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Oncology Team Resiliency

How To Build a Resilient Oncology Team

To help members of the cancer care team better manage stress and improve their overall well-being, ACCC 2021-22 President Krista Nelson—and several special guests—hosted a virtual Mindfulness Meditation series. Through meditation, we cultivate an awareness of the present moment and train the mind to better understand how and why we think and feel the way we do.
View Meditations

Results from Mini Z Burnout Survey


To gauge the level of burnout in the multidisciplinary cancer care team, ACCC surveyed its membership in 2019 using the clinically validated Mini Z survey developed by the American Medical Association. While only a small number of respondents (14.9%) report dissatisfaction with their current job, burnout and stress levels are significant.

Download Survey Infographic


Cancer Buzz Podcast

  • [MINI-PODCAST] Ep 74: The Business Case for Hiring Oncology Social Workers
    Jan 18, 2022

    Hear from ACCC 2021-2022 President, Krista Nelson, MSW, LCSW, OSW-C, FAOSW, as she talks about two new resources (a business case brief for hiring and a benchmarking survey) coming from ACCC that demonstrate the value oncology social workers play in cancer care.

  • [MINI-PODCAST] Ep 71: Leading with Gratitude
    Nov 23, 2021

    In this special podcast episode, we talk with oncology social worker and ACCC President Krista Nelson, MSW, LCSW, OSW-C, FAOSW, about finding opportunities to practice gratitude each day for colleagues and patients.   

  • [MINI-PODCAST] Ep 68: Supportive Care in Radiation Oncology
    Sep 21, 2021
    Early in the pandemic, members of the Stanford Health Care Radiation Oncology Department created an internal podcast for their department to creatively address the need for connections among onsite and remote staff, acknowledge the emotional and psychological toll of caring for patients during this challenging time, and support the well-being and mental health for oncology staff.
  • [MINI-PODCAST] Ep 67: Coping with Pandemic Grief
    Sep 14, 2021
    In this special podcast episode, we talk with oncology social worker and ACCC President Krista Nelson, MSW, LCSW, OSW-C, FAOSW, about the overwhelming grief of the pandemic and its toll on cancer care professionals.  
  • [MINI-PODCAST] Ep 64: A Summer of Disconnect for Cancer Professionals
    Jul 20, 2021
    In this episode, we focus on the mental and emotional toll that COVID-19 continues to have on cancer care professionals—while much of the public experiences a “summer of joy” due to rising vaccinations.
  • [MINI-PODCAST] Ep 14: COVID-19 Self-Care
    Mar 31, 2020

    Krista Nelson, ACCC President 2021-22, shares self-care resources for cancer team members during the COVID-19 outbreak and guides us through a brief mindfulness exercise.

  • [PODCAST] Ep 02: Fostering Cancer Care Team Resiliency & Well-Being
    Jul 31, 2019
    Learn how organizations like Vidant Health and The Outer Banks Hospital are creating a healthier, more rewarding workplace by making employee wellness a strategic priority.

Burnout Defined

June 06, 2019

This post continues ACCC’s ongoing conversation on how mitigate burnout and foster well-being and resilience among all staff involved in the delivery of cancer care.

Besides the common understanding of burnout as a workplace phenomenon, the criteria for being “burned out” can vary widely. What one person calls burnout another may view as run-of-the-mill workplace stress.

While there have been many attempts to define burnout over the years, a mutually agreed upon definition remains elusive. Merriam-Webster defines burnout as “exhaustion of physical or emotional strength or motivation usually as a result of prolonged stress or frustration.” The Mayo Clinic has called it “a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity.” Some academic and mainstream reports and surveys on the topic assume a common understanding of the word rather than defining it explicitly.

At the end of May, the World Health Organization (WHO) took its turn by announcing it had revised its previous definition of burnout as a "state of vital exhaustion" to a more explicit, nuanced definition. This new definition will appear in the International Classification of Diseases (ICD-11), which will go into effect 2022. WHO refers to burnout as a “syndrome” caused by “chronic workplace stress that has not been successfully managed.” WHO assigns three characteristics to burnout:

  • feelings of energy depletion or exhaustion
  • increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job
  • reduced professional efficacy

WHO’s revised definition explicitly states that burnout is a workplace phenomenon and “should not be applied to describe experiences in other areas of life.” Because this definition articulates and enumerates burnout’s symptoms, it may give this workplace phenomenon more legitimacy, perhaps opening doors for people to get the professional help they need. 

