What is Burnout and how does it affect healthcare personnel?

Burnout is a term used to describe the emotional and physical exhaustion that can occur after being burnt out on one's job. It can be caused by experiencing multiple strains over an extended period of time, such as long hours, difficult tasks, or high expectations. If left untreated, burnout may lead to difficulties with work performance and interpersonal relationships. 

Burnout is a common problem in the healthcare industry. Healthcare professionals often work long hours and are frequently under pressure to meet high expectations. This can lead to continuous stress, which can eventually cause burnout. Burnout is also particularly common among doctors, nurses, and other health care professionals who work with patients or co-workers.

The World Health Organization (WHO) identified burnout as an “occupational phenomenon”, and the International Classification of Disease (ICD-11) defined it as, “Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed”. It is further explained as a stressed-out mental state that begins to deplete one’s energy resources resulting in distancing from the job and reduced professional capabilities. You will learn about 
  • Covid-19 and burnout
  • Signs of burnout
  • Why do healthcare professionals often suffer from burnout
  • Scientific evidence of burnout and coronavirus
  • Causes of burnout during the covid-19 pandemic
  • Impact of covid-19 on healthcare workers
  • Why is healthcare worker/physician burnout so common?
  • how to cope with burnout?
  • How can hospitals help to minimize healthcare workers' burnout
  • Conclusion

COVID-19 and burnout

Coronavirus is a recently identified virus and some of them are viral, in fact deadly. SARS-CoV-2 is the major source of the worldwide pandemic compromising the respiratory system. John Hopkins Medicine listed the common symptoms as cough, fever or chills, shortness of breath, muscle or body aches, sore throat, loss of taste or smell, diarrhea, headache, fatigue, nausea or vomiting, congestion or runny nose, and even death. It usually spread through the droplets of cough, sneeze, or breathing of an infected person so keeping a safe distance is crucial. 

Burnout among medical doctors and nurses is a regular yet increasingly prevalent phenomenon affecting more than one-third of all healthcare workers during a covid-19 pandemic. The pandemic has contributed to increased workload and burden on healthcare professionals at both the clinical and administrative levels to help a large number of people around the world.

Signs of burnout 

Several recent studies carried out during the global pandemic have revealed some of the major feelings and why they are manifested, when dealing with covid positive patients are:

1. Emotion contagion (EC)

Negative and depressing emotions can trigger the same emotions in another person by simply exposing to the sufferer’s behavior or emotions.

2. Compassion fatigue

It is a state of stressful emotions emerging from the traumatized individual but not from the trauma. This is possibly true because of the process of emphatic understanding and results in overwhelmed concern about the patient.

3. Secondary traumatic stress

Descriptive narratives-the first-hand knowledge by the patient of a traumatic event can trigger psychological distress in the healthcare professional.

4. Therapeutic effectiveness

The perception of treatment and therapy sessions as less effective can lead to feelings of burnout. Keeping in mind recent lockdowns and tele-counseling, absences of face-to-face interaction, and ineffective rapport building due to restricted mobility can breed feelings of helplessness and therapeutic inefficacy.

5. Longer duration of therapy

The high prevalence of the pandemic needs longer and more detailed sessions with the patients and the constant exposure to uncertain, deadly, painful, and deteriorating events poses a higher risk of burnout among health care professionals.  

6. Exposing family members to the risk

Many healthcare professionals also reported fear of putting their spouse, children, and loved ones at risk of the virus.

7.  Emotional exhaustion

Long-term exposure to stressful events (dealing with corona patients) can exacerbate feelings of loss of power or control over life. These feelings can make them feel emotionally fatigued, overwhelmed, and drained.

Why do healthcare providers often suffer from burnout?

There is more to burnout than the stress, exhaustion, or strain of living a carefree lifestyle. When it comes to individuals in healthcare there are personal and professional influences that set each individual on their separate progressions towards committing themselves to trauma-induced behavioral changes. But for some particular characteristics of the healthcare, workers often suffer from burnout, these include

The American Nurses Association has been conducting surveys for nearly 20 years now all complaining about overall health trends in healthcare, one recent finding however is that approximately 62% of nurses have experienced a burnout episode in the last year and 22% have experienced one within the past 2-5 years. Although these findings may seem somewhat plausible it remains an intriguing question as to why nearly half of elder nursing members have become unwell or fatigued all of a sudden! What are some particular job attributes that could assist in explaining this drastic data?
Although it has been well established that the effects of trauma on a person's health can potentially last for many long years after acute infection with viruses or bacteria. It is clearly apparent from empirical studies and observations that both depression, as well as stress-related illnesses, may have an impact on long-term mortality rates for people in the public sector such that it could comprise up 20-30% or more of nursing's overall mortality rates.

