Managing Overworked Employees

Trying to accomplish singlehandedly all the work that used to be or should be done by two or three people would leave anyone feeling tired and stressed. Likewise, a sudden uptick in the number of patients who need attention can force any healthcare team into hyperdrive. Of course, such stressors can’t always be predicted, avoided, or eliminated. Circumstances can change quickly in healthcare, and you and your team may have to work extra hours or even days with little or no notice. Fortunately, most employees can manage the stress of overwork if it is rare, reasonable, and short-term.

However, a prolonged period of strenuous overwork is a different problem that requires a different management strategy. Such stress is particularly challenging when there is no end or relief in sight. Long-term and frequent overwork will cause most employee performance and morale to suffer. And, unfortunately, many employees won’t stick around for long in a never-ending stressful job; they will seek employment in a calmer healthcare organization where the hours, expectations, and work pace are more reasonable.

Certainly, it isn’t easy to manage a healthcare employee who is chronically overworked. Your team’s daily work performance and overall productivity will most likely decline. Tempers will be likely to flare, mistakes will be more commonplace, overtime costs typically will go through the roof, and the thought of returning to work on Monday morning will likely send you and everyone else into dread mode. Worst of all, your biggest management concern probably won’t be your staff but your patients, who expect and deserve only the best from you every day, regardless of your staffing shortages or work overages.

In the long run, a well-staffed team will allow everyone within your healthcare organization to do his or her best work. However, if that is not within your control, there is much more that you can do than to be sympathetic to your overworked employees’ plight or to cheer them on from the sidelines. Read on to learn what healthcare executives can do to improve chronic overworking for everyone, or at least to make the stress more manageable.

The Hidden Cost of a Chronically Overworked Employee

Mistakes, reduced productivity, and poor morale are often cited as the results of an overworked, understaffed team. However, Allen(1) suggests that there is one more cost that may not be as readily apparent: Your organization will miss huge opportunities for growth. A well-staffed healthcare organization allows its employees to do their best work; an overworked staff will not be as productive. As Allen explains, “When it comes to your workforce, doing ‘more with less’ will cost you more money after everything is said and done.”

There is quite a bit of research that supports Allen’s assertion that work overload may lead to decreased employee productivity. For example, Sullivan(2) cites a Stanford University study that found that employee output falls sharply after a 50-hour work week, and that it falls off a cliff after 55 hours. According to the Stanford study, an employee who puts in 70 hours in a week produces nothing more with those extra 15 hours. Longer hours have also been connected to higher rates of absenteeism and employee turnover, both of which are costly, Sullivan says.

When a healthcare organization begins to have productivity issues that impact its ability to manage existing workloads, it will not be able to grow and accept new opportunities. Rather, it will often revert to survival mode. In severe instances of understaffing and overwork, an organization puts itself at great disadvantage when compared with better-staffed competitors.

Poor Health Habits for the Overworked Employee

Chronically overworked employees are in danger of developing poor health habits that can have severe consequences for them and for your organization. Chief among these is sleep deprivation. As Basner(3) reports, a study at the University of Pennsylvania Perelman School of Medicine found that employees who said they slept six hours or less at night worked 1.5 hours more than others who got more sleep. As well, research by the Vickie Milazzo Institute(4) reports that overworked nurses often do not get adequate sleep. Of the more than 3,300 nurses surveyed by the Vickie Milazzo Institute in Houston, 64% said they rarely get seven to eight hours of sleep per night. As well, only 31% of survey participants said they get enough sleep just two to three nights a week. As Basner warns, “Sleep is a biological imperative. Undisturbed sleep of sufficient duration is essential for memory consolidation and for maintaining levels of alertness and cognitive performance required for safe and effective functioning. Insufficient sleep increases the likelihood of errors and accidents.” Basner also cautions that habitual short sleep duration is associated with serious negative health outcomes for the individual including obesity, diabetes, hypertension, cardio-metabolic risk factors and cardiovascular disease, declines in cognitive function, and all-cause mortality.

