Understanding, Preventing,
and Managing Professional
Burnout
Brad Bennett, PhD
Licensed Psychologist
PRESENTATION OUTLINE
• What is Burnout and why does it matter?
• Sources of Burnout
• Signs, Symptoms, and Impact of Burnout
• Prevention of Burnout
• Coping with and Remediating Burnout
Symptoms
What is Burnout?
• Definition #1 - a psychological state of
•
exhaustion, manifested by a general sense of
ineffectiveness and loss of enthusiasm, often
due to relatively chronic job stress
Definition #2 - the exhaustion of physical and
psychological resources, caused by excessive
striving for unrealistically high expectations
(from yourself and/or from others).
What is Burnout?
• Three components of Burnout, any one of which
•
•
•
meets the criteria for the condition Emotional Exhaustion – excessive work demands
exhaust a person’s energy
Depersonalization –an increasing cynicism about
one’s job and a detachment from a sense of
personal responsibility within it
Low Sense of Personal Accomplishment – a
decline in a person’s sense of value and sense of
effectiveness
Why be concerned about Burnout?
• Significant association between physician
satisfaction and patient satisfaction
• Significant association between burnout
symptoms and medical error commission
• Significant association between burnout
symptoms and major depressive disorder
Why be concerned about Burnout?
• Significant association between nurse
burnout and patient infection risk, as well
as higher patient mortality rates
• Burnout is “contagious” – associating with
colleagues in this state increases chances
of developing it oneself
• Significant association between burnout
and suicidal thoughts/actions
Why be concerned about Burnout?
• The suicide rate among male physicians is 40%
•
•
•
higher than among men in general
The suicide rate among female physicians is
130% higher than among women in general
In a 2012 study of 2248 US medical students
50% met criteria for burnout, and 25% had
considered suicide
In a 2006 study, students who screened positive
for burnout were 2X as likely to have suicidal
ideation the following year
Why be concerned about Burnout?
• In a study of IM residents in 2008/9, 51%
•
•
reported at least one of the 3 burnout
symptoms
Burnout among ICU professionals ranges
from 14-70% (depending on how it was
measured)
In a study of 7300 practicing physicians in
2012, 45% met criteria for burnout, with the
highest rates in EM, FM, and Critical Care
Why be concerned about Burnout?
• And – between 2011 and 2014 burnout rates
•
•
among physicians increased in every single
medical specialty - In most areas, by more
than 10%
Burnout rates among nurses were already at
the 40% mark as far back as 2002
A more recent study found that burnout
among Critical Care nurses ranged from 4571% (depending on how measured)
WHY?
Any thoughts as to why Emergency
Medicine, Critical Care, and Family
Medicine are at the top of the list?
WHY?
The next chart lists the primary causes for
physician burnout, based on those
surveyed in 2012…
WHY?
• Also
– Increased demand for “patient numbers”
– Decreased opportunity for
• Connecting with patients
• Connecting with peers
• Receiving support and guidance from administrators
– Increased nurse-to-patient ratios
– Stagnant salaries
– Higher turnover of staff
WHY?
• OVERALL…
• An increased sense of helplessness over work
•
demands and workplace changes
Paired with a significant decline in the
opportunity to do the job that attracted us to
medical care in the first place
Measuring your own Burnout
• Take the Abbreviated form of the Maslach
Burnout Inventory
• Score according to scoring key
Measuring your own Burnout
• Scoring Guidelines:
• Personal Accomplishment – 13-14 – Moderate Burnout; <13 – High Burnout
• Depersonalization –
– 4-6 Moderate Burnout; >6 – High Burnout
• Emotional Exhaustion –
– 7-10 – Moderate Burnout; >10 – High Burnout
Common Sources of Burnout
• Personality Factors
– Perfectionism
– Rigid Thinking
– Unreasonably High Expectations of Self
and/or Others
• Is any of this familiar to you or to
someone you know?
Common Sources of Burnout
• Workplace Factors
– Noisy/Crowded/Uncomfortable Workplace
– Responsibility without decision-making
– Inadequate support and feedback
• Is any of this familiar to you or to
someone you know?
