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Episode 34

Burnout and compassion fatigue: a new perspectives on resilience for care providers

Jeff Howell (00:01): 

Welcome to Home Health 360, a podcast presented by AlayaCare. I’m your host, Jeff Howell, and this is the show about learning from the best in home healthcare from around the globe. 

Erin Vallier (00:18): 

Welcome to another episode of the Home Health 360 Podcast, where we speak with home care professionals from around the globe. I’m your guest host Erin Vallier, US Director of Sales for AlayaCare software. And today I am joined by Rockstar Nurse Lourdes Wiley from Amity Healthcare Group to talk about a topic that is super relevant as we all approach the new year. And we find ourselves in this mode of trying to create the conditions for a fresh start and setting some really important goals. Now, Lourdes has 20 years of experience as an rn. She started in adult and pediatric critical care and then in 2006 decided to take her career out of the acute care space into a more diversified path, including leadership and education. She has experience in home health, hospice and nursing education, which uniquely positions her to speak to us today about burnout and compassion fatigue. Welcome to the show, Lourdes. 

Lourdes Wiley (01:23): 

Hello Erin. Thank you so much for, for having me yet again. , a pleasure to be here. 

Erin Vallier (01:28): 

I am excited. And this is your second appearance on our podcast. Yeah. So I’m guessing, or I’m hoping at least that some of our listeners are already familiar with who you are and if they’re not everybody listening, you gotta go back and listen to episode 14 and that’s where we were discussing nursing competency programs. But I’m sure everybody would love to know what’s new with you lords and what’s new with Amity Healthcare since the last time we spoke, can you give us an update? 

Lourdes Wiley (01:57): 

Yeah, it’s been, you know, an exciting year. We were keeping up with the competency program and trying to serve clients that way as well as with our consulting services that we have for agencies trying to get licensed, certified, accredited outta trouble, and all that good stuff. We are actually really excited that our competency program is currently being reviewed by ACHC and we may be getting an endorsement from them, but they’re taking a serious look at it as well as some of our other products that can help agencies such as WPI programs, admission packets, things that help agencies kind of not have to recreate everything, you know, especially small to mid-size companies. So that’s exciting. That 

Erin Vallier (02:36): 

Is super exciting, 

Lourdes Wiley (02:37): 

Super exciting. We authored a wound care program and we’re working with Chap actually on this one. But Chap has some disease management certifications open to folks who maybe are accredited with them or not accredited and just want that chap seal, of approval, so to speak. So, we crafted a program for agencies that might be interested in seeking that wound care certification and we’re hoping in 2023 to really put out some good courses and competencies that can match that. So, whether agencies want to get the certification or they just wanna up the quality of their wound program which is always a big, big thing, we have that going on. And then I’ve, you know, I’m excited to be here on this topic because it’s kind of my passion project, Erin, and I’ve been doing a lot of public speaking on burnout and compassion fatigue. Every chance I get, I’ve done some webinars with ACHC, I went to Florida to speak at their home health conference. Any chance I get kind of and I’m even helping some local clients through workshops and education and support with that. So that was a mouthful, but you asked, so , that’s what’s going on 

Erin Vallier (03:44): 

. There’s a lot of really exciting stuff going on. Yeah. And in case the listeners didn’t catch it, you are getting special attention or are recognized by ACHC and Chap. So if they are accredited or they’re seeking accreditation, they should come to talk to you guys. That’s much my takeaway. 

Lourdes Wiley (04:02): 

, yeah, we would love to help them with that. And also Oasis-e is looming speaking of burnout and challenges and so we’re happy to help with that too, you know, from support with our, our coding and with our documentation review and anything we can help customers with that. Cuz we know that that’s a big stressor with all the changes coming. Yeah, so a lot going on. 

Erin Vallier (04:22): 

So many changes. Well, thank you so much for the update. Now you shared with me a little bit about burnout and compassion fatigue prior to this episode and I did a little bit of research on my own and wow, it’s a big issue. You share with me that burnout and compassion fatigue are the leading causes of healthcare workers leaving their jobs and leaving the profession altogether. And that was pretty much in alignment with my research too. You also said that this is disappointing too, that the solution has historically been addressed as an individual’s problem and not the organization’s or a systemic problem. Now you’re clearly passionate about this topic. Why is this area focused so important to you? 

