By Gary Evans
Kathy Espinoza, MBA, MS, CPE, CIE, knows what she speaks — and she speaks a lot.
Retired from corporate work with decades of experience, Espinoza is a frequent speaker on work culture, including work-life balance, motivation and overcoming adversity, and the science of ergonomics in a variety of settings. Hospital Employee Health asked Espinoza to comment on the conditions healthcare workers are currently facing in the following interview, which has been edited for length and clarity.
HEH: One of your major themes is striking a balance between work and home. What are healthcare workers facing in this regard?
Espinoza: First, I think that healthcare workers are the hardest-working occupation I’ve ever dealt with, and I’ve worked with school districts, the state, and businesses. Those nurses who are on the [front line] work as hard as anybody I’ve seen. It’s because they sacrifice themselves. They’re very nurturing. They give everything they’ve got, so when COVID hit, they stepped up. That was a very long haul.
It was difficult to find balance with COVID because there was no remote work. If you are an active nurse, you’re on duty, you’re on the floor. That’s where I think the balance kind of got skewed. Post-COVID, though, I think that they’re finding a better balance, or they’re basically choosing a better balance.
HEH: You have talked before about how different generations have different approaches to work.
Espinoza: Boomers, we’re all about the money, and people know that. Nurses certainly do. Over time, as extra shifts become available, they are financially motivated. Now, when they put out [a notice] that ‘We have extra shifts with a $100 bonus for nurses,’ everybody knows if you just sit on it and wait, that bonus will get up to $800 or $1,000 to work that second shift.
Millennials and Gen Z are much more motivated by flexibility and work-life balance. That’s why we see so many going to the travel nurse [agencies] because it is a pretty good fit. There’s more money and more flexibility between assignments, and it gives you a balance.
HEH: When you talk about “self-care,” what are some things that you emphasize to healthcare workers?
Espinoza: I think one of the biggest things that everybody should realize is that we have a very difficult time recognizing when we are unbalanced. If you’re hobbling along with a broken leg, you’re off balance, and you know it. Women get hormonally unbalanced at certain times of the month, and they know that they’re off balance. But it’s hard for them to see when they are off balance with work. They are like the frog in a pot of water coming to boil, and they don’t realize it.
When you are working in a culture where everybody works to the Nth degree and they are all overstressed, they don’t even realize they’re in that pot of boiling water. That’s called nurse fatigue, and we see that. They’ll take it and work and take it until the day they say they are done. That’s nurse fatigue. That might be physical fatigue, compassion fatigue, or mental fatigue. What I tell people they have to do is develop the skills to recognize when they are becoming unbalanced. Your body will let you know when you’re unbalanced because you get sick more often.
HEH: You have talked about performing a self-assessment, using a 1 to 5 scale to calculate, for example, a nurse’s level of stress and burnout.
Espinoza: I ask workers where they are with [stress and burnout] on a scale of 1 to 5. If you’re at a 1 on this scale, you feel good. You still have your compassion and you’re smiling. If you’re at 2, you are at work but would rather be home. A 3 on the scale, you are agitated and bothered by interruptions. At stage 4, you’re stressed and you’re starting to disconnect. At stage 5, you’re not sleeping. You’re looking for comfort in food and alcohol and going down this big rabbit hole, and you resent it.
You’ve got to know when you are getting to stage 3 or 4. I’ve done so many lectures on this, and everybody in the audience is, “I’m at a 5.” They’ve got an adrenaline drip line going every day, and that is going to affect your health. These younger generations are going to take their lunch breaks. They’re motivated by the flexibility of being able to handle work and life, and that’s a good shift in healthcare that we’re seeing.
HEH: You mentioned on your website that you have successfully fought cancer. If you care to comment on this, do you share this experience in your motivational talks?
Espinoza: When I’m talking with people, I help them realize that stress is a perception. I ask them to put a number [from the 1-5 scale] on what’s happening right now. Then I ask, “What is your 10? Something you never want to live through again?” For me, it’s four cancers and two whole rounds of chemo. That’s my 10. I never want to do that again. For a lot of people, it’s a divorce, the death of a parent, or the death of a child.
Then, I go back to what they are currently dealing with and ask, “Are you treating this like it’s a 10? OK, you have four patients pinging you at the same time. It’s not cancer, it is not a divorce, it’s not the death of your child. Take it in stride, and then you can change your perception.” What cancer did for me, it made me realize that most things in life are ones or twos. They are not worth worrying about.
Kathy Espinoza, MBA, MS, CPE, CIE is a frequent speaker on work culture, including work-life balance, motivation and overcoming adversity, and the science of ergonomics in a variety of settings. Hospital Employee Health asked Espinoza to comment on the conditions healthcare workers are currently facing.
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