we are desensitized to a lot of things. To everything. Pretty much everything. And so we don't get to grieve the loss of that that uh that innocence that most people have when it comes to healthcare in general. Right. You don't know anything about all this other shit until it happens to you. And then when it happens to you, you get a peek inside the window of what we see every single day ten times over. Right. For instance, for instance, I took my son for an x-ray today.

SPEAKER_02 14:51

Because he has been complaining of Let me get your differential going for months. And it wasn't until another person that or I'm sorry, my child comes home and says, Hey mom, this guy at class said that I should use a knee brace or a seat. And it then it dawned on me that he is now talking to other people, teens, about his knee pain because I have shown not enough care and concern about said knee pain that, and that's what it did.

SPEAKER_01 15:25

So him needing a brace, and I did buy him one, by the way, because I'm it's like a band-aid. And you got him an X ray.

SPEAKER_02 15:32

And I ordered an X-ray. So today I get here to do this podcast, and Ashley says, Hey, the radiologist wants you to call her. Immediately, I'm like, Cancer! Oh god, he has ewing sarcoma.

SPEAKER_01 15:49

Oh my god. It's oh my god, oh my god. I'm gonna throw up. It's not something simple.

SPEAKER_02 15:55

And then it is actually very simple.

SPEAKER_01 15:57

She just had, I guess my son, when he was getting his x-ray today, mentioned to the tech that he plays the sport and the radiologist, and then the tech noted it, and the radiologist happened to have a child that also played the sport, and she's like, I need to call her specifically because there's something I learned about this. But the whole time I have, I mean, all the things were put together and it worked out perfectly, but nonetheless, I blew it off forever. My own child, until some random child told him he needed a knee brace. And so, yeah. Some random non-healthcare parent child. And I have to apologize. I'm like, buddy, I'm sorry I didn't take this seriously. I mean, granted, the x-ray was fine, it's not cancer today. But um look at this. What needs to change to the healthcare system level? Treating healthcare workers as humans, not units of productivity.

SPEAKER_02 16:53

Oh, listen, we talked a lot about this already. Real mental health support and without career reworking.

SPEAKER_01 17:00

Yeah, oh my god. Protected time for documentation, safe staffing ratio. Oh, weird. Sweet. Really weird. Luckily, that's all over social media, though. Safe staffing ratios is all over social media because it doesn't happen. Everybody Some states have them. Like, oh my God, can you imagine working in California? I think one state has them. Yeah, like California has it, but then they have like they have 15-minute breaks, they have a specific nurse hired just to relieve lunches. So this one nurse that you go to lunch and you go to lunch and you go to lunch, and everybody gets a lunch. And you're not worried about your own patients while they're someone. Yeah, they're actually being taken care of. You don't have to rely on another nurse who has her own load of patients to pass a med or two for you, or if anything goes wrong, so they're doubling up on their the amount of patients they have. That's not the same. I know, but us old school nurses, here I'll tell you the other thing I've heard. I can do it all. Right. I know you can. Because they the old school nurses who come in to relay to relay to relieve lunches, then they're like, go, you go, and you go, and they're like, but you're gonna be left with 15 patients, no less than eight patients. And they're like, it's fine, I got this. Which I know that they do, but they're so that that is definitely a seasoned nurse that's gonna do that. So they've probably been doing it more than a decade. More than a decade. And they're gonna do that. Why? Because they came from a generation where it was not acceptable. Like, yeah, you if this person came in and sent that person home, you've got all their patients. No one cares. You absorbed it, no one cared. So, so then you have people like the the older nursing guys with the newer nursing kids coming in who have set boundaries and have done these things. They're not gonna take this many patients, they're gonna take this many patients. And and I think that they're right. They are right. It's we are wrong. I won't tell you. Older nurses, you know who you are. One of my very first jobs that was a med surge nurse. Yay, and I love some med surge now. Med surge, too. So at this hospital, the hallways were like a big U. Like this half and this half. So this half was like, we were like real med surge. We had renal, neuro, diabetes, all the things, everything, lungs, all of it, pulling it, whatever. We had all the things. And so the back rooms on that back split, you know, the ones that go around the horn were single isolation rooms. Why were they always in the back? I don't know. They're always in the back. And you have the double bunks up front, you know, all the double brooms up front. And then down on that back split on that big U, you have the single rooms. Well, God forbid if your charge nurse sitting like you, or if you were a very strong nurse and she knew you could handle it, you would have our max was eight patients. We had eight patients at a time. Every single day. The max I took one time was 10 because I had a nurse leave and I had to absorb two of her patients. She got rid of her others, but I had 10 patients one time. But being on that back split, you have eight patients on that backsplit, and every single one of them is an isolation room. So you're gowning and gloving, and you're you're every single time, go in and out, MERSA, VRE, whatever, CDF, it doesn't matter. You are constantly gowning and gloving out of every single room.