Common Sources of Burnout
• Job Factors
–
–
–
–
–
–
High Responsibility for Others
High “People Contact”
Repetitive, Monotonous Work
Much Deadline Work
Role Ambiguity/Uncertainty
Inadequate attention to, or opportunity for, healthy
habits (particularly nutrition & sleep)
• Is any of this familiar to you or to someone you
know?
Common Sources of Burnout
• And, overall…
– A strong sense that the job you are doing is not
the job you signed up for
• Is this thought familiar?
Common Signs/Symptoms of
Burnout
• Psychological
–
–
–
–
–
–
–
–
Nervousness, Anxiety, Depression, Guilt
Low Frustration Tolerance, Irritability
Fatigue, Low Energy, Low Motivation
Feeling Pressured, Trapped
Sleep Problems, Feeling “Drained”
Loss of Interest in Social Activities
Ruminating, Trouble Concentrating
Decline in Self-Esteem and Sense of Value
• Impact of these on functioning?
Common Signs/Symptoms of
Burnout
• Behavioral
–
–
–
–
–
–
–
–
Appetite Changes
Excessive Use of Alcohol, Tranquilizers, etc.
Social Withdrawal
Excessive TV Watching/Internet/Social Media “Escaping”
Critical of Others
Cynical about Work & Resistant to Going to Work
Feeling Overwhelmed by Work, but Feeling
Indispensable
Trouble Meeting Commitments/Responsibility
• Impact of these on functioning?
Common Signs/Symptoms of
Burnout
• Physical
– Muscle Tension/Back Pain/Teeth Grinding
– Gastrointestinal Problems
– Susceptibility to, and Lingering of, Colds and
Illnesses (due to low resistance resulting from
persistently high stress levels)
– Headaches
• Impact of these on functioning?
Common Signs/Symptoms of
Burnout
Are there other signs or symptoms that you
know of, or can think of (perhaps based
upon people you know who have been in
this state)?
If you are not already there, what
can you do to help Prevent Burnout
from Developing?
• Assume personal responsibility for making
•
improvements, taking an active part in keeping
your job rewarding and feeling in control of it,
rather than taking the role of a “passive blamer”
Initiate new ideas for your work environment,
and/or for the role(s) you play, and/or the
meaning you attribute to your work
If you are not already there, what
can you do to help Prevent Burnout
from Developing?
• Improve your social support system - don’t
•
•
•
isolate self
Collaborate with others (peers and mentors) re:
new ideas and creative approaches to the more
tedious aspects of your work
AND…avoid taking part in peer environments
which reinforce the “burned-out” feelings and
attitudes
Consider ways of reconsidering, and then
staying mindful of, how you assess your own
success
What an Individual can do to help
Prevent Burnout from Developing
• Learn to assert yourself (or to do so more
•
effectively), both in job and home relationships
Learn, practice, and use Stress Management
Techniques
– Including some regular monitoring of “where you are
on the Stress Curve”)
What an Individual can do to help
Prevent Burnout from Developing
• Schedule time to relax, to plan, to be creative
• Make sure to involve yourself in enjoyable
•
activities outside of work
Utilize good health habits - exercise, good diet,
proper sleep, avoidance of stress-inducing habits
If you are not already there, what
can you do to help Prevent Burnout
from Developing?
• Evaluate your self-expectations, and
ensure that they are reasonable, not
unrealistic or perfectionistic
• Keep tabs on your mood and attitude - if
they are persistently negative or
pessimistic, consider options for changing
it (talking with others, consulting
physician, seeking therapy)
If you are not already there, what
can you do to help Prevent Burnout
from Developing?
Other ideas?
What an Organization can do to
help Prevent Staff Burnout from
Developing or Increasing
• Wise Hiring - Selecting individuals for jobs with
•
expectations that fit their areas of strength
Empowerment of staff – giving each individual
opportunities for independence, decisionmaking, and growth, especially in the area(s) of
his/her strength
• Clear job expectations
What an Organization can do to
help Prevent Staff Burnout from
Developing or Increasing
• Collaboration with staff – involving individuals in
•
•
decision-making, project development and
implementation, etc.