This may be of particular importance to clinicians and allied healthcare professionals, who repeatedly report experiencing more burnout than others. When ACCC surveyed its membership earlier this year, approximately 33 percent of respondents said they are “definitely burning out,” while nearly 16 percent said their symptoms of burnout “won’t go away.”

Other surveys have also uncovered high burnout rates in the healthcare community. In a recently released survey of 5,000 physicians by the American Medical Association, nearly 44 percent said they had at least one symptom of burnout in 2017. In comparison, 28 percent of all U.S. workers report burnout symptoms.

Concern over growing rates of burnout among U.S. clinicians has captured national attention in recent years, and in 2017 resulted in the launch of the National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience. This network of more than 60 organizations, including ACCC, is committed to reversing trends in clinician burnout. 

As a multidisciplinary organization, ACCC recognizes that caring for patients can take a physical and emotional toll on all members of the multidisciplinary oncology care team, from the front desk staff who greets patients to the physician who treats them. In a 2013 survey cited in the Annals of Family Medicine, of 508 employees working for 243 healthcare employers, 60 percent reported burnout, and 34 percent said they planned to look for a different job.

Time will tell whether the new ICD-11 definition of burnout will affect its perception and diagnosis among healthcare professionals. But having an explicit, detailed definition can definitely enhance the ongoing conversation about how we can better care for our caregivers.

