Burnout is not a ‘you’ problem.
Burnout.
It’s not a ‘you’ problem.
And yet –
It does require a ‘you’ solution.
Deep breath.
This topic is a big one.
And it’s very close to my heart.
Burnout is a word that is becoming common in our daily language.
It is a well known phenomenon in high-performance careers, and especially in the healthcare space.
Healthcare clinicians are burning out at very high rates – and it’s not just a personal health issue, it’s a public health issue.
That’s because burnout leads to people leaving their jobs.
It leads to a declining workforce.
And in the case of healthcare, it also leads to more errors (you can read about this here and here) and more costs associated with delivery (you can read about this here).
As a GP, I’ve seen that the work we do – holding space for all the hurt in the world, dealing with our own lives and trying to meet unrelenting standards of documentation whilst maintaining a healing disposition – is extremely hard.
When I started working with doctors in this space, the interventions were focused on individual wellbeing, individual resources and individual-led change.
I’m ashamed to admit that early on, the events I ran focused a lot on the individual rather than the systemic issues.
How can this person be more resilient?
What can this person do differently?
How can this person DO MORE to BE LESS burnt out?
As it turns out, asking someone to do more to be less does not solve the problem.
Research into burnout amongst doctors has shown that they have high levels of individual resilience but this is affected by environmental factors.
That shows us that individual resilience is not the primary issue.
It’s the consistent, systemic (i.e. workplace) factors that can wear people down over time, until they feel like they cannot not function anymore.
Putting the onus on the individual is not the solution. Real progress requires widespread systemic change and holistic organisational support (you can read about this here and here).
However, just like the body, we’re all individual parts within a wider system – so there are things we can do as individuals to address our own risk and tackle organisational issues.
Let’s start by defining burnout.
In 2019, the World Health Organisation defined burnout as:
“A syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. It is characterised by three dimensions:
feelings of energy depletion or exhaustion;
increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and
reduced professional efficacy.
Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”
Burnout is different from a mental health issue like depression or a medical issue like chronic fatigue syndrome. With burnout, the issue is usually resolved when the person is removed from their workplace.
Burnout is an occupational problem. It is a result from workplace stress that has not been successfully managed, and it requires workplace-based changes to resolve.
Why does it happen?
Burnout happens when people have to do more with less resources and less support – basically, their workload outweighs the organisational resources they have to complete them.
It is a balance of many risk factors across domains including workload, control, reward, community, fairness and values (you can read more about this here).
For example, someone might be asked to take on more work, but this won’t always result in burnout because they may have:
A sense of autonomy and agency.
Supportive workplace relationships.
A team that values them.
Work distributed equally amongst the team.
Appropriate compensation.
However, if these things aren’t in place and there is little opportunity to rest, recover and restore balance, then workload will become an issue.
Additionally, if you work in a job where workplace values conflict with your personal values, you may find yourself compromising in ways that go against your essential self – and this can cause a moral injury, increasing your chance of burnout.
Burnout also always involves workers saying ‘yes’.
“Yes I will do that quicker.”
“Yes I will forgoe my break time to complete that task.”
“Yes I will work more overtime.”
“Yes I will take on that extra project.”
We say yes for many reasons.
Because saying ‘no’ might lead to unemployment.
It might lead to conflict.
Or put pressure on others.
Or make us feel uncomfortable.
In healthcare, we might say ‘yes’ because there's literally no one else who can do that job, right there and now, and not doing the job leads to patients suffering.
And yet somewhere an internal boundary of ‘no’ needs to be formed.
So what can we do?
Like I said. This is not just a ‘you’ problem. However you can be part of the solution.
Firstly:
Identify what it is that is contributing to your sense of burnout. Is it just work? Or other things? If it is other things, it may be more than burnout. I’d love to talk about this with you – book a chat with me and we can find out. (Link: Book a chat with me to find out?)
If work is an issue, you can brainstorm. Sit down with a piece of paper.
Think about the domains listed above. What is happening inside the organisation? What is happening inside you? What is driving that? Consider – is there something you can do? Is there someone you can speak to about workplace demands? Can you let them know what it is about the cultural environment that is not ok?
Ask yourself if you need to take time out. Is your workplace still a safe environment? Can this issue be resolved? Sometimes, burnout can only be solved by leaving the environment.
Ask yourself if you need to learn new skills to manage this. Can you learn how to say no? Set boundaries? Ask for support or help? Understand what is the ‘right’ level of workload for you – and how to communicate this effectively? Can you find ways to develop compassion for yourself and your own capacity?
Recognise that you are not alone. Society values ever-increasing productivity and efficiency. The way it is designed demands us to do more, more, more! This isn’t your fault.
And if you’re anything like me, you might be interested in leading change through advocacy.
I spent years advocating for doctor’s health wellbeing – speaking up for what was needed, identifying which systems needed to change, and how we could be part of the solution.
I’ve included a bunch of literature that discusses organisational change and systemic shifts in working with burnout in workplace culture in this article, so if this interests you, I’d encourage you to check out those links.
You can also listen the 'Just a GP' podcast episode that Charlotte, Bek and I released with guest Dr Bethan Richards. In it, we discuss the 'MDOK' program and how it is supporting doctors working in the hospital system to optimise their wellbeing with a focus on system-wide changes. You can listen to it here.
Managing burnout – and creating change – is part of the work we do in my 9-month Vitality Medicine program.
First, we find out what supports you, then we uncover what stamp you’d like to make on the world, and how to bring this to life.
If this interests you, you can sign up to find out more about the program here.