Burning out the Burnout

Burnout affects 54% of physicians and 34-38% of nurses, and the numbers are only increasing. But what is burnout, how does it affect the medical industry, and how can it be prevented?

What is Burnout?

Herbert Freudenberger coined the term “burnout” in the 1970’s to describe how severe work-related stress and high ideals negatively affected those in the “helping” professions, such as nurses and doctors. It is now more generally applied to overworked employees in any industry, but still remains a particular issue within the medical industry.

There are many warning signs associated with burnout, though most researchers agree with a core set of symptoms medical professionals may suffer from. These include:

• Exhaustion/ physical fatigue
• Alienation from duties
• Apathy towards patients and/or tasks
• Reduced concentration
• Cynicism towards the profession/organisation

What are the effects of Burnout?

Burnout has been linked to dire effects for doctors and nurses, including depression, anxiety, fatigue, alcohol and drug misuse, marital dysfunction and the individual leaving their profession or retiring. Most seriously, it also increases the risk of suicide. In the US, approximately 400 doctors each year commit suicide, and healthcare workers across all specialities have higher rates of suicide compared to people in other professions. Doctors under 30, who work the longest hours, are most at risk of experiencing severe psychological distress and potentially burning out.

In addition to the effects on the healthcare professional individually, burnout also impacts the hospital or institution. The trending high turn-over for nurses in hospitals can lead to a decrease in ward efficiency and time mismanagement for the hours required for training. One study has found that burnout is one of the highest predictors of medical errors. Medical errors have been identified as the third leading cause of death in the US. Burnout has also shown to increase hostility from doctors towards patience, decrease productivity among staff workers and cause conflicts between staff and management.

There is a variety of reasons healthcare professionals have given for why they experience burnout. One of the most common cited is feeling overworked, as nurses and doctors work long hours in demanding roles. A poor work environment was noted as the top reason by nurses working in hospitals, and a study of doctors also found organisational disfunction as one of the most common responses. Other issues include the emotional and mental strain that comes with “healing”, conflicts within hospital bureaucracy and feeling unheard by management.

How can we prevent Burnout?

There is still a stigma around burnout and work-place related stress, which often means the individual feels pressure to overcome it alone. However, although doctors and nurses are encouraged to think about implementing strategies to avoid work-related stress, workplace safety is the responsibility of hospital and healthcare institution employers. In 2016, Stanford University began a program to combat burnout among surgery residents, focusing on strategies that improve the physical, professional, social and psychological wellbeing of the residents. Organisations are encouraged to be inspired by this approach, and can apply some strategies to better their workers’ holistic wellbeing such as:

• Physical wellbeing: Offering healthy snacks in break rooms, providing exercise options such as a gym or classes.
• Professional wellbeing: Re-engineering workflow and increasing staff numbers, strong and empathetic leadership, establish and maintain mentoring programs.
• Social wellbeing: Organising casual staff events outside conferences and educational forums.
• Psychological wellbeing: Installing an open-door policy and group therapy sessions, implement a culture of safety to decrease the stigma around work-related stress and depression.

There are also simple devices that institutions can implement which are designed with healthcare workers’ wellbeing as their primary goal. The SnapIT ampoule opener can prevent nurses from hand injuries and increase productivity, and the Qlicksmart BladeFLASK blade remover was engineered by surgeons to prevent doctors and other medical staff from sharps injuries and the untold consequences of injuries, including psychological distress.

Institutions and individuals can make simple efforts to burn out the burnout this year… and be safe.

If you or a colleague has been experiencing any of the effects of burnout or need help, contact:

Lifeline (Australia): on 13 11 14 for 24-hour Australian counselling services.
National Suicide Prevention Lifeline (USA): on 1-800-273-TALK (8255).
Samaritans (UK): on 116 123 for 24-hour service available every day of the year.
Or visit this website to find your regional hotline.