Lourdes Wiley (05:11): 

Thanks for doing your research cuz I think part of the disconnect is you know, we’re all gonna be patient. So why is it important to me? Because I’ll, I’ll start with my professional side. We’re all going to be patients. You, me, our loved ones, everybody, right? Like it or not, even if we’re super, I know you’re super fit and healthy. I try to stay super fit and healthy. Eventually, you’re gonna be a patient , your body’s gonna fail. You we’re all gonna die. You know, I hate to be morbid, but it’s true. And so sometimes I think when we’re not in the system as a customer, as a patient, or we’re not a worker, people don’t realize how bad it truly is. And so professionally it matters to me because I see the detriment. I see what it’s doing and we’ll, we’ll talk a lot today about, I pulled a lot from what’s happening. 


 Our surgeon general has actually made this almost like a national emergency. So a lot of my data comes from, you probably found this in your research. The Surgeon General has a call to action and a whole advisory out on this. And the National Academies of Medicine started sounding the alarm in 2019 before covid hit us. So professionally, after 20-plus years in healthcare, I could make an analogy that when I started nursing, I already saw the system kind of as maybe a middle-aged patient that is not taking care of themselves. You see them going towards that disease, you see them doing all the wrong stuff. They’re smoking, they’re eating badly, and they’re stressed out, right? And over the course of 20 years, I’m watching this 50-something patient decline now to a 70-something-year-old who’s now ready for I C U. That’s how sick our system is. 


And so it, it’s a whole problem, which is why we’re going to talk about why it’s not just an individual thing. Cuz I could go meditate all day, we can all take care of ourselves. It’s not going to fix it. So professionally I see it for what it is and it isn’t. It’s actually a global emergency right now, Erin. I mean, we’re seeing strikes in the uk you know, nurses are burnt out and done there, but so professionally awful because it’s, it’s just not good for anybody. It’s hard to work in and that’s why people are leaving cuz it’s affecting their physical and their mental health. Personally I’ve dealt with burnout and compassion fatigue the day I started, but we didn’t know back then, you know, all that. We know now. We didn’t prepare ourselves for the, the hardship that it is sometimes. And I went straight into, you know, pediatric hematology, oncology and critical care with, with kids and with adults. And so not knowing how to regulate as an individual was a thing. But then now we’ve got it compounded with the system. So I’m really passionate about it because again, it affects us all. And as the Surgeon General says, the wellbeing of our nation is now at risk because of the situation at hand. 

Erin Vallier (07:59): 

I believe it, I believe it. I I did a little bit of the same, you know, research, I found the surgeon general’s commentary on it and, you know, the top three most stressful jobs in the US healthcare’s number one. And it was a general category, but if you’re in healthcare, you have a very stressful job followed closely by social workers and then fast food and retail. But it’s a, it’s a real big issue. It’s more so than I thought. I think 90% of employees say that stress and frustration negatively impacts the quality of their work. Now think about that as it applies to healthcare. I don’t really want a stressed out nurse coming to see me and doing their job. How could that influence my outcomes? You know, 57% of employers say that burnout has directly impacted their churn rates. And we already have such terrible churn rates in healthcare. We just have to do something about this. So I’m really glad that, that you’re speaking out about it. 

Lourdes Wiley (09:05): 

And if I can add to that, it’s even, it’s everything from physicians down all the way. So I think when we say healthcare, we gotta remember it’s all, I mean we talk a lot about nurses and doctors cuz we’re the most obvious and the more numerous and the more, you know, whatever expensive, I guess . But the crisis goes from physicians who by the way, physicians and nurses, the suicide rates are outta control. You know, I do wanna talk about the mental health piece today because it’s, it’s awful. But all the way down to our personal, you know, care workers are unlicensed personal care workers who are the, the workhorses of helping to take care of this aging population. We need everyone. So I just wanna remind the audience that we’re talking about the gamut, you know, and especially since this is a home health-based show, you know, a a lot of home health depends on nurses all the way down to your CNAs, to your unlicensed providers and, and, and they’re all sometimes hurting the most even as we go through that chain. So I just wanna make sure we we’re clear on that. You know, that everybody, everybody’s important here and everybody matters. 

Erin Vallier (10:03): 

That’s a really good reminder. 

Lourdes Wiley (10:05): 

It affects our 

Erin Vallier (10:05): 

Industry. It does. Thanks for that reminder. Now, burnout and compassion fatigue, these two terms sound very similar and I think they could probably be mistaken for one another and use interchangeably. So for the listeners who aren’t familiar with this jargon, can you explain the difference between burnout and confession fatigue? And as a follow-up, how are each of these impacting healthcare workers? 

