Home News EPtalk by Dr. Jayne 9/15/22 – HIStalk

EPtalk by Dr. Jayne 9/15/22 – HIStalk

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A colleague recently asked me what I thought about “quiet quitting” and the attention that the concept has been getting recently in the mainstream media. There has been quite a bit of discussion around it in physician-specific social media groups, alongside discussion of burnout and the role of self-care in a post-COVID workplace.

Many workers in healthcare are still being asked to come in to work when they are sick, despite the fact that they have designated sick days allocated for such a thing. They are pressured that if they call off sick, they’ll be burdening their teammates. Others are told that they can only call off if they find a replacement, which really shouldn’t be the employee’s job.

By most definitions, quiet quitting is the idea that a worker only does what is required of them based on their job description. This means no extra work, no volunteering for additional projects, and in the case of many clinical workers, no picking up of extra shifts. Hospitals have been short staffed for years and the COVID pandemic only exacerbated a problem that was already there. During the first year, everyone was motivated by a sense of needing to pull together, to help humankind, and to be there for their co-workers, but after two and a half years in the grind with ever decreasing support and appreciation, people are simply done with it.

Hospitals (and medical practices, and other clinical organizations) have always had the ability to create safety nets for their workers. It’s easy to come up with excuses not to. I remember trying to implement a “float pool” for our medical group’s ambulatory practices more than a decade ago, similar to what hospitals had in place at the time. Staff could volunteer to be part of the pool on their days off and they would be paid a small amount to remain on call in the event they were needed to cover a shift. If they worked, they would receive their usual rate of pay. Instead, the group’s leadership balked at paying people “for doing nothing.” They failed to understand that it wasn’t about what the float pool member was doing, it was about what they were not doing on their day off in exchange for being on call.

The administrators decided instead to ask for people to volunteer to pick up extra shifts if there were shortages, and then if they had no takers, they offered various hourly incentives. Guess what? Staff learned not to pick up extra shifts until the incentives reached a certain level, which ultimately cost more than what someone would have been paid to be on call. Once a clinical staffing pool reaches a certain size, it’s a virtual guarantee that someone will be out sick on any given day, so the economics would have favored the float pool approach. Additionally, creating a float pool would have ensured people were ready to work on a given day rather than offices having to hope and pray that someone would volunteer, and then to cope with the scrambling that inevitably ensued when someone rolled in an hour or more after the practice opened.

These types of bad decisions have only been magnified in the last two years. Just look at travel nursing during COVID surges. A major driver behind that was the unwillingness of hospitals to appropriately compensate existing staff nurses. I had friends who quit their medical / surgical nursing jobs and then worked as “travel nurses” in a hospital less than five miles away for a significant salary bump. Hospitals went way over budget paying traveling and locum staff, when they could have avoided having those nurses quit if they addressed underlying drivers of low employee satisfaction. Those nurses who stayed put are now increasingly burned out and quiet quitting is the order of the day.

The other reality in our post-COVID world is that people’s priorities simply have changed. If they’re struggling with childcare, they’re not going to volunteer to work extra hours. Families with two wage earners where one has a significantly higher earning potential have redone the math and determined that it doesn’t make sense for both partners to work when there are children requiring care. People seem to be retaining some of the hobbies that they cultivated during the early days of the pandemic and want to ensure they’re spending time on activities that make them feel good and in which they find value.

It will be interesting to see how organizations respond to the shifts in productivity that will result from quiet quitting. Some high-profile companies have already signaled that they’ll just fire people, which doesn’t seem like the way to become employer of choice.

I had some travel this week, which always makes for good people watching. For the first time since spring of 2020, I actually had difficulty getting a space at my favorite airport parking garage. The airport was hopping, although many of the stores remain closed during peak times. I’ve learned to pack a lunch if I have any hopes of eating something that is healthy and convenient. I would estimate that 80% of the people waiting in the gate areas are on either laptops or phones, so I wonder what they would think about this study that looks at the relationship between chronic blue light exposure and accelerated aging.

Researchers at Oregon State University looked at the impact of such exposure on fruit flies. Where previous studies had looked at the consequences of light-related stress on retinal cells, newer studies have examined whether exposure to blue light caused reduced lifespan and degeneration of organs such as the brain. The authors looked at flies that were genetically altered to not have eyes, in an effort to study metabolism and cellular pathways. Some flies were kept in constant darkness and others in constant blue light, for varying durations. The authors noted that those kept in blue light for longer durations had changes in metabolism including impairments in cellular energy production. There was also neurodegeneration in the blue light group, with decreased levels of certain chemical transmitters in the brain.

The study found that if the impacted flies were placed in darkness, their lifespan could be brought back to normal. Reading the paper sent me straight back to my freshman year in college, where the fruit fly lab convinced me that I no longer wanted to be a biology major even though that was what pre-meds were expected to do. Even though I never want to see another diagram of a metabolic pathway, it was interesting to see how much research has evolved over the intervening years. The next step in research of this type would be to look at the impact of blue light on cultured human cells, which have similar metabolites.

Only time will tell the fullness of consequences that we’ll experience from prolonged screen time. I’m perfectly happy to spend my free minutes in the outdoors, reading an actual paper book, or doing some retro hobbies. I’m taking a stained-glass class next weekend, so we’ll have to see how that goes.

Do you have a pandemic hobby that you’ve kept? Leave a comment or email me.

Email Dr. Jayne.

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