Happy New Year!
If you’re new here, welcome to our blog! If you’re not new here, then welcome back! We are excited you are here because this is the bread and butter of our mission- burnout. You can read more about us and our mission here! We figured what better way to start the New Year off than to address burnout? Although I don’t resonate with New Year’s resolutions, I still believe that the New Year is a good time to reassess your health, happiness, goals, and more. If you’re burned out, I can make an educated guess that you don’t want to stay burned out.
Burnout is interesting because as an occupational therapist, it totally fits within our scope of practice. It is a phenomenon that impacts an individual’s occupational performance and well-being. The environments, contexts, client factors, daily occupations such as work and social participation etc.- all play a role in the development of burnout. So from an OT lense, I am on a mission to study burnout and help individuals and organizations affected by burnout to fully grasp this phenomenon from perhaps a slightly different stance or vantage point. We can’t talk about recovery from burnout if you don’t understand first what it is, the causes, the consequences, and the cycle of burnout.
What is burnout?
It involves three main ingredients: exhaustion, cynicism, and decreased efficacy. Some people quit their jobs or leave their professions entirely. Some stay at their jobs and produce the minimum output. Overall it’s a negative experience for the individual. Burnout encompasses feelings, attitudes, motives, and expectations. This can look like feeling depleted, withdrawal, irritability, low morale, low ability to cope.
What are the causes?
Based in all the research I’ve consumed over the past year and a half, here is a bullet-point list of the most frequent causes of burnout amongst healthcare professionals:
- High workload
- Low levels of psychological detachment from work during non-work hours
- Low frequency of belly-laugh
- Difficulties setting boundaries
- Low income satisfaction
- < 10 years of experience
- Mismatch in values with the organization
- Influence of environment and context
- Culture and broken community
- Lack of support
- Documentation demands
- Role discrepancy
- Glass ceilings
- Time demands
- Lowered morale over bureaucratic delays
- Lack of autonomy
- Unable to customize practice
- Policies and procedures of the workplace
- Juggling clinical and nonclinical duties
- Coordinating care
- Lack of respect and unfairness
What are the consequences?
Physical symptoms include headaches, chronic fatigue, gastrointestinal disorders, muscle tension, hypertension, cold and flu episodes, and sleep disturbances. Burnout has been predictive of depression, anxiety, and irritability. Negative responses to the job includes job dissatisfaction, low organizational commitment, absenteeism, poor job performance, intention to leave job, and turnover.
How does it happen?
I like to think about the analogy of being in the ocean. You left your beach umbrella, chair, and towel on the shore and you took a dive into the ocean with your friends. You spend the next half hour chatting in the ocean, standing in one spot. You and your friends got caught up in talking so much that you didn’t notice that you all have been shifting away from your spot slowly but surely. The ocean’s currents have been moving you inch by inch without you being aware of it. Once the half hour has passed and you scan the shore for your umbrella so you can head back for a snack, you realize you have completely shifted away from your original spot! I like to think of burnout occuring in the same way. You’re too in it to notice the micro movements that are occurring simultaneously to create your current state of burnout. Burnout can occur in several ways, but these are two main pathways:
- Unmanageable workload → exhaustion → greater cynicism → reduced efficacy
- Mismatch between values → all three aspects of burnout → reduced energy and involvement → reduced efficacy
So my friend, that was burnout 101 in a nutshell. I cover this much more in-depth in my online course. There are varying degrees of burnout and although it’s characterized by three major components, it plays out differently for everyone and for different reasons. What I have learned in my journey is that I experienced it twice, but for two completely different reasons. The second time I experienced it there were many layers of complexity involved. This leads me to a myth that burnout is just a matter of self-care and it’s just your responsibility. Because it’s not. I’m here to tell you it’s not. I don’t want to generalize because like I said burnout is a complex phenomenon that involve an interplay between intrinsic and extrinsic factors.
Generally speaking, burnout is a sign that something in the workplace is wrong and the way in which that has impacted you has manifested in the form of burnout, depression, or anxiety for example. In the research that I’ve been doing over the past year and half about burnout, I have learned that burnout is regarded more so as a social phenomenon than an individual phenomenon. I’m going to go into three things that you can do right now to start your journey to recovery. Three simple things to get you going in the right direction:
“Just like burnout did not happen overnight, recovery won’t happen overnight either.” Erika del Pozo, MOT, OTR/L
The first thing you might be tempted to do is to blame yourself or others for getting to this place of burnout. I encourage you to first go inwards and do something radical. Instead of beat yourself up, be kind to yourself. Practice kindness every single day towards yourself. In fact the moment I started to be kind to myself for not being perfect, I started to lose that negative dialogue I had with myself about myself. Practicing self-compassion daily and also during moments of pain. For example, the pain of dealing with burnout. Recognize that suffering is a part of life. For example, you can say to yourself, “I know I’m burned out. Other people also experience this. I’m not alone.” And then you can say kind words to yourself. Ask yourself, “What do I need to hear right now to express kindness to myself?” You can say whatever comes to mind. For example, things like “May I be patient with myself, may I forgive myself, may I be strong, may I love myself as I am.” You can even your hands on your heart or hug yourself. By starting from a place of self-compassion, you are building a foundation to take the necessary action from a place of strength, kindness, and love.
