Addressing burnout in rural healthcare workers through online courses

For many rural Minnesotans, the local hospital is more than just a place for a checkup — it’s where you are born, have your kids and visit sick family members. Most of us don’t realize the toll placed on our healthcare staff or see that the neighbors who care for us are burning out.

In a survey of more than 200 people working at rural hospitals in northeastern Minnesota, researchers found that significant staffing shortages and job vacancies are part of the reason for high burnout rates, so the researchers from the University of Minnesota Duluth (UMD), supported by the Center for Urban and Regional Affairs and the Institute for Advanced Study pressed on, past the statistics, into the essential question: How do we fix it? Their answer began with the development of new online courses tailored to support healthcare workers’ well-being.

Feeling disconnected: deep-loyalty in rural hospitals can’t stop burnout

“The job is hard,” says David Beard, a University faculty member, a board member of the University of Minnesota Extension Northeast Regional Sustainable Development Partnership (RSDP) and part of the team investigating why rural hospital staff are struggling.

“Caring for others is meaningful, but it can also be exhausting. Long shifts, workforce shortages and the emotional weight of serving the entire community can lead dedicated professionals to feel stretched thin or disconnected from their work,” says Kim Dauner, a professor of healthcare management at UMD.

University researchers Dauner, Beard and Julie Slowiak partnered with Wilderness Health, a collaborative network of independent healthcare providers, to set up listening sessions in the many small hospitals that make up the rural healthcare system of northeastern Minnesota.

Through Beard’s connections with RSDP the research team connected with two ClimateCorps Vista members, Natalie Lavenstein and Faye Duster, who joined the team to support outreach, data collection and interpretation.

Lavenstein and Duster led the focus group at one of the partner hospitals. The group included all staff ranging from nursing assistants and accountants to facilities workers. Staff talked about what it felt like to be “in the zone” at work. Lavenstein and Duster then asked what kept them from experiencing joy or flow in their work. Even more importantly, they helped identify themes and analyze the data emerging from the focus group data.

Together, the team identified that one in four rural hospital workers they interviewed spent their entire career at one hospital, and one in five was born in the hospital where they work today.

High personal investment in a hospital's success, caring for patients who are neighbors, constant multi-tasking, and a shortage of staff to fill crucial roles all contributed to the feeling of being stretched too thin.

One [healthcare] worker might fulfill the roles of security, registration, dietary help and nursing in one shift ... We talked with one nurse who was required to snowblow the emergency bay after hours.

— David Beard, Northeast RSDP board member

“Universally, everyone was incredibly welcoming and very proud to be working at these institutions that are the lifeblood of the communities,” says Dauner. “But they’re wishing they had more ability to provide the services people come in expecting.”

For example, rural hospitals often lack the record-sharing systems found in metropolitan areas making medical records difficult to access in a timely manner, if at all.

“If you’re going on a fishing trip, you probably didn’t think to bring your insurance card,” says Beard, “but fishing hooks don’t always end up in the fish, and now you’re at the hospital without an insurance card, ID or medications. This puts a lot of stress on the staff who want to help you, but don’t have the necessary information.”

On top of paperwork stressors, staff routinely step up for their neighbors by handling duties well outside their official job descriptions. “One worker might fulfill the roles of security, registration, dietary help and nursing in one shift.” Beard says. “We talked with one nurse who was required to snowblow the emergency bay after hours.”