• Ethical Kollektiv Team

Burning Out In 2020 - By Dr. Isobelle Smith



Introduction


Burnout is one of the great epidemics of the 21st century. The concept emerged in the 1970s amongst human services workers, however, since then has extended to other occupations with everyone from shop assistants to lawyers suffering burnout.


There are numerous theories and potential causes for why we’re all getting so burnt out, however longer than ever working hours, an immensely competitive job market and the fact that outside of work we’re contactable on more platforms than I have toes, are thought to be major players in the burnout game.


Although most people are familiar with the term, a lot of people don’t actually know what it means to be “burnt out”. You may have even had burnout yourself but confused it with depression, stress or even laziness.


When I was a junior doctor, I used to legitimately hope I’d get appendicitis so I could have time off work. I now realise I didn’t have some rare psychiatric condition in that people wish illnesses on themselves. I was just “burnt out".




WHAT IS BURNOUT?


Firstly, let’s talk about what it’s not;


  • It’s not depression, although it can lead to depression.

  • It’s not being stressed, but chronic stress increases the risk of it.

  • It’s not laziness or being an inherently rude person or “bad” at your job, although from the outside it could appear that way.


Rather and as per the WHO, “burn out” is characterised by 3 hallmark signs;



1. Emotional Exhaustion

Indifference towards colleagues, managers and/or clients. Cynicism, lack of compassion and generally not giving two hoots about your job.




2. Depersonalisation

Feeling disconnected from your body and self. You’re aware that your doing things but almost feeling like an observer in a dream.





3. Sense of low personal accomplishment


e.g. Feeling like you’re not accomplishing much or your work isn’t of high importance. Undervaluing your own self worth and contributions in the workplace.

Other warning signs of burn out include irritability, tiredness, frustration, feeling overwhelmed and like the person who used to love their job is a whole different person to who you are now.

Maybe I’m biased, but to me, these points are particularly concerning. Doctors and nurses are the groups most at risk of burnout, feeling that looking after people’s health is of low importance is a terrifying concept.

Dr Isobelle K Smith
Dr. Izzy Smith

My Personal Experience


Using my own experiences as an example, I was very burnt out after my specialist exams followed by a continuous 12 day on, 2 day off roster working in rural oncology.


I pride myself on always being polite, kind and having time for communicating with my patient’s families. I knew I was getting burnt because I was becoming short and snappy with nursing staff and getting irritated with patients or their families for asking too many questions.


This was not the doctor I trained to be and was the equivalent of a big flashing neon sign telling me I needed a break! At the time I wondered if I was depressed. This is not uncommon as despite there being distinct differences, burn out is often confused with depression.


Burnout vs Depression


The simplest way to distinguish between burn out and depression is if the lack of interest and enjoyment is defined to the workplace vs extending to other aspects of life.

E.g. If you’ve always loved watching the footy or playing with your dog, you’ll still enjoy them if you’re burnt out. This is in contract to depression which usually impacts enjoyment across all areas of life. Further differences are that symptoms of burning out improve with a holiday/decrease in workload and self-worth is usually preserved.


Finally burnt out is associated with irritability, cynicism, and hating your job which is less common in depression.



WHY DOES BURN OUT HAPPEN?


So now we know what burn out looks like (and you’ve probably realised you’ve had it in the past), its time to think about what causes burnout.


There is a common misconception that burn out is simply due to working too hard and too long hours. If this was true, people at risk of burn out would simply be those working the most hours. Whereas in reality, we see specific careers and both individual and organisational factors depicting risk.


Research suggests 6 key components of a workplace that lead to burning out;


1. Workload and Hours

2. Control Over Work/Tasks

3. Reward and Recognition

4. Community and Collegial Atmosphere In The Workplace

5. Fairness

6. Value in Work


In more simple terms burnout results when work stressors such as deadlines, demands and work hours are not balanced by rewards, recognition and relaxation.


Thriving workplaces provide opportunities to develop skillsets, create a supportive culture, recognise/reward efforts and encourage self-management & self-development.

At-Risk Careers


Emotionally taxing careers such as nursing, teaching, and medicine are at especially high risk, but essentially anyone if persistently pushed beyond their limit to cope for extended periods of time, can develop burn out. Lawyers, CEOs, athletes and call centre workers are other groups at high risk.


Is It Only Work That Can Cause Burnout?


Out of work stressors can also impact burn out risk, and why parents, and especially mothers of young children have an increased risk of burn out. Often people with burnout feel like they’re being lazy and just need to “be more resilient”, “work harder” etc, however it’s important to recognise that chronic stress literally changes people’s brain through altering neurochemistry and neural circuits.

Parts of the brain which regulate stress and emotion such as the amygdala, hypothalamus and hippocampus are especially impacted and MRI studies show that burnout can have a similar physiological appearance (Amygdala swelling) as trauma/PTSD.


These changes create a vicious cycle of neurological dysfunction, decreased performance and increased risk of depression, and recovery requires resolution of these neural changes.

No Bandaid Solutions or Easy Fix


The occasional day off or quarterly free yoga class will not fix burn out. Instead, the gold standard of care is an extended work break (at least a few weeks) or a significant decrease in workload and modification of what led to burn out in the first place, e.g. Looking at which of the 6 main organisational risk factors for burnout are out of balance.


