Discussion of factors leading to increased frustration among Intensive Care Staff. A well known entity "BURNOUT SYNDROME" lecture to help establish the causes and to find solutions.
1. Burnout
among medical staff in
Critical Care Unit
Muhammad Asim Rana
MBBS, MRCP, SF-CCM, EDIC, FCCP
Department of Critical Care Medicine
King Saud medical City
2. Studies we have gone through to prepare today's presentation
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facilites:Strategies for prevention and change. Rockville:Aspen Syst Co.1985.
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Barnett, Lisa andill. Hospice j 1987;3:121-147.
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OrganizationsAn Assessment of Burnout in Academic About It. SanAmerica
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3. If constant stress has you feeling disillusioned,
helpless, and completely worn out, you may be
Burnout Syndrome in ICU physicians
suffering from burnout.
When you’re burned out, problems seem
insurmountable, everything looks bleak, and it’s
difficult to muster up the energy to care—let alone
do something about your situation.
The unhappiness and detachment burnout
causes can threaten your job, your
relationships, and your health.
4. Learning Objectives
To understand the concept of burnout
To describe sources of stress
To determine coping behaviour
To understand possible interventions
5. Performance Objective
Understand the importance of Burnout in Drs
Beware of symptoms of Burnout
Determine the sources of stress
Beware of intervention approaches
6. What is burnout?
Burnout is a state of emotional, mental, and physical
exhaustion caused by excessive and prolonged stress.
It occurs when you feel overwhelmed and unable to
meet constant demands.
As the stress continues, you begin to lose the interest or
motivation that led you to take on a certain role in the first place.
7. Burnout
reduces your productivity
saps your energy
Feeling increasingly helpless
Eventually, you may feel like
Hopeless more to give.
resentful
you have nothing
Cynical
8. You may be on the road to burnout
if
Every day is a bad day.
Caring about your work or home life seems like a
total waste of energy.
You’re exhausted all the time.
The majority of your day is spent on tasks you find
either mind-numbingly dull or overwhelming.
You feel like nothing you do makes a difference or is
appreciated.
9. The Concept of Burnout
Burnout is a reaction to chronic, job-related stress
“A literal collapse of the human spirit” (Storlie 1979).
“The loss of concern for the people with whom one
is working (Maslash 1976)”
“psychological withdrawal from work in response to
excessive stress and dissatisfaction”
(Cherniss 1980).
10. Degrees of burnout
1st degree: Failure to keep up and gradual loss of
reality
2nd degree: accelerated physical and emotional
deterioration
rd degree: major physical and psychological
3
breakdown
11. Sources of Stress
Long training/working hours
Excessive work loads
Sleep deprivation
Changing work conditions
Peer competition
Conflicts with colleagues
Lack of Control
12. ICU Physician find new stresses waiting
for them
Work faster and longer hours
Mountains of paper work
Threat of malpractice suits
Economic security prove elusive
Difficulties to keep up to date
Challenge to explain and defend work
Perception of unfairness & insufficient reward
Value Conflicts
Daily confrontation with sickness and death
Lack of routine unit level meetings
13. Coping Behaviour
Working harder and longer
Sense of entitlement
Belief on immunity to difficulties
Failure of self recognition of mental problems
Alienating family members and friends !!!!
14. Anger and frustration are vented to family and friends
Inability to share troublesome experiences
Family and friends are another source of demand
Alienating family members and friends
16. Stress VS Burnout
Burnout
Stress
Characterized by over engagement
Emotions are over reactive
urgency and hyperactivity
Loss of energy
Leads to anxiety disorders
Primary damage is physical
May kill you prematurely
Characterized by disengagement
Emotions are blunted
helplessness and hopelessness
Loss of motivation, ideals, and hope
Leads to detachment and depression
Primary damage is emotional
May make life seem not worth living
17. Dealing with Burnout: The "Three R" Approach
Recognize –
Watch for the warning signs of burnout
Reverse
Undo the damage by managing stress & seeking support
Resilience –
Build your resilience to stress by taking care of your physical and
emotional health
19. Burnout Prevention tips
Start the day with a relaxing ritual.