Moreover, overworked employees may be more likely to develop poor eating habits. The Vickie Milazzo Institute study indicates that even though nurses work in the health industry and know the importance of a healthy diet, 77% of those taking part in the University of Pennsylvania study said they regularly do not eat well. Eating poorly while overworking is easy to understand. Buying, preparing, and eating nutritious food takes time that many overworked employees do not have. Overworked employees may skip meals or choose the most convenient food options, which may not be the healthiest. As well, overworked employees may eat unhealthy comfort foods to cope with and assuage the stress they are feeling from overworking day in and day out.

What do these findings mean for the healthcare executive? First, it’s important for you to resist the temptation to reward your staff by bringing them sugary treats. That’s easy and fun to do, and a lot of people like it. However, your overworked employees need healthy food to fuel them for the extra work they’re doing, not more donuts and cookies. If you want to give your overworked staff a food reward, go for a treat of a veggie platter or fresh fruit. Or, spring for healthy salads for lunch. Second, assess when your employees are dangerously sleep deprived. Send severely sleep-deprived employees home when they are unable to work sufficiently. They will not do themselves or anyone else any good in the long run if they are driving themselves into the ground. As well, severely sleep-deprived employees are more accident and error prone, and pose a potential danger to themselves, to their coworkers, and to the patients they serve.

20 Strategies for Managing Chronically Overworked Employees

You may feel when your employees are chronically overworked that you are powerless to change the situation. Perhaps you’re right about the workload. However, there are many things that you can do to help your chronically overworked staff:

1. Increase the effectiveness of your communication. A time of chronic overwork is not the time to skip meetings to save time. In fact, you will usually need more opportunities for quality face-to-face communication with your team during times of chronic overwork than you will at other times. That’s because not meeting often will make overworked team members feel isolated or that you don’t care about them or their situation. Use regular meetings to keep your team focused on your healthcare organization’s goals and to acknowledge the positive results and efforts your employees make every day. Meet to quell fears, get your team energized, and help everyone to stay on track to support your long-term goals. No matter how challenging the work pace, employees will fare better working closely together as a team than they will alone. That requires good, regular communication.

2. Admit that you have a problem. A healthcare executive who doesn’t acknowledge when the team is chronically overworked will be perceived as uncaring or out of touch, or both. Tell your employees that you recognize the problem and that you are truly sorry that it is impacting them the way that it is. Mean it. Don’t minimize or sugarcoat the problem or try to sweep it under the rug. If the workload is massive, say so.

3. Personally work harder. Your staff will resent you if they perceive that they’re pushing themselves to their limits while management is sitting back and taking it easy. Boost your overworked employees’ morale by rolling up your sleeves and pitching in to help them. However, don’t try to fill in all the gaps yourself to spare them the overwork. That’s a sure recipe for failure. You’ll burn out, your reputation will suffer, and the work may not end up getting done the way it needs to be done anyway. Let your employees see you working harder to help them, but not to the point of exhaustion.

4. Develop and share your healthcare organization’s big-picture, long-term strategy. When things are bad, no one wants to hear that “it is what it is.” It will be much easier for your employees to endure the challenging overwork situation if they perceive it as temporary and limited. Figure out what you’re going to do to make things better for them, and if not now, when. Be realistic about costs and timeframes. Don’t promise what you can’t deliver, but share your organization’s real game plan with your employees.

5. Do something to improve the situation immediately, even if it is small and temporary. Can you hire a temporary employee to assist you, even one day a week? If not, can you hire out any of the duties usually performed by your employees until you can come up with a permanent solution? For example, would some additional hours from your cleaning service provide needed relief for your overworked staff?

6. Remember the little picture. Encourage your team to focus on immediate goals and results. Use their small milestones and successes to boost, reinforce, and energize them.

7. Be realistic. It may not be reasonable to expect to accomplish everything you’d like when your team is overworked. You may have to put some goals on the back burner or let them go entirely. According to Michelman,(5) ask yourself five questions to determine which of your goals are critical: What is the economic impact? Is your goal aligned with your bigger strategy? How will accomplishing the goal satisfy your stakeholders? What is the employee’s level of passion, talent, and energy for achieving the goal? Do you have the resources you need? Seek input from your boss and/or colleagues if you’re not sure how to reorganize priorities for your chronically overworked staff.