1. High work-pressure 

This can be defined as a multitude of stressors including high pressure from employers which in turn leads to emotional burnout. Work overload in form of patients and less societal/personal support provided by colleagues and nurses is least conducive to the working environment.

2. Exhaustion

The inability or even a feeling of not being able to cope with overwhelming demands which result in extreme fatigue and irritability 

3. Interpersonal stress 

Like the above, interpersonal stresses are a result of burnout which forces people to reevaluate their behaviors and actions 

4. Insomnia

Exhaustion and work overload in absence of restful breaks or simple downtime for themselves. 

5. Organizational demands

This type of strain on nurses' work environment is related to the above perceptive High intense pressure with this being an essential part "one can't sleep" in short 5. Lack of restful breaks: The absence of relaxing and restful breaks increases the chances for such situations as well. 

6. Depression

This obvious one has been shown many times connected with organizational demands where it could lead people into a state of sadness

7. Lack of autonomy 

Many tasks within healthcare are carried out under constant surveillance or direct supervision, which can feel limiting and reduce personal responsibility.

8. Sense of social isolation 

Working in a setting where colleagues are often distant and anonymous can lead to feelings of isolation and loneliness. 

Scientific evidence of burnout and coronavirus

Coronavirus brought colossal changes to each spectrum of an individual’s life, be it the patients, their families, or the health professionals themselves. Walton et al. (2020) demonstrated the changes that are established in the workplace, namely, workload, fear of getting infected, and working along with the latest practices and procedures. Supervisory support and access to safety measures act as a healthy barrier against workplace stress.
The outbreak has led to frequent periods of lockdown and quarantines. It is important to consider that a larger expansion of virus-infected patients is a challenging task for limited health professionals that consequently feel increased workload, work stress, anxiety, and a potential risk factor for disturbed professional competence (Elman and Forrest, 2007).  Fear of social stigma attached to health care workers with corona patients is also at its toll in Asian countries. In a recent survey, Medscape has found the rate of burnout among different healthcare specialties

Many researchers have found that stress, anxiety, post-traumatic stress disorder, psychological distress, depression, somatization, and even hostility symptoms are quite evident in healthcare staff. Being in constant exposure to stressful events, invalidating knowledge about the virus, and scarcity of essential treatment protocol puts them at higher responsibility and need to make life-saving decisions.  These high levels of crucial decision-making about uncertainty and life are associated with guilt and regret (Del Missier et al., 2008).

Causes of burnout during the covid-19 pandemic

Burnout by employees can occur anytime however, it is more obvious during the pandemic.
  • Prior knowledge of the disease.
  • Increased workload due to lockdown and increased number of patients
  • Overwhelming job demands and requirements
  • Introduction to the new treatment protocol
  • Lack of emotional and constructive support
  • Fear of stigma
  • Fear of exposing family members and loved ones to the disease.   

Impact of covid-19 on healthcare workers

During pandemics, frontline healthcare personnel face stigma, prejudice, and social isolation in the workplace and in their social environments, according to the World Health Organization (WHO). Stigmatization of front-line health care personnel caring for COVID-19 patients may have a negative influence on their attention and ability to make appropriate judgments. 
The common symptoms contributed by workers generally consist of a lack of motivation, emotional exhaustion, and medical turnover. The psychological health of healthcare personnel is not the only thing affected by such conditions. Nonetheless, it may have an impact on their professional abilities to deliver high-quality care to the public throughout the epidemic.
How you can measure burnout among healthcare professionals?
The Maslach Burnout Inventory (MBI) is a questionnaire that measures the symptoms of burnout. The MBI has been used to screen for burnout in healthcare professionals and to diagnose burnout in patients. 
The recent MBI is composed of 22 items, which are scored on 7 point Likert scale. The responses range from “never” to “daily”, with higher scores indicating greater levels of burnout.
The questionnaire measures 
• Emotional exhaustion
• Depersonalization 
• Personal achievement

How to cope with burnout?

