The document emphasizes the importance of workforce wellbeing among anesthetists, particularly in light of growing burnout and stress levels exacerbated by COVID-19. It identifies key stressors, including long hours, poor work-life balance, and negative organizational culture, while proposing initiatives to improve health and wellness through nutrition, mental health programs, and supportive work environments. The goal is to create a culture that prioritizes employee wellbeing, reduces burnout, and enhances overall job satisfaction and patient care quality.

1. DR SANTOSH KR SHARMA
PROFESSOR
DEPT OF ANAESTHESIA, PAIN MEDICINE & CRITICAL CARE
ALL INDIA INSTITUTE OF MEDICAL SCIENCES
GORAKHPUR, U.P., INDIA
WORKFORCE WELLBEING
- PROMOTING HEALTH & WELLNESS AMONG ANESTHETISTS

2. •Official theme of World
Anesthesia Day 2024
•Celebrated every year on
16th
October
Disclaimer: Conflict of interest NONE

3. • Providers health directly affects ability to fully
serve their patients
• Provider burnout affects other members of
health care workforce
• Goal: Incorporation of physical activity, healthy
nutrition, & positive mental, emotional & social
health into work place
• Improve work life balance & reduce incidence of
chronic diseases (DM, obesity, HTN etc.) leading
to absenteeism & increased burnout related
turnover costs
INTRODUCTION & PURPOSE
Well-being is not just something we should think about during crises; we need to think about it every day

4. Physicians burnout & depression report 2022:
Specialty wise (Medscape)
TOP 5
BOTTOM 5

6. • Long working hours, poor work–life balance & limited personal time
• Creating unrealistic deadlines & pressure to provide quality patient care despite increased
workload & staffing shortage
• Emotional interaction with patients (death, sickness), maintaining electronic health records, &
additional administrative assignments
• High turnover rate & task shifting without adequate training of support staff
• Feeling undervalued/ unsupported at work & frustrated by inadequate reimbursement
• Stress in pg. students due to excessive clinical work plus academic sessions & exams
• Physical environment: noisy, non ergonomic, excessive cold, anesthetic gas & radiation exposure
• Pressure to publish (or perish), attend/organise CMEs & workshops
• External factors: staying away from family, no support at home
SOURCES OF STRESS, FATIGUE (BURNOUT) & DISSATISFACTION
Demands of the night call & difficult anesthetic cases are most stressful aspect

7. Based on 2698 responses from US attending anesthesiologists. Nov 2022

8. BURN OUT SYNDROME
• Defined by
• Emotional exhaustion (EE): unrelenting tiredness & feeling of
energy depletion
• Depersonalization (DP): feeling detached & negativism or
cynicism related to one’s job
• Low personal accomplishment (LPA): low self esteem
• Measured using Maslach Burnout Inventory-Human Services
Survey (MBI-HSS)
• EE (≥27 and/or DP ≥10): “High risk for burnout”
• High risk of burnout + LPA ≤33 = Burnout syndrome
• Predictors:
• Fewer years of experience, inadequate support by colleagues
at workplace & thoughts of quitting anesthesia

9. Increase in burnout rate & symptoms from 2020 to 2022 based on 3893 & 2698 responses from
US attending anesthesiologists in march 2020 & Nov 2022 respectively

10. HEALTH CONCERNS
• Sleep disturbances-
• Commonly in interns, residents, people working in night
shift
• Daytime sleepiness
• Impaired performance & risk of accidents to self & patients
•GI & cardiovascular diseases
•Emotional disorders, depression & suicide
•Musculoskeletal disorders (IDD, PIVD, MFPS)
•Impaired glucose metabolism, obesity, hypertension
•Substance abuse disorders

11. COVID 19 IMPACT
•Excess work load during COVID-19, with
Anesthesiologists often performing on
front lines
•Burnout (14–59%); stress (50–71%);
anxiety (11–74%); depression (12–67%);
PTSD (17–25%); psychological distress
(52%); and insomnia (17–61%)
•Communication with coworkers
decreased
E. Paterson. Mental health and well being of anaesthetists during
‐
the COVID 19 pandemic: a scoping review. Anaesthesia 2023
‐
Thankfully it has brought the burnout epidemic to light

12. NEGATIVE ORGANISATIONAL CULTURE/ BULLYING
• 75% say most stressful aspect of their job are their superiors
• Openly aggressive, humiliating or insulting behaviour
• Constantly criticise or micromanage (imposing “ITS MY WAY OR NO
WAY”)
• Not giving credit for job done well
• Taking decisions without consultation
• Not dealing with complaints or listening but not taking action
• Not allowing time for personal development & attending training
courses

13. NEGATIVE ORGANISATIONAL CULTURE/ BULLYING
• Being indecisive
• Unaware of team pressures
• Lack of precise definition of job descriptions
• Unequal work delegation & ineffective briefing of employees on their
job description
• Derogatory comments or ‘jokes’ in public
• No consideration for work life balance & threaten about job security
or patient care
• Inappropriate touching or sexual comments
Work environment & feeling of being treated unfairly has greatest effect on employees mood