Lourdes Wiley (10:32): 

Yeah, thank you for that cuz it, it is confusing. And when we look at signs and symptoms, if you will, they’re very similar and they can overlap. So where all of this stems from is chronic stress. So if we look at what chronic stress does to anyone, and, and here’s the bad thing and the good thing, burnout’s getting a lot of attention. Not just because of the healthcare effect, but because it’s affecting all industries and America in general is burnt out. So that helps too, right? But at the end of the day, when you have chronic stress that isn’t regulated, that isn’t being managed well from, you know, different angles, right? Maybe from your ability to cope more the workplace environment, you know, the organizational piece of it. So burnout is very related to chronic stress due to the, the, the, the system you’re working in, your work stressors, your documentation, your workload, you know, whether you’ve got bad leadership going on the hours that you’re not, you know, able to, to keep up compassion, fatigue and contrast is more of the burden that happens when you are caring for other people. 


And this makes us unique in healthcare, right? Because most of us that are clinicians and and caregivers, we’re kind of wired different . So we, we have this calling for various reasons and, and I could write a book on this and I might for various reasons we’re called to help people in need, right? And so what ends up happening is if we are not able to disconnect or have good boundaries and barriers that, that chronic suffering that we’re seeing, you know, and those of us that work in life and death situations that see, and sometimes it’s not even that you’re directly caring for someone maybe who’s critically ill. Maybe you’re exposed to all the stories. So vicarious traumatization is something that is now being studied deeply because whether you’re a healthcare provider, a first responder a police officer, for example, we’ve learned over the years that vicarious trauma, the trauma we’re taking in and absorbing through the pain and suffering of those that we are working around and with and caring for, it affects us. 


So in healthcare we have a double whammy effect. We have the burnout effect because the system is so burdened, right? Where we’re short staffed, we’re being asked to spend more than half our time. And that’s a big one. We don’t get to spend the time with the patients, which is what we signed up to do. We have this burden of all this other stuff. So you’ve got the workplace stuff and then you’ve got the, the, the human part of it. And then they come together and we have this double whammy effect. I wanna throw in one more term if I may, because if we have healthcare professionals listening, as I’m sure we do, we have a lot of cynicism around the whole burnout, compassion fatigue in some circles. Cuz they’re like, yeah, yeah, yeah. So a lot of, especially my physician colleagues, they like moral injury, to be thrown in there. 


Moral injury. Yeah. Because what happens is we’re put into this situation where we can’t provide care the way that it should be. We’re having to suffer through all of this, right? We don’t have enough time. And then we, so at the end of the day, I just wanna throw that in there too. Because when you’re, when you’re at odds with what your values are versus what you can do, what you have to work with and what the whole picture is people end up with, with that. So I hope I answered what you were asking because it is very convoluted now. The science and symptoms can overlap. So early on with burnout, we tend to see people getting really cynical, which can be confused with the gallow’s humor that sometimes we use just to kind of cope with job stress. So a lot of cynicism, disconnect. 


Disconnect with our job job performance starting to go down. And then when you look at compassion fatigue and burnout side by side, it overlaps. So again, the source is chronic stress and what does chronic stress do to us? It affects our physical health, our blood pressure might go up, we’re feeling crappy, we’re not sleeping good. That’s a big one. And then the mental health stuff comes into play where we start feeling the anxiety and the depression and maybe the rumination. You know, and I mentioned suicide because ultimately, yeah, it’s contributing to that. And there’s a 2019 I think study that was done right before Covid through JAMA that showed that nurses and and physicians have twice the suicide rate as you know, maybe the general population because of that. So yeah, that’s, that’s a lot. 

Erin Vallier (14:52): 

. That is a lot. Thank you for diving into that. And it does, it, it it’s a very complex problem. And I can see where a healthcare provider, especially cuz you guys are, are definitely wired differently. You’re more empathetic and empathetic. People have this ability to absorb other people’s energy and the demands on them. And if they don’t set healthy boundaries, it can really influence their health. And I was reading about the statistics of the impact on, on health and it’s crazy, it’s 63%. Like if you, if you’re burnout or if you have compassion fatigue, you are 63% more likely to take a sick day, sick day and 23% more likely to end up in the er. And I think this problem is somewhere around 190 billion a year problem for 

Lourdes Wiley (15:53): 

Employers at least. Yeah. 