Restoring the physical and mental health of health care professionals is inevitable, particularly during the dark times of the pandemic. Preserving their health and well-being is crucial when they are the only asset to help fight off the deadly virus globally.
  • Promote a friendly atmosphere at workplace
  • Evenly distributed workload
  • Special attention to health care professionals’ health
  • Eat well and have plenty of sleep
  • Take small breaks while working at home
  • Identify the main source of stress and cope accordingly
  • Take good care of yourself
  • Have a healthy recreational activity, talk to a friend, writa e journal, walk, jog anything you like
  • Stay at distance from covid-19 news and updates on social media and T.V.
  • Have a flexible timetable and don’t exhaust yourself

How can hospitals help minimize healthcare workers’ burnout?

Hospitals can reduce burnout of their physicians as for prevention, by doing a study of the level and cause patient well-being. This is one way to help hospital staff overcome symptoms that larger expansion

1. Recognition of the problem at the institute level

The hospital should recognize the phenomenon of burnout first to combat it effectively. Different departments should have one on one training sessions to draw out feelings and experiences leading to low productivity and efficiency of the healthcare workers and make a checklist of common issues and sort them out with the best solutions. 

2. Financial benefits

Financial benefits or salary increments should be determined between hospitals according to the level of service being rendered so that their overall cost per patient can be reduced. A call for healthcare providers offering free access to medical professionals with limited resources at either ends could get them off the ground when they began work soon afterward in a different area like emergency or public health service or service sector critical consent systems.

3. Cultural and gender differences

In some countries, men have greater power than women in the workplace/hospitals I think nurses are more compassionate due to their constant interaction with patients and high level of compassion burns out if they are not provided proper training to create an entirely safe working environment as well as backing up each other while on duty. If the officer is a female and working in male-dominant organization, she will be more likely to become burned out due to the low probability that men value her input when making decisions This can also lead women unwilling to step up positions because of fear for lack of interest from others.

4. Tensions within work teams

Retaining employees becomes difficult if team members are incapable or inadequate at performing their duties. In a hospital setting, there is high competition among staff which puts stress on everyone involved. Various studies have shown that the healthcare workers who are affiliated with unions are more beneficial to staff members such as patient satisfaction and employees generally feeling happier as well. Unwanted resignation, falling behind expectations at workplace productivity, dissatisfaction with a company's overall performance, and failure to align within healthcare practices often result when faced with increased tensions with teammates. 

5. Resolving inter-organizational conflicts

Research has shown that inter-organizational conflicts, rows, and violent behavior pose a threat to health and safety despite comprehensive risk-management facilities and strategies. This usually translates into challenges such as potential breaches between co-workers which can lead to not only violent situations but also burnout amongst employees.

6. Low morale

When it comes to unhappiness with their jobs, those on the lowest rungs in occupational studies (84% percent) saw a significant correlation in low work-life balance. Job dissatisfaction stemming from an inability to cope with demanding work conditions, extended working hours combined with overtime, and the psychological strain connected with patient decision-making and ethical difficulties all pose an extra burden on healthcare practitioner's life.  

7. Practicing Gossip

Nurses who tend to gossip by nature, especially in front of the younger health professionals, a high number see this work experience has not only helped them develop special skills for their profession but also have influenced negatively on patient outcomes through co-worker influences. The co-workers may face lower productivity, diminished morale, wounded feelings and loss of competent staff in form of employee turnover. 

Conclusion 

The words depression, trauma and burned out sound like they come from different scientific fields and domains, but they actually relate to the same thing; mental or physical distress resulting from exposure to repeated or highly stressful experiences such as either extreme highs or lows.
There is no single answer that can address the problem of burnout in all its various forms, but coordinated action across all layers of the healthcare system is needed to ensure that allied health professionals have opportunities for refreshment and a sense of collective progress. It is clear that there are some risks associated with burnout. Amongst these, nurses and doctors exposed to high levels of chronic stress had higher use of medicines and a higher impression of terror, which is considerably worse than those who are solely affected by chronic fatigue.
What are your thoughts on the leading cause of burnout among healthcare workers? Do they need to practice self-care and develop personal coping methods, or organization-based fundamental reforms can ensure their health and well-being?

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