8. Be a servant leader. Do everything you can to support your employees and to make their jobs easier. For example, help them to establish priorities. Make sure they have the tools and supplies they need to do their jobs well. Clear as many obstacles from their path as you can. Listen to them when they have a problem completing their work on time. And ask your employees what you can do to help them.

9. Reward your overworked employees for their efforts. Your sincere recognition, praise, and gratitude can make a huge difference to an employee who is working full tilt. Small gestures such as treating your staff to lunch or giving each employee a modest gift card won’t change the workload. However, it can demonstrate your recognition of and appreciation for their hard work.

10. Thank your employees and their families. It’s important to recognize the stress of high workloads, both for employees and their families. According to Erb,(6) “Showing appreciation [to the families] tells employees their leader understands the stress of their situation, sees them as people not just workers, and helps gain support at home.”

11. Model good self-care. Crisis time in your healthcare organization is not the time to forego a healthy lifestyle. You will need good nutrition, exercise, and sleep to tackle the challenging circumstances in your work. You will also need the caring people in your life to remain active in your life, even if the time you have with them may be less than you’d like. Take care of yourself physically and emotionally during your overwork times and encourage your employees to do the same.

12. Assess the risks of an exhausted team. According to Kelley,(7) tired people are more likely to make mistakes, and drowsy people even more so. Kelley suggests that drowsy employees will also have slower reaction times, reduced vigilance, and deficits in information processing. Therefore, assess whether the financial benefits of running a lean, overworked staff are justified. In some cases, the risks you will take by continuing to do business as usual with an exhausted or burned-out team won’t be worth it.

13. Avoid platitudes. If you’re tempted to tell your chronically overworked employees to buck up or to do more with less, don’t. According to Sotis,(8) such a strategy almost always backfires. Team morale is likely to plummet, and your employees are likely to become less engaged in their work. Sotis warns that “disengaged employees will be the first to go” when the opportunity presents itself. Speak about your overwork crisis honestly, but without platitudes and clichés.

14. Identify the root cause of your chronic overwork problem. Do you have high employee turnover? Is your overwork problem caused by frequent absenteeism or tardiness? Or is your healthcare organization often inundated by emergencies and urgencies for which you’re not prepared? If so, your staff will be forced into overwork mode every time these problems crop up. In such cases, your most important management goal should be to resolve the problem, not to manage the understaffing and overwork fallout. Figure out what you need to do to stop the source of the chronic problem. If you don’t know how to do that, seek help. A consultant should be able to assess what’s going on and suggest strategies to correct the problem.

15. Working hard? Then play hard too. A fun team activity can go a long way to alleviating the stress caused by overwork. Look for something that you can all do together that is light and that leads to laughter. A night out at a comedy club may be just the thing you need to let off some steam and keep your team upbeat when they’re working so hard for your organization.

16. Avoid “everyone should be like me” thinking. As a healthcare executive, you probably aspired to that role and were willing to go the extra miles needed to get there. You may even enjoy a rather brisk or harried work pace. Perhaps deadlines and pressure motivate and energize you. There’s no doubt that adrenaline kicks in for some people when they are racing a deadline. However, Hill(9) warns that some leaders may unconsciously motivate their teams by creating a sense of drama. Sometimes that strategy can work, at least in the short run. However, not everyone finds this type of environment stimulating. And no one, not even the urgency addicts of the world, can operate successfully in an environment with unrealistic deadlines for extended periods of time without experiencing burnout. According to Hill, “We have to acknowledge and respect the fact that not all of our team members are — nor should they be — just like us. Each team member’s productivity is driven by individual focus and motivation.”

17. Encourage breaks. Employees need to take breaks throughout the day, even if they don’t recognize that need. And breaks at your desk don’t usually feel as refreshing as those that involve stepping away. As Vanderkam(10) suggests, “Show your team that it’s okay to get up from the desk for 20 minutes and take a real break. Some studies find breaks make people more productive anyway.”

18. Provide incentives. Moss(11) suggests that incentives may help overworked employees to stay focused. They will feel rewarded for their efforts when they work hard for and eventually earn them. The incentive does not have to be costly. According to Moss, “Just because your budget restricts you from giving monetary recognition doesn’t mean you can’t reward your staff for a job well done.”

