November 20, 2025 • 48 mins
We unpack burnout in physical therapy with new Nebraska data and lived stories, moving from clear definitions and risk factors to practical fixes for clinicians and leaders. The conversation closes with concrete resources, ongoing research, and an invitation to act together.
• Defining burnout across emotional exhaustion, depersonalization, and reduced accomplishment
• Nebraska study design, funding, and why the state focus matters
• Frequency of engagement vs burnout in PTs
• Demographics linked to risk, including early career and debt
• Workload, autonomy, and leadership support as primary drivers
• Cultural red flags like leaderboards and misaligned incentives
• Personal costs to health, empathy, and career decisions
• Individual strategies for sleep, exercise, nutrition, and boundaries
• Organizational actions: assess, listen, redesign metrics, protect flexibility
• Advocacy through APTA for reimbursement and regulation change
Don’t forget to subscribe, share, and join the discussion. Because together, we’re driving the future of physical therapy forward.
Episode Links:
The Emotional PPE Project https://emotionalppe.org/
988 Lifeline / National Suicide Prevention Website https://988lifeline.org/
A Multiple Methods Study to Describe the Manifestation of Burnout of NE Physical Therapists: https://digitalcommons.unmc.edu/etd/791/
Manuscript citation: Sleddens N, Beam E, Meyer KP, Stamler LL, LaFramboise LM, Sayles H, Wengel SP 2025 Examining the frequency, severity and associated factors of burnout in Nebraska physical therapists. Physiotherapy Theory and Practice [In Press] https://doi.org/10.1080/09593985.2025.2571795.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_02 (00:01):
Welcome to the APTA Nebraska Podcast, where we dive
into the stories, challenges,and innovations shaping physical
therapy in our state.
We're here to advance, promote,and protect the practice of
physical therapy, optimizing thehealth and quality of life for
all Nebraskans.
Join us as we connect withexperts, share insights, and
(00:22):
build community throughout ourprofession.
Welcome back to the APTANebraska podcast.
My name is Brad Dexter, yourhost, and today I'm joined by
Nikki Sleddens.
Hi, Nikki.
Hi Brad.
So Nikki has been around for alittle while in the PTA
profession, and it may be afamiliar name to some of you.
From 2009 to 2015, Nikki, youwere at SEC as part of the PTA
(00:46):
program, correct?
Right.
Yes.
And probably had a lot of PTAstudents going out to a number
of clinics there.
And in 2015 you transitioned tofaculty at UNMC, where you've
been the director of clinicaleducation for the last decade,
correct?
Correct.
SPEAKER_01 (01:05):
Yes.
SPEAKER_02 (01:05):
Yes.
You were telling me earlier KyleMeyer still holds a record for
longest tenured director ofclinical education, correct?
SPEAKER_01 (01:14):
Yes, he's very proud of that.
And um, I think he's 14 years,maybe 15.
SPEAKER_02 (01:21):
Okay.
SPEAKER_01 (01:21):
So I'm getting up to almost 11 now in January.
So I'm I'm coming for him.
SPEAKER_02 (01:28):
So you're aiming for at least 16, minimum of 16,
right?
SPEAKER_01 (01:32):
I mean, it's looking that way, right?
SPEAKER_02 (01:35):
Then you can hold it over him after that.
SPEAKER_01 (01:37):
That's right.
That's right.
SPEAKER_02 (01:39):
So while Nikki's the director of clinical education,
she wears a number of other hatsas well.
You're also the associateprogram director for the PT
program and an associateprofessor within the college,
too.
SPEAKER_01 (01:52):
Yes.
SPEAKER_02 (01:54):
So, and that that comes with a number of different
roles.
Uh, before we jump into ourcontent today, though, you
brought up that you lovetortilla chips.
Any kind of tortilla chips,doesn't matter what it is.
SPEAKER_01 (02:06):
Nope.
No, they can be the cheapest bagfrom the grocery store, they can
be the delicious homemadetortilla chips at a restaurant,
not picky, they can be plain,they can have seasoning on them.
Does not matter.
SPEAKER_02 (02:22):
So tortilla tortilla chips that are maybe like a
little bit thicker with you knowlightly salted, where where does
that rank for you?
SPEAKER_01 (02:30):
Um I mean it's still a tortilla chip.
So I would say if I was if I ifI was given the option, it's
always gonna be more the thinnertortilla chip, but if you know,
if the thicker, lightly saltedis what you've got, then I'm in
for that too.
SPEAKER_02 (02:50):
Yeah, I'm I'm a fan, I'm a fan of the thinner, salted
lime, you know, has that limeflavor to it.
That's that's up there for me.
SPEAKER_01 (02:59):
But yeah, lime, queso, paprika, it it and chilli
powder, any of the other yeah.
SPEAKER_02 (03:07):
It's just that's great.
SPEAKER_01 (03:08):
Kind of a problem.
But as I mentioned, I can I canpass on the ice cream, just not
the tortilla chips.
SPEAKER_02 (03:14):
That's right.
Do you and is it just straighttortilla chips, or do you have
to have like guac or salsa orsomething to go with it?
Either or.
SPEAKER_01 (03:24):
I mean, I can't play, but I do love all of the
things that you just mentionedas well.
Along with embarrassingly, pumpcheese.
Pump cheese?
I also like pump cheese.
Yep.
SPEAKER_02 (03:39):
Okay.
SPEAKER_01 (03:39):
Well that goes back to my 7-Eleven days.
SPEAKER_02 (03:43):
Did you work at 7-Eleven?
SPEAKER_01 (03:45):
No, we just went there.
SPEAKER_02 (03:46):
You just went to 7-Eleven.
Got a fountain soda and somepump cheese.
Slurpee.
SPEAKER_01 (03:51):
Yep.
Yep.
You didn't know this about me,Brad, did you?
SPEAKER_02 (03:55):
I did not know this about you, but I I love little,
you know, snippets ofconversation like this that are
fun.
Okay, so we did not, we did notput a podcast together today to
talk about pump cheese ortortilla chips.
We sure didn't.
Or or even Nikki's accolades,right?
Though I I think we shouldhighlight more that you're
you're going to be passing KyleMeyer at some point as a
(04:18):
director of clinical education.
We'll we'll make sure wehighlight that.
Put it in the title orsomething.
Yes.
Well, what I actually wanted totalk to you about was burnout.
Um, burnout specifically withinthe physical therapy profession.
And you know, this is this hasbeen a topic for a number of
years now.
I think the pandemic probablyhighlighted it more within
(04:41):
healthcare professions, maybephysical therapy too, but I'm
not the expert on this.
You are, which is why I'm gonnastart asking you the questions.
So can you just start to tell usa little bit more about your
background uh in regards towanting to dive into burnout
within the physical therapyprofession?
What led you to that?
SPEAKER_01 (05:03):
Yeah, so really the what got me there was really
deciding to pursue my PhD, whichI mean, if you had said that I
was ever gonna do that, I wouldhave told you you were crazy.
But in a like 2016, I startedtaking some graduate classes to
work towards my PhD and theneventually settled on, yep, this
(05:23):
is what I'm gonna do.
So I obviously had to come upwith a topic for my
dissertation.
And really, as my role inclinical education, you know, I
frequently, you know, talking toclinicians and DPT students that
are out in the clinicalenvironment.
And I just was struck by, youknow, the discussions about the
(05:47):
different caseloads that thatthey were describing and the
productivity standards.
Um and then also just being aclinician out in the field for,
you know, working full-time for15 plus years.
I kind of, while back then,maybe there wasn't necessarily a
name to burnout, or I certainly,you know, maybe experienced some
(06:12):
of that myself and certainly sawit in some of my colleagues.
So kind of landed on this topicof burnout just through through
pursuing a PhD.
So that became my the topic thatI decided was going to be my
focus.
And when I dug into theliterature a little bit, just
found that there was atespecially at that point.
So this would have been in maybe20 um 17, 18, there was really
(06:38):
just not much out there relatedto PT, um, especially PT in the
United States and in kind of thecurrent environment.
There were just a few studiesthat were out there at that
time.
Now there's been a lot moreresearch since then, but at that
time, most of the work had beendone in the late 90s, early
2000s.
(06:59):
So there was definitely a needthat I had identified for
additional research in thatarea.
SPEAKER_02 (07:05):
Excellent.
So did you, I guess as you werelooking into some of the older
research that was out there, Ithink you ended up settling on
wanting to focus or yeah, focusyour research more on PTs in
Nebraska, not necessarilynationwide, but I'm I'm assuming
you you needed to trim thatpopulation a little bit more for
your research.
(07:26):
And yeah, I would just love tohear how you process through
some of that.
SPEAKER_01 (07:30):
Yeah.
So as I started on the theprocess for, you know, exploring
burnout in the profession andand pursuing my PhD, you know,
you have your supervisorycommittee.
And fortunately, my committeewas wonderful and they really
challenged me to, they called itfinding my pee, right?
So, you know, you you have thesegrand ideas about what you're
(07:54):
gonna do, but at the end of theday, you know, the best
dissertation is a donedissertation.
So they said you need to findyour pee.
You need to pair this down.
And so, what better populationto study than my own colleagues
in the state of Nebraska to findout how, you know, those that
are that I'm directly workingwith or that, you know, my
(08:15):
students are working with, whatis our, how are we doing in the
state of Nebraska?
And so that's really how Ilanded on Nebraska.
Also, my committee, you know, weassumed that I would probably
have a better chance of gettingthe recruitment numbers that I
needed, just because, you know,I I do know a lot of the PTs
(08:36):
practicing in Nebraska.
And so when that email camethrough to recruit for my study,
it would be a familiar name.
And so more likely to click onthat link.
So that's really how I landed onNebraska.
And then I was very fortunatebecause studies cost money.
So I wanted to do a study whereI collected some quantitative
(08:56):
data using the MASLOC burnoutinventory, and there's a cost to
utilizing that assessment tool.
I also wanted to be able tofollow up with some interviews,
and I wanted to be able to, youknow, compensate those
individuals for spending timeparticipating in my interviews
and then just, you know, costslike a statistician to help and
(09:21):
you know, data analysissoftware.
So I was very fortunate that Iwas able to receive the George
Blanton research grant throughthe Nebraska Foundation for
Physical Therapy, um, also somesupport from the UNMC physical
therapy program, but that'sreally what allowed me to do a
study of this nature.
