Over the last 3 years, as the world has grappled with a pandemic, the healthcare industry has come to the forefront of our minds, the news, and workplace issues. In particular, one could describe the atmosphere surrounding the industry with one word—stress. Stress at work is a reality of most industries. However, a quick look at the circumstances that healthcare employees have been enduring reveals numerous stressors:
Naturally, health workers have felt the impacts of this heightened stress. Rates of depression and anxiety have gone up. Workloads have pushed people to their limits, with 43% suffering from overload, and 49% feeling burnt out.  Perhaps worst of all, the increased effort and stress seems to fall on a thankless populace. Just 41% of healthcare professionals feel respected at work (59% average across industries) and just 23% feel that their contributions are acknowledged (42% in other industries).
High stress, low appreciation. It is a perfect storm for the healthcare industry, and the effects have begun to ripple. Past recessions have had a relatively low impact on the health sector. For example, during the Great recession of 2007, employment increased steadily while most industries saw layoffs. However, during the Covid-19 recession health sector jobs fell alongside their counterparts. When it came to the amount of people leaving their jobs, healthcare sectors paved the way in terms of percent change ahead of other industries, reaching all time highs in 2021. 
Additional studies of US healthcare workers revealed that turnover rates had risen across the industry, particularly with traditionally marginalized groups such as minorities and women with young children. As the pandemic has worn on, there has been a slow recovery to pre pandemic levels, but concerns linger around employee retention, burnout, and job quality for health care workers moving forward. 
Sometimes stress seems to get talked about as a positive indicator of a competitive, fast-paced work environment. However, the numbers don’t really back this claim:
While some stress has been tied to increased performance, the impacts of chronic workplace stress are on clear display when the U.S. workforce is examined. From physical stressors such as poor lighting or noise, to psychosocial stressors such as job demands and poor job control, stress in the workplace has been tied to elevated blood pressure, anxiety and risk factors of substance abuse and anxiety disorders. Stressed workers manage their time poorly, have a lack of focus on tasks, and tend to have more strained relationships with co-workers and management. The level of stress in most workplaces today doesn’t appear to be healthy.
Oftentimes, organizations can appear to be thriving. Unfortunately, we often look at the success of organizations instead of their health? What is the difference? Well times of great crisis can reveal the answer. A successful business is operating in the black, they are meeting their customers needs and have found a way to drive profits. The healthcare industry is a prime example, long recession proof, and had great success at driving revenue. In fact, over the last 20 years the industry has seen constant increase in spending on healthcare, with the pandemic not providing an exception as patient, provider, and governmental spending rose.
But health is different from success. What is it costing the people of an organization to drive those profits? Stress that is driving anxiety, burnout, and high turnover is an indicator that in this time of crisis in the industry that profit has come before people in terms of priorities. An intentional focus is required to focus on the factors that drive stress, addressing them in order to create a culture that empowers employees instead of just using them.
All work no play
In a study of 5000 employees, Norwegian author Morten Hansen found that performance is not correlated with work hours. The greater the number of hours an employee worked, the lower their productivity was per hour they worked. In fact, extensive shifts at work were more positively tied to adverse health conditions like diabetes, disability, cardiovascular problems and more. It is vital to a healthy work environment to strike a balance between productive hours spent at work and time with family and friends, all without creating unreasonable stigmas around “leaving early.
The world isn’t fair. But apparently we wish it was. Several vital employee health factors are tied to employees' perceptions of fairness and justice in the workplace. Employee satisfaction, organizational commitment, and turnover are all positively correlated with how fair employees feel the workplace is. Our goal should be to create a level playing field for employees. This includes:
Business leaders will need to take intentional steps to promote fairness and justice at work, and also ensure that it is effectively communicated with employees. After all, it is the perception of justice that matters in this scenario to build employee trust.
Job design, in this case, refers to the amount of control that people have over their work. Employees who are in high pressure roles and have very little control over their work find themselves feeling negative effects more acutely. McKinsey worked with a British epidemiologist Michael Marmot and found that the higher someone's rank within an organization, and the higher their autonomy within their role, the lower their risk of adverse health effects such as stress and cardiovascular disease. 
The goal for organizations should be to create additional autonomy, train leaders to avoid micromanagement, and allow employees the fluidity and discretion to choose what, when, and how they complete their goals. This will allow them more room to be creative and thrive.
Work and Life
When work and life intersect, it often results in challenging and emotional choices. Some must choose between completing that extra hour of a project and attending their child’s soccer game. Other choices, like staying home when our significant other is sick can result in feelings of guilt and fear about letting down their work team, their family or both.
Stress is a major contributor to mental health issues and these difficult tradeoffs often result in severe stress inducing emotions and situations. We need to recognize that family and personal commitments are an irreplaceable part of employees' lives and that employees with a strong work life balance are empowered to bring their best selves to each project.
Workplace incivility and negative rumination
Even the kindest people have days that make them a bit snippy. Even those with the toughest skin have days that they are more sensitive than usual. Whether it is due to a bad night's sleep, or a stressful day at work, sometimes we treat people with less respect than they are due. McKinsey describes this workplace phenomenon as workplace incivility—”the accumulation of thoughtless actions that leave employees feeling disrespected”.  From feeling ignored or undermined to feeling belittled by a manager, these behaviors are essentially small violations of mutual respect.
When looking at the impacts of a workplace on mental health, one determining factor on insomnia and overall mental health was negative rumination—mentally replaying an event and incessantly thinking about it, even after the work day has ended. Toxic work environments drive employees to spend additional energy and stress on the workplace outside of work and have been tied to increased depression, substance use, health issues, lower productivity, increased turnover, and lower commitment to the organization from employees.
We can’t control every action of each employee, but business leaders can drive increased awareness, ensure accountability for actions, protect vulnerable employees, and train their people in both emotional intelligence and resilience. The goal should be to reinforce that a healthy culture is built on trust and respect, and that we are committed to building it on a daily basis.
Whether you are a healthcare leader, or attempting to drive an organization forward in any sector of the economy, it is vital to keep health in mind as you push for success. If you have any questions about reducing stress, improving mental health, or any other factor of a healthy workplace culture, we would love to connect. Just head to www.ledgestone.com/contact to get in touch with one of our culture experts.
 Torkelson E, Holm K, Bäckström M, Schad E. Factors contributing to the perpetration of workplace incivility: the importance of organizational aspects and experiencing incivility from others. Work Stress. 2016;30(2):115-131. doi:10.1080/02678373.2016.1175524