“I became interested in burnout in the way a lot of physicians get interested. I experienced it, and it was a pretty intense experience,” Ara S. Hall, MD, told attendees at the 2019 annual meeting of ASET: The Neurodiagnostic Society. Dr. Hall, a neurologist from Children’s Mercy in Kansas City, gave the Ellen Grass Lecture and focused on a huge industry problem: healthcare worker burnout.

“There’s a growing understanding that burned-out healthcare providers aren’t just miserable individuals. Their misery has consequences for their patients as well as the overall cost of healthcare,” said Hall. So, what does burnout look like?

For Hall it started as a growing sense of dread on Sundays when she thought about the week to come, but it got much worse. “My breaking point came about 6:30 in the morning one day. I was standing there brushing my teeth in my pajamas, and I realized that I wasn’t actually thinking about brushing my teeth or what clothes I was going to wear. I was actually composing a suicide note in my head,” she said.

While everyone’s experience is unique, there are three universal signs of burnout, as described by Christina Maslach in 1981:

  1. Emotional Exhaustion
    • I feel emotionally drained from my work.
    • I feel used up at the end of the workday.
  2. Depersonalization
    • I worry that this job is hardening me emotionally.
    • I’ve become more callous toward people since I took this job.
  3. Reduced professional efficacy
    • I work really hard and I can’t seem to get the job done.
    • Nothing I do at work is good enough.

Once you recognize the signs of burnout in yourself, the next step to recovery is to root out its drivers, so you can then move toward change. In her talk, Hall pointed out six common sources of burnout:

  • Work overload
  • Lack of control
  • Insufficient reward
  • Unfairness
  • Breakdown of community
  • Value conflict

“While the drivers of burnout are universal,” said Hall. “The specific way in which each of these drivers manifest is different based on context. There is no one-size-fits-all solution out there.”

There are many ways to solve this problem, but it is rare that the solution lies solely with the individual experiencing burnout. “Everybody who’s burned out suffers individually, but it is a systems-driven problem,” said Hall. “You cannot treat it solely from the individual level.” Yes, things like self-care, meditation, and other personal wellness strategies will help you cope, but change often needs to happen at an organizational level for burnout to be effectively addressed.

What all this means is that if you are suffering from burnout, you need to speak out so leadership knows there is a problem. Hall said that was the hardest part of her recovery process: asking her boss for help. But she did and that is why she was able to get out of the situation she was in and survive her bout with burnout.

When you talk to your supervisor, know that you are not alone in this issue. Burnout in the workplace is a common issue in healthcare and there are solutions that work. Leaders at the Mayo Clinic have successfully addressed issues of burnout in their institution, and in this 2017 paper they shared nine organizational strategies:

  • Acknowledge and assess the problem
  • Harness the power of leadership
  • Develop and implement targeted work unit interventions
  • Cultivate community at work
  • Use rewards and incentives wisely (not just pay)
  • Align values and strengthen culture
  • Promote flexibility and work-life integration
  • Provide resources to promote resilience and self-care
  • Facilitate and fund organizational science

“There are probably more,” said Hall, “but these nine things have actually been researched and have evidence to support their use. If you implement these things in your organization or even in your work group, it is likely that you will be able to reduce this level of burnout in your group.”

At the time of her lecture, Hall had been back at work full time for four years and said she spends much of her time talking about the importance of addressing burnout in the workplace. “In our department, the fact that I burned out had a huge impact because I was actually willing to talk about it.” She ended her talk with a plea, “Think about how you can encourage open conversations in your workplace.” Whether you are experiencing the signs of burnout in yourself or you recognize them in someone you work with, speak up. It’s too important not to.

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