So very fortunate in that.
SPEAKER_02 (09:41):
You know, just having previous conversations
with you, I think this projectis just kind of unique in a
sense in those ways too.
And not to be a Nebraska homer,but I am, you know, you you're
thinking about putting studentsout into clinics in, you know,
in the state of Nebraska.
You're thinking about yourcolleagues in the state of
Nebraska.
You're supported, Nikki, andyou've given back in a lot of
(10:03):
ways to the association, theNebraska APTA, right, over the
years too.
And and then this is also fundedand supported by the BLAM grant
through the Nebraska Foundationfor Physical Therapist.
So I just I kind of think that'sfun.
It's unique.
You know, this is a study aboutPTs in Nebraska, for PTs in
(10:24):
Nebraska, by a PT in Nebraska.
SPEAKER_01 (10:26):
We'll probably get into this later, but I'm doing
some additional research aroundthis area with some colleagues
from Colorado.
As part of that, we're kind ofdoing a larger study, but it
still includes Nebraska PTs.
And they're always like, oh mygosh, how how do you get these
Nebraska people to participatelike this?
(10:47):
So it's pretty impressive forour state that we really are
willing to take time andcontribute to science.
SPEAKER_02 (10:55):
I love it.
All right.
Well, let's let's kind of diveinto some of the nitty-gritty
then.
You've given us a greatbackground for how you got
there, but help us help help theaudience understand what is
burnout.
When we talk about that, whatare what are some of the
symptoms?
How do they affect a person'sprofessional and personal life?
SPEAKER_01 (11:14):
Yeah, so you know, we we hear the term burnout, I
think, thrown around a lot.
Yeah.
But really, when you're, youknow, I draw upon the definition
that's by Masloc and Leader, whohave really been some of the
pioneers just in in burnoutresearch in general, and who
ended up developing the Maslocburnout inventory.
(11:36):
But really, burnout is is threedimensions, and it's defined by
experiencing high emotionalexhaustion, high
depersonalization, and lowpersonal accomplishment.
And where emotional exhaustionis really just feeling exhausted
and overextended, specificallyby one's work.
(11:56):
Um, depersonalization is youjust have an impersonal response
towards one's the recipient ofone's service or care.
So you just don't feel thatconnection anymore towards your
patients or clients.
And then personal accomplishmentis really just that achievement
in one's work.
And so those are really thethree key dimensions that define
(12:20):
burnout.
And burnout is is really reallyhas some detrimental effects to
it.
So, you know, they theliterature shows that it it
results in fatigue,irritability, you can have
musculoskeletal issues.
They've talked about increasedabsenteeism, job
dissatisfaction, an increasedintent to leave.
(12:42):
They have also found thatproviders who have it that are
experiencing burnout have ahigher risk of substance abuse.
And really, most concernconcerning it they can
experience suicidal ideation.
So really can have some prettynegative effects on the provider
themselves.
But in addition to that, burnoutalso can impact um a decline in
(13:06):
patient care.
So there's statistics abouttwice the odds of unsafe care
when care is provided by aprovider experiencing burnout.
And by unsafe care, thatincludes adverse events, medical
errors, and a higher mortality.
And then they've also found animpact of burnout is an increase
(13:26):
in health care costs.
So all things that are reallypretty significant.
SPEAKER_02 (13:31):
So you you did a great job of really kind of
defining what burnout actuallyis, but I want to come back to
the the point where you said,you know, burnout can be used
pretty loosely uh these days.
Again, you said high emotionalexhaustion, depersonalization,
like giving impersonal responsesand a lack of personal
(13:52):
accomplishment are kind of thethree main domains that would
describe burnout.
Does a person need to have allthree of those to have burnout?
Is it just one of them?
Like what is, you know, becauseI I think there's a difference
between maybe being tired orhaving a season where you're
just a little bit more worn out,as opposed to getting to a point
(14:12):
where all three of these aremaybe hitting at the same time.
So can you just talk to us alittle bit more about that
concept?
SPEAKER_01 (14:18):
Yeah, so I mean, really by definition, to be
burned out, you would beexperiencing all three of those
dimensions.
The high emotional exhaustion,the high depersonalization, and
the low sense of personalaccomplishment.
Now, the one thing that we foundin PTs, in in my research as
(14:39):
well as some of the previousliterature, is a lot of PTs, if
you're if you're looking at, youhave to pick one dimension,
right, where PTs are mostimpacted, it would be emotional
exhaustion.
So you see a lot of PTs withthat high emotional exhaustion,
less so into thedepersonalization or the low
(14:59):
sense of personalaccomplishment.
PTs tend to do a pretty good jobof, even though maybe they're
experiencing this emotionalexhaustion, of still maintaining
that empathy and that connectionwith patients and still feeling
really good about the work thatthey do and feeling that it's
(15:20):
meaningful and there is a senseof accomplishment.
But eventually, you know,there's different models of the
development or the sequence ofburnout that show that many
times emotional exhaustion cansort of be the first dimension
that individuals experience.
SPEAKER_02 (15:39):
Okay.
SPEAKER_01 (15:40):
And then you kind of progress into deep low de or
high depersonalization and lowpersonal accomplishment.
Okay.
So there's just some differentmodels out there, theories out
there about the development ofburnout, but one that in my
opinion seems to fit PT a littlebit or is consistent with PT is
that the first really dimensionthat's impacted for us is
(16:02):
emotional exhaustion.
SPEAKER_02 (16:04):
Okay.
And now I'm I'm assuming as youtalk to PTs around Nebraska,
that was that was something thatcame out often.
SPEAKER_01 (16:12):
Yeah.
In my study, the the first phaseor aim of the study was really
just kind of a quantitative A.
And so we really looked at usingthe Maslowc burnout inventory,
actually assessing the frequencyand severity of burnout.
So that was kind of the firstpiece.
And and the MASLAC burnoutinventory is is the tool that we
(16:33):
utilize to um to accomplishthat.
And you know, what we found on apositive note, really, was half
of the sample, so about 55% ofthe sample was considered
engaged.
And engaged by definition on theMASLAC burnout inventory is
(16:55):
really opposite a burnout.
So it's a low emotionalexhaustion, low
depersonalization, high personalaccomplishment.
And 50% of our sample wasengaged.
So that's fantastic.
The not so fantastic piece of itis the other half, about 45%,
were experiencing at least onecomponent of burnout.
(17:18):
So they either had highemotional exhaustion, high
depersonalization, or lowpersonal accomplishment.
22% were in that high emotionalexhaustion phase, showing that
if PTs are only experiencing onedimension or PTs in Nebraska,
it's it's most likely going tobe emotional exhaustion.
(17:39):
When we talked about thatdefinition of, you know,
burnout, where it's all three ofthose dimensions, you know, 10%
of our sample in Nebraska wasexperiencing burnout.
SPEAKER_02 (17:48):
Were there any other elements from your research that
were surprising to you as youlooked into it?
SPEAKER_01 (17:53):
I would say as far as the frequency, it wasn't
really surprising.
There's some, you know, the theone thing that I found in the
burnout literature and PT isit's it's really still
relatively new in the currentenvironment.
So if we're not looking back at1995 or 2001, if we're you know,
(18:15):
we're if we're kind of lookingsort of 2015 and beyond, it's
one of the things that we foundis hard because it is new, is
there's so many different toolsthat are not so many different,
but people use different tools.
And so in making comparisonsbetween, you know, what I found
(18:37):
for for my frequency andseverity versus maybe what
another study found, we're notnecessarily comparing apples to
apples.
So they might have utilized acompletely different tool, or
they might have defined burnouta little bit differently.
So, you know, there was a 2015dissertation by Ellen Zambo
(19:02):
Anderson, and and she used theMASLAC burnout inventory and
used the same, you know,definition of burnout.
And according to that, you know,PTs in Nebraska were at a higher
level than her national sample.
SPEAKER_00 (19:19):
Okay.
SPEAKER_01 (19:20):
That was also in 2015.
Um certainly things, you know,changed pretty significantly
over, you know, my data wascollected in 2021.
That timing could have impactedthose scores.
Something happened in 2020.
SPEAKER_00 (19:40):
Yeah.
SPEAKER_01 (19:40):
Just yeah, just a little thing called COVID.
But so if I wouldn't sayanything was surprising.
And then if you even look atsome of the studies, like more
recent, more recently publishedstudies that were done during a
similar time period, 2021, 2022,the burnout rates are not
significantly different.
SPEAKER_02 (20:01):
Okay.
SPEAKER_01 (20:02):
From Nebraska PTs to some of the other populations
that were studying.
SPEAKER_02 (20:06):
Okay.
Interesting.
What what about any findings,trends along the lines of
demographics?
So are we talking in your insome of your own research, are
we talking, you know, more menthan women, women than men,
urban versus rural, younger PT,middle career PT, older PT?
Like what talk to us a littlebit about that.
Who's out there?
SPEAKER_01 (20:26):
Yeah, probably one of the the more, I would say,
significant findings in in termsof if we're just looking
strictly at demographics.
If you're looking atdemographics, you're really
looking at, and and these werenot necessarily, so let me back
up.
So when I when I looked atassociations, I looked at, you
(20:48):
know, was it associated withwith burnout, all three
dimensions, or was were therecertain factors that were
associated with like oneparticular demographic or work
environment characteristic?
So interestingly, the onlysociodemographic factor that was
associated with all threedimensions of burnout was the
(21:13):
presence of children,specifically that they didn't
have children.
So individuals without children,that was statistically
associated with burnout.
Then if you just look at some ofthe factors that were associated
with one dimension of burnout,and so this then starts to, I
think, tell a little bit of astory, but younger therapists
(21:34):
was associated with at least onedimension of burnout.
Male physical therapists hadhigher levels of
depersonalization than femaletherapists.
There was also a positiveassociation between
depersonalization and studentloan debt.
So higher debt equaled higherdepersonalization.
And then single participantsalso displayed higher levels of
(21:58):
depersonalization.
All of that to say it seems likeif you're looking at
individuals, you know, who don'thave children, they would
typically be younger, notmarried.
Those younger therapists likelyhave more student loan debt
because they would havegraduated more recently.
(22:19):
And so really a lot of the datawas really looking at, you know,
kind of this earlier careertherapists we're seeing tend to
have more association withburnout than mid-career or later
therapists.