From Oncology Issues

  • President: Recapping the 2018 ACCC Institute for the Future of Oncology
    Tom Gallo
    On June 27, 2018, ACCC convened the sixth Institute for the Future of Oncology forum in Washington, D.C., to bring together interdisciplinary experts and key stakeholders to discuss my Presidential theme: “Reflect, Renew, Reignite: Creating a Resilient Oncology Team in Your Community.”
  • Community-Based Psychological First Aid for Oncology Professionals
    By Sam Gaster, MA; Christina Early, MSW; Amanda Reed, PhD; and Brandon Gray, MA
    Training in community-based psychological first aid is a promising intervention that promotes adaptive functioning by instilling individuals with the knowledge and skills necessary to support oneself and others when stressful events occur. The Avera Cancer Institute, Sioux Falls, S.D., has conducted community-based psychological first aid for its workforce since August 2017.
  • Views: Making the Most out of Drug Representatives
    Connie Renfroe
    Medical science representatives possess critical information about new drug regimens, protocols, and indications. However, scheduling them often requires a part-time position that few practices can afford—it’s a catch-22.
  • Removing the Blame from Burnout
    ACCC Editorial Staff
    Burnout among U.S. healthcare clinicians is a national concern, and cancer care is no exception. To gauge the level of burnout in the cancer care team, ACCC surveyed its membership and created a hub for team well-being resources.
  • One Best Practice: Streamlining Workflow, Unifying Staff, and Reducing Redundancy
    Elizabeth Koelker, MHA, FACHE
    When Kettering Health Network reorganized its operations by service lines, oncology had major problems—internal competition, communication deficits, inefficiencies, and a lack of infrastructure. Learn how Kettering united its oncology staff under “one best practice,” streamlined operations, increased patient volume, and decreased internal competition.
  • Turning Off Turnover
    Tom Gallo, MS, MDA
    Though stemming burnout at the source is vital work, it is also important to recognize and alleviate symptoms as they appear. One such symptom is decreased workforce retention.
  • Small in Stature, Large in Impact
    By ACCC Editorial Staff
    Caring for patients with cancer is inherently stressful, but many cancer team members say that their difficulties go beyond the expected emotional strain. Robin Hearne, RN, MS, director of Cancer Services and Chronic Disease Care at The Outer Banks Hospital, elaborates on the burdens of bureaucracy and shares the programs she’s developed to provide staff with necessary tools for patient and self-care.
  • Caring for the Caregiver
    By ACCC Editorial Staff
    Dr. Farley directs Christiana Care Health System’s strategy to promote the professional fulfillment and personal well-being of its caregivers—and, subsequently, its patients.
  • Utilizing Scribes to Improve Patient-Centered Care and Efficiency and Reduce Burnout
    By Amy Hindman
    More oncology programs across the country are hiring scribes in their practices to improve patient-centered care, reduce physician burnout, and create administrative efficiencies.
  • Burnout Prevention & Education
    By Monique Dawkins, EDD, MPA, et al.
    Being aware of how burnout manifests itself can help supervisors and staff identify the condition early.
  • Breaking Down Silos
    Pamela R. Proman, MBA, RTT, et al.
    Using its EHR and billing data to examine key metrics—including charge lag, patient registration, and insurance verification—the Nancy N. and J. C. Lewis Cancer & Research Pavilion at St. Joseph’s/Candler identified four key effects of the “silo mentality” on its cancer program. Focusing on efficiency and urgency, the program broke down its silos, reducing waste and incorrect denials, improving cash flow, and alleviating patient—and program—financial toxicity.
  • Can You Hear Me Now?
    Kimberly Smith, MPHA
    After integrating voice recognition software with its EMR, Mount Sinai Health System reduced physician workload, improved patient care, and streamlined clinic workflow. Physicians and staff shared that this process improvement initiative also improved their well-being, freeing clinicians up to spend more time doing what they want to do—caring for patients.
  • Caring for the Caregiver
    April Alexander, MSW, LCSW, OSW-C, et al.
    A holistic Self-Care and Resiliency Program for Oncology Professionals has helped to decrease oncology staff burnout rates. Key components include Patient Remembrance Ceremonies, staff support groups, educational opportunities, and social events.
  • How to Combat a Virus
    Jennie Crews, MD, MMM, FACP
  • Go Viral with Compassion and Kindness
    Jennie R. Crews, MD, MMM, FACP, AND Krista Nelson, MSW, LCSW, OSW-C, BCD
    What can those experiencing cancer and its overwhelming unpredictability teach us about dealing with COVID-19?
  • ACCC, With an Assist
    Randall A. Oyer, MD
    Oncology has always faced challenges, and cancer care teams are ever ready to change course and do what needs to be done to care for our patients and their families. But we do not have to do this alone. ACCC stands ready to assist.
  • Telehealth at Its Best: Transitioning a Comprehensive Psychosocial Program to a Virtual Format
    Jennifer Bires, MSW, LCSW, OSW-C, and Drucilla Brethwaite, MSW, LCSW
    Due to the COVID-19 pandemic and its associated risks for patients with cancer, all Life with Cancer programming was cancelled on Mar. 12, 2020. Staff, struggling with their own anxiety over personal safety, quickly went into action on how best to continue to meet the psychological and educational needs of patients and families.
  • Working Toward a Better Tomorrow
    Sibel Blau, MD
    Since those early days so much has changed in our world. The COVID-19 pandemic led to unprecedented challenges, both within the healthcare industry and the world at large. Though we have witnessed much unrest, we have already made it through some very difficult times with stories of great heroism and innovation, especially within the healthcare industry.
  • Views: Mentoring Those New to Oncology
    Kerri Michalik, MHA, BSN
    In my breakout session at the 37th ACCC [Virtual] National Oncology Conference, held Sept. 14-18, 2020, I shared that mentorship is often the missing link to facing these staffing challenges.
  • Trending Now in Cancer Care
    Alexandria Howson, PhD
    Rather than fielding its annual Trending Now in Cancer Care survey while cancer programs were experiencing unprecedented challenges due to the extended public health emergency, ACCC chose to facilitate conversations with its members to capture the lived experiences of the most pertinent issues impacting oncology practice and care delivery.

Building a Resilient Oncology Team: Issues and Solutions

Burnout is on the rise as oncology becomes increasingly complex with new treatment options, growing financial toxicity, an aging patient population, and an increasingly burdensome healthcare system. It has received much media attention, with some calling it an epidemic.

Thomas A. Gallo, MS, MDA, ACCC President, selected his 2018–2019 president’s theme: Reflect, Renew, Reignite: Creating a Resilient Oncology Team in Your Community, in order to shed light on the pain points that frustrate physicians, nurses, social workers, administrators, pharmacists, and all of the other professionals who collaborate to provide the highest level of patient care.

The ACCC 35th National Oncology Conference, October 17 – 19, in Phoenix, AZ, featured stories and strategies for fostering resilience and a healthcare culture that mitigates burnout among all members of the cancer care team. Three featured speakers inspired while providing practical strategies to help increase engagement, transform your work culture, and embrace experimentation. 

6 essential standards for a healthy work environment

ACCC is committed to identifying shared strategies and solutions to help combat the burnout and frustration that many of its members experience. This Building a Resilient Oncology Team: Issues and Solutions infographic details key findings on clinician burnout and a bevy of solutions to help you mitigate stress and bring the joy back to your workplace. 
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