TAKE A DAY OFF.
For me, burnout happened twice, in two different jobs, for two different reasons, but each related to some degree of burnout. The first time it happened I was so unfamiliar with what happened and how I was feeling. I worked in a fantastic clinic and they understood that after my burnout breaking point that I needed a day off afterwards. It occurred that time due to a feeling of being overworked without knowing proper advocacy for myself, along with other intrinsic factors like my anxiety and my physical fatigue. I felt like a battery that had a power surge that just exploded. During that day off I slept in and I remember going to 11 AM yoga and it was the thing I needed so badly at that point. I needed to unplug from always being ‘on’ and reconnect with my body and my soul.
The second time it happened in another job, the element of workload was one thing, but it wasn’t the reason I burned out at all. It were the other work factors, such as unfairness, lack of community, huge disconnect of values, insufficient reward, corrosive work energy, etc. There was a day at work where without going into all the details, I felt directly attacked, manipulated, belittled- all the emotions. I went into the bathroom and cried. I actually took the rest of that day off and went to the beach. I felt for the first time that I could breathe, that all that stress and anxiety left me for a few hours.
It was within these two separate breaks that I was just allowed the space to BREATHE. Step out of it. Reflect. Did I completely solve burnout in those days off? No. But those days allowed me to get closer to ideas that allowed me to move forward. During those times, I didn’t know what to do or what I needed. So in the first example, what I came up with was to reduce my hours at that first amazing clinic. Did it help in the short-term? Yes. But it didn’t actually help me to deal with stressors better. But it was a start for me at the time. In the second instance, I decided in that day I needed a new job. Again, in hindsight both a short and long term solution. Short-term because I could have easily gone somewhere else and experienced burnout a third time. Long-term solution because I knew that that clinic wasn’t good for me no matter how equipped I was to make a change in that clinic and I recognized that.
So before you reach a breaking point but you feel it coming, take a day OFF. Go to yoga. Go to the beach. There was something so special about those days because it wasn’t just like a normal day off. It was so absolutely necessary and something that I hadn’t experienced. Although I had weekends off, I was still doing things with my husband then boyfriend, with friends, doing chores, errands- nothing for myself.
REFLECT AND RE-ESTABLISH YOUR BELIEFS, VALUES, PRIORITIES, AND INTENTIONS.
Ask yourself “What will I tolerate and what will I not tolerate?” This is a great opportunity to get in touch with your beliefs and maybe redefine them. What I learned when I burned out was that I had a belief that working hard meant stress and it meant dealing with a lifetime of the Sunday scaries. I had a belief that my anxiety will always be a part of me until I’m a seasoned therapist and feel 100% confident in everything that I’m doing. I valued dread and stress during the week to then be able to have reckless fun on the weekends. These weren’t things I ever said aloud, but what you tolerate and how your day to day pans out is a reflection, whether consciously or unconsciously, of your beliefs and values. Take a paper or if you have a journal, refine your beliefs, values, and priorities in life.
What are your intentions with your LIFE? Work, family, socially, leisurely, what are you working towards? What are you living for? Are you going through perhaps a temporary phase at work with high stress but you have determined that you greatly align with your work’s values and that this phase you’re in will pass? Are you not setting intentions and goals for yourself personally or professionally and you’re just coasting without a real direction? I think many times we may get to our ‘dream’ job and we think that life is just set. We’ve made it. Nothing else to do, nothing else to work for.
Reflect also on what exactly is going on at work. Is there injustice going on? Poor work energy- for example, is everyone just comfortable and coasting? Is there so much toxicity that it’s damaging the environment? Is there a lot of fast-paced yet negative quality energy that has consumed the clinic or office? Are your coworkers complaining about the same things you’re feeling? Do you have an autocratic leader, meaning your boss or manager has a ‘my way or the highway’ standoffish attitude? This is a great opportunity to get clear with what it is that’s happening and then see based on your re-established priorities, beliefs, and values if there is a match or mismatch.
To summarize the top three things to do to start your recovery from burnout is to practice self-compassion, take a day off, and reflect and re-establish your beliefs, values, and intentions. Since burnout is a social phenomenon, it wouldn’t be enough to say just take a bubble bath and you’ll recover from burnout. Recovering from the personal and professional consequences of burnout cannot be solved by a bubble bath and you cannot only focus on your own recovery without changing something in the workplace that caused you to burnout in the first place. It’s important to take care of yourself and take care of your physical, emotional, mental needs and do whatever makes you feel good.
You can build all the resilience in the world and take the most care of yourself, but if you are in a work environment that is perpetuating a burnout cycle, then recovery from burnout a holistic individual and organizational approach. The good news is that I have whole online course on a comprehensive framework for burnout for healthcare professionals that just so happens to be a continuing education course for occupational therapists in Florida and a few other states! You can learn more about it here. Whether you’re a new grad or seasoned vet, burnout can happen to anyone- it’s time to take your personal AND professionally seriously together!