SPEAKER_02 (22:35):
Okay.
SPEAKER_01 (22:36):
In in my particular population.
SPEAKER_02 (22:38):
Right, Nikki, I think some of that information
is really helpful just thinkingabout the the you know
sociodemographic aspects.
Primarily that the main thingwas the presence of children.
You know, those that didn't havechildren were more associated
with burnout.
Um what about like workplace orthe culture within the
(22:58):
workplace?
Is there anything within thoseenvironments that you picked up
on within your research?
SPEAKER_01 (23:05):
Yeah, so as I said, you know, when you're looking at
those sociodemographiccharacteristics, there's just
the just the one that wasassociated with all three
dimensions.
And then there were, you know,the few others that I mentioned
that were sort of the one-offs,right?
That were associated with atleast one factor.
But really the the biggestimpact, or I guess the the
(23:27):
factors that were most likely toinfluence burnout or most
associated with burnout werework-related work environment
characteristics.
Um, and so this was things likethe workload being manageable,
feeling supported by yoursupervisor, supported by your
coworkers, provided autonomy,provided flexibility in your
(23:52):
work schedule and time off,working in a place where you
felt your judgment was valued.
And then also being confidentthat you felt like your employer
would do what was right if in inyou know ethical type of
situations.
And then certainly, as we havealready mentioned, COVID-19 was
(24:12):
also associated with burnout.
SPEAKER_02 (24:15):
Can you, okay, so kind of the sociodemographic
factors, the workplace factors,can you speak maybe more
specifically about our NebraskaPTs?
What's the effect this is havingon PTs from Nebraska?
SPEAKER_01 (24:28):
Right.
So, so as part of the study, youknow, we did this survey and
then I interviewed individualswho were in the burnout
category, and then also thosethat were in the overextended
category or the emotionally highemotional exhaustion category,
just knowing that that was alarge piece of the population.
And we talked about a lot ofthese, we talked about these
(24:50):
factors, you know, like yes, Ihad this quantitative data that,
you know, told me these thingswere statistically associated,
but like what did that mean?
Right?
What did that mean for for themindividually?
And so what really came out insome of those interviews was
that there are some intrinsicfactors, right?
There's just there are somefactors, uh, individual factors
(25:14):
that seem to place you at riskfor burnout, according to to
some of the interviews Icompleted.
And and some of those things arelike just having really, really
high personal standards andbeing a perfectionist.
Um, it was very clear that thatthose individuals that I was
interviewing that were burnedout were perfectionists.
(25:36):
And so that was a pretty, prettycommon theme.
They also had a hard timeestablishing boundaries just
between their personal life andwork.
Some of them were dealing withsome just personal stressors in
their life, maybe an illness inthe family, a chronic illness in
the family.
And then the other piece thatwas interesting was, and this I
(25:57):
would say this was aninteresting piece of it, is
related to just like thisdisparity between what they
thought their career was goingto be and what the practical
realities of the professionwere.
So those were some of thoseintrinsic factors that were
explored in the interviews.
And then one of the other thingswas very consistent with my
quantitative data in regards toworkloads.
(26:17):
So just unrealistic productivitybenchmarks, which gave rise to
ethical dilemmas, talking aboutnot having autonomy for making
patient care decisions.
And then some also mentionedjust the workload and the
emotional and taxing nature ofthe job was a concern for many.
They also talked about theimpact of the work environment
(26:40):
in terms of culture.
So working in a culture that wasprioritizing the number of
patients seen versus the qualityof care provided or a workplace
environment that lacked a senseof psychological safety or
promoting a feeling ofcommunity.
There were participants thatspoke of having leaderboards in
(27:01):
their workplaces and fosteringthis sense of competition
amongst colleagues to who hadthe best productivity for that
day.
(27:22):
So not feeling respected bypatients or employers or other
healthcare providers orinsurance companies or regular
regulatory bodies just notadequately valid valuing
physical therapy.
So I thought that was reallyjust digging into some of those
factors outside of you know justthat strict quantitative data
(27:44):
was really interesting.
And then moving on with that, wewe dug into so so what?
Yeah, you know, so what?
And so, you know, you know, likeI had mentioned previously, the
literature was like, oh, there'syou know, substance abuse and
and you know, mood disorders,and you know, some of those
(28:04):
things are the impact ofburnout.
And so when I actually spoke totherapists in our state, it was
the the the impact is reallyquite significant of burnout on
individuals.
So, first just personal healthissues, so very consistent with
some of that previousliterature, but they had a a
range of of health challengesthat they spoke about, both
(28:26):
physical and and physicalillnesses as well as mental
health issues.
Um they found themselvesneglecting self-care routines,
so just not sleeping, notexercising, not prioritizing
nutrition, things like that.
Really, sadly, one participantexpressed to me that burnout had
(28:46):
taken such a toll on them thatthey really had gotten to the
point where they no longer had apurpose to live.
You know, that's in PT, right?
Like you hear about that in inmedicine, and but this was a PT.
And then very consistent withdespersonalization, they they
would just express how they justreally did not care anymore.
They did not care uh about theirpatients anymore, did not have
(29:12):
that empathy anymore, struggledto find empathy, and that
resulted in them just kind ofgoing through their motions in
designing treatment sessions,you know, no creativity, no
thought for for how they canmake sessions better, and just
not developing those meaningfulconnections that are so
important in PT.
And then finally, a lot of themultimately either left their
(29:35):
positions, their currentpositions, or they reduced their
work hours.
And unfortunately, many of themwere looking at pursuing career
changes, which is reallyunfortunate.
And so the toll of burnout is isquite significant.
SPEAKER_02 (29:50):
Yeah.
Yeah, I so question for you onthose lines, Nikki.
I I know like we we are not justlinear, you know, in in our
nature as people.
There are a lot of differentthings that are impacting our
lives and how we see the world,right?
For example, like we weunderstand that what can happen
(30:10):
in our personal lives can bleedover into work, and what can
happen in the workplace canbleed over into our personal
lives.
It's it's hard to just strike abalance there or to just
compartmentalize, right?
But how much how much of this ismaybe just the workplace versus
the profession?
You you talked about each ofthose things.
(30:31):
So my question is, you know,I've I've seen a lot of PTs that
are just thriving and love whatthey do and the connection that
they have to the people thatthey're working with.
Um is it the case that, hey,maybe if it if something's going
wrong in the workplace or you'refeeling at least one of these
dimensions of burnout, is it theprofession or is it more likely
(30:53):
the workplace?
And it just might be a cue thatmight need to step out of that
place that you're at and andlook elsewhere.
Is that right?
SPEAKER_01 (31:02):
So, you know, while the the impact was certainly
significant, at the end of theday, you have to remember 55%
were engaged.
So 55% were not experiencing anydimension of burnout.
And and so really were thriving,right?
And so we have to keep that inmind.
(31:22):
So I think there's definitely,you know, this organizational
piece, right?
So there's definitely the pieceand of how your facility is
managed, what type of leadershipyou have, the relationship with
your coworkers, howdocumentation is managed, how
productivity standards aremanaged.
(31:43):
So that's definitely a piece ofthat.
But then we have to look at whatis driving some of that.
So what's driving these very,very high productivity standards
or driving this need for all ofthis documentation, you know,
that goes to a higher level.
And so certainly there's there'ssome clinics, some hospitals,
(32:06):
some facilities that are areable to manage this more
effectively, I would say, atleast for preventing burnout.
But there's also just thislarger issue just with maybe not
the profession, but the societalview of the profession and how,
(32:26):
you know, kind of what roadwe're going down in terms of
being able to provide servicesand how we're reimbursed and
things of that nature.
That it's just multifactorial,really.
There's, you know, I I certainlysaw there, you know, one of my
themes for qualitative wasindividual, right?
There were some individualfactors for sure.
But then there's a just kind ofthis workplace piece, but then
(32:48):
there's just also that bigger,broader societal piece.
So, you know, it's it's notsomething that's just easily
solved.
Let's say that.
SPEAKER_02 (32:58):
Okay.
Well, that's a that's a goodjumping off point because we've
been talking about a lot of theproblems.
We've been talking about howburnout impacts us.
Uh, but let's turn our attentionto, okay, so now what?
So yes, yes, this is here.
And you know, it's not justphysical therapy, it's not just
healthcare professions, like,you know, people experience this
(33:22):
across the board.
Um, we just happen to be zoomingin on this because listen,
you've done some research,that's great, and it fits our
profession really well.
So let's name that.
So, but let's let's turn ourattention to not just like
what's going wrong, but how dowe be a part of the solution?
What kinds of things can we doto prevent this from happening?
How do we build resilience inourselves?
(33:45):
So, can you just maybe talk tothose things, right?
Are there are there strategiesor habits that in our profession
as physical therapists we canstart to adopt to protect
ourselves from burnout?
SPEAKER_01 (33:57):
Yeah.
So, you know, obviously we knowit's this multifactorial
problem, but there's stillsomething to say for just
generally taking care ofyourself.
I mean, we know that exercise,sleep, nutrition, stress
management, setting boundaries,right?
(34:17):
Do you does a does a patientneed your cell phone number so
they can contact you at allhours?
Right.
So there's also that piece of ofsetting some of those
boundaries, being willing to sayno, which I think is hard for
PTs in general.
And so, you know, there'sthere's certainly a piece of
that on an individual level.
(34:39):
You know, I also think goingback to just some of those, uh,
you know, that strong sense ofjust this uh perfectionism and
these very, very high personalstandards, you know, can we can
we be okay with just being okay?
That seems like an easier saidthan done, but certainly
(34:59):
something to think about ifyou're if you're in, if you're
if you are feeling burned out,right?
That something that maybe thatneeds some work.
But then from an organizationalstandpoint, you know, there's
it's kind of and I mean it's anold older article now, but there
is an article in 2016 by ShanaFelton Noseworthy, and there
kind of have been some bigresearches in medicine, and they
(35:23):
have an article that where theyprovide like nine organizational
strategies, you know, to helpaddress burnout.
And they really talk about, youknow, step one is just
acknowledge it and assess it.
So at your organizations, assessit.
And if you're if you find thatthere's a problem, acknowledge
(35:44):
that there's a problem and becurious about exploring it,
right?