Adopt healthy eating, eating, exercising, and sleeping
habits.
Set boundaries.
Take a daily break from technology.
Nourish your creative side.
Learn how to manage stress.
20. Recovering From Burnout
Burnout recovery Strategy #1 :Slow Down
When you’ve reached the end stage of burnout, adjusting your
attitude or looking after your health isn’t going to solve the
problem. You need to force yourself to slow down or take a
break. Cut back whatever commitments and activities you
can. Give yourself time to rest, reflect, and heal.
21. Burnout recovery strategy #2: Get Support
When you’re burned out, the natural tendency is to protect
what little energy you have left by isolating yourself. But your
friends and family are more important than ever during
difficult times. Turn to your loved ones for support. Simply
sharing your feelings with another person can relieve some of
the burden.
Burnout recovery strategy #3: Reevaluate
your goals and priorities
Burnout is an undeniable sign that something important in your
life is not working. Take time to think about your
hopes, goals, and dreams. Are you neglecting something that is
truly important to you? Burnout can be an opportunity to
rediscover what really makes you happy and to change course
accordingly.
Physicians must continuously respond to the needs of patients and families and expend their own emotional resources to provide care and caring to others. Medical encounters are often stressful and the physician must reach deep within him-or herself to give to those unable to give back or express gratitude. Patient and societal expectations demand certainty from the medical profession, while medical knowledge includes limitations and uncertainties. Physicians everyday are called on to cope and adapt with stresses characteristics of their role. Intense withdrawal of emotional reserves is required, while emotional deposits may be infrequent and few. For some coping capabilities prove insufficient and emotional reserves become depleted. For these burnout becomes reality .
The negative effects of burnout spill over into every area of life – including your home and social life. Burnout can also cause long-term changes to your body that make you vulnerable to illnesses like colds and flu. Because of its many consequences, it’s important to deal with burnout right away.
It is an emotional state that may be accompanied by a number of physical and behavioural changes. It is also described as the extend to which a worker has become separated or withdrawn from the original meaning and purpose of his work.
Simmendiger and Moore suggested a three degree model on burnout. First degree burnout is charecterized by a failure to keep up, complacency regarding status quo and a gradual loss of reality. Second degree burnout is accompanied by accelerated by deterioration, where individuals have problems to sleep and have little energy. They may gain or lose weight. Third degree burnout involves major physical and/or psychological breakdown (heart attack, ulcer, mental illness, most frequently depression.
It is an emotional state that may be accompanied by a number of physical and behavioural changes. It is also described as the extend to which a worker has become separated or withdrawn from the original meaning and purpose of his work.
Rapidly increasing medical knowledge and technology make it difficult to keep up to date and there is an increasing pressure to focus on the disease rather than the patient.Many physicians are now challenged by patients, nurses, administrators and government agencies to explain and defend their job.Physicians are daily confronted with death and are thus focused to deal with the issue of their own mortality and the purpose and meaning of life. Many unfortunately begin to view death and disease as well as life in general as a battle. Some see battle already lost and develop a sense of hopelessness and powerlessness.
Physicians trying to cope with demands of their practice by working harder and longer may experience severe inefficiency, psychological impairment, and poor patient care.İt is often difficult for physicians to express they are having trouble in coping with stress. This frequently stems from sense of entitlement .Physicians own expectations are often their greatest source of stress. Few spend time in self-reflection or in attending their own needs. Medical training reinforces false beliefs in one’s immunity to difficulties and prevents self-recognition of serious psychological problems.
Three primary explanations for alienating family mambersabd friends have been proposed (10):1. Anger and frustration are vented to family and friends in the belief it is safer to express these negative feelings to family members and friends than towards patients and coworkers.2. Fearing breech of confidentiality physician may feel unable to share troublesome experiences with others.3. Family and friends may be perceived as another source of potential demands.
Brent and Brent describe three ways in which physician manage to avoid being with their families (3):1. The “physician dawdler” spends excessive time socializing around andtherefore has to stay late to get al work done.2. The “electronic physician” arranges to be available for patients 24 hours a day, 7 day a week.3. “Out-of-town Academician” must accept every invitation that comes along.