For burn out suffers it’s important to advocate that it may take quite some time to return to normal. From my own experiences of burn out, it took several months for me to feel like my happy, enthusiastic medicine loving self again!




SHOULD WE CARE ABOUT BURNOUT


Short answer YES, we should definitely care. Burn out leaves staff feeling miserable, exhausted and can lead to depression and even suicide. Furthermore, burnout results in high-quality staff falling out of love with their career, or even leaving their profession for good. Protecting our staff from burnout is not only the moral and right thing to do, it also has a productivity benefit and, in the future, may prevent costly workers compensation payouts.


Economic Pressure


A report by Professor Allan Fels from Melbourne University, estimated mental health costs Australian businesses 10 billion dollars per year. Sick days, carers leave, high staff turnover, decreased productivity + more can all be associated with burnout and is costing Australia not just out mental wellbeing, but also our economy.




HOW CAN WE STOP BURNOUT?


Obviously reasonable hours and workload are a good start, however it’s in important to remember that predictors of burn out go far beyond time spent at work.

Getting back to the 6 predictors of burn out, here are some considerations regarding workplaces and wellbeing;


1. Workload and hours


What’s deemed reasonable workload and hours will differ between individual people and organisations. In the medical industry less than 50 hours per week is generally deemed safe.


2. Control Over Work


Giving staff the opportunity for input and control over which projects they’ll be working on, time of deadlines, as well as flexible working hours etc.

Reward and recognition


3. Positive Feedback


Words of gratitude and appreciation literally cost nothing but can have such a powerful role in preventing burnout. My personal rule is if I am thinking nice things about my junior staff, I don’t keep those words in my head and instead make sure I tell them!


4. Community and collegial atmosphere of the workplace


We spend more of our awake hours at work than we do at home so it’s no surprise a miserable stressful work environment also makes us miserable. Don’t forget the power of things like an occasional free BBQ, Friday afternoon drinks or birthday cake for staff to get to know each other better and feel like they’re cared about beyond just their ability to do their job.


5. Fairness


No more complicated than it sounds. People should not work under unfair conditions such as be expected to complete tasks with unreasonable deadlines or experience sexism, racism, bullying or other unfair treatment in the workplace.


6. Value in work


Staff are less likely to feel burnout if they believe the cause of why they’re working so hard is worthy. At times this may cross over with recognition but also includes education and awareness of the outcomes of people’s individual work as well as their team and greater organisations.


Workplace Wellbeing Expert


Another new and increasingly common tool to prevent burnout, is to hire a workplace wellbeing expert who can provide evidence-based advice and interventions to help maintain staff wellbeing, whilst maximising productivity and business outcomes.


Bec Row


One of my favourites is Bec Row from Groundwork Wellbeing. Bec is a physiotherapist turned workplace wellness expert who educates on habit formation, sleep, meditation + much more. Bec’s LinkedIn was recently in the top 12 viewed profiles in Australia, which highlights the growing interest and need for workplace wellbeing initiatives and burnout prevention.


Awareness


Finally, a simple, but often overlooked way to prevent serious burnout, is to make staff aware of the condition and find out if they’re experiencing early signs. The below link is an excellent evidenced based quick survey by the British Medical Association which can help diagnose likely burnout. Not only is this a subjective measure to help identify those at risk of burn out, it also makes staff feel valued and recognised for their hard work, which in itself prevents burnout;


https://questionnaires.bma.org.uk/burnout-questionnaire/?OpenForm


Personal Responsibility


Workplaces becoming aware of their responsibility to prevent burnout is fabulous, however as an individual we also have an important role to play.

  • Learning to say no

  • Set healthy boundaries

  • Feel like we can ask for help or speak up if something isn’t fair are so important both at work and in our personal lives.

  • Delegating or eliminating unnecessary tasks can be a game-changer

  • Prioritising self-care through exercise, getting enough sleep, scheduling free time and trying to maintain some passions or hobbies outside of work.



Conclusion


When it comes to burnout, prevention is better than the cure and being aware of the symptoms and taking action early, will always help down the track. Finally, if you think you’re burnout, the best people to speak to are your employee assistance program, your GP and a psychologist. There is no benefit to anyone from suffering in silence and the earlier you address your burnout symptoms, the easier and quicker it is to get back to your motivated, enthusiastic and happy self again!


And here we are, at the end of another blog that of courses ended up being much longer than planned! I hope you leave feeling knowledgeable and empowered on the topic of burnout and what you can do to prevent it in yourself and others. However more than anything I hope you understand the importance of your own wellbeing and that there is nothing shameful or embarrassing about suffering burnout, or any other mental illness.

Our modern-day lives are filled with more stressors, deadlines, and problems to solve than our brains (that were hunter-gatherers only a few thousand years ago) are designed to handle and burnout is a reflection of problems with our society, rather than the individual. Ebbs and flows in life stressors are normal and why resilience is so important, however, I promise when you’re old and getting to the end of your life, you’ll care much more about relationships and happy moments than any work deadline or promotion.


This is why looking after wellbeing should always be our number one priority and I hope this blog has given you a few tools to help make this happen for yourself and others.


If this article hit home with you or you feel it is important for more people to hear, feel free to share or repost this article through the links or simply copy and paste the URL into your next social media post.


By Dr Isobell Smith for www.ethicalkollektiv.com