And and talking to your peopleand and finding out what some of
those challenges are.
SPEAKER_02 (35:51):
You have to be willing to have the conversation
about it.
SPEAKER_01 (35:54):
Right.
Okay.
Right.
Kind of step one.
SPEAKER_02 (35:57):
Yeah.
SPEAKER_01 (35:57):
But and then they, you know, talked about just
having good leaders.
And so do your leaders haveleadership training and and are
you holding your leadersaccountable?
You know, that's that camethrough loud and clear in my
sample, you know, feelingsupported by your supervisor.
And I think that goes back totoo, just being willing to
(36:19):
listen and have thoseconversations with your
employees.
They also talked about um if youfind, you know, if you are
assessing and you haveconversations, then target your
interventions based on yourassessment.
Seems like that would make sensethat, you know, if you identify
(36:40):
the problem and then you targetthe interventions, just like
what we do every day as PTs,right?
It's not one size fits all.
And so don't just throw, youknow, throw what you think might
work.
You know, really individualizeor cater those interventions to
what you're finding in yourparticular facility or work work
unit.
Okay.
(37:00):
Cultivating teamwork andcommunity.
So, you know, I mentioned, youknow, people talking about
having these leaderboards.
I mean, what a way to not fostercommunity.
Teamwork, yeah.
SPEAKER_02 (37:14):
Right.
Pitting one another against eachother.
SPEAKER_01 (37:18):
Yeah.
And then you, and then, youknow, then you're adding on to
that.
Here you have these individualswho are already perfectionists,
right?
And then you're telling themthat they were number 10 out of
the 10 people on productivityyesterday.
I mean, talk about settingpeople up for failure.
SPEAKER_02 (37:33):
Yeah.
There, there's there's aninteresting concept there of,
you know, I've I've heard thisput before, keep the main thing
the main thing, right?
If if our if our patients andtheir care, their outcomes is
supposed to be the main thing,how do we make that the main
thing?
Now, don't get me wrong, thebusiness aspect is really
important.
And we have certainly we have tomake money, right?
For sure.
(37:54):
Yes.
But if that becomes the mainthing that is going to influence
culture and it has atrickle-down effect, right?
SPEAKER_01 (38:02):
Well, Brad, it sounds like you should have
written this article becausereally that speaks to the next
two things that they reallytalked about, which were using
rewards and incentives wisely.
So do is productivity what weshould be rewarding?
Um, and then also check in andsee are you are you actually
(38:22):
having individuals practiceaccording to your values and
mission at your facility?
SPEAKER_00 (38:27):
Yeah.
SPEAKER_01 (38:28):
Everyone has a mission statement, right?
And so are you is thatconsistent?
And so checking in with that andand and checking in with your
employees, right?
SPEAKER_00 (38:40):
Yeah.
SPEAKER_01 (38:41):
And then uh one of the other strategies they talk
about is promoting flexibilityand work-life integration.
So, you know, we one of thethings that I mentioned even in
our in my own in the NebraskaPTs was related to having some
flexibility in your workplace.
Can you allow people to tailortheir hours?
You know, does everybody have towork between eight and five or
(39:05):
seven and six?
Like, is there some flexibilityin that?
Um, can can you give people timeoff to go, you know, take a
chunk of time in the afternoonto go to their kids' event?
Are you allowing them theability to take their vacation
time?
So looking at those practices.
And then certainly promotingself-care.
(39:27):
So, you know, providing thoserisk those those resources.
And I think institutions aregetting, you know, that's that's
been probably the easiest thingfor most to do is is providing
some sort of, you know, we'regonna do yoga or you know, do a
potluck or something like that,which are all really good
things, can't be the only thing,but they are good things to do.
SPEAKER_02 (39:51):
Well that's how potlucks differ, you know,
they're they can be all wideranging, right?
That's right.
SPEAKER_01 (39:58):
That's right.
And maybe it needs to be new andgood nutrition, really getting
tapped to it.
But so there's definitely thingsthat can happen.
And then, you know, the otherpiece I think is, you know, here
we are doing a podcast for APTin Nebraska, but is you know, we
have to be involved in ourprofession.
We are a large group.
PTs and PTAs are a large group,and we can have a big voice, but
(40:22):
it has to be a collective voice.
And so if we really want to knowhow we were saying, you know,
what's driving these highproductivity standards, well,
reimbursement for one, right?
So that's a a larger issue thatrequires changes at a much
higher level.
And so I would just encouragepeople to to also make sure that
(40:45):
they're staying involved intheir in the APTA, in our
professional organization, wherewe can have a collective, a
collective voice.
SPEAKER_02 (40:53):
Uh hey, putting on my membership committee hat real
quick.
Thank you for the intro, Nikki.
Uh absolutely, right?
We're we're we're going to we'regoing to make more happen if we
have a collective voice.
There's also a sense ofcommunity there, right?
If you feel isolated, you feelalone, you feel like you can't
do something about a particularissue, that's why our
(41:14):
organization exists.
But it can't, it cannot be anorganization that relies on
eight people to do the work,right?
We we have, I don't know thenumber.
How many thousands of PTs do wehave in our state?
NPT?
Twenty five hundred thereabouts.
Right?
Yeah.
I should know that number, but Idon't.
Um that's that's a large group.
(41:36):
That's a large voice.
And uh again, we can do thattogether, but it it does, it
does, it does take some smallsacrifices, whether that's
paying your membership, just andjust doing that faithfully on a
on a regular basis, or gettinginvolved at different levels,
getting involved in a committee,even just in an ad hoc way,
(41:58):
someone that is involved saying,Hey, if you ever need anything,
let me know what you need.
I can't be involved at thislevel right now because of X, Y,
and Z.
But let me know if you needsomething, I'd be happy to try
to pitch in where I can, right?
Those things are so valuable.
Okay.
SPEAKER_01 (42:12):
I I agree.
So I'm I think it's reallyimportant.
And I think that's when whenwe're talking about addressing
the issue, that is one of theways that we're gonna be able to
do that.
SPEAKER_02 (42:23):
Yeah.
It is interesting talking tosome uh individuals that are
probably moving, you know,toward retirement within our
profession in the next fewyears, and just to hear them
talk about the the way that thePT community would have looked
30 years ago, right?
And the connections that youmaybe had with one another.
And technology has changed someof that, right?
(42:46):
You can connect in ways like weare right now over Zoom.
People, you know, maybe evenlead a different type of
busyness within their livesright now and and or are
connected in different ways toother organizations, and it's
not as much connected to thestate, it's more regional or
even national in some ways.
So I realize those things areare different and things have
(43:08):
changed, but uh it's also okayto hopefully reinforce we we
need this community, we need tohave a collective voice.
That's how we're gonna getthings done from a legislative
standpoint.
And with that, I'm I'm gonnadrop off the membership
committee hat and I'm gonna askyou one last question here,
Nikki.
(43:28):
This has been great.
I really appreciate your time.
I appreciate the thought thatyou put into this, and I really
hope that it's helpful to manyof our listeners, whether they
can share it with somebody elseor it's helpful to them in
particular.
But, you know, if you could giveeven just one piece of advice to
any of our listeners, fellowPTs, PTAs that might be
(43:49):
struggling with burnout, whatwould it be?
SPEAKER_01 (43:51):
Get help and don't be too proud.
And there's, you know, therethere might be resources through
your institution, you know,employee assistance programs,
things of that nature.
You might be able to get supportfrom your leadership or your
coworkers.
Um, if you're not able to dothat, I'm just gonna throw out
if if any of this, you know, aswe were talking about those
(44:14):
dimensions of burnout, or, youknow, when I was describing what
some of those individuals wereexperiencing, if any of that was
resonating with you, please makesure that you get help because
it won't just go away.
So if you don't have thoseresources at your facility or or
you know, within your realm,there's there's a great
(44:35):
organization.
It's called Emotional PPE, andit's just emotional PPE.org.
And there's volunteer counselorsspecifically for healthcare
providers who are experiencingburnout.
So something you could possiblyseek through there.
And there are local providers onthat website.
And then certainly, if you're tothe point of despair, that I
(44:58):
certainly that one of the myparticipants had certainly
experienced, there's theNational Suicide Prevention
Hotline, 1-800-273-talk, or theNational Suicide Prevention
website.
So my biggest piece of advicewould just be that it's real,
um, and it has real impact onyour own well-being as well as
(45:20):
the care that you might beproviding to your patients.
And so it's it's not somethingto take lightly.
And and so getting the help thatyou need, and and maybe you've
got to look at some changes interms of you know what's gonna
be a good fit for you.
That's good.
SPEAKER_02 (45:36):
The last thing for you if a podcast wasn't enough
for some of our listeners andthey want to know a little bit
more about the work that you'vedone, they want to learn a
little bit more, how can theyhow can they get access to some
of the information that you'resharing?
SPEAKER_01 (45:53):
Yeah, so I I just had the the manuscript, the
quantitative manuscript has justbeen published in physiotherapy
theory and practice.
So you would be able to read thethe full article through that.
I'm hoping to get thequalitative, or at least maybe
for sure, at least one of thequalitative manuscripts
(46:14):
published as well.
So stay tuned.
My dissertation will bepublished on UNMC Digital
Commons after December 6th.
So my full dissertation would beavailable there, which has lots
of, you know, pretty extensiveliterature review, things like
that for some of those differentresources.
Um, and then I'm still involvedin in research related to this
(46:38):
topic.
So some colleagues of mine fromUniversity of Colorado are
looking at both engaged andburnout because we're we also
want to see if we can find outmaybe what that secret sauce is,
right?
So, you know, we've kind oflooked at what are some of the
things that are influencingburnout, but on the flip side,
what are some of the things thatare influencing engagement and
(46:59):
how can we really, you know,grab hold of that and and
promote that?
SPEAKER_02 (47:04):
That's great.
That's great.
Well, we'll make sure that weget your dissertation linked,
you know, if anyone needs alight read at some point.
SPEAKER_01 (47:13):
Very short.
SPEAKER_02 (47:14):
Yes, we'll make sure we get that linked in the show
notes.
And I know you've you've shareda couple other resources
throughout the time too thatwe'll try to get linked into the
show notes.
If if anyone is interested uh inin uh partnering or maybe even
being like a subject for some ofyour research, is it okay for
them to reach out to you?
(47:34):
Absolutely, for sure.
