How to Deal with Burnout

At some point, we have all heard the saying “You can’t pour from an empty cup.” Many clinicians enter the field of healthcare for the sole purpose of serving others. However, constantly giving of oneself without taking time to recharge can lead to negative consequences such as burnout. Heavy workload or lack of clarity/purpose around one’s work could also contribute to feelings of burnout.

What is burnout?

Burnout is a syndrome that results from workplace stress in which an individual feels both physically and emotionally exhausted. The three main symptoms associated with burnout are emotional exhaustion, depersonalization, and reduced personal accomplishment. According to a recent Mayo Clinic study, more than 60% of physicians experienced burnout in 2021. The prevalence of burnout increased roughly 25% from 2020 to 2021, and satisfaction with work-life integration also declined over this time period.

Who is experiencing this burnout?

According to JAMA Network, changes in emotional exhaustion varied among different healthcare roles. For example, among physicians, emotional exhaustion decreased between September 2019 and September 2020, going from 31.8 percent to 28.3 percent, but increased to 37.8 percent in the second year. The decline between 2019 and 2020 signified a stark difference from other healthcare workers. This may be attributed to the flexibilities physicians experienced in 2020 from an increase in telehealth utilization and decreases in patient volumes, researchers said. The sharp incline in 2021 coincides with an increase in patient volumes.

According to the study, nurses reported higher patient volumes, significant burdens from childcare, remote learning, and evolving processes and standards in 2020, which may have contributed to increased emotional exhaustion. Emotional exhaustion for other roles, excluding physicians and nurses, increased from 31.2 percent to 36.3 percent to 40.5 percent across the three timeframes.

What are the causes?

Even as early issues of insufficient personal protective equipment, increased workload, risk of infection, and lack of vaccinations and COVID-19 treatments have improved, physicians are still struggling with new challenges. There are multiple waves of new variants such as Omicron, the chronicity of the COVID-19 work burden, mistreatment of health professionals, staffing shortages, politicization of vaccination and anti-science attitudes, which have all contributed to a significant spike in the overall rate of physician burnout compared to earlier surveys conducted over the last decade-plus, says the study.

Physicians have had to learn ways to deal with their stress, along with the stress of their patients. This stress, called secondary stress or compassion fatigue, is caused when physicians acquire stress while attending to the extreme emotional needs of their patients and their patients’ families and by having to treat trauma victims. Secondary stress mirrors the symptoms of post-traumatic stress disorder, leaving physicians feeling hyperarousal, numbness, anxiety, and avoidance. While different from burnout, compassion fatigue can contribute to the emotional exhaustion and disengagement associated with burnout.

Burnout is situational. Different physicians react to situations in different ways. But the bottom line is simple. Our physicians are facing burnout at an alarming rate, and but the good news is there are potential solutions.

Could you recognize burnout in others? While stress is normal in the day to day work place – it is transient, and individuals will typically bounce back from behavioral changes that could result from stress. Burnout, on the other hand, leads to negatively trending changes in attitude or level of energy that someone is bringing into the workplace. Clinicians who are burned out may exhibit the signs of depersonalization (feeling detached from oneself), emotional exhaustion, sarcasm, self-doubt and blaming.

If you are thinking about searching for a standardized way to assess burnout within your organization, the National Academy of Medicine has referenced many of the available tools for reference. The gold standard for determining burnout is the Maslach Burnout Inventory tool which is commonly use in research; two items from this tool have a strong correlation with burnout including “I feel burned out from my work” and “I have become more callous toward people since I took this job”.

Recognizing and addressing burnout has come to the forefront of healthcare as an urgent and important issue to address. What strategies/programs does your organization have in place to combat this challenge?