“Though usually regarded as the result of trying to give too much, burnout…results from trying to give what I do not possess.”
Stress is a condition in which there is a marked discrepancy between the demands of our environment or situation and our perceived capacity to respond. Contrary to popular belief, stress is not inherently bad. In fact, both positive and negative life events contribute to our stress levels – and some amount of stress is required for us to perform optimally. Eustress is stress that motivates us, helps us to focus our resources, and feels exciting; distress is stress that causes anxiety, feels overwhelming, and decreases our capacity to perform. Unfortunately, chronic distress is a common problem for most American workers, regardless of their profession.
The effects of chronic distress are easy to spot. They include behavioral signs (agitation, outbursts, avoidance), emotional signs (anxiety, overwhelm, anger), cognitive signs (distorted thinking, confusion, and decision paralysis), and physical signs (fatigue, chronic pain, and organ dysfunction). Chronic distress also impacts our most important relationships, frequently leading to isolation and conflict.
A close relative to chronic stress is “burnout,” a syndrome traditionally thought to result from excessive demands in an occupational environment deficient in support. Burnout is characterized by emotional exhaustion, cynicism, and a sense of inefficacy or reduced accomplishment. Burnout is also considered to be a result of a critical mismatch between the job and the person performing it, with most mismatches falling into six categories (Leiter & Maslach, 2005):
- Workload: the amount of work to complete each day, and the resources necessary to complete it.
- Control: the ability to influence decisions affecting your work, and the quality of management/supervision.
- Reward: recognition and acknowledgment, opportunities for advancement and raises, and the inherent satisfaction gained from work.
- Community: the presence and frequency of supportive interactions with others in the workplace.
- Fairness: equal consideration, clarity and transparency for the allocation of resources and rewards.
- Values: being able to ‘buy in’ to the meaning behind the organization’s mission and work, and having the potential to contribute to the larger community.
All workers can take active steps to counteract the daily effects of work stress and combat burnout. Most coping strategies can be broken down into two categories: problem-focused coping and emotion- focused coping:
Problem-focused coping includes individual efforts to modify or limit the effects of stressors. Such strategies may include time management efforts, improving work relationships, delegating unnecessary tasks, advocating for task reassignment, and all active self-care strategies (like exercising, eating healthfully, and spending time in nature). Many problem-focused coping strategies place us into the “focused mode” of the brain, counteracting the stress response.
Emotion-focused coping includes individual efforts to modify or reduce the negative emotions resulting from acute and chronic stress. Intentionally focusing on positive emotions (like gratitude and kindness), reappraising/reframing both threats and failures (finding what went right within what went wrong), and striving to accept what we cannot control have been proven to reduce the emotional impact of stress and improve resilience to chronic stress.
Workers can also address burnout by assessing areas of potential mismatch between themselves and their current job, and then taking active steps to improve the match. Guiding ideals to improve the match include:
Make changes in how you approach daily tasks such that you are more efficient and less stressed. For example, schedule paperwork and call-backs for small pockets of time when you can focus your attention clearly with fewer distractions. Also look, and advocate for, small opportunities to improve individual and team efficiency. Small changes can make a big impact.
Stay hydrated and consume small, healthy snacks throughout your busy day to combat mental fatigue. Dehydration and lack of glucose actively contribute to confusion, overwhelm, and emotional dysregulation. Breathe deeply, stretch frequently, and move your body to discharge the stress that accumulates over the course of the day.
While we all enter service professions to help to others, we may not realize optimal outcomes all of the time. The noble ideals that propel us into our profession are not always possible to achieve! Setting realistic daily goals, and recognizing concrete accomplishments, will allow you to take stock of what you have completed – and spot small victories – at the end of each day.
Taking a one-minute breather, a five minute walk, or a few moments to connect with a colleague can give us a chance to cool off and refresh our perspective. Taking advantage of break time, planned or unplanned, is also critical to preventing – and healing — burnout. Pressing “pause” also includes unplugging from the tethers of technology and, whenever possible, placing boundaries on email, texting, and phone calls when away from the office or hospital.
Toxic stress and burnout often manifest in team disintegration and strained personal relationships. When work relationships begin to suffer, remember that your colleagues are doing their very best with what they have in difficult circumstances. Small acts of kindness, acknowledging others’ hard work, and giving co-workers the benefit of doubt can soothe strained relationships while boosting our emotional resources. Of equal importance: take active steps to maintain meaningful connections with those you care about outside the workplace.
To feel engaged, happy, and balanced, we all have to feel like we’re contributing the best of who we are to our work with patients, clients, and community members. If you find yourself unable to identify the links between your inherent skills, your values, and your work, look for one or two things that might improve alignment and then craft opportunities to do more of what you value and enjoy, whether that be improving patient care or creating new resources for clients.