Cath Lab Digest

As we discussed development of this article, we struggled with even using the word burnout, because it seems that just isn’t typically part of the language of wound care clinicians and providers. Not that we don’t have our share of frustrations in our day-to-day practice, but burnout?
When you peruse the literature related to true burnout, there is a plethora of information about the signs and symptoms and warning signs. Burnout is described as an emotional and physical exhaustion caused by excessive and prolonged stress, which can reduce productivity and energy, and leave one feeling helpless, hopeless and eventually resentful, feeling that you have nothing more to give.
According to helpguide.org, you may be on the road to burnout if:
• Every day is a bad day.
• Caring about your work or home life seems like a total waste of energy.
• You’re exhausted all of the time.
• The majority of your day is spent on tasks you find either mind-numbingly dull or overwhelming.
• You feel like nothing you do makes a difference or is appreciated.

Additionally, physical signs of burnout may include:
• Feeling tired and drained most of the time.
• Lowered immunity, sick a lot.
• Frequent headaches, back pain,
muscle aches.
• Change in appetite or sleep habits.
For tips on avoiding burnout visit www.todayswoundclinic.com/burnout

As we read on about true burnout, while it may affect those working in wound centers and providers of wound care, it seems that those of us especially in wound centers, hopefully are at less of a risk. But that is not to say that we don’t have our own set of stresses and frustrations. We encounter those daily. Stressors contributing to wound clinician burnout are often a result of dealing with patients not adhering to treatment plans (“noncompliant”), the never-ending challenge of dealing with payers requiring multiple hoops to jump through in order to get authorizations for visits or diagnostics, and certainly with the current state of the economy and job losses, an increase in non- and under-insured patients who still require our care. The end result does cause an increase in frustrations among wound care providers, the difficulties can lead to longer visits for the patient, which effects productivity, and can lead to that frustration showing in clinician attitudes both towards the patients and each other.
While there aren’t simple answers to any of the aggravations encountered in our specialty, there are some ideas and hints that may help us get through a day. These come out of the author’s clinics, so certainly is not an exhaustive list. We would value any additional input from the readers that can be posted at todayswoundclinic.com as a resource to troubleshooting in all areas of wound clinic care. Both questions as well as ideas are welcome. Additionally, if tips and timesavers from other clinicians can make another person’s job easier, the ripple effect of daily frustrations can be averted, and hopefully the pathway towards “burnout” will be blocked.

THE UNINSURED PATIENT
With the numbers of unemployed on the rise, the number of uninsured patients is also rising. This is a difficulty not unique to wound care, but all healthcare providers. It is particularly challenging when we already have a relationship with a patient, have already begun treating them, and a new month begins and they inform you that they have lost their insurance. Do we tell them to cut the wrap off and go back to the primary care physician that referred them to us? Or to go to the ED and have their cast removed? The challenge is that we have a personal, ethical and legal relationship with the patient, which makes it close to impossible to just “turn it off.”
It is critical that with the type of care that we provide, that we have an ongoing dialogue with hospital administrators on how to handle these situations. Keeping patients out of the hospital and emergency department with complications makes more financial sense, so using the resources of the wound center may be the better alternative. Utilizing the hospital resources to look for financial alternatives and payer sources may be a stop-gap measure depending on local health department, state Medicaid programs or other sources.