Erin Vallier (15:55): 

Just for the morbidity and mortality in the healthcare cost. 

Lourdes Wiley (15:59): 

And that’s not counting the impact on our patients because here’s, here’s the cross, 

Erin Vallier (16:03): 

Let’s not forget about them. 

Lourdes Wiley (16:04): 

Back to why I’m so passionate about this. This is literally, this is gonna sound really extreme. It’s killing people, it’s killing the people trying to do the work maybe long term, you know, in different degrees if you look at it. But you decided great data on the morbidity, the mortality, and, and this is taking, you know, this is the human factor. There’s also the impact on, on the industry, right? And on the business side of it. But when you’ve got folks who are suffering from this burnt out, tired, overworked, all of this medication errors go up, patient outcomes decline patients know they’re not getting good care. You know, nobody’s happy with it, but I, I mean there’s no, and there’s no way for us to really measure hard data on how many people may be totally are affected. But it would be a very, very scary statistic. I think if we looked at the sides, right, of, of the health outcomes and the what’s happening on the caregiver side and then how it’s impacting patient patient outcomes and things of that nature. It’s, it’s, it’s not good. 

Erin Vallier (17:03): 

It’s scary 

Lourdes Wiley (17:05): 

And it was really bad before covid and a lot of the data that we’re looking at is actually pre covid. So imagine cuz we all know having thrown the last couple three years into the mix and what’s happened. Yeah. Life support for the system. 

Erin Vallier (17:21): 

I think if we look at the statistics next year when they’re able to analyze covid, it’s gonna be worse. And that paints a very gloomy picture to start us off. 

Lourdes Wiley (17:32): 

I know 

Erin Vallier (17:32): 

I want to talk about the solution here cuz you’ve been speaking out a lot about how change needs to happen on multiple levels, on the individual level, on the team level and the organizational level. Tell me how this looks like in practice. 

Lourdes Wiley (17:49): 

Well, I hate to disappoint, but I’m not here with the magic answers cuz I don’t have ’em. , the surgeon general doesn’t have ’em at National Academy of Medicine. sadly doesn’t have ’em. But here’s, here’s what I will tell you, Erin. I described this, this analogy of the system as a patient, right? That I saw declining and I’m describing my experience over 20 something years. So we have to be realistic and we, we have to understand that we’re not gonna fix this problem quickly, instantaneously, because we didn’t get here overnight. So, but the, the short term, you know what, what, what I believe and all of the, what I’ve been researching in this last year backs that up. We need a culture shift. We need to recreate the culture and that’s where those three levels come in. Because as individuals, as teams and as organizations. So even though we’re talking and like you said, this sounds really gloomy and ominous and impossible. Every single one of us actually everybody, even patients, it’s not even just us in the system. Cause as we mentioned, everybody’s gonna be a patient. Everybody needs healthcare. We need a complete paradigm shift and a complete culture shift. Because what we are experiencing and living in right now simply is not, is not working. 

Erin Vallier (19:01): 

Mm-Hmm . So what do you think are a few actionable items for the listeners to consider implementing? 

Lourdes Wiley (19:10): 

So I’m gonna guess that most of our audience is gonna be probably home health, you know, companies, leadership, clinicians. Here’s, here’s what I would recommend and what I’ve been recommending. Ask a lot of questions. Any of you who have any kind of coaching, training, background, experience, think like a coach and ask yourself the hard questions. What do I need to do as an individual because, and here’s where my cynical healthcare workers need to take a breath and dive in. Yes, it isn’t all about just you taking care of yourself and being healthy, I know, but we need you to do that. So as an individual, I’m responsible to ask myself, what can, if I choose to stay in, okay, what am I doing to care for myself so that I can do this? What boundaries am I setting? Am I choosing to work in a place? 


Because guess what, the number one reason people leave their positions, and this is, I pulled from the nursing management journal, I think it was done within the last couple of years. Toxic workplaces are still the number one reason people don’t stay. So what do I need to do to be healthy and be part of a more positive culture? And hey, I’ve got choices everybody. And that can be good because if I don’t need to stay in a toxic workplace and there’s no fix, am I choosing to work at organizations that are trying to do a good thing? Because then everybody’s gotta make those changes. Cause that’s where the nurses and the clinicians are gonna go. So your choice matters. So don’t be a victim and be stuck in an awful place that you’re not helping to fix. So start with yourself and then team. 