14. WAYS TO RESPOND TO NEGATIVE BEHAVIOUR
• Control your impulses and don’t react
emotionally
• Tell a colleague what’s going on
• Worth keeping a record of the incidents
• Discuss your concerns, talk calmly & tell
that the behaviour is unacceptable
• Try to work together on a developmental
plan
• Report to higher authorities KNOCK IT OUT

15. • u

16. Surgeon
Anaesthetist
SURGEONS HAVE NO PATIENCE TO WAIT MINE
SURGEON-ANESTHETIST INTERPERSONAL RELATIONSHIP
A THANKLESS JOB (DEMOTIVATING AT TIMES)
• Poor interpersonal relationship (feeling of powerlessness to change/control situation)
• “MY PATIENT” rather than “OUR PATIENT” concept
• Surgeries last longer than expected
• Pressure to get lists going on time, for rapid turnover
• Conflicting expectations (surgical time can get prolonged but anesthesia time be minimal,
anesthetist blamed for postponement all the time)
• Expect Safe anesthesia, with quick induction & quick recovery
• Pressure to proceed with high risk cases instead of optimization & workup
• Colleague rates the anesthetist irrespective of his experience, seniority or understanding
of anesthesia domain
• Minimal threshold for delayed anesthesia time or block procedures

17. HEALTH CARE INSTITUTIONAL INITIATIVES
• Make environment conducive to applying learned skills & abstain from “DO MORE
WITH LESS” mentality that is pervasive around the world
• Plan, recruit & retain adequate anaesthetist workforce
• Promote team work & Zero tolerance policy for bullying or violence
• Reducing working hours with schedule flexibility
• Hiring scribes to reduce administrative workload
• Culture of no-blame: every worker feels safe & supported by leadership & colleagues
• Teaching Positive Mental Strategies & Bulletins of Encouragement
• Physician wellness & health promotion programs
• Undertake regular monitoring of workforce wellbeing

18. HEALTH CARE INSTITUTIONAL INITIATIVES
WORKPLACE EATING: THE OFFICIAL JUNKYARD!
• Increased awareness regarding nutrition, mental wellness & physical activity
• Need for more facilities overall that promote physical activity: “Take the stairs is not enough!”
• Create rewarding exercise competitions each week (i.e. reaching step goals, attending a fitness class)
• Weekly Yoga Class & Breathing Exercise Fitness Class
• Nutritional Classes to teach about healthy eating
• Healthy Cafeteria & Vending Machine Options
• Healthy Recipe Newsletters
• Ergonomic Architectural Designing: proximity of operating rooms to monitoring station & ancillary
services, ICU & lounge (reduce frequent staff walking & fatigue)
• Workplace accommodations in the operating room for rest & relaxation
• Provision of adequate toilet facilities

19. POSITIVE WORK CULTURE
CORRECTIVE MEASURES (AMONG COLLEAGUES)
• Feelings of support (in mentorship, at work & at home) most critical
• Culture of Mutual recognition, support & trust from constant
collaboration
• Formation of stable anesthesia teams & establishment of
interpersonal relationships between members
• Focus on developing leadership skills
• Provision for repeated feedback without fear of reprisal
• Workplace culture directly linked to leadership (in particular
executive leadership)

20. • Individual Resilience & Mindfulness training
• Control of aggression: be calm & cooperative
• Time management
• Focus on important matters
• Don’t feel guilty on saying NO
• Take leave when needed
• Schedule things as per priority
• Create a calendar & allocate time for family, friends, exercise & personal time
• Stop negative thoughts (remember positive experiences)
• Laugh it up (everything will pass)
• Assertive communication & Speaking up
CORRECTIVE MEASURES (SELF CARE)
RESILIENCE
MINDFULNESS

21. ME TIME/ SELF CARE
• Develop a strong support network
• Schedule monthly get-togethers with close friends & family
• Seek help when needed (strong network of family & friends= low stress)
• Take good care of self
• Carve out time just for you
• Exercise, plenty of rest & sleep, eat healthy, no smoking, alcohol or substance abuse
• Do things that you enjoy: favourite TV show, reading a book, artwork, music or
meditating
• Be present in the moment
• When at work be focused on task at hand & your patients’ needs.
• When at home or with friends or family, focus on their & your own needs instead
• Let go on negative things & look ahead

22. Based on 2698 responses from US attending anesthesiologists. Nov 2022

23. CONCLUSIONS
• Seek new & different ways to cope with daily workplace stresses
• Reflect on self care & how to support each other
• Efficient work schedules & rotas to allow personal/professional development
• Provision of adequate rest & catering facilities for all
• Support cultural shift towards no-blame learning environment prioritising safety of
patients & development of staff
• Incorporating workplace wellness programs for physical activity, nutrition & mental
wellbeing
• Methods for excellence reporting be implemented to support positive workplace
culture with provision for carrier development oppurtunities
• Plan, recruit & retain an adequate anaesthetic workforce
The hallmark of effective Leadership is to understand & support employees need for well-being

24. Thank you
DEVELOP A HOBBY AND ENJOY LIFE!