SPEAKER_02 20:12

See, and I think that's a terrible It was terrible because not only that, but if you're looking at safety control infection control, infection control.

SPEAKER_01 20:19

Because that same nurse is gowning and gloving and gowning and gloving. So when those are split up, you're you're not entering each other's it was awful. Because the first room you have would be a double bunk, regular kind of patient, maybe, and then from then on out, the other six or seven or whatever were isolation rooms. Yeah. That is uh isolation room. It was exhausting. I'm surprised I don't have C diff to this day. Or VRE. Oh, VRE, absolutely. We all got MRSA. That's just a given. It's just a given. We all have MRSA, it's fine. That is that is a tough gig for, you know, I in general. So when I and I'll be honest, there's a hundred percent transparency. When I see these and I say, I'm not taking any more than five pages. I'm like, bitch, I took eight on a backsplit isolation ward and still got done with my day and document, but we had paper charting so we could document it as we go. We didn't have to go find a computer either. But we're also broken. You see when it's broken. That's my props to them for like, I'm not I love that they're doing that, but it's it is tough. That's what I'm saying. That's what I'm saying. Yeah.

SPEAKER_00 21:24

As us older nurses are still in this game, it's gonna be short of breath.

SPEAKER_01 21:29

It is very hard for me not to be resentful for the first time. I am resentful because I wish we had stood up for ourselves better. Right. Why the fuck did you have to do with them? It really has nothing to do with them. It really doesn't. We're mad at ourselves. We are so mad at ourselves, and we're proud of you for standing up for we're just burnt out.

SPEAKER_02 21:46

But we're burnt out. I don't know. I don't think there's an actual cause. I think it it's time. At least we recognize, right?

SPEAKER_01 21:55

They say that you know, accepting and speaking the Words is the first step to healing. I think maybe it's our generation too. Oh, guaranteed. I think that has a lot of transference into what we how we are. And what we didn't want. So these kids coming up, the the new nurses that are boundary setters. That's from our generation. Their parents teaching them. So our kids will be the same. Because a lot of our our people have children that could be nurses. What? I tried to talk mine out of it. She's still gonna go. Mine still vomits at the thought of blood. So it's we're good. I don't think mine's gonna be in any kind of health care. But I think too, that's a a lot of the reason why a lot of us older, salty dogs, got out of hospital health care. That's exactly why I got out of it because I just felt like I was turning and burning. We were just go, go, go through the motions all day, every day. It wasn't changing, it wasn't getting better, it was monotonous. Yes, it's ER, yes, it's fun. And yes, you get to see all the fun stuff. But then you also see the moral injury and the emotional just uh I like I can't even think of a word. There was my brain fog with my burnout. Burnout. I let the emotional burnout. So you know, I think and for me, stepping out and doing this instead. Oh my god, I'm a different person. And so I I did a little different route. Um I'm still in it, but I've not made it my priority. I love that. That's what it is not my priority. Because they made it be, they made it be our priority. I I I cannot give my entire soul anymore. I mean, they get they get my soul for the time that I'm there, and I try to do the best job that I can and how they want it done. And but once that I'm done, I'm with that day, I'm done with that day. Yeah, I used to be able to walk away and just leave it there. But that's the difference one here too, is I usually can leave it here, but then I worry about my patients at home. Yes. No, I do worry about some patients, like I think about them, but not the 15 cough cold and congestions I saw.

SPEAKER_02 24:08

I'm probably not thinking about those guys. But there's a few that, yeah, we all think about them.

SPEAKER_01 24:13

I don't think you'll never not think about your patients, um, because it's part of your life. So it creeps in. But what I'm saying is uh I have learned to do other things that I find enjoyable that are not part of the ER instead of ER stuff. I gotta do more stuff. I gotta get out and two points. Oh, because there's more time for you to do more things.

SPEAKER_03 24:35

Yeah, let's take it to that. The show we're two real life providers in real life. Health habits, wellness, and the broken healthcare system. We're gonna educate, empower, and entertain you. This is healthcare without the vulture.