So no matter how small or how big your organization or your company is, we’re all part of some kind of, of team. Here’s what the research is showing quality, connection and leadership. How are we working on that team level? Are your leaders on the smaller scale, the bigger scale? What’s the leadership like? We know that people want management where they have the ability to have some choices and not be micromanaged. So what’s, what’s going on with the team and what can the team do for that cohesion? And especially in home health where it’s historically hard for us to find connection, cuz we’re out there a lot as as lone ranger clinicians. We need that for our mental health and our physical health, that connection. And then at the organization, that’s where the folks up top need to say, Hey, what are we doing this, what are we doing to make this a healthy place for people to wanna work? 


What assessments? So here’s another piece. All clinicians there are if you go to the National Academy of Medicine, just n am is our website. They have a huge compendium with all these free tools, the surgeon general’s report. I strongly encourage anybody listening in leadership to look up the Surgeon general’s advisory on building a thriving health workforce. The report that came out in May of this year, because there are tons of tools and recommendations and we have to find what works for the, the culture and the company and the place that we are at. So, sorry Erin, it’s a long answer. 

Erin Vallier (22:09): 

It’s a good answer. 

Lourdes Wiley (22:10): 

We have to get creative. We have to ask questions cuz you know what? Our solution in a maybe mid-size home health company is gonna be really different than a hospital system solution. And if we don’t start having the conversations and acknowledging, hey, we’re not okay, how can we be healthier? Taking the stigma out of mental health, out of what we need to do for ourselves, right? So start with the questions and build from there and, you know, reach out for resources, people that can help you through this. It’s not gonna be an easy fix, but we do have to take away the, hey, it’s just about you. It’s you can’t handle the stress. Okay, bye. Let’s get the next nurse, the next c n a and then the churn continues. Everybody loses money, everybody’s unhappy, the patients are getting crap care. So, lot of questions, 

Erin Vallier (22:55): 

Lot of questions. And a big important answer. So from an individual’s perspective, you ask yourself those hard questions, take your own responsibility, own your destiny. And then if you decide not to work in that toxic environment, I heard you say something important, which is basically choose a good leader to your investigation and make sure that leader has your best interest and your wellbeing at heart. And then take a step further if you’re looking for a better environment. And look at the organization and look for employee assistance programs and any other programs they might have in place to help people deal with stress. If I were to summarize in a few sentences, did I get it or am I missing a piece of that puzzle? 

Lourdes Wiley (23:41): 

You did amazing. Cause that’s a lot of information the sift through. And it’s funny, funny cuz you know, when I do talks and webinars and presentations, I’ve got little visuals about, you know, like the cycle, where to begin and all these angles different suggestions for for tools that can be used. I came across something really interesting last night kind of preparing for today. And I apologize, I don’t remember exactly where I pulled it from, but I thought this was great. So here’s a leadership suggestion if you’re gonna work on wellness. So listen, if you have a system problem, you know, your, your EMR isn’t working or something’s not working with your billing, you’re gonna approach it as a, you know, problem solving solution. You might get a consultant to help you, for example, or get, get creative. So what if you had a key performance indicator or a KPI somehow linked to the wellbeing of your workforce because it’s that vital. 


So maybe, maybe you decide to say, Hey, we’re going to use something like the professional quality of life inventory and we’re gonna see how we can improve our scores. Or, you know, it’s, it’s the beginning of the year. This is a fantastic time to start some workplace health challenges. Get people involved at every level, you know buddy buddy people up. That’s a big one that has been, been proven to help. But it just getting creative and finding out how can we also make it part of what we measure in terms of the health and the vitality and the success of our organization. Just like we measure our patient outcomes and our financial outcomes and our, you know, all of our other things. So it’s, it’s that important. 

Erin Vallier (25:10): 

It is important and it’s a little bit tricky when you’re trying to measure people’s emotions in their physical state, but there are technology tools out there that can help you do that. It can take into account like na, natural Language Processing and some other artificial intelligence tools to look at your notes like a nurse’s notes in your, in the house and habits on the emr. Are you filling out your notes? Are you completing your tasks? Are you clocking in late? Have you asked for more time off and produce that KPI that you just mentioned that says, Hey, this person might be at risk for churn or there might be something going on. So you, you brought in a a very important point that in order to address this problem, we might need to lean a little bit heavier on our technology partners to e even help us identify where the problem exists in the organization so that we can focus our energy there. And thinking more about the organization because this is the house. Like it’s, if I think on, on a level you’ve got the individual, then you’ve got their, their initial like manager and then you’ve got the organization itself. This is the one that, that has the most responsibility to make sure that there’s, there’s systems in place to deal with this. What recommendations do you have for these employers who might be looking to improve their workplace morale and make their organization a place where nurses and other caregivers really wanna be? 

