Burnout syndrome in healthcare workers

Burnout Syndrome, or BEB, is a term used to describe psycho-emotional exhaustion, the extreme degree of fatigue that occurs when exposed to chronic stress at work.

Signs and causes of professional burnout

The term was first introduced by the American psychologist Herbert Freudenberger in 1974. And later, in 1986, scientists Maslach and Jackson systematized the descriptive characteristics of the syndrome and developed a questionnaire for its quantitative assessment. According to the researchers, a group of symptoms is typical for SES:

• emotional exhaustion;

• Depersonalization — the inability to perceive others as a person and accept their right to emotions, dehumanization of the interlocutor;

• Reduction of personal achievements — depreciation of one’s own successes, loss of zeal for work, loss of motivation. 

Simply put, burnout is associated with work stress that, for some reason, has not been effectively overcome. Absolutely any specialists are subject to this condition. However, there is a range of professional areas that are at high risk: nurses, doctors, teachers, social workers — almost everyone whose activities are related to regular communication with people.

However, even in this list, medical workers are a special risk group for a number of reasons.

• The social contacts in which medical workers are involved imply a high level of emotional stress — physicians are faced with strong experiences of patients, one way or another they are forced to respond to them, often without having the opportunity for their own emotional release.

• The level of work responsibility of nurses and doctors is extremely high.

• They do not have the opportunity to rest in conditions of intense workload.

• The profession is accompanied by an insufficient level of recognition, especially in relation to middle and junior medical personnel, expressed both in material terms (wages) and in psychological terms (recognition from patients and management, status in society).

The combination of these reasons often leads people who have chosen this profession at the call of their hearts and for humanistic reasons, to a feeling of powerlessness, disappointment in themselves and society, a sense of the meaninglessness of their work and loss of motivation to work. Nurses and doctors, who initially have a genuine desire to care for patients, stop seeing them as people and lose the ability to show empathy. 

Relevance of the problem

The problem of BS is global in nature in the medical environment: in the domestic study «Features of the emotional burnout syndrome in medical workers of a multidisciplinary hospital» in 2018, it is indicated that every second doctor shows signs of emotional burnout. During the pandemic, the numbers only increased: a study by the Bureau of SMEs shows that in 2019, from 70 to 80% of all medical workers were exposed to SEB, and international (USA, Japan, Portugal, China, Italy) studies in 2020 showed that that 45–55% of physicians and 60–70% of nurses are affected by the syndrome. 

Sergey Babin, Professor of the Department of Psychotherapy and Sexology, North-Western State Medical University. I. I. Mechnikova, argues that during a pandemic, the problem of burnout of medical staff is especially acute: “A huge number of infected people, constantly changing rules and standards that come down from above, stimulate an increase in general stress among doctors, who actually face death every day, and also have to deal with the severe complications that COVID-19 causes.”

Otherwise, employees of medical institutions will expect not only the syndrome itself, but also a whole range of disorders to which it can lead: anxiety, depressive, asthenic, obsessive-phobic and vegetative. They, in turn, not only interfere with the performance of their professional duties, but can also significantly worsen the overall quality of life. 

How to deal with this syndrome 

There are many techniques that can help healthcare professionals protect themselves from EBS:

• Breathing exercises;

• Gymnastics and other types of physical activity;

• Reception «Reassessment» — a cognitive technique associated with a change in the perception of the situation;

• Self-compassion and self-support techniques;

• positive meditations;

• Art therapy. 

But in order for them to work, you need to learn how to follow the rule of the plane: put the mask on yourself first, and then on the child (in our case, the patient). In other words, the first step is to teach yourself to prioritize your own psycho-emotional state. 

Without the ability to take care of ourselves, we lose the ability to take care of someone else and end up with two victims. Therefore, it is important for health workers to learn to monitor the following points.

Balance between work and leisure

A nurse or doctor, overwhelmed with responsibility and complex tasks, needs a source of positive emotions and a means of relaxation. Healthy sleep, communication with loved ones, hobbies — all this is vital for medical staff.

Often, people who are completely immersed in caring for others simply do not know how to notice their own need for rest or do not know how to rest at all and after a hard day they plunge into housework, mistakenly taking household chores for free time.

In this case, it is necessary to build and verbalize a clear boundary: set aside a certain amount of time in the day that you will spend exclusively on yourself — watching your favorite series, knitting, taking a hot bath. Something that will not require you to return, but, on the contrary, will return the resource. 

Maintaining healthy social connections

Work in the clinic is associated with the need to feel someone else’s pain. Therefore, it is important for a medical worker that in his life outside the institution he has the opportunity to spend time with people who can charge him with positive emotions, provide support and show understanding. Try to set aside time to communicate with family and friends in order to have an example of positive interaction before your eyes and shift the focus from difficult experiences. 

Maintaining personal boundaries

A health worker needs to learn how to allocate time and internal resources so that the tasks that arise before him are performed quickly and efficiently, be able to properly interact with colleagues and patients. It is important to have the skill of effective communication with people around you, set them up in a friendly way, convey your position and perceive someone else’s.

Good communication and the establishment of boundaries within it reduces the level of overall stress at work and reduces the risk of conflict. Therefore, it is important for medical staff to develop communication skills: this will allow them to learn to listen to their own and other people’s needs.

However, these methods may not always be effective. And in this case, the best thing a health worker can do for themselves is to seek help. Don’t be afraid to ask for it! A person does not have to deal with everything alone. No one is embarrassed to go to the doctor with a broken leg or to the nurse for an injection — just like with EBS, one should not be shy about contacting a psychologist or a psychiatrist.

It is important to note that the medical staff does not always have the opportunity to solve the problem of burnout on their own — often the risk of exposure to EBS increases due to the poor organization of working time and space by the clinic itself. Therefore, the employer must pay attention to the needs of his employees with the same regularity with which the employee himself must fix his psychological needs.

Of course, the resources of clinics are limited, but the correct organization of working hours, the even distribution of duties, the encouragement of employees in a form accessible to the institution, the organization of comfortable information spaces — all this is real for modern hospitals. Only a combination of individual efforts of a physician and an organization can lead to a decrease in the risk of developing a burnout syndrome.

However, I would also like to draw the attention of patients to the situation. Of course, each of us has the right to receive quality medical care, this right should be upheld and protected. However, it will be great if we, as patients, do not forget that we are assisted by living and feeling people who, like us, need understanding and correct, polite treatment.