FAST FACT AND CONCEPT #169: Health Professional Burnout: Part III

Author: Linda Blust , MD

Parts I and II have described burnout, its risk factors, symptoms, and consequences. Part III will address strategies to avoid burnout while sustaining personal and professional health, integrity, and growth. Part IV will describe assessment tools validated for burnout.

I. Individual Strategies

• Reflection upon work: journaling, discussion with colleagues
• Am I burned out/healthy?
• Why do I do this/continue to do this?
• What inspired/moved/surprised me today?
• Attend to health: diet, exercise, rest, regular health care
• Plan activities that rejuvenate: Play!
• Professional supervision: Regular interaction with a mental health professional with the express purpose of exploring dynamics of the provider/patient relationship
• Make time for yourself
• Plan vacations at regular intervals
• Allow for “timeout” when stressors increase

II. Interpersonal Strategies

• Give important relationships priority – strengthen existing relationships with family and friends
• Expand your community beyond existing relationships through activism or spiritual engagement

III. Professional Strategies

• Debrief emotional events
• Reach out to colleagues
• Seek out or strengthen a mentor relationship
• Write about your work for a larger audience
• Utilize your institution’s Critical Incident Response Team if available
• Psychosocial rounds with colleagues to explore these issues
• Schwartz Center Rounds : interdisciplinary hospital rounds to explore emotions surrounding provider/patient interactions.
• Advocate for change in your job, organization, or profession

Triggers for Professional Counseling

• Persistent feelings of sadness, exhaustion, anger, worthlessness, hopelessness, suicidal ideation, or anxiety interfering with work or interpersonal relationships
• Self-prescribing sedative/hypnotic medication
• Substance abuse: alcohol, prescription, or non-prescription drugs
• Other ‘addictions’ interfering with work/relationships: gambling, exercise
• Persistent sleep disturbance: nightmares, difficulty initiating or staying asleep, early morning awakening
• Loss of professional boundaries
• Inappropriate relationships with patients, families, or trainees
• Lack of attention to patients’ rights, safety, or autonomy

If, after careful attention to the variables within your control, you still feel burned out and at risk for serious consequences, it may be necessary to temporarily or permanently leave your current job to regain your health.

References

1. Gundersen L. Physician Burnout. Annals of Internal Medicine 2001;135: 145-148.
2. Kuehn Kelly C. Strategies to Balance Training, your Personal Life. ACP-ASIM Observer. 2001.
3. Meier DE, Back AL, Morrison RS. The Inner Life of Physicians and Care of the Seriously Ill.JAMA. 2001;286: 3007-3014.
4. Remen RN. The Doctor’s Dilemma: Returning Service, Grace, and Meaning to the Art of Healing. Whole Earth. Summer 2000; 4-10. http://www.theschwartzcenter.org

Fast Facts were edited by David Weissman MD, Palliative Care Center, Medical College of Wisconsin until January 2007.  For comments/questions write to the current editor, Drew Rosielle MD: drosiell@mcw.edu. The complete set of Fast Facts is available at EPERC: www.eperc.mcw.edu

Copyright/Referencing Information: Users are free to download and distribute Fast Facts for educational purposes only. Fast Fact and Concept #169. Health Professional Burnout Part III. November 2007. Fast Fact and Concept #169. Health Professional Burnout Part III. November 2007. End-of-Life / Palliative Education Resource Center www.eperc.mcw.edu.

Disclaimer: Fast Facts provide educational information. This information is not medical advice. Health care providers should exercise their own independent clinical judgment. Some Fast Fact information cites the use of a product in dosage, for an indication, or in a manner other than that recommended in the product labeling. Accordingly, the official prescribing information should be consulted before any such product is used.

Purpose: Self-Study Guide, Teaching

Audience(s)

ACGME Competencies: Professionalism

Keyword(s): psychosocial and spiritual experience