Promoting a separation between work and home
life, including reasonable job time commitments
Providing regular opportunities for professionals
to talk as a group together about their
challenges, their needs, and ideas for resolution,
in a respectful and supportive environment
What an Organization can do to
help Prevent Staff Burnout from
Developing or Increasing
• Frequent feedback provided to staff members
– Regarding affirmation of their strengths/successes
– Regarding areas in which they could improve, paired
with ideas of how to achieve this
• Listening to staff
–
–
–
–
Hearing their ideas
Empathizing with their concerns and feelings
Soliciting feedback regularly
And responding to all of this with serious
consideration
• Structuring and Scheduling Opportunities for
Creativity, Problem-solving, & Collaboration
What an Organization can do to
help Prevent Staff Burnout from
Developing or Increasing
Other ideas?
Coping with and Remediating
Burnout Symptoms
• Options for Coping -Approaching vs.
Avoiding
– Approach – to take an active role in altering
or decreasing the stressor(s)
– Avoid – to decrease or eliminate exposure to
the stressor
Coping with and Remediating
Burnout Symptoms
• Options for Coping – Problem-Focused vs.
Emotion-Focused
– Problem-Focused – to take an active role in
altering the stressor(s) – a focus on the
solving the problem
– Emotion-Focused – to decrease or eliminate
one’s emotional reaction to the stressor(s) –
a focus on improving oneself
Coping with and Remediating
Burnout Symptoms
• Most effective is an “Approach/Problem-
•
Focused” coping style – most likely to prevent or
reduce burnout
Least effective is to use an “Avoid/EmotionFocused” coping style, since that involves
managing one’s emotions by simply avoiding
what is producing the emotions (which leads to
a chronic avoidance pattern, rather than
learning how to manage situations differently)
Specific Strategies for Coping with
and Remediating Burnout
Symptoms
• (Approach/Problem-Focused) Use some of
the above-mentioned strategies –
assertiveness, better health habits,
creative problem-solving, enhance skills
• (Approach/Problem-Focused) Talk with
others - to vent, to seek alternative
perceptions, to brainstorm ideas, to not
“feel alone”
Specific Strategies for Coping with
and Remediating Burnout
Symptoms
• (Approach/Emotion-Focused) Establish
and strive to meet realistic expectations
of yourself, given how you are feeling
now (rather than how you “should” be
feeling, behaving, or performing)
– Note that this may require you collaborating
with someone else, since we often have
trouble recognizing and altering unrealistic
expectations of ourselves
Specific Strategies for Coping with
and Remediating Burnout
Symptoms
• (Approach/Emotion-Focused) Therapy?
Medication? Social Support? - consider
whatever it may take to help you out of
the feeling of helplessness
• (Avoid/Problem-Focused) Take a vacation
(even if only briefly), and use part of it to
consider what you can do to improve your
work situation
Coping with and Remediating
Burnout Symptoms
• Getting a new position (which may or may not work
•
•
successfully)
If the major sources of burnout are internal (e.g., high
self-expectations, pessimistic or negativistic personality,
rigid thinking style), you will bring these along to any job
you take on
If the major sources are in the job itself, and the
earlier methods mentioned do not work successfully,
there are two other potentially effective options
– (Approach/Problem-Focused) Find a new job or role within the
organization
– (Avoid/Problem-Focused) Leave the organization for a new
position elsewhere
Coping with and Remediating
Burnout Symptoms
• If you do absolutely nothing else,
schedule and take just 10 minutes towards
the end of each day
– To sit down
– Take some deep breaths until you’re a little bit
calmer
– And think about one thing you did that day which
you felt good about
– And one small thing you would like to do
tomorrow to make things a little better for you
Remediation of Burnout
OVERALL –
REMEMBER THAT YOU ARE
NOT ALONE!!
(the statistics don’t lie!)
ANY FINAL QUESTIONS
OR COMMENTS?
Thank you for listening!
I hope this has been helpful!