Recognizing “Burnout”

Nurse practitioners are at high risk for burnout. It is important to recognize the warning signs of burnout. Burnout is described as specific psychological condition brought on by excessive, prolonged and unrelieved work-related stress.

Burnout occurs when enthusiasm is replaced by frustration and disappointment. If left unaddressed, it can lead to irritability and resentment, productivity drops, behavior changes, confidence and passion are lost.

Risk factors include:

Job-related stressors:

• Unclear Requirements
• High-Stress Times with No “Down” Times
• Big Consequences for Failure
• Lack of Recognition
• Impossible Requirements
• Poor Communication
• Insufficient Compensation
• Poor Leadership

 Personal characteristics:

• Perfectionist Tendencies
• Type A Personality
• Pessimistic
• Poor Fit for the Job
• Lack of Belief in What You Do
• Feel they must always give “110 percent”
• Personalize failure for outcomes beyond their control

Common warning signs:

• Increased absenteeism
• Rushed patient care
• “By the book” approaches
• Emotional outbursts
• Boredom
• Tend to procrastinate
• Withdraw from friends
• Self medicate with alcohol
• Physical symptoms can include:
• chronic headaches
• sleep disturbances
• fatigue/exhaustion
• stress/anxiety
• overall sadness
• irritability
• forgetfulness
• GI upsets
• Cardiac arrhythmias 

Transition to full-blown burnout:

• Can be rapid, or...
• Can be progressive and insidious
• Progressive pessimism
• Dissatisfaction and increased absenteeism
• Low work productivity
• Withdrawal and depersonalization from relationships leads to desire to                                  disappear, and potentially, to thoughts of suicide

Preventing burnout:

• Realize that self care is not selfish
• Take care of yourself first
• Create relaxation time, even at work
• Take a few minutes during the day to meditate, read or go for a walk
• Go out to lunch, or get out of the office
• Be realistic of your expectations
• Create balance in your life
• Talk to others
• Ask for support when you feel the need  

Reducing Stress in the Health Care Workplace

• Build group cohesiveness through regular training, discussions, and in-services.
• Encourage peer support
• Offer recognition for success and excellence
• Vary professional responsibilities
• Create a monthly newsletter with updates an kudos
• Let staff know it is all right to ask for a “stress break”
• Watch for signs of significant stress in staff, and offer them help.

Self-Care Tips to Prevent Burnout

• Take care of you. It will relieve some of your stress and allow you to take better care of others
• Treat yourself with the same care you give to your patients
• Allow yourself to say no. Offer alternatives if you feel unable to say no
• Develop a routine to help ease the transition from work to home (Do not use alcohol to unwind)
• Avoid over-identification with patients
• Recognize and accept your own feelings
• Practice stress-reduction techniques (exercise, relaxation, meditation, distraction)
• Plan for regular breaks, conferences, and vacations
• Know when to say “enough”. If necessary, change to another practice environment

Life needs to be approached from the preventive perspective. We need to live what we have been preaching to our patients. Create relaxation time, even at work. Create balance. Take care of yourself first!

  

References

Duffy, V.J. (2012). Beating burnout. Advance for Nurse Practitioners and Physician Assistants. Retrieved from http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/Beating-Burnout.aspx

Nadan, R.J. (2012). Dousing burnout. Advance for Nurse Practitioners and Physician Assistants. Retrieved from http://nurse-practitioners-and-physician-assistants.advanceweb.com/article/dousing-burnout.aspx