Abstract
This chapter introduces complexity science as a framework for understanding the healthcare delivery system and the inherent challenges it poses for healthcare providers. The Institute for Healthcare Improvement's triple aim, which focuses on the patient experience, population health, and decreased costs, served the health disciplines for a short period of time. It was then recognized that the healthcare provider, the worker at the point of care, was instrumental in the success of the triple aim. This concept, the health and wellbeing of the worker, came to be crystallized as meaning and joy in one's work. The chapter explores this positive affect concept as well as that of compassion satisfaction along with negative affect occupational-based strains occurring for the healthcare provider as they navigate working in the complex healthcare delivery system of the United States.
TopIntroduction
The healthcare system in the United States (US) is complex. It is difficult to navigate as a patient, and at times it is even more difficult for the healthcare provider. Most healthcare providers, when asked, will state they entered healthcare to help people. They felt a calling and/or recognized behaviors in themselves congruent with helping others. They entered the profession with bright eyes and cheerful smiles knowing they were on the path to fulfillment through assisting others. They envisioned saving lives, bringing comfort, guiding one’s health and well-being, and easing the process of death amongst other things. Many find meaning and joy in that work; they are satisfied as their purpose is fulfilled. Others felt the stress of the complexity of the healthcare system and lost that passion and satisfaction. They burned out as the morally distressing situations stayed with them; in turn, they lost their compassion, and they were affected by others’ tragedies. In most instances, the quality of care they delivered suffered and, usually, they left the work they deliberately selected to do. The providers lost meaning and joy ad were no longer fulfilled. In the following chapter these topics will be explored in depth to enhance understanding of these healthcare provider responses to the complex system of healthcare delivery.
After completing the chapter, the reader will be able to:
- 1.
Recognize the complex nature of health care delivery.
- 2.
Discern the essence of meaning and joy.
- 3.
Identify the factors contributing to meaning and joy.
- 4.
Address the states of burnout, moral distress, compassion fatigue, and secondary traumatic stress.
- 5.
Propose well-being strategies for themselves to promote meaning and joy.
Key Terms in this Chapter
Compassion Satisfaction: The sense of comfort and achievement one experiences when their work meets their own expectations.
Compassion Fatigue: The exhaustion and emotional withdrawal experienced by those in the helping professions that results in the diminishment or loss of compassion towards one’s clients or patients.
Moral Distress: The knowledge of the right thing to do, yet the inability to act accordingly due to multifactorial systemic constraints.
Organizational Culture: The activities below the surface which permeate the organization. Much like an iceberg, what we see is one thing but what we do not see is quite another. Culture is what we do not see but its presence is powerful.
Burnout: The cynicism and questioning of professional value resulting from unresolved chronic occupational stressors.
Meaning and Joy: The raison d'être for doing one’s work. It is the intangible but powerful reason one chose to enter the career they did, and the search for meaning and joy is what keeps us providing care in the best and the worst of times.
Organizational Structure: The way an organization is set up from the bottom to the top; is its focus on patients, on hierarchy, on participation? How is the vice of the provider encouraged and heard?
Secondary Traumatic Stress: The indirect stress felt by caregivers resulting from caring for someone undergoing a traumatic situation.
Affective Responses: The emotional responses to a situation.