Okay, absolutely, would love it.
Fantastic.
Nikki, thanks again for theconversation.
Appreciate you joining thepodcast and and also you know a
belated thank you because you'vedone a lot of work within TA
Nebraska as well in the past.
And so thank you for the waysthat you have served in that
way.
SPEAKER_01 (47:52):
Of course.
Enjoy it at all.
SPEAKER_02 (47:54):
All right, listeners, hopefully this was
helpful to you and look forwardto getting any feedback and
sharing our next podcast withyou as well.
Thanks for tuning in to the APTANebraska podcast.
Stay connected with us for moreconversations that elevate our
profession and improve the livesof Nebraskans.
Don't forget to subscribe,share, and join the discussion.
(48:17):
Because together, we're drivingthe future of physical therapy
forward.
Welcome to the APTA Nebraska Podcast, where we dive
into the stories, challenges,and innovations shaping physical
therapy in our state.
We're here to advance, promote,and protect the practice of
physical therapy, optimizing thehealth and quality of life for
all Nebraskans.
Join us as we connect withexperts, share insights, and
(00:22):
build community throughout ourprofession.
Welcome back to the APTANebraska podcast.
My name is Brad Dexter, yourhost, and today I'm joined by
Nikki Sleddens.
Hi, Nikki.
Hi Brad.
So Nikki has been around for alittle while in the PTA
profession, and it may be afamiliar name to some of you.
From 2009 to 2015, Nikki, youwere at SEC as part of the PTA
(00:46):
program, correct?
Right.
Yes.
And probably had a lot of PTAstudents going out to a number
of clinics there.
And in 2015 you transitioned tofaculty at UNMC, where you've
been the director of clinicaleducation for the last decade,
correct?
Correct.
SPEAKER_01 (01:05):
Yes.
SPEAKER_02 (01:05):
Yes.
You were telling me earlier KyleMeyer still holds a record for
longest tenured director ofclinical education, correct?
SPEAKER_01 (01:14):
Yes, he's very proud of that.
And um, I think he's 14 years,maybe 15.
SPEAKER_02 (01:21):
Okay.
SPEAKER_01 (01:21):
So I'm getting up to almost 11 now in January.
So I'm I'm coming for him.
SPEAKER_02 (01:28):
So you're aiming for at least 16, minimum of 16,
right?
SPEAKER_01 (01:32):
I mean, it's looking that way, right?
SPEAKER_02 (01:35):
Then you can hold it over him after that.
SPEAKER_01 (01:37):
That's right.
That's right.
SPEAKER_02 (01:39):
So while Nikki's the director of clinical education,
she wears a number of other hatsas well.
You're also the associateprogram director for the PT
program and an associateprofessor within the college,
too.
SPEAKER_01 (01:52):
Yes.
SPEAKER_02 (01:54):
So, and that that comes with a number of different
roles.
Uh, before we jump into ourcontent today, though, you
brought up that you lovetortilla chips.
Any kind of tortilla chips,doesn't matter what it is.
SPEAKER_01 (02:06):
Nope.
No, they can be the cheapest bagfrom the grocery store, they can
be the delicious homemadetortilla chips at a restaurant,
not picky, they can be plain,they can have seasoning on them.
Does not matter.
SPEAKER_02 (02:22):
So tortilla tortilla chips that are maybe like a
little bit thicker with you knowlightly salted, where where does
that rank for you?
SPEAKER_01 (02:30):
Um I mean it's still a tortilla chip.
So I would say if I was if I ifI was given the option, it's
always gonna be more the thinnertortilla chip, but if you know,
if the thicker, lightly saltedis what you've got, then I'm in
for that too.
SPEAKER_02 (02:50):
Yeah, I'm I'm a fan, I'm a fan of the thinner, salted
lime, you know, has that limeflavor to it.
That's that's up there for me.
SPEAKER_01 (02:59):
But yeah, lime, queso, paprika, it it and chilli
powder, any of the other yeah.
SPEAKER_02 (03:07):
It's just that's great.
SPEAKER_01 (03:08):
Kind of a problem.
But as I mentioned, I can I canpass on the ice cream, just not
the tortilla chips.
SPEAKER_02 (03:14):
That's right.
Do you and is it just straighttortilla chips, or do you have
to have like guac or salsa orsomething to go with it?
Either or.
SPEAKER_01 (03:24):
I mean, I can't play, but I do love all of the
things that you just mentionedas well.
Along with embarrassingly, pumpcheese.
Pump cheese?
I also like pump cheese.
Yep.
SPEAKER_02 (03:39):
Okay.
SPEAKER_01 (03:39):
Well that goes back to my 7-Eleven days.
SPEAKER_02 (03:43):
Did you work at 7-Eleven?
SPEAKER_01 (03:45):
No, we just went there.
SPEAKER_02 (03:46):
You just went to 7-Eleven.
Got a fountain soda and somepump cheese.
Slurpee.
SPEAKER_01 (03:51):
Yep.
Yep.
You didn't know this about me,Brad, did you?
SPEAKER_02 (03:55):
I did not know this about you, but I I love little,
you know, snippets ofconversation like this that are
fun.
Okay, so we did not, we did notput a podcast together today to
talk about pump cheese ortortilla chips.
We sure didn't.
Or or even Nikki's accolades,right?
Though I I think we shouldhighlight more that you're
you're going to be passing KyleMeyer at some point as a
(04:18):
director of clinical education.
We'll we'll make sure wehighlight that.
Put it in the title orsomething.
Yes.
Well, what I actually wanted totalk to you about was burnout.
Um, burnout specifically withinthe physical therapy profession.
And you know, this is this hasbeen a topic for a number of
years now.
I think the pandemic probablyhighlighted it more within
(04:41):
healthcare professions, maybephysical therapy too, but I'm
not the expert on this.
You are, which is why I'm gonnastart asking you the questions.
So can you just start to tell usa little bit more about your
background uh in regards towanting to dive into burnout
within the physical therapyprofession?
What led you to that?
SPEAKER_01 (05:03):
Yeah, so really the what got me there was really
deciding to pursue my PhD, whichI mean, if you had said that I
was ever gonna do that, I wouldhave told you you were crazy.
But in a like 2016, I startedtaking some graduate classes to
work towards my PhD and theneventually settled on, yep, this
(05:23):
is what I'm gonna do.
So I obviously had to come upwith a topic for my
dissertation.
And really, as my role inclinical education, you know, I
frequently, you know, talking toclinicians and DPT students that
are out in the clinicalenvironment.
And I just was struck by, youknow, the discussions about the
(05:47):
different caseloads that thatthey were describing and the
productivity standards.
Um and then also just being aclinician out in the field for,
you know, working full-time for15 plus years.
I kind of, while back then,maybe there wasn't necessarily a
name to burnout, or I certainly,you know, maybe experienced some
(06:12):
of that myself and certainly sawit in some of my colleagues.
So kind of landed on this topicof burnout just through through
pursuing a PhD.
So that became my the topic thatI decided was going to be my
focus.
And when I dug into theliterature a little bit, just
found that there was atespecially at that point.
So this would have been in maybe20 um 17, 18, there was really
(06:38):
just not much out there relatedto PT, um, especially PT in the
United States and in kind of thecurrent environment.
There were just a few studiesthat were out there at that
time.
Now there's been a lot moreresearch since then, but at that
time, most of the work had beendone in the late 90s, early
2000s.
(06:59):
So there was definitely a needthat I had identified for
additional research in thatarea.
SPEAKER_02 (07:05):
Excellent.
So did you, I guess as you werelooking into some of the older
research that was out there, Ithink you ended up settling on
wanting to focus or yeah, focusyour research more on PTs in
Nebraska, not necessarilynationwide, but I'm I'm assuming
you you needed to trim thatpopulation a little bit more for
your research.
(07:26):
And yeah, I would just love tohear how you process through
some of that.
SPEAKER_01 (07:30):
Yeah.
So as I started on the theprocess for, you know, exploring
burnout in the profession andand pursuing my PhD, you know,
you have your supervisorycommittee.
And fortunately, my committeewas wonderful and they really
challenged me to, they called itfinding my pee, right?
So, you know, you you have thesegrand ideas about what you're
(07:54):
gonna do, but at the end of theday, you know, the best
dissertation is a donedissertation.
So they said you need to findyour pee.
You need to pair this down.
And so, what better populationto study than my own colleagues
in the state of Nebraska to findout how, you know, those that
are that I'm directly workingwith or that, you know, my
(08:15):
students are working with, whatis our, how are we doing in the
state of Nebraska?
And so that's really how Ilanded on Nebraska.
Also, my committee, you know, weassumed that I would probably
have a better chance of gettingthe recruitment numbers that I
needed, just because, you know,I I do know a lot of the PTs
(08:36):
practicing in Nebraska.
And so when that email camethrough to recruit for my study,
it would be a familiar name.
And so more likely to click onthat link.
So that's really how I landed onNebraska.
And then I was very fortunatebecause studies cost money.
So I wanted to do a study whereI collected some quantitative
(08:56):
data using the MASLOC burnoutinventory, and there's a cost to
utilizing that assessment tool.
I also wanted to be able tofollow up with some interviews,
and I wanted to be able to, youknow, compensate those
individuals for spending timeparticipating in my interviews
and then just, you know, costslike a statistician to help and
(09:21):
you know, data analysissoftware.
So I was very fortunate that Iwas able to receive the George
Blanton research grant throughthe Nebraska Foundation for
Physical Therapy, um, also somesupport from the UNMC physical
therapy program, but that'sreally what allowed me to do a
study of this nature.
So very fortunate in that.
SPEAKER_02 (09:41):
You know, just having previous conversations
with you, I think this projectis just kind of unique in a
sense in those ways too.
And not to be a Nebraska homer,but I am, you know, you you're
thinking about putting studentsout into clinics in, you know,
in the state of Nebraska.
You're thinking about yourcolleagues in the state of
Nebraska.
You're supported, Nikki, andyou've given back in a lot of
(10:03):
ways to the association, theNebraska APTA, right, over the
years too.
And and then this is also fundedand supported by the BLAM grant
through the Nebraska Foundationfor Physical Therapist.
So I just I kind of think that'sfun.
It's unique.
You know, this is a study aboutPTs in Nebraska, for PTs in
(10:24):
Nebraska, by a PT in Nebraska.