19. Evaluate what’s working and what’s not. When your employees are overworked, they may not take the time they need to assess their work systems and processes. And as an overworked healthcare executive, you may not allow yourself the time you need to assess what’s going on, either. However, taking even 20 minutes to see how the team is functioning can help you identify new and better strategies that will improve the workflow. Ask your employees to tell you how they are spending their time. Together, try to identify repetitive tasks and needless steps that can be eliminated.

20. Use yes and no strategically. Avoid a mindless yes to new work that sends your team into a tailspin. Ask: Is this necessary? Can someone else do it? Can we do it later?

Take Care of Your Overworked Employees

There will be times when you have no choice but to ask your employees to continue to overwork. When this happens, Miller(12) suggests several effective strategies that can make your employees feel valued and comfortable while they are putting in those extra hours:

• Leave the lights on. Do what you can to keep the office vibrant, comfortable, and engaging when employees work late. For example, if you have lights and HVAC systems that go into energy-saving mode after hours, make sure the systems don’t shut down when employees stay late.

• Take steps to ensure employee safety. Make sure that your buildings and parking lots are well lit, that shrubs and trees are kept trimmed and to a minimum, and that building security guards are alerted when employees are on site after hours. If your healthcare organization is in the city, consider reimbursing employees for after-hours cab rides home to avoid late-night travel on foot or public transportation.

• Feed your employees. Nutritious food keeps energy levels high. It can also play an important role in motivating employees to work more effectively and to retain a positive view of your organization.

• Acknowledge and thank those who work late. Let them know that you appreciate the extra effort. Seek opportunities to offer public recognition in front of peers. Write letters of commendation for their personnel files.

• Remove the stress of personal chores. Along with overtime comes increased stress for employees trying to keep up with things at home. Look for ways to help your employees better meet work and life demands. For example, provide laundry service for uniforms or a gift card to a local car wash or meal delivery service.

• Reduce the amount of red tape for employees. You may be able to reduce overwork if you ensure that your employees’ time isn’t wasted on unnecessary paperwork and procedures. Look for ways to streamline your organization’s processes.

Teach These Strategies to Your Chronically Overworked Employees

Encourage your overworked employees to eat well and get plenty of rest when they are at home. In addition, Ashkenas(13) suggests the following coping strategies that you can teach to your chronically overworked employees:

• Reflect on your goals, both professional and personal. Think through the aspirations you have for your career and your life. What do you want to achieve? What are your priorities? What makes you feel fulfilled? Focus on your personal big picture. Keep that in mind when you’re asked to invest more effort and time in your work. You may have to delay gratification now. But what you’re doing today will impact where you’re going tomorrow.

• Talk about it at home. Discuss your goals and priorities with the people closest to you — your spouse, partner, friends, or children (if appropriate). Find out the extent to which their expectations match yours. Seek their support for your working harder. As Ashkenas warns, “Without this dialogue you run the risk of constantly disappointing each other.”

• Open a dialogue at work. Look for ways to redesign the work process so that you can manage your tasks better. Are there better and faster ways of doing things without sacrificing work quality?

• Don’t stay late just because you want to be perceived as a hard worker. As Sullivan warns, “Plenty of workers bring it [overwork] on themselves.” Do not become a work martyr. Don’t try to rack up unnecessary overtime hours. Stay when there is a legitimate work requirement. Otherwise, go home. As Ashkenas says, “Remember that if you don’t take conscious control of your own work hours, the work hours can easily take control of you.”

• Don’t develop a new normal. Once you begin regularly expanding your work hours, working “normal” hours starts to feel like you’re slacking off. As Ashkenas explains, “If you establish a pattern of staying late, your extended hours will become the new normal.” Overwork should be the exception, Ashkenas says, not the rule.

How to Tell Higher-Ups That Your Team Is Chronically Overworked

You may be reluctant to tell your boss that you’re experiencing an overwork problem. However, part of your job as a healthcare executive is to tell the truth to those who can do something about it, even when they don’t want to hear that truth. Chronic overwork may be your boss’s fault for expecting so much. But according to Corcodilos,(14) “It’s your fault for letting them think you can handle it.”