Lourdes Wiley (26:39): 

And that’s a tough one cuz we’re at that place I think where everyone’s in survival mode and it seems like the answer is too much to reach for, it’s too costly, but I’m, I’m at the point where I think we can’t afford not to, to change things. And I love how you mentioned the, the technology. So to answer your question, what, what, what employees want and what nurses want. One is to feel valued, you know, and sometimes just that I think outreach of, hey, we’re gonna use our technology partner or hey, we have this company that’s already doing our, our our insurance, right? And our wellness and our e a p. So I mean, I’ve got one, I’ve got an app that reminds me to do like these wellness checks on myself, right? Stuff like that. So what are we doing to make people feel valued? 


And it’s not about the junk food and the donuts guys stop doing that. Nurses don’t need , no healthcare worker needs more sugar maybe, maybe something for healthy food, but what can help people care for themselves and feel valued. So they want flexibility. Easier said than done, right? How can we create a staffing situation? And I know, I know people are gonna roll their eyes at this where people can take their time off, you know, where they can have flexibility. And I have seen some companies get more creative about job sharing and different things, you know, where people can have that. Because as healthcare providers, we feel like we can’t ever take time off and sometimes the organization feels like they can’t afford us to take time off. So how can we get creative with maybe different from the classic structure? Oh, I I need a nurse, I need a case manager full-time. 


That’s it. That may not work anymore. So if we know nurses are still co you know, having to deal with like childcare stuff and family stuff from the covid time, they want flexibility, autonomy, they want to feel, you know, as I mentioned, valued they, they don’t want that toxic work environment. So if you can go into that high quality connection. So I, I’ll go, I get on my soapbox for a second about this. We, we laugh that we don’t have time for this, but we need it so much. And, and the surgeon general going back to him, it’s not even just in his report, he actually wrote a book on this because his two priorities, the same office that tells us that smoking is gonna kill us and stop doing that. Not only did he put out this advisory on the healthcare workforce, you know, situation, but also on isolation and loneliness and how that’s making us all sick. 


So if we feel isolated and lonely, even in our workplaces, how can we have those connections? So how can we take moments during meetings, you know, get creative again, ask those questions to get to know each other as people buddy up, have a combat buddy or a battle buddy. I think that’s a program that’s been real successful. So what can you do within the organization to make that culture feel more like community so that people want to work there because we’re all hungry for that connection and that support, but we don’t know how to ask for it. And Aaron, you mentioned how we’re wired different. I think I said that too. We are, if you let us, we’re gonna go try to fix and save everybody and get through. And so we also again have to go back to buying into that and you have to kind of reel people in sometimes into, hey, yes, we’re serious, let’s talk, let’s improve these high quality connections because that is the lifeblood of any organization succeeding and the people wanting to to be part of it. 

Erin Vallier (29:49): 

Those are all very good recommendations, very good recommendations. And I think you’re right, we are gonna have to lean more on technology to help facilitate some of these things. Mm-Hmm , there are some insightful apps that you can apply to your staff. Like you say you get your reminders to do a health check, but you know, just even more broadly, if if we are gonna continue to experience the shortage of nursing and other care workers, how can we leverage technology so that we’re still providing good care but we’re not burning out that case worker that that nurse. So I think this is, this is definitely gonna take a long time to solve, but 

Lourdes Wiley (30:30): 

It is. And notice I didn’t say my wait, I mean, okay, let me, let me backtrack. People want fair pay. So we do know that people want fair pay and that’s right. You know, and I think we’ve all heard the stories and have experienced how nurses will go to the high paying traveler jobs, which won’t be around forever. So yes, you have to pay competitively and you have to pay fair, but, but those sign-on bonuses are not retaining and keeping people. That isn’t the solution. At least not long term. And I know that that’s been the big thing is throw money at it and hopefully cuz we’re desperate. So yes, take care of your people financially. Of course we need that, especially now with inflation. However, that never comes up as the top thing people are looking for. It’s these softer things, if you will, that we’re discussing. So give that a lot of thought because you might save yourself a lot of money in some ways, right? Indeed. But it, it’s something to consider. Just the bonuses alone are not gonna fix this. 