SPEAKER_01 (10:26):
We'll probably get into this later, but I'm doing
some additional research aroundthis area with some colleagues
from Colorado.
As part of that, we're kind ofdoing a larger study, but it
still includes Nebraska PTs.
And they're always like, oh mygosh, how how do you get these
Nebraska people to participatelike this?
(10:47):
So it's pretty impressive forour state that we really are
willing to take time andcontribute to science.
SPEAKER_02 (10:55):
I love it.
All right.
Well, let's let's kind of diveinto some of the nitty-gritty
then.
You've given us a greatbackground for how you got
there, but help us help help theaudience understand what is
burnout.
When we talk about that, whatare what are some of the
symptoms?
How do they affect a person'sprofessional and personal life?
SPEAKER_01 (11:14):
Yeah, so you know, we we hear the term burnout, I
think, thrown around a lot.
Yeah.
But really, when you're, youknow, I draw upon the definition
that's by Masloc and Leader, whohave really been some of the
pioneers just in in burnoutresearch in general, and who
ended up developing the Maslocburnout inventory.
(11:36):
But really, burnout is is threedimensions, and it's defined by
experiencing high emotionalexhaustion, high
depersonalization, and lowpersonal accomplishment.
And where emotional exhaustionis really just feeling exhausted
and overextended, specificallyby one's work.
(11:56):
Um, depersonalization is youjust have an impersonal response
towards one's the recipient ofone's service or care.
So you just don't feel thatconnection anymore towards your
patients or clients.
And then personal accomplishmentis really just that achievement
in one's work.
And so those are really thethree key dimensions that define
(12:20):
burnout.
And burnout is is really reallyhas some detrimental effects to
it.
So, you know, they theliterature shows that it it
results in fatigue,irritability, you can have
musculoskeletal issues.
They've talked about increasedabsenteeism, job
dissatisfaction, an increasedintent to leave.
(12:42):
They have also found thatproviders who have it that are
experiencing burnout have ahigher risk of substance abuse.
And really, most concernconcerning it they can
experience suicidal ideation.
So really can have some prettynegative effects on the provider
themselves.
But in addition to that, burnoutalso can impact um a decline in
(13:06):
patient care.
So there's statistics abouttwice the odds of unsafe care
when care is provided by aprovider experiencing burnout.
And by unsafe care, thatincludes adverse events, medical
errors, and a higher mortality.
And then they've also found animpact of burnout is an increase
(13:26):
in health care costs.
So all things that are reallypretty significant.
SPEAKER_02 (13:31):
So you you did a great job of really kind of
defining what burnout actuallyis, but I want to come back to
the the point where you said,you know, burnout can be used
pretty loosely uh these days.
Again, you said high emotionalexhaustion, depersonalization,
like giving impersonal responsesand a lack of personal
(13:52):
accomplishment are kind of thethree main domains that would
describe burnout.
Does a person need to have allthree of those to have burnout?
Is it just one of them?
Like what is, you know, becauseI I think there's a difference
between maybe being tired orhaving a season where you're
just a little bit more worn out,as opposed to getting to a point
(14:12):
where all three of these aremaybe hitting at the same time.
So can you just talk to us alittle bit more about that
concept?
SPEAKER_01 (14:18):
Yeah, so I mean, really by definition, to be
burned out, you would beexperiencing all three of those
dimensions.
The high emotional exhaustion,the high depersonalization, and
the low sense of personalaccomplishment.
Now, the one thing that we foundin PTs, in in my research as
(14:39):
well as some of the previousliterature, is a lot of PTs, if
you're if you're looking at, youhave to pick one dimension,
right, where PTs are mostimpacted, it would be emotional
exhaustion.
So you see a lot of PTs withthat high emotional exhaustion,
less so into thedepersonalization or the low
(14:59):
sense of personalaccomplishment.
PTs tend to do a pretty good jobof, even though maybe they're
experiencing this emotionalexhaustion, of still maintaining
that empathy and that connectionwith patients and still feeling
really good about the work thatthey do and feeling that it's
(15:20):
meaningful and there is a senseof accomplishment.
But eventually, you know,there's different models of the
development or the sequence ofburnout that show that many
times emotional exhaustion cansort of be the first dimension
that individuals experience.
SPEAKER_02 (15:39):
Okay.
SPEAKER_01 (15:40):
And then you kind of progress into deep low de or
high depersonalization and lowpersonal accomplishment.
Okay.
So there's just some differentmodels out there, theories out
there about the development ofburnout, but one that in my
opinion seems to fit PT a littlebit or is consistent with PT is
that the first really dimensionthat's impacted for us is
(16:02):
emotional exhaustion.
SPEAKER_02 (16:04):
Okay.
And now I'm I'm assuming as youtalk to PTs around Nebraska,
that was that was something thatcame out often.
SPEAKER_01 (16:12):
Yeah.
In my study, the the first phaseor aim of the study was really
just kind of a quantitative A.
And so we really looked at usingthe Maslowc burnout inventory,
actually assessing the frequencyand severity of burnout.
So that was kind of the firstpiece.
And and the MASLAC burnoutinventory is is the tool that we
(16:33):
utilize to um to accomplishthat.
And you know, what we found on apositive note, really, was half
of the sample, so about 55% ofthe sample was considered
engaged.
And engaged by definition on theMASLAC burnout inventory is
(16:55):
really opposite a burnout.
So it's a low emotionalexhaustion, low
depersonalization, high personalaccomplishment.
And 50% of our sample wasengaged.
So that's fantastic.
The not so fantastic piece of itis the other half, about 45%,
were experiencing at least onecomponent of burnout.
(17:18):
So they either had highemotional exhaustion, high
depersonalization, or lowpersonal accomplishment.
22% were in that high emotionalexhaustion phase, showing that
if PTs are only experiencing onedimension or PTs in Nebraska,
it's it's most likely going tobe emotional exhaustion.
(17:39):
When we talked about thatdefinition of, you know,
burnout, where it's all three ofthose dimensions, you know, 10%
of our sample in Nebraska wasexperiencing burnout.
SPEAKER_02 (17:48):
Were there any other elements from your research that
were surprising to you as youlooked into it?
SPEAKER_01 (17:53):
I would say as far as the frequency, it wasn't
really surprising.
There's some, you know, the theone thing that I found in the
burnout literature and PT isit's it's really still
relatively new in the currentenvironment.
So if we're not looking back at1995 or 2001, if we're you know,
(18:15):
we're if we're kind of lookingsort of 2015 and beyond, it's
one of the things that we foundis hard because it is new, is
there's so many different toolsthat are not so many different,
but people use different tools.
And so in making comparisonsbetween, you know, what I found
(18:37):
for for my frequency andseverity versus maybe what
another study found, we're notnecessarily comparing apples to
apples.
So they might have utilized acompletely different tool, or
they might have defined burnouta little bit differently.
So, you know, there was a 2015dissertation by Ellen Zambo
(19:02):
Anderson, and and she used theMASLAC burnout inventory and
used the same, you know,definition of burnout.
And according to that, you know,PTs in Nebraska were at a higher
level than her national sample.
SPEAKER_00 (19:19):
Okay.
SPEAKER_01 (19:20):
That was also in 2015.
Um certainly things, you know,changed pretty significantly
over, you know, my data wascollected in 2021.
That timing could have impactedthose scores.
Something happened in 2020.
SPEAKER_00 (19:40):
Yeah.
SPEAKER_01 (19:40):
Just yeah, just a little thing called COVID.
But so if I wouldn't sayanything was surprising.
And then if you even look atsome of the studies, like more
recent, more recently publishedstudies that were done during a
similar time period, 2021, 2022,the burnout rates are not
significantly different.
SPEAKER_02 (20:01):
Okay.
SPEAKER_01 (20:02):
From Nebraska PTs to some of the other populations
that were studying.
SPEAKER_02 (20:06):
Okay.
Interesting.
What what about any findings,trends along the lines of
demographics?
So are we talking in your insome of your own research, are
we talking, you know, more menthan women, women than men,
urban versus rural, younger PT,middle career PT, older PT?
Like what talk to us a littlebit about that.
Who's out there?
SPEAKER_01 (20:26):
Yeah, probably one of the the more, I would say,
significant findings in in termsof if we're just looking
strictly at demographics.
If you're looking atdemographics, you're really
looking at, and and these werenot necessarily, so let me back
up.
So when I when I looked atassociations, I looked at, you
(20:48):
know, was it associated withwith burnout, all three
dimensions, or was were therecertain factors that were
associated with like oneparticular demographic or work
environment characteristic?
So interestingly, the onlysociodemographic factor that was
associated with all threedimensions of burnout was the
(21:13):
presence of children,specifically that they didn't
have children.
So individuals without children,that was statistically
associated with burnout.
Then if you just look at some ofthe factors that were associated
with one dimension of burnout,and so this then starts to, I
think, tell a little bit of astory, but younger therapists
(21:34):
was associated with at least onedimension of burnout.
Male physical therapists hadhigher levels of
depersonalization than femaletherapists.
There was also a positiveassociation between
depersonalization and studentloan debt.
So higher debt equaled higherdepersonalization.
And then single participantsalso displayed higher levels of
(21:58):
depersonalization.
All of that to say it seems likeif you're looking at
individuals, you know, who don'thave children, they would
typically be younger, notmarried.
Those younger therapists likelyhave more student loan debt
because they would havegraduated more recently.
(22:19):
And so really a lot of the datawas really looking at, you know,
kind of this earlier careertherapists we're seeing tend to
have more association withburnout than mid-career or later
therapists.
SPEAKER_02 (22:35):
Okay.
SPEAKER_01 (22:36):
In in my particular population.
SPEAKER_02 (22:38):
Right, Nikki, I think some of that information
is really helpful just thinkingabout the the you know
sociodemographic aspects.
Primarily that the main thingwas the presence of children.
You know, those that didn't havechildren were more associated
with burnout.
Um what about like workplace orthe culture within the
(22:58):
workplace?
Is there anything within thoseenvironments that you picked up
on within your research?
SPEAKER_01 (23:05):
Yeah, so as I said, you know, when you're looking at
those sociodemographiccharacteristics, there's just
the just the one that wasassociated with all three
dimensions.
And then there were, you know,the few others that I mentioned
that were sort of the one-offs,right?
