Preventing burnout: detecting the signs

By Jurie G Rossouw*
Monday, 22 April, 2019

You are your own most important patient — take care of yourself first so you can better help others. Here we outline the warning signs to help you reduce the risk of burnout and to improve your mental health.

Working in health care is an extraordinary undertaking. It’s an industry that attracts the most intelligent and caring individuals, yet the high stakes of patient health and funding complexity create one of the most gruelling work environments in the world.

This takes a toll. In a study¹ on 1171 hospital-employed nurses, it was found that 18% met the diagnosis for depression — much higher than the national norm. I caught up with Dr Melissa Yang, co-founder of the Doc to Doc Network,² a community of female doctors that provides support and connection.

Reflecting on the education system, she sees healthcare staff being well trained in medical knowledge but believes little to no training is provided on how to be a good leader or supervisor, or how to run practice finances, or simply how to develop yourself as a person — which may contribute to your ability to cope at work. We explored this further through the lens of resilience.

Internal vs external factors

At Driven, we conducted research into resilience and developed the Predictive 6 Factor Resilience Scale (PR6)³ as a peer-reviewed psychometric to quickly check six domains that contribute to individual wellness. These six domains are:

Vision — Sense of purpose and goals
Composure — Timely emotion regulation
Reasoning — Anticipating challenges and problem-solving skills
Tenacity — Persistence and strong motivation
Collaboration — Strong support networks and connection
Health — Quality sleep, nutrition, exercise

Resilience is a protective factor against depression and other mental health conditions, so it’s helpful to consider how you’re tracking across these domains. With that in mind, let’s look at a few early warning signs that we find across the domains of resilience.

Notice: Disconnection from purpose (Vision)

Do you find yourself wondering “what’s the point?”, or “why bother!”, or just not caring anymore?

Our 2017 research paper⁴ showed that a strong sense of purpose, or Vision, is the most important factor in enabling resilience, so staying connected to your ‘why’ is important. An earlier study⁵ on nurses notes that “the higher the sense of personal accomplishment, the higher the level of mental health”.

If you are feeling disconnected from your sense of purpose, one reason could be your expectations. Research with various nursing specialities⁶ has shown that having high expectations of being able to control factors that are not within your control can have a negative impact on mental health.

TIP: Take a moment to write down what’s really under your control and what isn’t. Be realistic. This will help you keep perspective of the crucial role you play and why it matters to you, without overburdening yourself with unrealistic expectations.

Notice: Flaring emotions (Composure)

Do you find yourself snapping at people, struggling to calm down, or highly emotional?

Consider how the nature of your work is impacting on you. Secondary trauma and compassion fatigue add up over time if you don’t take care of yourself. Emotional and physical exhaustion due to working a stream of 12-hour shifts, and constantly being on call, takes a toll. So, take a moment to consider how much you should really be able to bear, and recognise when your body and brain need a break.

There are many practical skills you can develop here, including simple but effective breathing exercises, or reappraising emotions. Again, we see expectations influence our reality. When facing an ambiguous situation (a situation that is neither positive nor negative), nurses who tend to interpret situations more optimistically show a 6-fold decreased risk of developing depressive symptoms.⁷

TIP: Take a moment to notice your bias and if you automatically expect the worst of situations. It might be time for a mental shift.

Notice: Losing touch (Collaboration)

Do you find yourself ever busy, but more and more alone?

Loneliness has become more common. These days, most people don’t have any close confidants⁸ that they can truly open up to. If this sounds familiar, think about why this is. Is it because — between work and life admin — you have no time left for other people? Or maybe because you prefer the company of Netflix?

It’s easy to sacrifice time with friends and colleagues to make time for everything else. But the eventual price of loneliness is high and over time is a major health risk factor.

TIP: Reprioritise human connection and make the time to go out of your way to build relationships. It can be hard to find the right people to connect with so networks like Doc to Doc, which are dedicated to this cause, are a great start.

Notice: Fatigue and bad habits (Health)

Waking up tired? Feeling fatigued? Eating a lot of junk food?

If you are struggling to look after your physical health, it’s helpful to consider why. Do you have free time and just don’t feel like it? Or is it because you’re so busy working long shifts that you literally don’t have time to eat well, or get enough sleep, and you can’t exercise due to another sprained back?

TIP: Remember that you don’t have an invincible body. Just like you tell your patients to look after themselves, you should take care of yourself physically. Maybe it means changing some bad habits, or maybe it means fighting for some time off.

Remember, you are human too

If you notice these risk signs in yourself, it might be time to pause. If you notice these in colleagues around you, take a moment to check in with them.

“So much of our identify as doctors is tied up in our work, so when something goes wrong many of us have trouble separating our careers from who we are. This can make it difficult to see a way out of a difficult situation,” noted Dr Yang, highlighting just how impactful these challenges can be, specifically for healthcare staff.

Completing a medical degree doesn’t grant you magical powers to thrive without self-care. Remember to treat yourself like a human being and consider your own wellbeing when facing inhuman expectations. You are your own most important patient — take care of yourself first so you can better help others.

*Jurie G Rossouw is the author of Executive Resilience: Neuroscience for the Business of Disruption, and Director of Hello Driven, a technology company building an AI-powered virtual coaching platform that helps people become more resilient.

Preventing burnout: detecting the signs

Internal vs external factors

Notice: Disconnection from purpose (Vision)

Notice: Flaring emotions (Composure)

Notice: Losing touch (Collaboration)

Notice: Fatigue and bad habits (Health)

Remember, you are human too

References

Losing our minds — an AU$85bn phenomenon

Upholding a new model of mental health care

Enhancing hearing loss diagnostics and outcomes in primary care

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