I interviewed a fellow applicant who confessed to me – in a very sincere way – that she had noticed a lot of the Peds Heme Onc docs she had talked to on the interview trail seemed to be “burnt out” – if not already fizzled. . .
This brought me back to my time as a fellow – aka) the closest I’ve been to burning out. There were so many little things that added to so many big things that I was dealing with – things were overwhelming to say the least. I don’t remember exactly how I got through it all, but I know I was lucky.
What is burnout?
Let’s start with defining “burnout”. . . Maslach & Schaufeli (1993) described it as a syndrome of occupational stress among health care workers that results from demanding and emotionally charged relationships between caregivers and their recipients. Specifically, burnout is a combination of:
- Emotional exhaustion = depletion of psychic energy or the draining of emotional resources
- Depersonalization = development of negative, cynical attitudes toward the recipients of one’s services
- Reduced personal accomplishment = tendency to evaluate one’s own work with recipients negatively, an evaluation that is often accompanied by feelings of insufficiency (Malasch, 1993)
Yep – that all sounds a bit familiar to me. Feelings I’ve had or ones I’ve seen in my colleagues or friends. A lot of us know how fine of a line we have to walk sometimes. My most vivid memory was having a DNR conversation with a family who had just finally accepted their teenager’s cancer was terminal, then having to walk into the next patient room with a smile on my face and have a lengthy conversation about their concerns related to constipation. I mean, I think I did a good job not letting on that deep down I wanted to cry. . . Dhruv Khullar, MD wrote a great op-ed in the New York Times about this topic – check it out. He said it perfectly:
“If you feel too much, you will never get through the day. If you feel too little, you won’t be human by the end of it.” – Dhruv Khullar, MD
Sooo. . . how many physicians experience burnout? Good question! Well, over half of us (54.4% per a 2014 study in the Mayo Clinic Proceedings) – AND that was up from 45.5% in 2011. YIKES!!
What can we do?
Things we can do for ourselves – (AMA ref) These sound so artificial and simple, but so true too:
- Take time to do things you like at least once a week! Ah yes, get back to the hobbies that we neglected – or choose a new one! I’ve started doing watercolor painting. I’m pretty bad at it, but it is a fun way to get creative and is easy to clean up – win, win.
- Actually take a vacation! Or stay-cation if you want!!
- Eat healthy and exercise – Yep, just like we tell our patients ; )
- Talk to your close friends and family members – They may not want to hear about the tragic or sad patient stories you bring home in your heart, but they should want to know how you are feeling about your work. They just might be more sympathetic and supportive if they knew what you were dealing with. We have learned how to turn on and off our emotions when we deal with patients, but we shouldn’t hide our pain or sadness from our loved ones.
Show empathy to each other – we’ve all had bad days, had a short temper, got a bit sassy at someone because we hadn’t had a bathroom break or eaten anything since 7am (and it was now 6pm). As Hot Heels. Cool Kicks, & a Scalpel put it nicely – “Healthcare is about relationships, not write-ups.” There are definitely things that should be taken directly to your superiors, but if someone you work with is being rude, snappy, or just not themselves – reach out and see if they are burning out. Then direct them to resources ; )