That were associated with atleast one factor.
But really the the biggestimpact, or I guess the the
(23:27):
factors that were most likely toinfluence burnout or most
associated with burnout werework-related work environment
characteristics.
Um, and so this was things likethe workload being manageable,
feeling supported by yoursupervisor, supported by your
coworkers, provided autonomy,provided flexibility in your
(23:52):
work schedule and time off,working in a place where you
felt your judgment was valued.
And then also being confidentthat you felt like your employer
would do what was right if in inyou know ethical type of
situations.
And then certainly, as we havealready mentioned, COVID-19 was
(24:12):
also associated with burnout.
SPEAKER_02 (24:15):
Can you, okay, so kind of the sociodemographic
factors, the workplace factors,can you speak maybe more
specifically about our NebraskaPTs?
What's the effect this is havingon PTs from Nebraska?
SPEAKER_01 (24:28):
Right.
So, so as part of the study, youknow, we did this survey and
then I interviewed individualswho were in the burnout
category, and then also thosethat were in the overextended
category or the emotionally highemotional exhaustion category,
just knowing that that was alarge piece of the population.
And we talked about a lot ofthese, we talked about these
(24:50):
factors, you know, like yes, Ihad this quantitative data that,
you know, told me these thingswere statistically associated,
but like what did that mean?
Right?
What did that mean for for themindividually?
And so what really came out insome of those interviews was
that there are some intrinsicfactors, right?
There's just there are somefactors, uh, individual factors
(25:14):
that seem to place you at riskfor burnout, according to to
some of the interviews Icompleted.
And and some of those things arelike just having really, really
high personal standards andbeing a perfectionist.
Um, it was very clear that thatthose individuals that I was
interviewing that were burnedout were perfectionists.
(25:36):
And so that was a pretty, prettycommon theme.
They also had a hard timeestablishing boundaries just
between their personal life andwork.
Some of them were dealing withsome just personal stressors in
their life, maybe an illness inthe family, a chronic illness in
the family.
And then the other piece thatwas interesting was, and this I
(25:57):
would say this was aninteresting piece of it, is
related to just like thisdisparity between what they
thought their career was goingto be and what the practical
realities of the professionwere.
So those were some of thoseintrinsic factors that were
explored in the interviews.
And then one of the other thingswas very consistent with my
quantitative data in regards toworkloads.
(26:17):
So just unrealistic productivitybenchmarks, which gave rise to
ethical dilemmas, talking aboutnot having autonomy for making
patient care decisions.
And then some also mentionedjust the workload and the
emotional and taxing nature ofthe job was a concern for many.
They also talked about theimpact of the work environment
(26:40):
in terms of culture.
So working in a culture that wasprioritizing the number of
patients seen versus the qualityof care provided or a workplace
environment that lacked a senseof psychological safety or
promoting a feeling ofcommunity.
There were participants thatspoke of having leaderboards in
(27:01):
their workplaces and fosteringthis sense of competition
amongst colleagues to who hadthe best productivity for that
day.
(27:22):
So not feeling respected bypatients or employers or other
healthcare providers orinsurance companies or regular
regulatory bodies just notadequately valid valuing
physical therapy.
So I thought that was reallyjust digging into some of those
factors outside of you know justthat strict quantitative data
(27:44):
was really interesting.
And then moving on with that, wewe dug into so so what?
Yeah, you know, so what?
And so, you know, you know, likeI had mentioned previously, the
literature was like, oh, there'syou know, substance abuse and
and you know, mood disorders,and you know, some of those
(28:04):
things are the impact ofburnout.
And so when I actually spoke totherapists in our state, it was
the the the impact is reallyquite significant of burnout on
individuals.
So, first just personal healthissues, so very consistent with
some of that previousliterature, but they had a a
range of of health challengesthat they spoke about, both
(28:26):
physical and and physicalillnesses as well as mental
health issues.
Um they found themselvesneglecting self-care routines,
so just not sleeping, notexercising, not prioritizing
nutrition, things like that.
Really, sadly, one participantexpressed to me that burnout had
(28:46):
taken such a toll on them thatthey really had gotten to the
point where they no longer had apurpose to live.
You know, that's in PT, right?
Like you hear about that in inmedicine, and but this was a PT.
And then very consistent withdespersonalization, they they
would just express how they justreally did not care anymore.
They did not care uh about theirpatients anymore, did not have
(29:12):
that empathy anymore, struggledto find empathy, and that
resulted in them just kind ofgoing through their motions in
designing treatment sessions,you know, no creativity, no
thought for for how they canmake sessions better, and just
not developing those meaningfulconnections that are so
important in PT.
And then finally, a lot of themultimately either left their
(29:35):
positions, their currentpositions, or they reduced their
work hours.
And unfortunately, many of themwere looking at pursuing career
changes, which is reallyunfortunate.
And so the toll of burnout is isquite significant.
SPEAKER_02 (29:50):
Yeah.
Yeah, I so question for you onthose lines, Nikki.
I I know like we we are not justlinear, you know, in in our
nature as people.
There are a lot of differentthings that are impacting our
lives and how we see the world,right?
For example, like we weunderstand that what can happen
(30:10):
in our personal lives can bleedover into work, and what can
happen in the workplace canbleed over into our personal
lives.
It's it's hard to just strike abalance there or to just
compartmentalize, right?
But how much how much of this ismaybe just the workplace versus
the profession?
You you talked about each ofthose things.
(30:31):
So my question is, you know,I've I've seen a lot of PTs that
are just thriving and love whatthey do and the connection that
they have to the people thatthey're working with.
Um is it the case that, hey,maybe if it if something's going
wrong in the workplace or you'refeeling at least one of these
dimensions of burnout, is it theprofession or is it more likely
(30:53):
the workplace?
And it just might be a cue thatmight need to step out of that
place that you're at and andlook elsewhere.
Is that right?
SPEAKER_01 (31:02):
So, you know, while the the impact was certainly
significant, at the end of theday, you have to remember 55%
were engaged.
So 55% were not experiencing anydimension of burnout.
And and so really were thriving,right?
And so we have to keep that inmind.
(31:22):
So I think there's definitely,you know, this organizational
piece, right?
So there's definitely the pieceand of how your facility is
managed, what type of leadershipyou have, the relationship with
your coworkers, howdocumentation is managed, how
productivity standards aremanaged.
(31:43):
So that's definitely a piece ofthat.
But then we have to look at whatis driving some of that.
So what's driving these very,very high productivity standards
or driving this need for all ofthis documentation, you know,
that goes to a higher level.
And so certainly there's there'ssome clinics, some hospitals,
(32:06):
some facilities that are areable to manage this more
effectively, I would say, atleast for preventing burnout.
But there's also just thislarger issue just with maybe not
the profession, but the societalview of the profession and how,
(32:26):
you know, kind of what roadwe're going down in terms of
being able to provide servicesand how we're reimbursed and
things of that nature.
That it's just multifactorial,really.
There's, you know, I I certainlysaw there, you know, one of my
themes for qualitative wasindividual, right?
There were some individualfactors for sure.
But then there's a just kind ofthis workplace piece, but then
(32:48):
there's just also that bigger,broader societal piece.
So, you know, it's it's notsomething that's just easily
solved.
Let's say that.
SPEAKER_02 (32:58):
Okay.
Well, that's a that's a goodjumping off point because we've
been talking about a lot of theproblems.
We've been talking about howburnout impacts us.
Uh, but let's turn our attentionto, okay, so now what?
So yes, yes, this is here.
And you know, it's not justphysical therapy, it's not just
healthcare professions, like,you know, people experience this
(33:22):
across the board.
Um, we just happen to be zoomingin on this because listen,
you've done some research,that's great, and it fits our
profession really well.
So let's name that.
So, but let's let's turn ourattention to not just like
what's going wrong, but how dowe be a part of the solution?
What kinds of things can we doto prevent this from happening?
How do we build resilience inourselves?
(33:45):
So, can you just maybe talk tothose things, right?
Are there are there strategiesor habits that in our profession
as physical therapists we canstart to adopt to protect
ourselves from burnout?
SPEAKER_01 (33:57):
Yeah.
So, you know, obviously we knowit's this multifactorial
problem, but there's stillsomething to say for just
generally taking care ofyourself.
I mean, we know that exercise,sleep, nutrition, stress
management, setting boundaries,right?
(34:17):
Do you does a does a patientneed your cell phone number so
they can contact you at allhours?
Right.
So there's also that piece of ofsetting some of those
boundaries, being willing to sayno, which I think is hard for
PTs in general.
And so, you know, there'sthere's certainly a piece of
that on an individual level.
(34:39):
You know, I also think goingback to just some of those, uh,
you know, that strong sense ofjust this uh perfectionism and
these very, very high personalstandards, you know, can we can
we be okay with just being okay?
That seems like an easier saidthan done, but certainly
(34:59):
something to think about ifyou're if you're in, if you're
if you are feeling burned out,right?
That something that maybe thatneeds some work.
But then from an organizationalstandpoint, you know, there's
it's kind of and I mean it's anold older article now, but there
is an article in 2016 by ShanaFelton Noseworthy, and there
kind of have been some bigresearches in medicine, and they
(35:23):
have an article that where theyprovide like nine organizational
strategies, you know, to helpaddress burnout.
And they really talk about, youknow, step one is just
acknowledge it and assess it.
So at your organizations, assessit.
And if you're if you find thatthere's a problem, acknowledge
(35:44):
that there's a problem and becurious about exploring it,
right?
And and talking to your peopleand and finding out what some of
those challenges are.
SPEAKER_02 (35:51):
You have to be willing to have the conversation
about it.
SPEAKER_01 (35:54):
Right.
Okay.
Right.
Kind of step one.
SPEAKER_02 (35:57):
Yeah.
SPEAKER_01 (35:57):
But and then they, you know, talked about just
having good leaders.
And so do your leaders haveleadership training and and are
you holding your leadersaccountable?
You know, that's that camethrough loud and clear in my
sample, you know, feelingsupported by your supervisor.
And I think that goes back totoo, just being willing to
(36:19):
listen and have thoseconversations with your
employees.
They also talked about um if youfind, you know, if you are
assessing and you haveconversations, then target your
interventions based on yourassessment.