Corcodilos suggests that the simplest way to broach the subject is to say outright that the work you do in your organization requires more manpower. Outline the work that needs to be done, the rough cost of manpower to do it, and an estimate of the benefits of the work. Also describe the relationship between headcount and output. As Corcodilos explains, “Sixteen-hour days are not allowed.” As long as you are willing to accept more and more work, your healthcare organization will continue to heap it on your team. Your boss may not realize how stretched thin your employees are. Or she may have unrealistic expectations about the work or what they can accomplish in the time they have. It’s up to you to put her straight.

When speaking about chronic overwork, don’t tell your boss that you’re having a problem. Explain that you have the work organized and show your plan for doing it, including the requirements for additional staff. Don’t complain and don’t apologize for doing your job the right way. Just state the facts. It is your responsibility to explain what needs to be done to handle the work effectively. It is not your job, or your employees’ jobs, to work 16-hour days as a way of life, Corcodilos says. Paint a picture for your boss of a typical workweek for your overworked employees. She may not be aware of what your overworked employees have had to do to keep up with the workflow. Tell her what you feel may happen if the situation doesn’t improve.

Finally, keep in mind that your boss may be on your side. She may want to address the overwork problem in your organization but not know how to do it. Recognize the constraints she must work within. Then, when possible, offer your ideas about how systems and processes can be streamlined to reduce overwork. Also suggest ways to cut costs elsewhere to free up the funds needed to hire additional staff. Focus your discussion on finding a solution, not on complaining, tempting though that may be.

References

1. Allen D. 4 Hidden Costs of Being Understaffed. Snelling. December 31, 2012. www.snelling.com/2012/12/31/4-hidden-costs-of-being-understaffed .

2. Sullivan B. Memo to Work Martyrs: Long Hours Make You Less Productive. CNBC, January 26, 2015. www.cnbc.com/id/102363524# .

3. Basner M, Spaeth AM, Dinges DF. Sociodemographics and Waking Activities and Their Role in the Timing and Duration of Sleep. Sleep. 2014;37(12):1889–1906.

4. Vickie Milazzo Institute. Are You Way Too Stressed Out? Survey Results, 2014. Vickie Milazzo Institute. www.legalnurse.com/wp-content/uploads/2014/06/RN-Stress-Survey-Results-2014-VickieMilazzoInstitute.pdf .

5. Michelman P. Overworked and Understaffed: Now What? Harvard Business School Working Knowledge. July 14, 2003. http://hbswk.hbs.edu/item/3590.html .

6. Erb M. Do Your Employees Feel Overworked? Entrepreneur. October 4, 2010. www.entrepreneur.com/article/217386 .

7. Kelley D. Why Overworked Employees Are Security Risks. Security Intelligence. May 9, 2014. http://securityintelligence.com/security-risk-staffing-it-teams-overworked-employees/#.VL_1Gi4t6hw .

8. Sotis B. Overworked and Understaffed: Recession Erodes Employee Morale and Leaves Staffs Stretched Thin. Credit Union Magazine. April 1, 2011.

9. Hill S. Leaders: Is Your Team Overachieving or Simply Overworked? CARA.

10. Vanderkam L. 7 Ways to Keep Your Team from Feeling Overworked. Fast Company. July 29, 2014. www.fastcompany.com/3033596/the-future-of-work/7-way-to-keep-your-team-from-feeling-overworked .

11. Moss H. 8 Ways to Help Your Overworked Team. Govloop. October 1, 2014. www.govloop.com/8-ways-help-overworked-team .

12. Miller K. 5 Tips to Make Overworked Employees Feel Valued. Huffpost Live The Blog. July 25, 2014. www.huffingtonpost.com/karen-miller/5-tips-to-make-overworked_b_5614198.html .

13. Ashkenas R. Chronically Overworked? How to Cope. Huffpost Healthy Living. January 26, 2015. www.huffingtonpost.com/ron-ashkenas/should-you-stay-late-or-g_b_1022512.html .

14. Corcodilos N. How Do I Tell My Boss I’m Overworked? Ask the Headhunter. June 20, 2011. http://corcodilos.com/blog/3639/how-do-i-tell-my-boss-im-overworked .