Erin Vallier (31:25): 

Yeah. It’s more about the culture. I read some statistics a while back about employee churn and what makes people stay and one of the top things that made people stay wasn’t pay it was how does that company make them feel? Are they valued? Do they have the flexibility? Flexibility was a big thing, but are they recognized for their work? So just providing an environment where people can get a pat on the back and, you know, a good job and attaboy and I’m here for you. That goes a long way. 

Lourdes Wiley (31:58): 

Like we said, we’re wired different, so maybe in a different industry the money would help, I don’t know. But yeah, we thrive on feeling we’re we’re, we’re mission driven people working in an environment where we wanna make a difference, we wanna help people get better, we wanna help people not suffer. So we get our validation and our gratification from being able to work in an environment that isn’t gonna make us sick. Where we can do that. That’s kind of where the answer lies. And it’s complicated . But if we can, if we can keep track of that’s what makes people tick and that’s what’s needed, then asking ourselves those questions. Okay, great. Then what can we creatively do at our place, at our company, our organization with an our team to achieve more of that? 

Erin Vallier (32:46): 

Absolutely. And for our leadership, listening to this episode, be thinking about this as you are setting your 2023 business goals, be thinking about how you can implement a program or a culture change that is gonna make your workplace the best place to work. And you also mentioned along the way that, you know, when people are coming up against some of these challenges, they might reach out to a consultant to help. And I know that Amity Healthcare Services provides a number of different products and services that might be able to assist a company in implementing a program that will improve employee retention. So I have a final question for you is how can the listeners connect with you and learn more about this particular topic and the additional services that EMITY provides? 

Lourdes Wiley (33:41): 

So a couple things I’d like to, to suggest. Obviously you can reach out. We have our website, amityhealthcare My personal email address is lw@amityhealthcaregroup dot com. So go to our website, but I would love to invite you it, I have two free webinars on the ACHC University website that I put out this year. One is specific to what we’re talking about a lot today, the, the compassion fatigue and the burnout and, and the levels to look at that. So if you want more details and suggestions and data, it’s, it’s on there. You can download it. I did a second one on developing and leading resilient healthcare teams. That one I did a little bit. I’ve lost track of what happened this year, Erin. I think I did the first one in the spring and then the other one happened maybe October. 


But go to ACHC University. ACHCU, I know many of you are familiar with that, where you have all those free educational tools and the, it’s under the home health at the hospice webinars. Please listen to those and if anything at all resonates with you, my contact information is there. I invite you to please reach out to me if I can assist you in any way or even just offer support based on what you heard or answer questions. I, it is my passion to, to work with that. So please check out those two offerings. They’re free to you, they’re full of good information. And if we can go beyond that, here I am. 

Erin Vallier (35:09): 

Wonderful. Thank you so much for joining us today, Lourdes, and sharing your wisdom and your experience. Yeah, I think it’s gonna be really valuable for the listeners to, to hear more about this topic and some ideas for how they might be part of the solution. 

Lourdes Wiley (35:26): 

Thank you so much, Erin, for, for opening up the conversation and, and being part of the solution cuz every little bit matters, every single one of us. So this is, this is a way to do that. Thank you. 

Jeff Howell (35:36): 

Home Health 360 is presented by AlayaCare. First off, I want to thank our amazing guests and listeners. To get more episodes, you can go to, that’s spelled Home Health 360, or Search Home Health 360 on any of your favorite podcasting platforms. The easiest way to stay up to date on our new shows is to subscribe on Apple Podcasts, Spotify, or wherever you get your podcasts. We also have a newsletter you can sign up for on to get alerts for new shows and more valuable content from all care right into your inbox. Thanks for listening and we’ll see you next time. 


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Episode Description

As we enter 2023, it is an opportunity to consider a different approach to prevent caregiver burnout. The “solution” has historically been vaguely addressed as an individual responsibility rather than an organizational or systemic problem.

In this episode we welcomed RN Clinical Educator and Nurse Consultant, Lourdes Wiley, from Amity Healthcare Group LLC, who discussed ways home care agencies could shift the focus to healing the healers so that they, as well as the organizations and patients/clients they serve, can thrive collectively.

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