Seems like that would make sensethat, you know, if you identify
(36:40):
the problem and then you targetthe interventions, just like
what we do every day as PTs,right?
It's not one size fits all.
And so don't just throw, youknow, throw what you think might
work.
You know, really individualizeor cater those interventions to
what you're finding in yourparticular facility or work work
unit.
Okay.
(37:00):
Cultivating teamwork andcommunity.
So, you know, I mentioned, youknow, people talking about
having these leaderboards.
I mean, what a way to not fostercommunity.
Teamwork, yeah.
SPEAKER_02 (37:14):
Right.
Pitting one another against eachother.
SPEAKER_01 (37:18):
Yeah.
And then you, and then, youknow, then you're adding on to
that.
Here you have these individualswho are already perfectionists,
right?
And then you're telling themthat they were number 10 out of
the 10 people on productivityyesterday.
I mean, talk about settingpeople up for failure.
SPEAKER_02 (37:33):
Yeah.
There, there's there's aninteresting concept there of,
you know, I've I've heard thisput before, keep the main thing
the main thing, right?
If if our if our patients andtheir care, their outcomes is
supposed to be the main thing,how do we make that the main
thing?
Now, don't get me wrong, thebusiness aspect is really
important.
And we have certainly we have tomake money, right?
For sure.
(37:54):
Yes.
But if that becomes the mainthing that is going to influence
culture and it has atrickle-down effect, right?
SPEAKER_01 (38:02):
Well, Brad, it sounds like you should have
written this article becausereally that speaks to the next
two things that they reallytalked about, which were using
rewards and incentives wisely.
So do is productivity what weshould be rewarding?
Um, and then also check in andsee are you are you actually
(38:22):
having individuals practiceaccording to your values and
mission at your facility?
SPEAKER_00 (38:27):
Yeah.
SPEAKER_01 (38:28):
Everyone has a mission statement, right?
And so are you is thatconsistent?
And so checking in with that andand and checking in with your
employees, right?
SPEAKER_00 (38:40):
Yeah.
SPEAKER_01 (38:41):
And then uh one of the other strategies they talk
about is promoting flexibilityand work-life integration.
So, you know, we one of thethings that I mentioned even in
our in my own in the NebraskaPTs was related to having some
flexibility in your workplace.
Can you allow people to tailortheir hours?
You know, does everybody have towork between eight and five or
(39:05):
seven and six?
Like, is there some flexibilityin that?
Um, can can you give people timeoff to go, you know, take a
chunk of time in the afternoonto go to their kids' event?
Are you allowing them theability to take their vacation
time?
So looking at those practices.
And then certainly promotingself-care.
(39:27):
So, you know, providing thoserisk those those resources.
And I think institutions aregetting, you know, that's that's
been probably the easiest thingfor most to do is is providing
some sort of, you know, we'regonna do yoga or you know, do a
potluck or something like that,which are all really good
things, can't be the only thing,but they are good things to do.
SPEAKER_02 (39:51):
Well that's how potlucks differ, you know,
they're they can be all wideranging, right?
That's right.
SPEAKER_01 (39:58):
That's right.
And maybe it needs to be new andgood nutrition, really getting
tapped to it.
But so there's definitely thingsthat can happen.
And then, you know, the otherpiece I think is, you know, here
we are doing a podcast for APTin Nebraska, but is you know, we
have to be involved in ourprofession.
We are a large group.
PTs and PTAs are a large group,and we can have a big voice, but
(40:22):
it has to be a collective voice.
And so if we really want to knowhow we were saying, you know,
what's driving these highproductivity standards, well,
reimbursement for one, right?
So that's a a larger issue thatrequires changes at a much
higher level.
And so I would just encouragepeople to to also make sure that
(40:45):
they're staying involved intheir in the APTA, in our
professional organization, wherewe can have a collective, a
collective voice.
SPEAKER_02 (40:53):
Uh hey, putting on my membership committee hat real
quick.
Thank you for the intro, Nikki.
Uh absolutely, right?
We're we're we're going to we'regoing to make more happen if we
have a collective voice.
There's also a sense ofcommunity there, right?
If you feel isolated, you feelalone, you feel like you can't
do something about a particularissue, that's why our
(41:14):
organization exists.
But it can't, it cannot be anorganization that relies on
eight people to do the work,right?
We we have, I don't know thenumber.
How many thousands of PTs do wehave in our state?
NPT?
Twenty five hundred thereabouts.
Right?
Yeah.
I should know that number, but Idon't.
Um that's that's a large group.
(41:36):
That's a large voice.
And uh again, we can do thattogether, but it it does, it
does, it does take some smallsacrifices, whether that's
paying your membership, just andjust doing that faithfully on a
on a regular basis, or gettinginvolved at different levels,
getting involved in a committee,even just in an ad hoc way,
(41:58):
someone that is involved saying,Hey, if you ever need anything,
let me know what you need.
I can't be involved at thislevel right now because of X, Y,
and Z.
But let me know if you needsomething, I'd be happy to try
to pitch in where I can, right?
Those things are so valuable.
Okay.
SPEAKER_01 (42:12):
I I agree.
So I'm I think it's reallyimportant.
And I think that's when whenwe're talking about addressing
the issue, that is one of theways that we're gonna be able to
do that.
SPEAKER_02 (42:23):
Yeah.
It is interesting talking tosome uh individuals that are
probably moving, you know,toward retirement within our
profession in the next fewyears, and just to hear them
talk about the the way that thePT community would have looked
30 years ago, right?
And the connections that youmaybe had with one another.
And technology has changed someof that, right?
(42:46):
You can connect in ways like weare right now over Zoom.
People, you know, maybe evenlead a different type of
busyness within their livesright now and and or are
connected in different ways toother organizations, and it's
not as much connected to thestate, it's more regional or
even national in some ways.
So I realize those things areare different and things have
(43:08):
changed, but uh it's also okayto hopefully reinforce we we
need this community, we need tohave a collective voice.
That's how we're gonna getthings done from a legislative
standpoint.
And with that, I'm I'm gonnadrop off the membership
committee hat and I'm gonna askyou one last question here,
Nikki.
(43:28):
This has been great.
I really appreciate your time.
I appreciate the thought thatyou put into this, and I really
hope that it's helpful to manyof our listeners, whether they
can share it with somebody elseor it's helpful to them in
particular.
But, you know, if you could giveeven just one piece of advice to
any of our listeners, fellowPTs, PTAs that might be
(43:49):
struggling with burnout, whatwould it be?
SPEAKER_01 (43:51):
Get help and don't be too proud.
And there's, you know, therethere might be resources through
your institution, you know,employee assistance programs,
things of that nature.
You might be able to get supportfrom your leadership or your
coworkers.
Um, if you're not able to dothat, I'm just gonna throw out
if if any of this, you know, aswe were talking about those
(44:14):
dimensions of burnout, or, youknow, when I was describing what
some of those individuals wereexperiencing, if any of that was
resonating with you, please makesure that you get help because
it won't just go away.
So if you don't have thoseresources at your facility or or
you know, within your realm,there's there's a great
(44:35):
organization.
It's called Emotional PPE, andit's just emotional PPE.org.
And there's volunteer counselorsspecifically for healthcare
providers who are experiencingburnout.
So something you could possiblyseek through there.
And there are local providers onthat website.
And then certainly, if you're tothe point of despair, that I
(44:58):
certainly that one of the myparticipants had certainly
experienced, there's theNational Suicide Prevention
Hotline, 1-800-273-talk, or theNational Suicide Prevention
website.
So my biggest piece of advicewould just be that it's real,
um, and it has real impact onyour own well-being as well as
(45:20):
the care that you might beproviding to your patients.
And so it's it's not somethingto take lightly.
And and so getting the help thatyou need, and and maybe you've
got to look at some changes interms of you know what's gonna
be a good fit for you.
That's good.
SPEAKER_02 (45:36):
The last thing for you if a podcast wasn't enough
for some of our listeners andthey want to know a little bit
more about the work that you'vedone, they want to learn a
little bit more, how can theyhow can they get access to some
of the information that you'resharing?
SPEAKER_01 (45:53):
Yeah, so I I just had the the manuscript, the
quantitative manuscript has justbeen published in physiotherapy
theory and practice.
So you would be able to read thethe full article through that.
I'm hoping to get thequalitative, or at least maybe
for sure, at least one of thequalitative manuscripts
(46:14):
published as well.
So stay tuned.
My dissertation will bepublished on UNMC Digital
Commons after December 6th.
So my full dissertation would beavailable there, which has lots
of, you know, pretty extensiveliterature review, things like
that for some of those differentresources.
Um, and then I'm still involvedin in research related to this
(46:38):
topic.
So some colleagues of mine fromUniversity of Colorado are
looking at both engaged andburnout because we're we also
want to see if we can find outmaybe what that secret sauce is,
right?
So, you know, we've kind oflooked at what are some of the
things that are influencingburnout, but on the flip side,
what are some of the things thatare influencing engagement and
(46:59):
how can we really, you know,grab hold of that and and
promote that?
SPEAKER_02 (47:04):
That's great.
That's great.
Well, we'll make sure that weget your dissertation linked,
you know, if anyone needs alight read at some point.
SPEAKER_01 (47:13):
Very short.
SPEAKER_02 (47:14):
Yes, we'll make sure we get that linked in the show
notes.
And I know you've you've shareda couple other resources
throughout the time too thatwe'll try to get linked into the
show notes.
If if anyone is interested uh inin uh partnering or maybe even
being like a subject for some ofyour research, is it okay for
them to reach out to you?
(47:34):
Absolutely, for sure.
Okay, absolutely, would love it.
Fantastic.
Nikki, thanks again for theconversation.
Appreciate you joining thepodcast and and also you know a
belated thank you because you'vedone a lot of work within TA
Nebraska as well in the past.
And so thank you for the waysthat you have served in that
way.
SPEAKER_01 (47:52):
Of course.
Enjoy it at all.
SPEAKER_02 (47:54):
All right, listeners, hopefully this was
helpful to you and look forwardto getting any feedback and
sharing our next podcast withyou as well.
Thanks for tuning in to the APTANebraska podcast.
Stay connected with us for moreconversations that elevate our
profession and improve the livesof Nebraskans.
Don't forget to subscribe,share, and join the discussion.
(48:17):
Because together, we're drivingthe future of physical therapy
forward.
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