Taking Care of Our Own: Burnout

What is it? And how to prevent it

Patients rightfully expect members of their health care team to have the knowledge and skills to provide the right care at the right time. Hospitals have an extensive array of safeguards in place to ensure this is the case. But delivery of good medical care depends on more than knowledge and skill. Human factors that can be hard to measure play a role, too. One thing that could limit good delivery of care by a competent provider is burnout.

Using the Maslach Burnout Inventory—an instrument that measures burnout—colleagues and I studied the prevalence of “high” emotional exhaustion levels among American surgeons. While surgery is clearly a high stress field, a subsequent study of the Michigan State Medical Society membership showed other specialties such as nursing demonstrated equal or higher levels of burnout, indicating burnout is a common condition among many types of health care professionals and one which has largely been underappreciated by the medical community.

Defining burnout

Burnout is “an exhaustion of emotional strength or motivation usually as the result of prolonged stress or frustration.” It is defined as a three-phase experience:

• Phase 1: Emotional exhaustion—feeling like you’ve “run out of gas” or have nothing left to give
• Phase 2: Depersonalization—feeling distant or separated (i.e., from your patients or co-workers)
  
• Phase 3: Loss of accomplishment—feeling that your work effort hasn’t amounted to much

Cause and effect

What causes burnout? Our study indicated that loss of balance between work, family life, and areas of personal growth and development is a major contributor to burnout. Another is loss of connection to the meaning of your work. People who are burned out experience a loss of satisfaction in work; their work is no longer a profession, but, instead, a job—a series of tasks—that has to get done.

When health care professionals experience burnout, patients and colleagues can feel the consequences. In some cases, actual medical care is compromised, but more commonly the relationship between caregiver and patient—what I would call the “human touch”—suffers the most. Burnout can affect a provider’s sense of humor, personality and general interest level, and patients are very sensitive to these aspects of care.

Prevention

For your personal and professional well-being, it’s important to prevent burnout. Studies have demonstrated effective strategies at both institutional and individual levels.

The institution does its part by controlling workload, ensuring fair compensation, developing ethical and fair policies, and ensuring that autonomy—or decision-making—is preserved as much as possible at all levels.

The individual does her/his part by making difficult decisions about employment, the most important being the trade-off between compensation and workload. Outside interests and time with family are important antidotes to burnout, as is taking time to know patients and establish a connection to the importance of your work. The intangible rewards that go with this relationship are why many of us went into medicine in the first place.

Assistance for UMHS faculty and staff

If you are concerned about or experiencing burnout, contact the Employee Assistance Program: phone 734-763-5409; e-mail.