The First Step To Address Burnout: Recognize What It Is
Happy Monday! This post is a timely one. I feel that burn out, for me, goes through seasons. I have felt it in my personal life. I have felt it professionally. And with life picking up again + implementing some new initiatives at work + kid activities and soccer season, I am reminded that the wellness principles I use to focus and thrive in my career are really there to help us live our best lives - at home AND at work.
I am also ready to shed the heaviness of the last two years and I think it’s time to start having fun again and to focus on living our best life. That doesn’t take away the seriousness of the pandemic, but over the last two years many of us have withdrawn a little too far into our heads, and it’s not somewhere we should stay for too long. I feel myself comparing myself to others more (ugh social media) and worrying that I am not doing enough.
What exactly is burnout? And how is it different from just feeling stuck or having a bad day? Does burnout mean you always have to switch jobs or does it mean that you just need to do a little more reflecting, double down on your long term goals and focus on your why? Can rituals and healthy habits be enough to sustain you through a relentless, stressful work environment?
I can’t answer all of that for you. But, I can give you the tools to make the decision for yourself and offer a guidebook. In this new series, we are going to go through the struggle of burnout, look at what we can do and learn how to turn the emotional exhaustion of burnout into a meaningful career. Along the way, we are also going to adopt some healthy habits so we have the energy and resilience to thrive in whatever goal we put our mind to.
A few years ago, I finally got the job opportunity that I had been waiting for - working in an administrative role that was a good fit for my training and my interests. This did not happen overnight. After years of drifting in the pharmacy field and figuring out what I didn’t like, I had almost come to the conclusion that there wasn’t a place in pharmacy for me.
But….then I got an administrative role at Duke and things started to fall into place.
What wasn’t as great was how much I started taking on. Though I did not work evenings and weekends any more, administration was stressful in a different way. With performance improvement projects that never ended and new systems to learn, I was now working consistent 10 hour days, and when I wasn’t at work I always felt “on call.” I will note that a lot of the pressure was self-induced. I had impossible standards surrounding my worth and what I had to achieve to maintain that - none of which were realistic and ultimately led me into a downward spiral straight to burnout.
After a year into this new role, I had a new baby. Add on a husband knee-deep in a medical fellowship and I was a sleep-deprived, stressed out mom who had no idea how to ask for help and was trying to be everything to everyone and ultimately failing at it all (or at least that’s how it felt!).
I had experienced this feeling before, only under different circumstances. And that is when I realized that you are not just burnt out when you are in a job you dislike (for me, retail pharmacy). Burnout can happen in jobs you enjoy too. Burnout also can come in many shapes and forms. And though we may not be able to control the circumstances, we can control our habits, resilience and how we take care of ourselves.
WHAT IS BURNOUT? -
First coined by Herbert Freudenberger in 1974, occupational burnout is a chronic state of stress that affects an individual both physically and behaviorally.
Characteristics of professional burnout fall into three categories:
Feelings of energy depletion or emotional exhaustion
Feelings of distance or cynicism
Reduced personal efficacy
Symptoms of the above include increasing anger, frustration, suspicion, and paranoia regarding colleagues’ influences on one’s career ambitions, excessive rigidity and inflexibility in practice, and can present with characteristics similar to depression.
When I entered the pharmacy profession, I was surprised at how negative everyone was. I now postulate that a lot of the negativity has to do with our temperaments. our training, and occupational burnout. Certain people are drawn to this profession and then we are molded to literally be OCD when it comes to looking for mistakes! This is not necessarily bad - we have to be extremely detailed oriented in this profession, bu this trait can bleed into other areas of our life too. We check labels, products, expiration dates, drug interactions, lab values, etc… over and over looking for anything that stands out. No wonder we fixate on the negative in our environment too!
As health professionals, we are devoted and committed to our duties. However, burnout symbolizes a culmination of the effects of professional responsibilities – not a lack of dedication.
At an individual level, the dimensions of burnout include:
Feelings of energy depletion or emotional exhaustion - a result of work overload, time pressures, interruptions, the severity of patients we care for and the extremes of activity (monotonous or chaotic).
Feelings of distance or cynicism - feeling isolated at work, a lack of social support or feeling undervalued. Many begin feeling this way due to a lack of transparency for job-related changes - smart, professional people need to know WHY!
Reduced personal efficacy - role ambiguity because of unclear expectations around the authority (or lack of authority) you have in certain situations. This could also be related to a lack of resources or a lack of feedback.
At the corporate or health system level, burnout correlates with more medical errors, poor patient satisfaction, decreased productivity, and increased turnover.
What is not burnout? Complaining, laziness, being a millennial (as many people like to say!), or depression. Burnout is a normal response to a stressful workplace (though there is substantial overlap in the symptoms of both depression and burnout).
Do any of these sound familiar? The rates of depression, post-traumatic stress syndrome, and burnout among healthcare professionals are high, even more so right now with the uncertainty surrounding a pandemic. In the first large national study of burnout in 2011, more than half of U.S. physicians reported symptoms, a number more than twice that of any other profession studied. Other studies have shown similarly high rates among nurses and other healthcare workers.
There are several different resources that you can use to assess your personal burnout level. Developed by Christina Maslach, The Maslach Burnout Inventory (MBI) is one of the gold standards that measures three dimensions of burnout - emotional exhaustion, depersonalization, and personal accomplishment pertaining to occupational burnout, but there are other good, online, free resources available.
Maslach Burnout Inventory
Oldenburg Burnout Inventory
Copenhagen Burnout Inventory
Stanford Professional Index
Clance Imposter Phenomenon Scale
Next Post: WHY do we get burnout and what are the contributing factors